Characterizing adverse childhood experiences among children and adolescents with prenatal alcohol exposure and Fetal Alcohol Spectrum Disorder

Flannigan, Katherine; Kapasi, Aamena; Pei, Jacqueline; Murdoch, Isabel; Andrew, Gail; Rasmussen, Carmen

doi:10.1016/j.chiabu.2020.104888

Cited by 63 publications

(67 citation statements)

References 55 publications

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“…The highest frequency of ACEs reported by the overall sample was exposure to drinking/substance misuse at home. This was present in over 70% of the cases and aligns with results from a Canadian FASD/PAE sample (69.7%) (24). Alcohol/substance misuse was previously found to be associated with social and economic disadvantage, especially in parents of children with FASD (6).…”

Section: Aces In the Overall Fasd Samplesupporting

confidence: 83%

“…Numerous studies (13,22) have explored the relationship between PAE and early life trauma, but research investigating the relationship between ACEs and FASD is still in its infancy, with only four published papers using a standardised ACEs questionnaire (11,(23)(24)(25). These studies revealed high rates of early life adversity in individuals with FASD.…”

Section: Introductionmentioning

confidence: 99%

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Adverse Childhood Experiences, Associated Stressors and Comorbidities in Children and Youth with Fetal Alcohol Spectrum Disorder across the Child Protection and Justice Settings in Western Australia

Tan

Symons

Fitzpatrick³

et al. 2021

Preprint

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Background: Individuals with Fetal Alcohol Spectrum Disorder (FASD) are at risk of having adverse childhood experiences (ACEs), especially those with child protection or justice system involvement. The complex relationship between FASD and psychosocial vulnerabilities in the affected individual is an important clinical risk factor for comorbidity. This study (1) explored the ACEs and associated stressors in individuals with FASD; (2) compared the ACEs profiles of those who had been involved with the child protection system only, justice system only, both or neither; (3) examined the relationship between ACEs and comorbid conditions such as mood and neurodevelopmental disorders. Methods: Data were collected retrospectively via file review from diagnostic clinics in Western Australia. Life adversity was coded using a standardised ACEs questionnaire. 211 participants (71.6% males) with FASD with a mean age of 11.12 (range = 2-21) were included in the total sample.Results: Exposure to drinking/substance misuse at home (70.1%) and domestic violence (51.7%) were the two most common ACEs across the total sample. In the entire cohort, 39.3% had four or more ACEs. Additional stressors reported were involvement with child protection system (69.7%), disengagement from school (43.1%), trouble with the law (40.3%), transiency (19.0%), documented victims of bullying (12.3%), traumatic brain injury (9.0%) and homelessness (5.2%). Further, individuals who had been involved with both the child protection and justice system were four to eleven times more likely than those without any involvement to report parental drinking/substance misuse at home, parental incarceration, exposure to domestic violence and emotional/physical neglect. Higher rates of life adversity in this clinical population were associated with an increased number of comorbidities, p <.001. Specifically, those with FASD who had comorbidities such as attachment disorder (p =.001), substance use disorder (p =.006), and PTSD (p <.001) also reported higher ACEs score.Conclusion: ACEs were common in this clinical population, particularly those who had been involved with both the child protection and justice system. Increased ACEs in this clinical population were associated with increased comorbidities. This highlights that prevention, intervention and early diagnosis of FASD are important for at risk children to reduce the negative effects of ACEs.

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Section: Aces In the Overall Fasd Samplesupporting

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Adverse Childhood Experiences, Associated Stressors and Comorbidities in Children and Youth with Fetal Alcohol Spectrum Disorder across the Child Protection and Justice Settings in Western Australia

Tan

Symons

Fitzpatrick³

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…We rigorously screened participant records to confirm PAE in all participants, but specific details of dose and timing were often unavailable. PAE is rarely the sole adverse exposure (Astley, 2010;Flannigan et al, 2021;, and most participants with PAE in this study had additional prenatal or postnatal exposures. Larger samples are necessary to fully disentangle the effects of other exposures.…”

