Association of adverse childhood experiences and neurodevelopmental disorders in people with fetal alcohol spectrum disorders (FASD) and non-FASD controls

Abstract

BackgroundFetal alcohol spectrum disorder (FASD) is a highly prevalent lifelong disorder with high rates of comorbid neurodevelopmental disorders. Individuals with FASD are often exposed to abuse, neglect and foster home placements which have uncertain effects on the lifelong course of FASD. In this study we compare the prevalence of adverse childhood events (ACEs) and neurodevelopmental disorders in subjects with fetal alcohol spectrum disorders (FASD) and non-FASD controls.MethodsA cross-sectional chart review of patients referred to a regional developmental center was used to identify people with FASD and non-FASD controls. We recorded the number of ACEs and neurodevelopmental disorders in each patient’s chart. The most common diagnoses were attention deficit hyperactivity disorder, comprehension deficits, sleep disorders, and cognitive impairments. T-tests and a regression equation were utilized to determine significant differences between the groups.ResultsThe review identified 203 subjects, 98 with FASD and 105 non-FASD controls. Group mean age was 8.6 years and 64.5% were male. People with FASD were more likely to have any ACEs (mean 5.3) with ACE scores 3.7 points higher than non-FASD controls (mean 1.69) (t = 11.29; p < .001). Increased ACEs were associated with increased rates of neurodevelopmental disorders for people with FASD (R = .179, p = .026) but not for non-FASD controls (R = .130, p = .094).Conclusions: Both FASD and subsequent exposure to ACEs are associated with increased risk for development of comorbid neurodevelopmental disorders. Prevention of ACEs during childhood may decrease risk for development of comorbid neurodevelopmental disorders.

Prenatal substance exposure, adverse childhood experiences and diagnosed mental and behavioral disorders – A longitudinal register-based matched cohort study in Finland

“…The results of this study are in line with previous findings showing a strong association between traumatic experiences ( Henry et al, 2007 ; Kambeitz et al, 2019 ; Koponen, 2006 ; Koponen et al, 2009 ; 2013 ; Lambert & Bauer, 2012 ; Price et al, 2017 ), residential care ( Sarkola et al, 2011 ; Fagerlund et al, 2011 ) and an increased risk of mental health problems among children and adolescents with PAE and PDE. Numerous studies carried out among the general population have also revealed the relationship between socioeconomic inequalities, multiple ACEs and high levels of mental health problems ( Hughes et al, 2017 ; Paananen et al, 2013 ; Reiss, 2013 ; Ristikari et al, 2018 ).…”

Comparing outcomes of children and youth with fetal alcohol spectrum disorder (FASD) in the child welfare system to those in other living situations in Canada: Results from the Canadian National FASD Database

“…This finding also remained significant when groups were examined by age. The finding that abuse was higher among individuals in care may be explained by abuse being a common reason for involvement with the child welfare system (Badry, 2009;Kambeitz et al, 2019 among child welfare (Mukherjee, Cook, Norgate, & Price, 2019). The results of this study support previous research that speaks to the high rate of abuse experienced by children and youth within the child welfare system (Mukherjee et al, 2019) and points to the need for further research that explores the protective factors for children with FASD in care who may have a history of abuse.…”

“…This finding also remained significant when groups were examined by age. The finding that abuse was higher among individuals in care may be explained by abuse being a common reason for involvement with the child welfare system (Badry, 2009; Kambeitz et al, 2019). A concerning finding was that when considering all living situations of individuals in our sample, over 30% experienced abuse.…”

“…Approximately 4% of individuals in Canada are estimated to have FASD (Flannigan, Unsworth, & Harding, 2018), with a noted elevation in special populations, including the child welfare system (Fuchs, Burnside, Marchenski, & Mudry, 2010;Popova, Lange, Burd, & Rehm, 2014). This overrepresentation in the child welfare system aligns with research indicating that children and youth with disabilities, including those with FASD, are at an increased risk for experiencing adversities such as abuse, neglect and exposure to substance use (Badry, 2009;Fagerlund, Autti-Ramo, Hoyme, Mattson, & Korkman, 2011;Kambeitz, Klug, Greenmyer, Popova, & Burd, 2019). The degree and severity of difficulties associated with FASD have been reported to be significant predictors of apprehension from biological homes and connection to child welfare (Popova et al, 2014).…”

Fetal Alcohol Spectrum Disorder: Can We Change the Future?

“…Adverse childhood experiences (ACEs), such as trauma, need to be understood in the context of preventing alcohol consumption during pregnancy and FASD. Women with ACEs are more likely to consume alcohol during pregnancy, and individuals with FASD are more likely to have ACEs, which contributes to the development of comorbid disorders in FASD (Kambeitz et al, 2019; Weyrauch et al, 2017). Understanding the important role of FASD as a predisposing risk marker for ACEs could reduce the large economic burden placed on service systems (Kambeitz et al, 2019), could improve outcomes for diagnosed individuals, and could possibly prevent FASD familial recurrence.…”