Latent classes of neurodevelopmental profiles and needs in children and adolescents with prenatal alcohol exposure

Abstract

Background: Fetal alcohol spectrum disorder (FASD) resulting from prenatal alcohol exposure (PAE) is a common neurodevelopmental disorder, but substantial interindividual heterogeneity complicates timely and accurate assessment, diagnosis, and intervention. The current study aimed to identify classes of children and adolescents with PAE assessed for FASD according to their pattern of significant neurodevelopmental functioning across 10 domains using latent class analysis (LCA), and to characterize these subgroups across clinical features. Methods: Data from the Canadian National FASD Database, a large ongoing repository of anonymized clinical data received from diagnostic clinics across Canada, was analyzed using a retrospective cross-sectional cohort design. The sample included 1440 children and adolescents ages 6 to 17 years (M = 11.0, SD = 3.5, 41.7% female) with confirmed PAE assessed for FASD between 2016 and 2020. Results: Results revealed an optimal four-class solution. The Global needs group was characterized by high overall neurodevelopmental impairment considered severe in nature. The Regulation and Cognitive needs groups presented with moderate but substantively distinguishable patterns of significant neurodevelopmental impairment.The Attention needs group was characterized by relatively low probabilities of significant neurodevelopmental impairment. Both the Global and Regulation needs groups also presented with the highest probabilities of clinical needs, further signifying potential substantive differences in assessment and intervention needs across classes.Conclusions: Four relatively distinct subgroups were present in a large heterogeneous sample of children and adolescents with PAE assessed for FASD in Canada. These findings may inform clinical services by guiding clinicians to identify distinct service pathways for these subgroups, potentially increasing access to a more personalized treatment approach and improving outcomes.

Current and ideal living arrangements and supports for Canadian adults with fetal alcohol spectrum disorder: Part II—Perspectives from caregivers

“…FASD is associated with neuropsychological effects that can result in lifelong challenges related to societal expectations around daily living (Mattson et al, 2019;McLachlan et al, 2020). Although challenges experienced by individuals with FASD vary (McLachlan et al, 2020(McLachlan et al, , 2023 and can depend on factors such as environmental influences and the frequency, quantity, and timing of alcohol exposure (May & Gossage, 2011), people with FASD often experience difficulties in executive functioning (i.e., cognitive processes governing the regulation of goal-directed attention and actions; Mattson et al, 2006;McGee et al, 2008;Rasmussen & Bisanz, 2009) and adaptive functioning (i.e., the interpersonal, daily living, and communication skills expected of a person given their chronological age; Quattlebaum & O'Connor, 2012;McLachlan et al, 2020). For individuals with FASD, executive and adaptive functioning realities can contribute to difficulties meeting societal daily living expectations (McLachlan et al, 2020).…”