Social Perspective Taking and Empathy in Children with Fetal Alcohol Spectrum Disorders

[Formula: see text]Parental interaction style, child engagement, and emerging executive function in fetal alcohol spectrum disorders (FASD)

Children with fetal alcohol spectrum disorders (FASD) are known to experience cognitive and neurobehavioral difficulties, including in areas of executive function and social skills development. Interventions for these challenges have focused on a number of areas, including parent-based training. Despite the general consensus that specific parenting styles consistent with an "authoritative" - warm but firm - parenting approach may influence behavioral self-regulation, it is not known what specific parental interaction styles are associated with child engagement and emerging executive function in this population. The current study used an observation-based behavioral coding scheme during parent-child play interactions and associated parent report-based executive function measures in children with FASD. Here, we demonstrate that parental interaction styles with increased responsive/child-oriented behavior and parental affect are associated with higher levels of child play engagement, while parental interaction that has increased achievement-orientation is associated with higher levels of emerging executive function in children with FASD. These findings help inform future studies on behavioral targets in parent-based training programs and highlight the importance of considering certain parental interaction styles during parent-child play.

2022 Prevention of chronic non-communicable diseases in Of the Russian Federation. National guidelines

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Evidence for long-lasting alterations in the fecal microbiota following prenatal alcohol exposure

BACKGROUND

There is growing evidence that the gut microbiota can be shaped by early-life experiences/exposures, with long-term consequences for brain, behavior, and health. Changes in the gut microbiota have also been identified in neurodevelopmental disorders including Autism Spectrum Disorder and schizophrenia. In contrast, no studies to date have investigated whether the gut microbiota is altered in individuals with Fetal Alcohol Spectrum Disorder (FASD), the neurodevelopmental disorder that results from prenatal alcohol exposure (PAE). The current study was designed to assess the impact of PAE on the fecal microbiota.

METHODS

We used a rodent model in which pregnant Sprague-Dawley rats were provided with an EtOH-containing diet or a control diet throughout gestation. Fecal samples were collected from adult male and female animals and 16s rRNA sequencing was performed.

RESULTS

Overall, PAE rats showed greater richness of bacterial species, with community structure investigations demonstrating distinct clustering by prenatal treatment. In addition, prenatal treatment and sex-specific alterations were observed for many specific microbes. For example, in males, Bacteroides and Bifidobacterium, and in females, Faecalitalea and Proteus, differed in abundance between PAE and control rats.

CONCLUSIONS

Taken together, these results show for the first time that PAE has a long-lasting and sex-specific impact on the fecal microbiota. Further research is needed that considers fetal microbiota in the development of new interventions in FASD.

Fetal alcohol spectrum disorder and confabulation in psycholegal settings: A beginner's guide for criminal justice, forensic mental health, and legal interviewers

Fetal alcohol spectrum disorders (FASD) are neurodevelopmental/neurobehavioral conditions caused by prenatal alcohol exposure (PAE). Impairments caused by PAE contribute to the over-representation of individuals with FASD in the United States juvenile and adult criminal justice systems. These same impairments can equally impact on individuals with FASD who are witnesses to or victims of crime who also have to navigate the complexities of the criminal justice system. Difficulties include increased susceptibility to confabulation throughout the legal process that, in turn, can contribute to increased rates of poor outcomes including false confessions and wrongful convictions. Individuals with FASD are particularity at risk of confabulation when they are subjected to tactics, such as stressful and anxiety-provoking situations, threats, and leading, suggestive, or coercive questioning. Many professionals in the forensic context are unfamiliar with FASD or related confabulation risk and may unintentionally utilize tactics that intensify impacts of pre-existing impairment. This article serves as a beginner's guide for professionals working in criminal justice settings by (a) providing research-based overviews of FASD and confabulation, (b) describing how FASD may lead to confabulation, and (c) suggesting ways that professionals can modify protocols when interacting with individuals with FASD. Suggestions in this article hold the potential to decrease the risk of confabulation in the criminal justice system and decrease problematic outcomes, such as false confessions and wrongful convictions among individuals with FASD.

