Emotional Lability In Children Research Articles

Being sensitive in their own way: parental ethnotheories of caregiver sensitivity and child emotion regulation across five countries.

Caregiver sensitivity builds a basis for children's sense of security and effective emotion regulation during their development. Applying a cross-cultural lens, caregiver sensitivity can be divided into two subtypes, reactive and proactive, and its prevalence and meaning may differ across cultures. Guided by the theoretical frameworks of developmental niche and parental ethnotheories, the current study examines culture-specific meanings of caregiver sensitivity across five countries: India, Nepal, Korea, the United States of America (USA), and Germany. We examine the prevalence of maternal reactive and proactive sensitivity, children's emotional lability and regulation, and how mothers' sensitivity types are related to children's emotional characteristics. Participants included 472 mothers from the five countries with children aged between 6 and 7 years. Mothers reported their sensitivity preference in multiple vignettes and completed an emotion regulation checklist to report their children's emotional lability and regulation. A set of analyses of covariance (ANCOVAs) found cultural differences in mothers' preference for proactive and reactive sensitivity. Mothers in India and Nepal reported the highest preference for proactive sensitivity followed by Korea and the USA, while German mothers reported the lowest preference for proactive sensitivity. Consequent regression analyses revealed varying associations between proactive sensitivity and child emotional characteristics in all five countries either directly or as moderated by child sex. These results evidence that parental ethnotheories are part of the developmental niche embedded in a larger cultural context. Findings on the differential links between the types of sensitivity and child emotion regulation provide cultural models of parental emotion socialization and children's emotional functioning.

IMPROVEMENTS IN EMOTIONAL LABILITY WITH DELAYED-RELEASE AND EXTENDED-RELEASE METHYLPHENIDATE TREATMENT IN CHILDREN WITH ADHD

Emotional lability (EL) is common in individuals with ADHD, with reported prevalence rates ranging from 38% to 75%. Pharmacologic treatments for ADHD have been shown to improve EL with modest effect sizes. This post hoc analysis examined the effect of HLD200, an evening-dosed delayed-release and extended-release methylphenidate (DR/ER-MPH; tradename: JORNAY PM®), on EL in children (6-12 years) with ADHD in 2 randomized, double-blind, phase 3 trials (HLD200-107 [NCT02493777] and HLD200-108 [NCT02520388]). EL was measured with the 3-item Connors’ Global Index–Parent (CGI-P) EL subscale, which was recorded weekly in the 6-week, open-label phase of HLD200-107, and at baseline and study endpoint (Week 3) in HLD200-108. In HLD200-107, mean scores were compared to baseline at each week using paired t test (N = 117). In HLD200-108, mean scores in the DR/ER-MPH (n = 79) and placebo (n = 76) groups at Week 3 were compared using ANCOVA analysis. Correlations were determined between CGI-P EL scores and the following measures/items: Clinical Global Impression–Severity (CGI-S), CGI–Improvement (CGI-I), Caregiver Strain Questionnaire (CGSQ), and the “arguing/struggling” items in the Morning (item 3) and Evening (item 8) subscales of the Parent Rating of Evening and Morning Behavior–Revised (PREMB-R) scale. In HLD200-107, CGI-P EL scores improved after 1 week of DR/ER-MPH treatment and remained improved vs baseline in each week (p < 0.0001). In HLD200-108, CGI-P EL scores were significantly improved after 3 weeks of DR/ER-MPH treatment compared to placebo (p < 0.01). Significant positive correlations (p < 0.005) were found between CGI-P EL scores and CGSQ, CGI-S, CGI-I, and the arguing/struggling items in both the Morning and Evening subscales of the PREMB-R. DR/ER-MPH treatment improved EL scores in two phase 3 trials of children aged 6-12 years with ADHD. EL was positively correlated with ADHD symptoms and functional impairment in children with ADHD and with strain on caregivers. Due to its pharmacokinetic profile and dose-dependent duration of effect that can provide consistent treatment effects from early morning to late afternoon/evening, DR/ER-MPH is predicted to be an effective treatment for ADHD patients with EL.

