Complexities in understanding attentional functioning among children with fetal alcohol spectrum disorder

Kimberly A Lane,Tania Fernandes,Jacob A Burack,James T Enns,Jillian Stewart,Natalie Russo

doi:10.3389/fnhum.2014.00119

Abstract

Parental reports of attention problems and clinical symptomatology of ADHD among children with fetal alcohol syndrome disorder (FASD) were assessed in relation to performance on standardized subtests of attentional control/shifting and selective attention from the Test of Everyday Attention for Children (TEA-Ch; Manly etal., 1998). The participants included 14 children with FASD with a mean chronological age (CA) of 11.7 years and a mean mental age (MA) of 9.7 years, and 14 typically developing (TD) children with no reported history of prenatal exposure to alcohol or attention problems with a mean CA of 8.4 years and a mean MA of 9.6 years. The children with FASD were rated by their caregivers as having clinically significant attention difficulties for their developmental age. The reported symptomatology for the majority of the children with FASD were consistent with a diagnosis of ADHD, combined type, and only one child had a score within the average range. These reports are consistent with the finding that the children with FASD demonstrated difficulties with attentional control/shifting, but inconsistent with the finding that they outperformed the TD children on a test assessing selective attention. These findings are considered within the context of the complexity in understanding attentional functioning among children with FASD and discrepancies across sources of information and components of attention.

Highlights

Common parental and anecdotal reports of general attentional problems among children with fetal alcohol spectrum disorder (FASD), a non-diagnostic umbrella term that refers to a spectrum of effects resulting from prenatal exposure to alcohol (PEA), seem consistent with high rates of clinical diagnoses of attention deficit hyperactivity disorder (ADHD) in this group
We examined the relationship among parental report of attentional problems and ADHD symptomatology in relation to performance on two standardized subtests of each of the essential attentional components of distractibility and cognitive control/switching among children with FASD as compared to typically developing (TD) children matched for mental age (MA)
The reported symptomatology for the majority (n = 10; 76.9%) of the children with FASD (n = 13) were consistent with a diagnosis of ADHD, combined type, as measured by the Conners’ (i.e., T-score of 70 or above), and only one child had a score within the average range

Summary

Introduction

Common parental and anecdotal reports of general attentional problems among children with fetal alcohol spectrum disorder (FASD), a non-diagnostic umbrella term that refers to a spectrum of effects resulting from prenatal exposure to alcohol (PEA), seem consistent with high rates of clinical diagnoses of attention deficit hyperactivity disorder (ADHD) in this group. Fetal alcohol syndrome (FAS), a specific pattern of birth defects associated with excessive maternal alcohol consumption during pregnancy, represents the most severe consequence of PEA These birth defects, which historically included growth deficiency, a pattern of facial anomalies, and central nervous system dysfunction, were first described in the medical literature in the early 1970s (Jones and Smith, 1973; Jones et al, 1973). Attentional difficulties have been cited as sequelae of prenatal alcohol exposure that lead to many of the concomitant difficulties that are reported among individuals with PEA (Kopera-Frye et al, 1997)

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