Language and literacy outcomes from a pilot intervention study for children with fetal alcohol spectrum disorders in South Africa

Abstract

This pilot study investigated the efficacy of a classroom language and literacy intervention in children with fetal alcohol spectrum disorders (FASD) in the Western Cape Province of South Africa. The study forms part of a larger, on-going study that includes metacognitive and family support interventions in addition to language and literacy training (LLT). For the LLT study, 65 nine year old children identified as either FASD or not prenatally exposed to alcohol, were recruited. FortyPublisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access Author ManuscriptAlcohol. Author manuscript; available in PMC 2008 September 1. Published in final edited form as:Alcohol. 2007 September ; 41(6): 403-414. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript children with FASD were randomly assigned to either a Language and Literacy Training (LLT) intervention group or FASD control group (FASD-C). Twenty-five non alcohol-exposed children were randomly selected as non-exposed controls (NONEXP-C). Prior to intervention and after 9 school-term months of treatment, general scholastic tests, teacher and parent questionnaires, classroom observations and specific language and literacy tests were administered to the participants. The 9 months assessment reflects the mid-point and the first assessment stage of the overall study. At initial diagnosis and prior to commencement of the interventions, participants with FASD were significantly weaker than non-exposed control children in reading, spelling, addition, subtraction, phonological awareness and other tests of early literacy. Teachers rated a range of adaptive behaviors of children with FASD as significantly worse than non-exposed controls. Mean scholastic and language and literacy scores for all groups showed improvement over baseline scores after 9 months of intervention. The mean test scores of children with FASD remained lower than those of nonexposed controls. Comparison of mean baseline to post-intervention score changes between the LLT, FASD-C and NONEXP-C groups revealed that although there were no significant gains by the LLT intervention group over control groups on the general scholastic assessment battery, significantly greater improvements occurred in the LLT intervention group compared to the FASD-C group in specific categories of language and early literacy. These categories were syllable manipulation, letter sound knowledge, written letters, word reading and non-word reading and spelling. In spite of cognitive and classroom behavioral difficulties, children with FASD from a vulnerable env...

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“…Proactive interventions designed to facilitate the maturation of PA in at-risk children have shown to be efficacious with at-risk groups of children (Nelson et al 2005;Adnams et al 2007;Vadasy and Sanders 2010;Collet et al 2012). With 75 % of the children with GAL investigated in this study presenting with diminished PA skills, a means of identifying which children with GAL require proactive support would be beneficial.…”

“…Further, proactive intervention programmes aimed at nurturing the maturation of PA (Morrow 2007) have been implemented with successful outcomes for at-risk populations such as children with Down syndrome (Lemons and Fuchs 2010), speech impairment (Al Otaiba et al 2009), specific language impairment (Collet et al 2012), minority language speakers (Vadasy and Sanders 2010), foetal alcohol spectrum disorders (Adnams et al 2007), and emotionally disturbed children (Nelson et al 2005).…”

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“…Cognitive Control Therapy (CCT) was developed several decades ago and is designed to reorganize dysfunctional cognitive controls and strategies by teaching children how to think differently, and enhance self-observation and regulation [18][19][20]. Adnams et al [19] piloted CCT techniques in 10 children (mean age of 8 years) with Fetal Alcohol Syndrome in classrooms in South Africa.…”

“…Adnams et al [19] piloted CCT techniques in 10 children (mean age of 8 years) with Fetal Alcohol Syndrome in classrooms in South Africa. Children in the CCT group improved significantly in terms of teacher-rated behaviours and showed a non-significant improvement in cognitive control, but no change was noted in neuropsychological test scores.…”