Monoaminergic Genetic Variants, Prefrontal Cortex–Amygdala Circuit, and Emotional Symptoms in Children With ADHD: Exploration Based on the Gene–Brain–Behavior Relationship

Objective: This study aimed to explore the association between monoaminergic genetic variants and emotional lability (EL) symptoms in children with ADHD. In addition, genetic effects on prefrontal cortex (PFC)–amygdala functional connectivity (FC) were investigated. Method: Children with ADHD and controls were genotyped for five monoaminergic genetic variants and were evaluated for EL symptoms. Imaging genetic exploration was conducted with previously reported aberrant PFC–amygdala resting-state functional connectivities (RSFCs) as target features. Results: A genotypic effect on EL symptoms was only found for NET1-rs3785143, indicating higher EL symptoms in TT genotype carriers than in C-allele carriers. Imaging genetic analyses indicated a marginal effect of NET1-rs3785143 on ADHD-altered FC between the superficial amygdala (SFA) and middle frontal gyrus (MFG). Mediation analysis suggested potential effects of NET1-rs3785143 via RSFC (SFA–MFG) on EL. Conclusion: NET1 variants might participate in the pathogenesis of EL in children with ADHD by influencing the function of the PFC–amygdala circuit.

The Contribution of Sensory Sensitivity to Emotional Lability in Children with ADHD Symptoms

ABSTRACTEmotional lability and sensory sensitivity have been shown to contribute to the overall clinical picture in children with attention deficit hyperactivity disorder (ADHD). Further, both of these characteristics have been individually demonstrated to contribute to poorer quality of life, increased functional impairment, and poorer treatment response. However, to date, no study has evaluated the relationship among all three of these factors. The current study hypothesized that increased sensory sensitivity would moderate the relationship between hyperactive/impulsive symptoms of ADHD and emotional lability in youth. Results indicate that heightened sensory sensitivity strengthens the relationship between hyperactive/impulsive symptoms of ADHD and emotional lability in children with three or more clinically impairing ADHD symptoms. This dimensional approach was taken in accordance with growing evidence that even children with sub-threshold ADHD experience significant functional impairment and high rates of sensory sensitivity. These findings suggest that clinicians treating children with ADHD symptoms and emotional lability should consider assessing for sensory sensitivity as integration of multi-sensory techniques or referral to concurrent occupational therapy may significantly improve treatment outcomes and quality of life for these children and their families.

Keeping Emotions in Mind: The Influence of Working Memory Capacity on Parent-Reported Symptoms of Emotional Lability in a Sample of Children With and Without ADHD.

Emotional lability (EL) often co-occurs with attention-deficit/hyperactivity disorder (ADHD) in children. However, difficulties of regulating intense emotions in ADHD are still poorly understood. We investigated the potential role of working memory (WM) as a protective factor against EL in children with ADHD by building on models describing the close relationship between WM and regulation of emotions. The parents of 41 children with ADHD and 34 typically developing children (TDC) filled out the emotional control scale (ECS) from the Behavior Rating Inventory of Executive Functioning and the child behavior checklist (CBCL). The children themselves completed the backward conditions of the digit span (DS) and spatial span (SS) tasks as well as the letter–umber sequencing (LNS) task. The results of a stepwise regression analysis confirmed the negative relationship between parent reported EL measured using the ECS and scores on the LNS, when controlling for symptoms of ADHD and oppositional defiant disorder (ODD). WM thus seems to be important for the ability of the children to express emotions in an adaptive and flexible way. We therefore suggest that a poorer WM capacity, which is often found in children with ADHD, may be a predictor of high levels of EL.

Measuring child and adolescent emotional lability: How do questionnaire-based ratings relate to experienced and observed emotion in everyday life and experimental settings?

Emotional lability (EL) is an important trans-diagnostic concept that is associated with significant functional impairment in childhood and adolescence. EL is typically measured with questionnaires, although little is known about the ecological validity of these ratings. In this paper, we undertook 2 studies addressing this issue by examining the relationship between rating-based measures of EL and directly measured emotional expressions and experiences. Furthermore, the associations between directly measured emotional expressions and experiences and attention-deficit/hyperactivity disorder (ADHD) symptomatology were also examined, given the clear association of EL with ADHD in former research. In Study 1, we examined the relationship between parental report of children's EL and ADHD, and children's emotional expressions in an experimental context (N=67). In Study2, we examined the relationship between parental ratings and real-time measures of emotional experiences in daily life in adolescents (N=65). EL ratings were associated with different elements of real-time emotional experiences and expressions. Elements of emotional expressions but not emotional experiences were also associated with ADHD symptom reports. These studies provide evidence for the ecological validity of EL ratings. Furthermore, they add evidence for the associations between EL and ADHD.

