Cognitive factors contributing to spelling performance in children with prenatal alcohol exposure.

Abstract

Objective Heavy prenatal alcohol exposure is associated with impaired school functioning. Spelling performance has not been comprehensively evaluated. We examined whether children with heavy prenatal alcohol exposure demonstrate deficits in spelling and related abilities, including reading, and tested whether there are unique underlying mechanisms for observed deficits in this population. Method Ninety-six school-age children comprised two groups: children with heavy prenatal alcohol exposure (AE, n=49) and control children (CON, n=47). Children completed select subtests from the WIAT-II and NEPSY-II. Group differences and relations between spelling and theoretically-related cognitive variables were evaluated using MANOVA and Pearson correlations. Hierarchical regression analyses were utilized to assess contributions of group membership and cognitive variables to spelling performance. The specificity of these deficits and underlying mechanisms was tested by examining the relations between reading ability, group membership, and cognitive variables. Results Groups differed significantly on all variables. Group membership and phonological processing significantly contributed to spelling performance. In addition, a significant group*working memory interaction revealed that working memory independently contributed significantly to spelling only for the AE group. All cognitive variables contributed to reading across groups and a group*working memory interaction revealed that working memory contributed independently to reading only for alcohol-exposed children. Conclusion Alcohol-exposed children demonstrated a unique pattern of spelling deficits. The relation of working memory to spelling and reading was specific to the AE group, suggesting that if prenatal alcohol exposure is known or suspected, working memory ability should be considered in the development and implementation of explicit instruction.

Academic Difficulties in Children with Prenatal Alcohol Exposure: Presence, Profile, and Neural Correlates

“…Our results are consistent with previous literature which found that school-age children who have been prenatally exposed to alcohol perform significantly lower than typically developing peers across academic domains (Streissguth et al, 1990, Howell et al, 2006, O’Leary et al, 2013, Glass et al, 2015, Crocker et al, 2015). Children with prenatal exposure to alcohol demonstrated impairments on higher order mathematical reasoning as well as lower order functions such as basic numerical processing, basic calculations, proximity judgment, and cognitive estimation (Coles et al, 2009, Lebel et al, 2010, Crocker et al, 2015, Kopera-Frye et al, 1996, Meintjes et al, 2010; Jacboson et al, 2011).…”

“…We found that alcohol-exposed children performed significantly worse than their demographically matched peers on spelling and reading tests, even after accounting for socioeconomic status and age. Prior research has found that alcohol-exposed children are impaired compared to controls on various aspects of verbal academic functioning (O’Leary et al, 2013, Streissguth et al, 1994a, Rose-Jacobs et al, 2012, Glass et al, 2015), however most studies, including ours, utilize fairly simple tasks such as single word oral word reading or basic spelling. Potentially, alcohol-exposed children may struggle more on complex or cognitively demanding tests of reading reasoning or comprehension and would show levels of impairment more similar to those observed on the more complex math measures.…”

“…Of note, the newly updated clinical guidelines for diagnosing fetal alcohol spectrum disorders include specific learning impairment (across academic domains) as satisfying the criteria for the neurobehavioral impairment in the diagnoses (Hoyme et al, 2016). However, poor performance on math has emerged as an area of selective vulnerability for children with prenatal alcohol exposure (Coles et al, 2009, Jacobson et al, 2011, Lebel et al, 2010, Crocker et al, 2015, Howell et al, 2006, Kerns et al, 1997, Kopera-Frye et al, 1996) with less research on other academic domains (O’Leary et al, 2013, Glass et al, 2015, Streissguth et al, 1994a, Howell et al, 2006). Howell et al, (2006), compared alcohol-exposed children with and without dysmorphology to children in special education classes and those with similar socioeconomic backgrounds, and found that all children performed one to two standard deviations below the normative mean.…”

Fetal Alcohol Spectrum Disorders: A Review of the Neurobehavioral Deficits Associated With Prenatal Alcohol Exposure

“…Interventions targeting mathematical skills in children with FASD have been effective in improving some of these academic challenges (Coles et al., ). In addition to mathematical impairments, lower performance on spelling and reading is found in association with FASD (Glass et al., , ; Jirikowic et al., ). These impairments are thought to be related to deficits in working memory (Glass et al., ).…”

Fetal Alcohol Spectrum Disorders: a Case Study

“…Learning deficits are also apparent in the presence of decreased academic performance across domains, with particular weaknesses seen in areas of mathematical functioning (Glass, Graham, Akshoomoff, & Mattson, 2015; Goldschmidt, Richardson, Stoffer, Geva, & Day, 1996; Howell et al, 2006). Memory deficits are also seen across domains (verbal, visual, auditory), and often appear to be associated with initial encoding difficulties with relatively spared retention (Kaemingk, Mulvaney, & Halverson, 2003; Willoughby et al, 2008).…”