Cognitive and Behavioral Effects of Prenatal Alcohol Exposure

Abstract

Children exposed to substantial amounts of alcohol prenatally are known to display a range of physical and cognitive anomalies, referred to as fetal alcohol spectrum disorders (FASDs). Animal models and neuroimaging studies of FASDs have consistently demonstrated that specific regions of the brain (e.g., midline structures) are more vulnerable to the teratogenic effects of alcohol than other regions. The main aim of this article is to assess whether findings from cognitive–behavioral studies of FASDs yield a profile that maps onto the pattern of damage revealed by neuroanatomical investigations. To achieve this aim, the findings from studies that have investigated elementary functions (e.g., associative learning), general functions (e.g., intellectual abilities), specific functions (e.g., language and memory) and behavior in children and adults with FASDs are examined. The cognitive–behavioral profile emerging from the data is defined as a generalized deficit in processing and integrating complex information. It is proposed that slow processing of information mainly contributes to this deficit. The clinical implications of the above characterization of the cognitive–behavioral profile in FASDs are discussed.

Higher functioning children with prenatal alcohol exposure: Is there a specific neurocognitive profile?

“…While these findings add support for a generalized deficit conceptualization (Kodituwakku et al, 2011), it is unknown whether higher functioning children with PAE demonstrate the same global impairments. Previous investigations have typically included a range of individuals having mild-to-severe intellectual deficits (e.g., Astley, 2010;Chasnoff et al, 2010;Crocker et al, 2009Crocker et al, , 2011Mattson et al, 2010;Vaurio et al, 2008) or were limited to only heavily exposed children .…”

“…Two recent reviews of the neurocognitive and behavioral effects of PAE (Kodituwakku, Segall, & Beatty, 2011;Mattson et al, 2011) provide a more comprehensive discussion and a similar conclusion, with persuading support for a generalized deficit conceptualization in which children with PAE demonstrate diffuse information-processing difficulties that become more pronounced as task complexity increases (Kodituwakku et al, 2011). This conceptualization is supported by a growing body of structural and functional imaging studies indicating abnormalities in nearly every brain structure and region investigated in participants with PAE (for a review, see Lebel, Roussotte, & Sowell, 2011).…”

“…A primary goal of the current study was to investigate whether a generalized deficit model of impairment (Kodituwakku et al, 2011) extends to children with PAE who do not have a global intellectual disability. Consistent with the results of PAE samples with heavy alcohol exposure and those with intellectual disabilities, as well as a number of structural and functional imaging studies, the results from this study support the generalized deficit model.…”

From Research to Practice: An Integrative Framework for the Development of Interventions for Children with Fetal Alcohol Spectrum Disorders

“…Recently, we proposed the hypothesis that children with FASDs have a generalized deficit in the processing and integration of multiple elements or relations (Kodituwakku et al 2011). Associated with slow information processing, this deficit manifests itself as impaired performance on relatively complex tasks involving executive control (Kodituwakku 2007(Kodituwakku , 2009).…”

“…In the next section, we will present animal models of interventions, including those designed to test pharmacological agents. In the third section, we will elaborate on a previously described theoretical framework (Kodituwakku 2009;Kodituwakku et al 2011) that sought to integrate the findings from animal and human studies. In the fourth and final section, we will discuss the relevance of this integrative framework for the development of future research on interventions for children and adults with FASDs.…”