The Neural Correlates of Emotional Lability in Children with Autism Spectrum Disorder.

Autism spectrum disorder (ASD) is exceptionally heterogeneous in both clinical and physiopathological presentations. Clinical variability applies to ASD-specific symptoms and frequent comorbid psychopathology such as emotional lability (EL). To date, the physiopathological underpinnings of the co-occurrence of EL and ASD are unknown. As a first step, we examined within-ASD inter-individual variability of EL and its neuronal correlates using resting-state functional magnetic resonance imaging (R-fMRI). We analyzed R-fMRI data from 58 children diagnosed with ASD (5-12 years) in relation to the Conners' Parent Rating Scale EL index. We performed both an a priori amygdala region-of-interest (ROI) analysis, and a multivariate unbiased whole-brain data-driven approach. While no significant brain-behavior relationships were identified regarding amygdala intrinsic functional connectivity (iFC), multivariate whole-brain analyses revealed an extended functional circuitry centered on two regions: middle frontal gyrus (MFG) and posterior insula (PI). Follow-up parametric and nonparametric ROI-analyses of these regions revealed relationships between EL and MFG- and PI-iFC with default, salience, and visual networks suggesting that higher-order cognitive and somatosensory processes are critical for emotion regulation in ASD. We did not detect evidence of amygdala iFC underpinning EL in ASD. However, exploratory whole-brain analyses identified large-scale networks that have been previously reported abnormal in ASD. Future studies should consider EL as a potential source of neuronal heterogeneity in ASD and focus on multinetwork interactions.

Emotional Lability in Children and Adolescents Affected by Tourette Syndrome

Ninety-two patients with Tourette syndrome (TS) were studied to investigate the occurrence of emotional lability (EL) in TS, its relationship to comorbid conditions, and the risk of developing bipolar disorder (BD). Patients were divided in three clinical subgroups, according with child behavior checklist anxious/depressed, attention and aggressive scales: group (G) 1: score >210 (risk of development BD), G2: score >180 but

Ignoring Children's Emotions: A novel ignoring subscale for the Coping with Children's Negative Emotions Scale

Researchers and theorists agree that parents may ignore children's emotions as a form of emotion socialization, yet few parent-report measures assess this emotion socialization strategy. This study describes a conceptual approach to understanding parents' ignoring responses and describes a novel subscale added to the Coping with Children's Negative Emotions Scale, which assesses parents' intentional ignoring of children's negative emotions. Eighty-one parents of 3–6-year-old children reported on their emotion socialization and their children's socioemotional adjustment. Relations between parents' ignoring responses and other emotion socialization strategies and among parents' emotion socialization strategies and children's adjustment are explored. The ignoring subscale is internally consistent and relates positively to unsupportive strategies such as punitive and minimizing responses and to children's emotional lability and anger/aggression. Implications and directions for additional research are discussed.

The association of emotional lability and emotional and behavioral difficulties among children with and without ADHD.

Children with ADHD often demonstrate a pattern of emotional lability characterized by sudden and intense shifts in affect. Emotional lability has been linked to emotional and behavioral problems in children with and without ADHD, but few studies have examined emotional lability over time. This study examined the effects of emotional lability over time on the behavioral and emotional difficulties of children with and without ADHD using an ecological momentary assessment (EMA) methodology. One hundred and two children aged 8-12years (56 with ADHD and 46 without ADHD) and their parents completed baseline measures of the children's behavioral and emotional difficulties. Parents then completed a 28-day 3-times daily EMA assessment protocol to rate their child's emotional lability. Results suggested that emotional lability was associated with internalizing and/or externalizing diagnoses independent of ADHD diagnostic status, but was not directly associated with ADHD. Hierarchical regression analyses supported ADHD diagnostic status as a moderator of the association of greater EMA-derived emotional lability with children's behavioral difficulties, such that greater emotional lability was associated with greater behavioral difficulties among children with ADHD but not among children without ADHD. Results indicated that greater emotional lability was directly linked with greater emotional difficulties and that this relation was not moderated by ADHD diagnostic status. Overall, this study suggested that emotional lability is related to emotional difficulties independent of ADHD, but is differentially related to behavioral difficulties among children with and without ADHD.

