Complexities in understanding attentional functioning among children with fetal alcohol spectrum disorder

Abstract

Parental reports of attention problems and clinical symptomatology of ADHD among children with fetal alcohol syndrome disorder (FASD) were assessed in relation to performance on standardized subtests of attentional control/shifting and selective attention from the Test of Everyday Attention for Children (TEA-Ch; Manly etal., 1998). The participants included 14 children with FASD with a mean chronological age (CA) of 11.7 years and a mean mental age (MA) of 9.7 years, and 14 typically developing (TD) children with no reported history of prenatal exposure to alcohol or attention problems with a mean CA of 8.4 years and a mean MA of 9.6 years. The children with FASD were rated by their caregivers as having clinically significant attention difficulties for their developmental age. The reported symptomatology for the majority of the children with FASD were consistent with a diagnosis of ADHD, combined type, and only one child had a score within the average range. These reports are consistent with the finding that the children with FASD demonstrated difficulties with attentional control/shifting, but inconsistent with the finding that they outperformed the TD children on a test assessing selective attention. These findings are considered within the context of the complexity in understanding attentional functioning among children with FASD and discrepancies across sources of information and components of attention.

Neurobehavioral Disorder Associated With Prenatal Alcohol Exposure

“…Specifying co-occurring disorders can provide the most complete picture of the child’s strengths and weaknesses to determine treatment or referral course. 42–45 Differential diagnoses of ND-PAE can be particularly challenging because the disorder does not always present the same way in all children because of differences in timing and amount of prenatal alcohol exposure and difference in genetic predispositions or postnatal environment. 33,46 Table 2 presents key differences between ND-PAE and several neurobehavioral conditions.…”

“…The severity of presentation and the constellation of characteristics vary greatly from child to child. 3,33,42–45 In a sample of children with FASDs, comorbid mental health conditions included (in descending order) mental retardation (ie, intellectual disability), sleep abnormalities, reactive attachment disorder, anxiety, posttraumatic stress disorder, oppositional defiant disorder, language disorder, learning disability, depression, bipolar disorder, some features of autism, and specific phobias. 45,47 Other conditions such as enuresis, encopresis, and eating disorders may be present depending on the age of the child.…”

Cognitive function of youths born to mothers with opioid and poly-substance abuse problems during pregnancy

“…There is also a relationship between neuroanatomical features, such as the thickness of the corpus callosum, and specific problems with executive functions and motor performance in people with fetal alcohol exposure (Bookstein, Streissguth, Sampson, Connor, & Barr, 2002). It is thought that such exposure may have specific consequences for basic abilities related to attention (Lane et al, 2014) and fine motor abilities (Doney et al, 2014). Although there is much less research concerning prenatal exposure to opioids and multiple drugs, there seems to be a growing consensus related to problems of attention and emotional and behavior regulation than cognitive problems (Behnke & Smith, 2013).…”

Brain development and the attention spectrum

“…This research topic challenges the reader to view attention in new conceptual ways, including: focusing on brain maturation delay among otherwise healthy children diagnosed with ADHD compared to their age group (Berger et al, 2013 ); the effects of age and task load on attention success (Remington et al, 2014 ); the attentional function among children with fetal alcohol spectrum disorder (Lane et al, 2014 ); the differential diagnosis of sensory modulation disorder and ADHD (Yochman et al, 2013 ); the effects of environmental distractors on attentional performance (Cassuto et al, 2013 ); and the much debated effect of alpha-linolenic acid supplementation on ADHD symptoms (Dubnov-Raz et al, 2014 ).…”