Adverse childhood experiences in children with fetal alcohol spectrum disorders and their effects on behavior

Abstract

Background: Children with fetal alcohol spectrum disorders (FASD) have high rates of adverse childhood experiences (ACEs). ACEs are associated with a wide range of health outcomes including difficulty with behavior regulation, an important intervention target. However, the effect of ACEs on different areas of behavior has not been well characterized in children with disabilities. This study describes ACEs in children with FASD and how they impact behavior problems. Methods: A convenience sample of 87 caregivers of children (aged 3 to 12) with FASD participating in an intervention study reported on their children's ACEs using the ACEs Questionnaire and behavior problems on the Eyberg Child Behavior Inventory (ECBI). A theorized three-factor structure of the ECBI (Oppositional Behavior, Attention Problems, and Conduct Problems) was investigated. Data were analyzed using Pearson correlations and linear regression. Results: On average, caregivers endorsed 3.10 (SD = 2.99) ACEs experienced by their children. The two most frequently endorsed ACE risk factors were having lived with a household member with a mental health disorder, followed by having lived with a household member with a substance use disorder. Higher total ACEs score significantly predicted a greater overall frequency of child behavior (intensity scale), but not whether the caregiver perceived the behavior to be a problem (problem scale) on the ECBI. No other variable significantly predicted the frequency of children's disruptive behavior. Exploratory regressions indicated that a higher ACEs score significantly predicted greater Conduct Problems. Total ACEs score was not associated with Attention Problems or Oppositional Behavior. Discussion: Children with FASD are at risk for ACEs, and those with higher ACEs had a greater frequency of problem behavior on the ECBI, especially conduct problems. Findings emphasize the need for trauma-informed clinical care for children with FASD and increased accessibility of care. Future research should examine potential mechanisms that underlie the relationship between ACEs and behavior problems to optimally inform interventions.

FASD: The Living Experience of People with Fetal Alcohol Spectrum Disorder—Results of an Anonymous Survey

“…When they are allowed to be open or feel safe to do so, the genuineness of relationships with caregivers, professionals, and the community at large remains very possible. They should also have the right to tell their story, as it is their story to tell [44][45][46]. Stereotypes lead to stigmatization arising from a single story of incapacity which flattens the experiences, capacities, and opportunities of persons with FASD [8].…”

FASD: The Living Experience of People with Fetal Alcohol Spectrum Disorder – Results of an Anonymous Survey

“…This study lays the groundwork for richer exploration or understanding of what appear to be disparities and potentially higher levels of stress and lower levels of quality in life within the adult FASD population. ACEs such as trauma, abuse, neglect, etc., have been shown throughout the literature to negatively impact development across the lifespan [41], but what happens as continuing adverse experiences happen in adulthood? What this survey demonstrated was high levels of reported stigma and lower levels of support.…”

Social Interaction in Adolescent Rats with Neonatal Ethanol Exposure: Impact of Sex and CE-123, a Selective Dopamine Reuptake Inhibitor

“…In fact, in individuals with FASDs, the high rates of disruptive social behavior are frequently described in terms of impaired social competence, which can broadly be defined as effectiveness in social interaction or ability to employ social skills successfully within various interpersonal contexts [6,7]. Accordingly, adolescents and adults with FASDs have impaired socialization skills that include failure as a consequence of their own actions and lack of reciprocal friendships, as measured by the Vineland Adaptive Behavioral Scale, even when deficits in I.Q.…”