Abnormal Amygdala Functional Connectivity Associated With Emotional Lability in Children With Attention-Deficit/Hyperactivity Disorder

A substantial proportion of children with attention-deficit/hyperactivity disorder (ADHD) also display emotion regulation deficits manifesting as chronic irritability, severe temper outbursts, and aggression. The amygdala is implicated in emotion regulation, but its connectivity and relation to emotion regulation in ADHD has yet to be explored. The purpose of this study was to examine the relationship between intrinsic functional connectivity (iFC) of amygdala circuits and emotion regulation deficits in youth with ADHD. Bilateral amygdala iFC was examined using functional magnetic resonance imaging in 63 children with ADHD, aged 6 to 13 years. First, we examined the relationship between amygdala IFC and parent ratings of emotional lability (EL) in children with ADHD. Second, we compared amygdala iFC across subgroups of children with ADHD and high EL (n = 18), ADHD and low EL (n = 20), and typically developing children (TDC), all with low EL (n = 19). Higher EL ratings were associated with greater positive iFC between the amygdala and rostral anterior cingulate cortex in youth with ADHD. EL scores were also negatively associated with iFC between bilateral amygdala and posterior insula/superior temporal gyrus. Patterns of amygdala-cortical iFC in ADHD participants with low EL were not different from the comparison group, and the effect sizes for these comparisons were smaller than those for the trend-level differences observed between the high-EL and TDC groups. In children with ADHD and a range of EL, deficits in emotion regulation were associated with altered amygdala-cortical iFC. When comparing groups that differed on ADHD status but not EL, differences in amygdala iFC were small and nonsignificant, highlighting the specificity of this finding to emotional deficits, independent of other ADHD symptoms.

Emotion Regulation Among Preschoolers on a Continuum of Risk: The Role of Maternal Emotion Coaching.

Parental emotion coaching involves acknowledging and validating children's feelings, as well as guiding them on how to manage intense or negative feelings. Although parental emotion coaching has been identified as a potentially important factor for children's emotional development, research into this topic is scant. The present study examined whether maternal emotion coaching can play a mediational role between family risk (i.e. economic disadvantage, family stress, and maltreatment) and emotion regulation in preschoolers. Seventy-four preschoolers, aged 46-58 months, and their maternal caregivers participated in an observational laboratory study, including a narrative task in which mothers and children reminisced about a mildly upsetting event. We coded these conversations for maternal emotion coaching behaviors with the Family Emotional Communication Scoring System. A family risk score was obtained via the Family Events Checklist and demographic data. We measured children's emotion regulation with the Emotion Regulation Checklist. Increased family risk was associated with both reduced child emotion regulation and reduced maternal emotion coaching. Maternal emotion coaching partially mediated the relation between family risk and child emotion regulation, in particular child emotional lability. The findings support further research into the possibilities of training mothers in high risk families in emotion coaching skills in order to foster their children's emotional development.

Impact of Sleep Extension and Restriction on Children's Emotional Lability and Impulsivity

OBJECTIVE:. To examine the impact of moderate sleep extension and restriction on child behavior in school.METHODS:. We conducted a randomized parallel group study to determine the impact of an experimental sleep extension (addition of 1 hour of sleep relative to baseline habitual sleep duration on weekdays) and experimental sleep restriction (elimination of 1 hour of sleep relative to baseline habitual sleep duration on weekdays) on child behavior in school. The primary outcome measures were scores on the Conners’ Global Index Scale, as determined by teachers blinded to sleep status of the participants. A sample of 34 typically developing children aged 7 to 11 years with no reported sleep problems and no behavioral, medical, or academic issues participated in the study.RESULTS:. Our main findings were that (1) a cumulative extension of sleep duration of 27.36 minutes was associated with detectable improvement in Conners’ Global Index–derived emotional lability and restless-impulsive behavior scores of children in school and a significant reduction in reported daytime sleepiness; and (2) a cumulative restriction of sleep of 54.04 minutes was associated with detectable deterioration on such measures.CONCLUSIONS:. A modest extension in sleep duration was associated with significant improvement in alertness and emotional regulation, whereas a modest sleep restriction had opposite effects.