The Effects of Early Life Stress on the Brain and Behaviour: Insights From Zebrafish Models

The early life period represents a window of increased vulnerability to stress, during which exposure can lead to long-lasting effects on brain structure and function. This stress-induced developmental programming may contribute to the behavioural changes observed in mental illness. In recent decades, rodent studies have significantly advanced our understanding of how early life stress (ELS) affects brain development and behaviour. These studies reveal that ELS has long-term consequences on the brain such as impairment of adult hippocampal neurogenesis, altering learning and memory. Despite such advances, several key questions remain inadequately answered, including a comprehensive overview of brain regions and molecular pathways that are altered by ELS and how ELS-induced molecular changes ultimately lead to behavioural changes in adulthood. The zebrafish represents a novel ELS model, with the potential to contribute to answering some of these questions. The zebrafish offers some important advantages such as the ability to non-invasively modulate stress hormone levels in a whole animal and to visualise whole brain activity in freely behaving animals. This review discusses the current status of the zebrafish ELS field and its potential as a new ELS model.

Oral and written communication skills of adolescents with prenatal alcohol exposure (PAE) compared with those with no/low PAE: A systematic review

BACKGROUND

Prenatal alcohol exposure (PAE) is associated with growth deficits and neurodevelopmental impairment including foetal alcohol spectrum disorder (FASD). Difficulties with oral and written communication skills are common among children with PAE; however, less is known about how communication skills of adolescents who have PAE compare with those who do not. Adolescence is a critical time for development, supporting the transition into adulthood, but it is considered a high-risk period for those with FASD.

AIMS

We conducted a systematic review to synthesize evidence regarding oral and written communication skills of adolescents with PAE or FASD and how they compare with those with no PAE.

METHODS & PROCEDURES

A comprehensive search strategy used seven databases: Cochrane Library, Cinahl, Embase, Medline, PsycInfo, Eric and Web of Science. Included studies reported on at least one outcome related to oral and written communication for a PAE (or FASD) group as well as a no/low PAE group, both with age ranges of 10-24 years. Quality assessment was undertaken.

MAIN CONTRIBUTION

Communication skills most often assessed in the seven studies included in this review were semantic knowledge, semantic processing, and verbal learning and memory. These communication skills, in addition to reading and spelling, were commonly weaker among adolescents with PAE compared with those with no/low PAE. However, the findings were inconsistent across studies, and studies differed in their methodologies.

CONCLUSIONS & IMPLICATIONS

Our results emphasize that for adolescents with PAE, communication skills in both oral and written modalities should be comprehensively understood in assessment and when planning interventions. A key limitation of the existing literature is that comparison groups often include some participants with a low level of PAE, and that PAE definitions used to allocate participants to groups differ across studies.

WHAT THIS PAPER ADDS

What is already known on the subject PAE and FASD are associated with deficits in oral and written communication skills. Studies to date have mostly focused on children with a FASD diagnosis as well as combined groups of children and adolescents with FASD or PAE. There is a gap in what is known about oral and written communication skills of adolescents, specifically, who have PAE or FASD. This has implications for the provision of assessment and supports during a period of increased social and academic demands. What this study adds to existing knowledge This review provides systematic identification, assessment and synthesis of the current literature related to oral and written communication skills of adolescents with PAE compared with those with no/low PAE. The review revealed a small knowledge base with inconsistent methodologies and findings across studies. However, the findings overall highlight that adolescents with PAE have weaker skills in oral and written language than those with no/low PAE. Results are discussed in relation to education, social and emotional well-being, and forensic contexts. What are the potential or actual clinical implications of this work? Findings emphasize that for adolescents with PAE, comprehensive assessment of both oral and written communication skills, through both standardized and functional tasks, should be undertaken. Speech-language pathologists have a key role in assessment with individuals who have PAE.

