Association of adverse childhood experiences and neurodevelopmental disorders in people with fetal alcohol spectrum disorders (FASD) and non-FASD controls

Cassondra Kambeitz,Svetlana Popova,Jacob Greenmyer,Larry Burd,Marilyn G Klug

doi:10.1186/s12887-019-1878-8

Abstract

BackgroundFetal alcohol spectrum disorder (FASD) is a highly prevalent lifelong disorder with high rates of comorbid neurodevelopmental disorders. Individuals with FASD are often exposed to abuse, neglect and foster home placements which have uncertain effects on the lifelong course of FASD. In this study we compare the prevalence of adverse childhood events (ACEs) and neurodevelopmental disorders in subjects with fetal alcohol spectrum disorders (FASD) and non-FASD controls.MethodsA cross-sectional chart review of patients referred to a regional developmental center was used to identify people with FASD and non-FASD controls. We recorded the number of ACEs and neurodevelopmental disorders in each patient’s chart. The most common diagnoses were attention deficit hyperactivity disorder, comprehension deficits, sleep disorders, and cognitive impairments. T-tests and a regression equation were utilized to determine significant differences between the groups.ResultsThe review identified 203 subjects, 98 with FASD and 105 non-FASD controls. Group mean age was 8.6 years and 64.5% were male. People with FASD were more likely to have any ACEs (mean 5.3) with ACE scores 3.7 points higher than non-FASD controls (mean 1.69) (t = 11.29; p < .001). Increased ACEs were associated with increased rates of neurodevelopmental disorders for people with FASD (R = .179, p = .026) but not for non-FASD controls (R = .130, p = .094).Conclusions: Both FASD and subsequent exposure to ACEs are associated with increased risk for development of comorbid neurodevelopmental disorders. Prevention of ACEs during childhood may decrease risk for development of comorbid neurodevelopmental disorders.

Highlights

Fetal alcohol spectrum disorder (FASD) is a highly prevalent lifelong disorder with high rates of comorbid neurodevelopmental disorders
Patients in the FASD group were more likely to have any of the 10 Adverse childhood experience (ACE) items (p < .001) with the exception of parental mental illness (p = .810) (Table 1)
A diagnosis of FASD was found to increase the risk for ACEs, demonstrating that the adverse impact of FASD is apparent early in life and is a persistent risk marker for exposure to childhood adversity

Summary

Introduction

Fetal alcohol spectrum disorder (FASD) is a highly prevalent lifelong disorder with high rates of comorbid neurodevelopmental disorders. In this study we compare the prevalence of adverse childhood events (ACEs) and neurodevelopmental disorders in subjects with fetal alcohol spectrum disorders (FASD) and non-FASD controls. FASD is a broad term encompassing a range of adverse effects including physical, mental, behavioral, and learning disabilities. Clinical diagnoses under this term have included Fetal Alcohol Syndrome (FAS), Partial Fetal Alcohol Syndrome, Fetal Alcohol Effect, Alcohol-Related Neurodevelopmental Disorder and Alcohol-Related Birth Defects [2, 4]. In the most recent revision of the Diagnostic and Statistical Manual of Mental Disorders a diagnostic category (Neurodevelopmental Disorder associated with Prenatal Alcohol Exposure) was included as an entity for further study [5]. In Canada, a consensus definition uses FASD a diagnostic entity [6]

Methods

Results

Discussion

Conclusion