Neuropsychological correlates of emotional lability in children with ADHD

Background: Emotional lability (EL) is commonly seen in patients with attention‐deficit/hyperactivity disorder (ADHD). The reasons for this association remain currently unknown. To address this question, we examined the relationship between ADHD and EL symptoms, and performance on a range of neuropsychological tasks to clarify whether EL symptoms are predicted by particular cognitive and/or motivational dysfunctions and whether these associations are mediated by the presence of ADHD symptoms.Methods: A large multi‐site sample of 424 carefully diagnosed ADHD cases and 564 unaffected siblings and controls aged 6–18 years performed a broad neuropsychological test battery, including a Go/No‐Go Task, a warned four‐choice Reaction Time task, the Maudsley Index of Childhood Delay Aversion and Digit span backwards. Neuropsychological variables were aggregated as indices of processing speed, response variability, executive functions, choice impulsivity and the influence of energetic and/or motivational factors. EL and ADHD symptoms were regressed on each neuropsychological variable in separate analyses controlling for age, gender and IQ, and, in subsequent regression analyses, for ADHD and EL symptoms respectively.Results: Neuropsychological variables significantly predicted ADHD and EL symptoms with moderate‐to‐low regression coefficients. However, the association between neuropsychological parameters on EL disappeared entirely when the effect of ADHD symptoms was taken into account, revealing that the association between the neuropsychological performance measures and EL is completely mediated statistically by variations in ADHD symptoms. Conversely, neuropsychological effects on ADHD symptoms remained after EL symptom severity was taken into account.Conclusions: The neuropsychological parameters examined, herein, predict ADHD more strongly than EL. They cannot explain EL symptoms beyond what is already accounted for by ADHD symptom severity. The association between EL and ADHD cannot be explained by these cognitive or motivational deficits. Alternative mechanisms, including overlapping genetic influences (pleiotropic effects) and/or alternative neuropsychological processes need to be considered.

The Effects of Lisdexamfetamine Dimesylate on Emotional Lability in Children 6 to 12 Years of Age With ADHD in a Double-Blind Placebo-Controlled Trial

Objective: To evaluate the effect of lisdexamfetamine dimesylate (LDX) on emotional lability (EL) in children with ADHD. Method: Post hoc analyses of a placebo-controlled trial of LDX-stratified children (aged 6-12 years) with ADHD to prominent and not prominent EL at baseline (score >3 or ≤3, respectively, on Conners’ Parent Rating Scale [CPRS] items of anger, loss of temper, and irritability). Efficacy was assessed by change in CPRS EL scores and ADHD Rating Scale-IV (ADHD-RS-IV) total and subscale scores. Safety measures included treatment-emergent adverse events (TEAEs). Results: LDX showed improvement versus placebo (p < .0005) for EL item least squares (LS) mean change scores at endpoint and throughout the day. At baseline, 138 and 73 participants randomized to LDX treatment and having baseline and endpoint CPRS scores were categorized with CPRS-derived prominent and not prominent baseline EL, respectively; 41 and 31 participants randomized to placebo were categorized with CPRS-derived prominent and not prominent baseline EL, respectively. ADHD-RS-IV total and subscale scores decreased with LDX regardless of baseline EL severity. TEAEs included decreased appetite, insomnia, upper abdominal pain, headache, and irritability. Conclusion: EL and ADHD symptoms improved with LDX regardless of baseline EL symptom severity. LDX demonstrated a safety profile consistent with long-acting psychostimulant use.

Models of Emotion Skills and Social Competence in the Head Start Classroom

Research Findings: Fostering the social competence of at-risk preschoolers would be facilitated by knowing which of children's emotion skills are most salient to social outcomes. We examined the emotion skills and social competence of 44 children enrolled in a Head Start program. Emotion skills were examined in terms of children's emotional lability and emotion regulation, whereas social competence was measured in terms of three aspects of preschoolers' social relationships: social skills, student–teacher relationships, and peer likeability. Although emotion regulation emerged as an important predictor for social skills and positive relationships with teachers, emotional lability was a significant predictor of student–teacher conflict and peer likeability. In fact, emotional lability mediated the relation between student–teacher conflict and peer likeability. Practice or Policy: The findings are discussed in terms of the complex associations between children's emotion skills and early social relationships.