Section: Discussionmentioning

confidence: 82%

White matter alterations in young children with prenatal alcohol exposure

Kar

Reynolds

Grohs

et al. 2021

Developmental Neurobiology

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Prenatal alcohol exposure (PAE) can lead to cognitive, behavioural, and socialemotional challenges. Previous neuroimaging research has identified structural brain alterations in newborns, older children, adolescents, and adults with PAE; however, little is known about brain structure in young children. Extensive brain development occurs during early childhood; therefore, understanding the neurological profiles of young children with PAE is critical for early identification and effective intervention.We studied 54 children (5.21 ± 1.11 years; 27 males) with confirmed PAE (94% also had other prenatal exposures, 74% had adverse postnatal experiences) compared with 54 age-and sex-matched children without PAE. Children underwent diffusion tensor imaging between 2 and 7 years of age. Mean fractional anisotropy (FA) and mean diffusivity (MD) were obtained for 10 major white matter tracts. Univariate analyses of covariance were used to test group differences (PAE vs. control) controlling for age and sex. The PAE group had higher FA in the genu of the corpus callosum and lower MD in the bilateral uncinate fasciculus. The PAE group also had lower tract volume in the corpus callosum, the bilateral inferior fronto-occipital fasciculi, and the right superior longitudinal fasciculus. Our findings align with studies of newborns with PAE reporting lower diffusivity, but contrast those in older populations with PAE, which consistently report lower FA and higher MD. Further research is needed to understand trajectories of white matter development and how our results of higher FA/lower MD in young children connect with lower FA/higher MD observed at older ages. K E Y W O R D Sdiffusion tensor imaging, fetal alcohol spectrum disorder, prenatal alcohol exposure, preschool children, white matter | 401

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“…Children with FASD often enter childcare systems such as foster care or orphanages (Lange et al, 2013 ). Children with FASD have high rates of early life adversity and are less likely to live with both biological parents compared to children without FASD (Flannigan et al, 2021 ). Specifically, in a recent cross-sectional study, 75% of individuals with FASD were involved with the child welfare system, and these individuals are more than four times more lately to also have an anxiety disorder (Popova et al, 2021 ).…”

Section: Neurodevelopment and Fetal Alcohol Spectrum Disorders (Fasd)mentioning

confidence: 99%

Epigenetic Impacts of Early Life Stress in Fetal Alcohol Spectrum Disorders Shape the Neurodevelopmental Continuum

Alberry

Laufer

Chater‐Diehl

et al. 2021

Front. Mol. Neurosci.

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Neurodevelopment in humans is a long, elaborate, and highly coordinated process involving three trimesters of prenatal development followed by decades of postnatal development and maturation. Throughout this period, the brain is highly sensitive and responsive to the external environment, which may provide a range of inputs leading to positive or negative outcomes. Fetal alcohol spectrum disorders (FASD) result from prenatal alcohol exposure (PAE). Although the molecular mechanisms of FASD are not fully characterized, they involve alterations to the regulation of gene expression via epigenetic marks. As in the prenatal stages, the postnatal period of neurodevelopment is also sensitive to environmental inputs. Often this sensitivity is reflected in children facing adverse conditions, such as maternal separation. This exposure to early life stress (ELS) is implicated in the manifestation of various behavioral abnormalities. Most FASD research has focused exclusively on the effect of prenatal ethanol exposure in isolation. Here, we review the research into the effect of prenatal ethanol exposure and ELS, with a focus on the continuum of epigenomic and transcriptomic alterations. Interestingly, a select few experiments have assessed the cumulative effect of prenatal alcohol and postnatal maternal separation stress. Regulatory regions of different sets of genes are affected by both treatments independently, and a unique set of genes are affected by the combination of treatments. Notably, epigenetic and gene expression changes converge at the clustered protocadherin locus and oxidative stress pathway. Functional studies using epigenetic editing may elucidate individual contributions of regulatory regions for hub genes and further profiling efforts may lead to the development of non-invasive methods to identify children at risk. Taken together, the results favor the potential to improve neurodevelopmental outcomes by epigenetic management of children born with FASD using favorable postnatal conditions with or without therapeutic interventions.

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Characterizing adverse childhood experiences among children and adolescents with prenatal alcohol exposure and Fetal Alcohol Spectrum Disorder

Cited by 63 publications

References 55 publications

Adverse Childhood Experiences, Associated Stressors and Comorbidities in Children and Youth with Fetal Alcohol Spectrum Disorder across the Child Protection and Justice Settings in Western Australia

Adverse Childhood Experiences, Associated Stressors and Comorbidities in Children and Youth with Fetal Alcohol Spectrum Disorder across the Child Protection and Justice Settings in Western Australia

White matter alterations in young children with prenatal alcohol exposure

Epigenetic Impacts of Early Life Stress in Fetal Alcohol Spectrum Disorders Shape the Neurodevelopmental Continuum

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