Recent attempts to identify a neurocognitive profile of children with prenatal alcohol exposure (PAE) have led to an emerging "generalized deficit" conceptualization marked by diffuse information processing and integration difficulties as opposed to a specific profile. This study examines whether this conceptualization can be extended to higher functioning children with PAE who are without intellectual disability and addresses several limitations of previous research. One hundred twenty-five children aged 6-12 years with social skills deficits, 97 of whom met diagnostic criteria for a Fetal Alcohol Spectrum Disorder (FASD), underwent a comprehensive, multi-informant assessment of neurocognitive, emotional, social, behavioral, and adaptive functioning. Multivariate analyses of variance examined differences in functioning between the PAE group and a nonexposed comparison group with and without controlling for child IQ. Results indicated that the PAE group returned significantly poorer scores than the nonexposed group on every construct assessed, including executive functioning, attention, working/visuospatial memory, linguistic abstraction, adaptive behavior, emotional/behavioral functioning, and social cognition. These differences largely maintained after controlling for IQ and were similar regardless of informant, although teachers reported somewhat fewer group differences. Within the PAE group, no differences were found across FASD subtypes. These results provide evidence extending the emerging generalized deficit conceptualization of children with PAE to those higher functioning individuals without global intellectual disability.
The success of this treatment development study provides preliminary support for effective treatment of adolescents with FASD to prevent or reduce alcohol use and its negative consequences in this high risk population.
Objective
The current study sought to examine the specificity of Digit Span (DS) scaled score from the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) as a performance validity test (PVT) in older adults with Mild Cognitive Impairment (MCI) or dementia.
Method
Archival data were utilized and included 195 patients (mean age = 72.8; mean education = 13.2) who underwent outpatient neuropsychological evaluations. Cases that had missing data, did not meet criteria for a neurocognitive disorder, or whose performance was deemed invalid were excluded. Participants were classified according to their evaluation diagnosis of MCI (n = 72; mean RBANS total score = 86.8) or dementia. Those diagnosed with dementia were divided by MoCA performance and categorized as mild dementia (n = 90; MoCA≥15; mean RBANS Total Score = 71.0) or moderate dementia (n = 33; MoCA < 15; mean RBANS Total Score = 55.9). Scaled score frequencies were analyzed to calculate specificity for each group.
Results
An RBANS DS scaled score of ≤4 occurred infrequently in older adults with MCI and mild dementia, resulting in specificity values of 0.93 and 0.90, respectively. In moderate dementia, specificity fell to 0.68 when using a scaled score of ≤4, with a cutoff of ≤2 required to maintain adequate specificity.
Conclusions
Findings suggest utility of RBANS DS scaled score as a PVT in dementia evaluations provided use of appropriate cutoffs. A more stringent cutoff was required in examinees with moderate dementia relative to patients with MCI and mild dementia. Future research should examine the RBANS DS sensitivity to invalid performance, as well as DS specificity across specific etiologies of MCI and dementia.
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