Executive dysfunction profile in children and adolescents with fetal alcohol spectrum disorder – systematic review

Abstract

The paper aims at reviewing data on the executive functioning in children and adolescents with fetal alcohol spectrum disorder (FASD) in the context of Suchy’s model of executive functioning. Suchy hypothesized that individuals with FASD would present with features of dysexecutive, disinhibited, apathetic and inappropriate, but not disorganized, syndromes. Eight papers satisfied the inclusion criteria for the review. In most respects, the performance of children with FASD was found to be lower than in the control group. According to Suchy’s model of executive functioning, children with FASD demonstrate features of dysexecutive syndrome (with deficits of executive cognitive functions) and of apathetic (deficit in initiation and maintenance) and disinhibited syndromes (deficit in response selection) as well as impaired social cognition that could correspond to socially inappropriate syndromes. None of the reviewed studies included measures of multi-tasking that would address features of disorganized syndrome. The results suggest a mixed pattern of executive deficits in FASD. Difficulties in delineating the executive functioning profile in children and adolescents with FASD may be related to heterogeneous patient populations (different clinical criteria, variable overall intellectual functioning and different living conditions) and also the complex nature of most of the executive measures that rarely tap one aspect of the executive functioning and typically engage a variety of cognitive processes.