Infant Symbolic Play as an Early Indicator of Fetal Alcohol‐Related Deficit

Molteno, Christopher D.; Carter, R. Colin; Jacobson, Joseph L.

doi:10.1111/j.1532-7078.2010.00031.x

Cited by 23 publications

(14 citation statements)

References 39 publications

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“…Overall, the articles that assessed intellectual functioning in individuals prenatally exposed to alcohol found general impairment in intelligence. 13,15,16,20,[25][26][27][28][29][30][31][32][33][34]45 This fi nding was consistent with the revisions included in this study. 11,12,22,32,38,39 Curiously, while compiling the studies data, we found that the intellectual performance injury occurs diff erently depending on the individual diagnosis.…”

Section: General Intelligencesupporting

confidence: 89%

“…11 However, one clinical sample of a high-quality study was classifi ed in the middle range, possibly due to environmental factors that favoured the cognitive development of children. 17 When the sampled individuals who were exposed to alcohol were compared with each other, it was found that those with FAS had greater impairment in terms of general, 16,27,31 as well as verbal and non-verbal intelligence. 13 which indicated the most severe form of the spectrum.…”

Section: General Intelligencementioning

confidence: 99%

“…Analyzing the samples addressed in these studies, it was clear that mostly they consisted of milder forms of FASD or of individuals who had been exposed to alcohol, but without a diagnosis, as stated in several studies. 13,14,17,20,31,34,35,46,47 The fact that the samples presented predominantly milder forms of FASD resulted in higher scores. This explains why some studies state that most individuals who were prenatally exposed to alcohol are not intellectually impaired.…”

Section: General Intelligencementioning

confidence: 99%

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2017

JPTCP

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Section: General Intelligencesupporting

confidence: 89%

Section: General Intelligencementioning

confidence: 99%

Section: General Intelligencementioning

confidence: 99%

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2017

JPTCP

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“…The infants are from the Cape Coloured (mixed ancestry) community in Cape Town, South Africa, and are participating in a prospective, longitudinal study on the effects of heavy prenatal alcohol exposure on development (Jacobson et al, 2008; Molteno et al, 2010). A very high incidence of FAS has been documented in this population (May et al, 2000; 2007; J.…”

Section: Methodsmentioning

confidence: 99%

Infant Emotional Withdrawal: A Precursor of Affective and Cognitive Disturbance in Fetal Alcohol Spectrum Disorders

Molteno

Jacobson

Carter

et al. 2013

Alcohol Clin Exp Res

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Objectives To test the hypothesis that emotional withdrawal is an early indicator of affective disorder in infants heavily exposed prenatally to alcohol, which is independent of alcohol-related effects on mother-infant interaction and temperament and discriminated between children later diagnosed with fetal alcohol syndrome (FAS) and partial FAS (PFAS) and predicted cognitive and affective outcomes at 5 and 9 years. Methods The sample consisted of Cape Coloured (mixed ancestry) infants, whose mothers were interviewed during pregnancy regarding their alcohol consumption using a timeline follow-back approach. Infant emotional withdrawal (n = 85) was assessed on the Alarm Distress Baby Scale at 6.5 months. Mother-infant interaction was evaluated from video recordings during free play and infant feeding at 6.5 months (n = 127). Infant temperament was assessed by maternal report on the EAS Temperament Survey at 13 months (n = 119). Socio-demographic and psychological correlates of maternal alcohol use and infant iron deficiency were examined as potential confounders. The children were diagnosed for FAS/PFAS by expert dysmorphologists at 5 years; cognitive and affective function, at 5 and 9 years. Results Prenatal alcohol exposure was associated with increased infant emotional withdrawal and decreased activity, but unrelated to mother-infant interaction or any other temperament measures. Children later diagnosed with FAS and PFAS at 5 years exhibited more emotional withdrawal and less responsivity and activity as infants. Infant withdrawal, responsivity, quality of interaction, and maternal sensitivity also predicted poorer IQ and affective response at 5 and 9 years. When all four infant affective measures were examined simultaneously in a regression analysis, only infant emotional withdrawal persisted as a significant predictor of 9-year IQ. Conclusions This study is the first to document a direct effect of fetal alcohol exposure on emotional withdrawal in infancy. These data link prenatal alcohol to a specific aspect of infant affective function not attributable to mother-infant interaction, infant temperament, or other socioemotional aspects of the infant’s environment and identify infant emotional withdrawal as an early indicator of affective disturbance, particularly in children later diagnosed with FAS and PFAS.

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“…Literature on neurobehavioral and developmental assessments in the very young infant suggests that infants with heavy prenatal alcohol exposure have poor habituation, low levels of arousal (including to acute painful stimuli), abnormal reflexive behavioral clusters and motor abnormalities compared to unexposed peers (Chiriboga 2003; Streissguth et al 1983; Oberlander et al 2010; Coles et al 1987). Behavioral disturbances in the first weeks of life are considered to have poor predictive validity for long-term cognitive outcomes, but a number of groups have described between group differences on formal early developmental assessments and measures of information processing and play complexity (Coles et al 2000; Jacobson et al 1993) and these may be better at predicting later outcomes (Molteno et al 2010). Neuroimaging reports to date, however, have focused largely on ages 5 years through to young adulthood with the majority in late childhood or adolescence (Lebel et al 2012; Treit et al 2013).…”

Section: Introductionmentioning

confidence: 99%

Alcohol exposure in utero is associated with decreased gray matter volume in neonates

et al. 2015

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Neuroimaging studies have indicated that prenatal alcohol exposure is associated with alterations in the structure of specific brain regions. However, the temporal specificity of such changes and their behavioral consequences are less known. Here we explore the brain structure of infants with in utero exposure to alcohol shortly after birth. T2 structural MRI images were acquired from 28 alcohol-exposed infants and 45 demographically matched healthy controls at 2-4 weeks of age on a 3T Siemens Allegra system as part of large birth cohort study, the Drakenstein Child Health Study (DCHS). Neonatal neurobehavior was assessed at this visit; early developmental outcome assessed on the Bayley Scales of Infant Development III at 6 months of age. Volumes of gray matter regions were estimated based on the segmentations of the University of North Carolina neonatal atlas. Significantly decreased total gray matter volume was demonstrated for the alcohol-exposed cohort compared to healthy control infants (p < 0.001). Subcortical gray matter regions that were significantly different between groups after correcting for overall gray matter volume included left hippocampus, bilateral amygdala and left thalamus (p < 0.01). These findings persisted even when correcting for infant age, gender, ethnicity and maternal smoking status. Both early neurobehavioral and developmental adverse outcomes at 6 months across multiple domains were significantly associated with regional volumes primarily in the temporal and frontal lobes in infants with prenatal alcohol exposure. Alcohol exposure during the prenatal period has potentially enduring neurobiological consequences for exposed children. These findings suggest the effects of prenatal alcohol exposure on brain growth is present very early in the first year of life, a period during which the most rapid growth and maturation occurs.

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Infant Symbolic Play as an Early Indicator of Fetal Alcohol‐Related Deficit

Abstract: Infant symbolic play was examined in relation to prenatal alcohol exposure and socioenvironmental background and to predict which infants met criteria for fetal alcohol syndrome (FAS) at 5 years. A total of 107 Cape-Colored, Correspondence should be sent to Christopher D. Molteno,

Cited by 23 publications

References 39 publications

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Infant Emotional Withdrawal: A Precursor of Affective and Cognitive Disturbance in Fetal Alcohol Spectrum Disorders

Alcohol exposure in utero is associated with decreased gray matter volume in neonates

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