Executive Functioning and Working Memory in Fetal Alcohol Spectrum Disorder

Abstract

The goal of this report is to critically review research on executive functioning (EF) and working memory in individuals with fetal alcohol spectrum disorder (FASD). Individuals with FASD exhibit EF deficits in the areas of cognitive flexibility, planning and strategy use, verbal reasoning, some aspects of inhibition, set shifting, fluency, working memory, and, recently, on tests of emotion-related or hot EF. Some researchers have linked prenatal alcohol exposure to abnormalities in the development of the frontal cortex of affected individuals or animals. One common finding is that these EF deficits persist regardless of whether the individual has facial dysmorphology. Furthermore, EF deficits are not simply due to a low IQ in these individuals. More research with larger sample sizes, smaller age ranges, and consistent measurement tools is needed in this area to ameliorate some inconsistencies in the literature. Furthermore, researchers should now focus on studying the pattern of weakness in EF in individuals with FASD as well as relations among working memory and EF, which will help to identify specific areas of weakness, to enhance diagnosis, and to improve treatment. There is limited research on the development of EF in individuals with FASD, which can have important implications for understanding of how these deficits unfold from childhood through adulthood.

Psychiatric conditions associated with prenatal alcohol exposure

“…Additionally, as Dodge's model suggests, neurologically mediated differences in behavioral regulation impact and interact with experience and the development of schemas stored in memory [Dodge, 2006]. There is considerable research indicating that children with PAE have difficulties with behavioral regulation, memory and executive functioning relative to children without prenatal exposure even when other cognitive differences have been statistically controlled [Rasmussen, 2005;Rasmussen et al, 2006;Schonfeld et al, 2006;Kodituwakku, 2007]. Considering the well documented neurocognitive deficits seen in children with FASDs, it would not be surprising for them to fail to develop a benign attributional style and, instead, develop impaired social cognitive processes.…”

“…Fetal alcohol syndrome (FAS), one of the most severe conditions resulting from in utero alcohol exposure, is defined by a pattern of characteristic facial malformations, growth deficiencies, and neurodevelopmental deficits [Jones and Smith, 1973]. A substantial body of research has documented significant neurocognitive difficulties among individuals with FAS as well as among individuals who have been prenatally exposed to alcohol but do not meet full criteria for FAS [Rasmussen, 2005;Riley and McGee, 2005;Rasmussen et al, 2006;Kodituwakku, 2007;McGee and Riley, 2007;Paley and O'Connor, 2007;Guerri et al, 2009]. This latter group of individuals may be described as having partial FAS (pFAS), alcohol related neurodevelopmental disorder (ARND), or alcohol related birth defects (ARBD) according to the diagnostic categories proposed by the Institute of Medicine [Stratton et al, 1996;Hoyme et al, 2005].…”

Adaptive Functioning, Social Skills, Mental Health, and Personal Strengths among Adolescents with Prenatal Alcohol Exposure (PAE)

“…Consistently, researchers looking at clinical and community samples, as well as caregivers, have found that individuals prenatally exposed to alcohol may have significant neurobehavioral impairments. In particular, deficits are reported in executive functioning (Rasmussen, 2005), learning, memory, language, intelligence, motor, visual-spatial abilities (see Kodituwakku, 2007Kodituwakku, , 2009Mattson, Crocker, & Nguyen, 2011), and academic achievement (Streissguth et al, 1994). Problems with disrupted school experiences, mental health problems, incarceration and retention in the justice system, as well as inappropriate sexual behaviors and alcohol and drug abuse have also been described (Streissguth, 1997).…”

Fetale Alkoholspektrumstörungen – Diagnose, neuropsychologische Testung und symptomorientierte Förderung

“…Die meisten Kinder mit FASD haben Schwächen in den Exekutivfunktionen (Fuglestad et al, 2014;Rasmussen, 2005).…”