Emotional lability in children and adolescents with attention deficit/hyperactivity disorder (ADHD): clinical correlates and familial prevalence

The goal of this study was to investigate the occurrence, severity and clinical correlates of emotional lability (EL) in children with attention deficit/hyperactivity disorder (ADHD), and to examine factors contributing to EL and familiality of EL in youth with ADHD. One thousand, one hundred and eighty-six children with ADHD combined type and 1827 siblings (aged 6-18 years) were assessed for symptoms of EL, ADHD, associated psychopathology and comorbid psychiatric disorders with a structured diagnostic interview (PACS) as well as parent and teacher ratings of psychopathology (SDQ; CPRS-R:L; CTRS-R:L). Analyses of variance, regression analyses, chi(2)-tests or loglinear models were applied. Mean age and gender-standardized ratings of EL in children with ADHD were >1.5 SD above the mean in normative samples. Severe EL (>75th percentile) was associated with more severe ADHD core symptoms, primarily hyperactive-impulsive symptoms, and more comorbid oppositional defiant, affective and substance use disorders. Age, hyperactive-impulsive, oppositional, and emotional symptoms accounted for 30% of EL variance; hyperactive-impulsive symptoms did not account for EL variance when coexisting oppositional and emotional problems were taken into account, but oppositional symptoms explained 12% of EL variance specifically. Severity of EL in probands increased the severity of EL in siblings, but not the prevalence rates of ADHD or ODD. EL and ADHD does not co-segregate within families. EL is a frequent clinical problem in children with ADHD. It is associated with increased severity of ADHD core symptoms, particularly hyperactivity-impulsivity, and more symptoms of comorbid psychopathology, primarily symptoms of oppositional defiant disorder (ODD), but also affective symptoms, and substance abuse. EL in ADHD seems to be more closely related to ODD than to ADHD core symptoms, and is only partly explainable by the severity of ADHD core symptoms and associated psychopathology. Although EL symptoms are transmitted within families, EL in children with ADHD does not increase the risk of ADHD and ODD in their siblings.

S15-01 - Emotional lability in children and adolescents with ADHD. Clinical correlates and familial prevalence

ADHD is often associated with symptoms of emotional lability (EL), such as irritability, hot temper, low frustration tolerance, and sudden unpredictable shifts towards negative emotions such as anger, dysphoria and sadness. EL has been consistently noted in the changing definitions of the ADHD construct and its diagnosis and is currently considered an associated feature of the disorder. However, it is still unclear how EL and ADHD are interconnected. Thus, 1186 children with ADHD-combined type and 1827 siblings (aged 6-18 years) were assessed for symptoms of EL, ADHD, associated psychopathology and comorbid psychiatric disorders with a structured diagnostic interview as well as parent and teacher ratings of psychopathology. EL was associated with increased severity of ADHD core symptoms, particularly hyperactivity-impulsivity, and more symptoms of comorbid psychopathology, primarily symptoms of oppositional defiant disorder (ODD), but also affective symptoms, and substance abuse. However, EL was only partly explainable by the severity of ADHD core symptoms and associated psychopathology, and seems to be more closely related to oppositional symptoms. Severity of EL in probands increased severity of EL in siblings but not prevalence rates of ADHD or ODD.

Risk Factors for Conduct Problems and Depressive Symptoms in a Cohort of Ukrainian Children

Potential risk factors for conduct problems and depressive symptoms were tested in a cohort of 10- to 12-year-old Ukrainian children (N = 544, 47.6% male). Risk factors examined were child emotional lability, child attention problems, poor mother-child communication, coercive maternal discipline, maternal depression, and low marital satisfaction. Results indicated that poor mother-child communication was related to conduct problems and depressive symptoms for both boys and girls. In addition, conduct problems and depression were associated with attention problems for boys and with low marital satisfaction for girls. Emotional lability was related specifically to conduct problems, and maternal punishment was related specifically to depressive symptoms.

Hyperactivity, learning disabilities, and alcohol.

The United States Food and Drug Administration had issued a warning to women that alcohol consumed during the prenatal period may cause deleterious effects on offspring. The present article examines the professional literature in regard to the history of and research in alcohol consumption by pregnant women. New research findings suggest that maternal alcohol consumption may be the cause for behaviors in children that have led to their being diagnosed as learning disabled. Hyperactivity, short attention span, and emotional lability in children may be the direct result of mothers' drinking during pregnancy. The present paper reaffirms the Food and Drug Administration's warning to pregnant women and potential mothers of the hazards of even mild or moderate drinking during pregnancy and the possible negative effects it may cause on a child's learning and behavior.