Interventions in FASD: we must do better

Burd, Larry

doi:10.1111/j.1365-2214.2006.00696.x

Cited by 13 publications

(6 citation statements)

References 16 publications

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“…The influence of high levels of alcohol intake by pregnant women on the health and development of their offspring is well recognized for very high levels of intake, in the form of foetal alcohol syndrome [73]. However, the influence outside of this extreme situation is less easy to assess, particularly as higher levels of alcohol intake will be related to a wide array of potential sociocultural, behavioural and environmental confounding factors.…”

Section: Maternal Genotype As An Indicator Of Intrauterine Environmenmentioning

confidence: 99%

Assessing Intrauterine Influences on Offspring Health Outcomes: Can Epidemiological Studies Yield Robust Findings?

Smith

2008

Basic Clin Pharma Tox

245

242

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The influence of factors acting during the intrauterine period on health outcomes of offspring is of considerable research and public health interest. There are, however, methodological challenges in establishing robust causal links, because exposures often act many decades before outcomes of interest, may act before it is evident that women are pregnant and would enter pregnancy birth cohorts, and may also be strongly related to other factors, generating considerable degrees of potential confounding. The degree of confounding can sometimes be estimated by comparing the association between exposures experienced by the mother during pregnancy and outcomes among the offspring with the association of exposures experienced by the father during the pregnancy period and offspring outcomes. If the effects are due to an intrauterine exposure, then maternal exposure during pregnancy should have a clearly greater influence than paternal exposure. A different approach is that of Mendelian randomization, which utilizes genetic variants of known functional effect that can proxy for modifiable exposures. If carried by the mother, these variants would influence the intrauterine environment experienced by her offspring. These genetic variants are stable over time and can be assessed after pregnancy is complete or even after outcomes in the offspring have been observed. The variants would also not generally be related to potential confounding factors. Other epidemiological strategies are briefly reviewed. It is concluded that the naïve acceptance of findings utilizing conventional epidemiological methods in this setting is misplaced.

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Section: Maternal Genotype As An Indicator Of Intrauterine Environmenmentioning

confidence: 99%

Assessing Intrauterine Influences on Offspring Health Outcomes: Can Epidemiological Studies Yield Robust Findings?

Smith

2008

Basic Clin Pharma Tox

245

242

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“…A review by Premji et al [2006] highlighted the paucity of researchbased interventions for this population, and further noted that the few extant studies were characterized by small sample sizes and methodological limitations. Burd [2006] similarly lamented the lack of quality diagnostic and treatment services available to alcohol-exposed children and their families, and emphasized the need for interventions that are aimed at reducing the secondary disabilities commonly associated with FASDs (e.g., mental illness, substance abuse). Encouragingly, however, in recent years there has been an increase in efforts to design and test interventions to remediate the impairments associated with PAE.…”

Section: Interventions For Fasdsmentioning

confidence: 99%

Intervention for individuals with fetal alcohol spectrum disorders: Treatment approaches and case management

Paley¹,

O’Connor²

2009

Dev Disabil Res Revs

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Exposure to alcohol in utero is considered to be the leading cause of developmental disabilities of known etiology. The most severe consequence of such exposure, fetal alcohol syndrome (FAS), is characterized by a distinct constellation of characteristic facial anomalies, growth retardation, and central nervous system (CNS) dysfunction. Some individuals with prenatal alcohol exposure (PAE) do not meet the full criteria for FAS, but instead are diagnosed with partial FAS, alcohol related neurodevelopmental disorder (ARND), or alcohol related birth defects (ARBD). The entire continuum of effects from PAE is increasingly being referred to under the umbrella term of fetal alcohol spectrum disorders (FASDs). An extensive body of research has documented major cognitive, behavioral, adaptive, social, and emotional impairments among individuals with FASDs. Although FAS was identified in the U.S. over 35 years ago, the development, evaluation, and dissemination of evidencebased interventions for individuals with FASDs have lagged behind significantly. Encouragingly, however, in recent years there has been a marked increase in efforts to design and test interventions to remediate the impairments associated with prenatal alcohol exposure. This article will review treatment needs and considerations for individuals with FASDs and their families, current empirically tested treatment approaches, case management issues, and suggestions for future directions in research on the treatment of FASDs. ' 2009 Wiley-Liss, Inc. Dev Disabil Res Rev 200915:258-267.

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“…Finally, future research efforts should be concentrated on developing empirically tested, evidence‐based interventions directly derived from the rich body of research on the neurocognitive and behavioral deficits associated with FASD. To date, very few empirically supported interventions have been proposed,129,130 and research is particularly scarce in terms of interventions that are suitable for young children and culturally diverse populations 131. Interventions focused on mitigating the diverse executive functioning deficits displayed by this population may be particularly fruitful, as these integrative cognitive functions are superordinate in the execution of adaptive behavior in daily life 132.…”

Section: Resultsmentioning

confidence: 99%

Cognitive aspects of fetal alcohol spectrum disorder

Davis

Gagnier

Moore

et al. 2012

WIRES Cognitive Science

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Nearly four decades have passed since a link was first established between alcohol consumption during pregnancy and a particular pattern of birth defects. Since then, autopsy, longitudinal, structural imaging, and functional imaging studies have revealed a great deal about the teratogenic effects of alcohol. This paper provides a comprehensive summary of the findings from the neurocognitive and behavioral literature on fetal alcohol spectrum disorder (FASD) and outlines the unique profile of cognitive deficits associated with it. We describe diagnostic issues as well as factors contributing to the heterogeneity of the FASD cognitive presentation. Next, we review research on the impact of prenatal alcohol exposure on intellectual functioning, attention, executive functioning, learning and memory, language, quantitative reasoning, and social cognition. In our opinion, future research can now begin to focus on FASD-specific interventions directly informed by the rich body of neurocognitive findings accumulated thus far. WIREs Cogn Sci 2013, 4:81-92. doi: 10.1002/wcs.1202 For further resources related to this article, please visit the WIREs website.

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Interventions in FASD: we must do better

Cited by 13 publications

References 16 publications

Assessing Intrauterine Influences on Offspring Health Outcomes: Can Epidemiological Studies Yield Robust Findings?

Assessing Intrauterine Influences on Offspring Health Outcomes: Can Epidemiological Studies Yield Robust Findings?

Intervention for individuals with fetal alcohol spectrum disorders: Treatment approaches and case management

Cognitive aspects of fetal alcohol spectrum disorder

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