Social behaviors and gray matter volumes of brain areas supporting social cognition in children and adolescents with prenatal alcohol exposure

The goal of this study was to examine: 1) differences in parent-reported prosocial and antisocial behaviors between children and adolescents with and without prenatal alcohol exposure (PAE); 2) differences in gray matter volumes of brain areas supporting social cognition between children and adolescents with and without PAE; 3) correlations between gray matter volumes of brain areas supporting social cognition and parent-reported prosocial and antisocial behaviors. Parents of children and adolescents ages 8-16 years completed measures on their prosocial and antisocial behaviors (i.e., Behavior Assessment Scale for Children, Vineland Adaptive Behaviors Scales, and Child Behavior Checklist) (n = 84; 41 with PAE, 43 without PAE). Seventy-nine participants (40 with PAE, 39 without PAE) also completed a structural Magnetic Resonance Imaging (MRI) scan with quality data. Gray matter volumes of seven brain areas supporting social cognitive processes were computed using automated procedures (FreeSurfer 6.0): bilateral fusiform gyrus, superior temporal gyrus, medial orbitofrontal cortex, lateral orbitofrontal cortex, posterior cingulate cortex, precuneus, and temporal pole. Children and adolescents with PAE showed decreased prosocial behaviors and increased antisocial behaviors as well as smaller volumes of the precuneus and lateral orbitofrontal cortex, even when controlling for total intracranial volume. Social brain volumes were not significantly correlated with prosocial or antisocial behaviors. These findings suggest that children and adolescents with PAE show worse social functioning and smaller volumes of brain areas supporting self-awareness, perspective-taking and emotion-regulation than their same-age peers without PAE.

Cross-Sectional Analysis of Spatial Working Memory Development in Children with Histories of Heavy Prenatal Alcohol Exposure

BACKGROUND

In children with prenatal alcohol exposure, spatial working memory is affected and brain regions important for spatial working memory performance exhibit atypical neurodevelopment. We therefore hypothesized that children with prenatal alcohol exposure may also have atypical development of spatial working memory ability.

METHODS

We examined the relation between spatial working memory and age using a cross-sectional developmental trajectory approach in youth with and without histories of heavy prenatal alcohol exposure. The Cambridge Neuropsychological Test Automated Battery Spatial Working Memory subtest was administered to children 5.0 to 16.9 years old.

RESULTS

While the controls and children with prenatal alcohol exposure showed similar performance at younger ages, larger group differences were observed in older children. This effect was replicated in a separate sample.

CONCLUSIONS

The atypical brain development that has previously been reported in children with heavy prenatal alcohol exposure may have clinically relevant implications for cognitive development; however, longitudinal cognitive analyses are needed.

Zebrafish Shoaling, Its Behavioral and Neurobiological Mechanisms, and Its Alteration by Embryonic Alcohol Exposure: A Review

Social cognition and social behaviors are complex phenomena that involve numerous brain areas and underlying neurobiological mechanisms. Embryonic alcohol exposure may lead to the development of Fetal Alcohol Spectrum Disorder (FASD), a disorder that manifests with varying symptoms including abnormal social behavior and other cognitive deficits. Animal models have been utilized to mimic aspects of the disease and to study potential underlying mechanisms. The zebrafish is a relative newcomer in this field but has been suggested as an optimal compromise between system complexity and practical simplicity for modeling FASD. Importantly, due to external fertilization and development of the embryo outside the mother and subsequent lack of parental care, this species allows precise control of the timing and dose of alcohol delivery during embryonic development. Furthermore, the zebrafish is a highly social species and thus may be particularly appropriate for the analysis of embryonic alcohol-induced alterations in this context. Here, we provide a succinct review focusing on shoaling, a prominent form of social behavior, in zebrafish. We summarize what is known about its behavioral mechanisms and underlying neurobiological processes, and how it is altered by exposure to ethanol during embryonic development. Lastly, we briefly consider possible future directions of research that would help us better understand the relationship between the behavioral expression and molecular basis of embryonic ethanol-induced social deficits in fish and humans.

Efficacy of group social skills interventions on social competency and participation in adolescents with acquired and developmental disabilities: a systematic review protocol

OBJECTIVE

The objective of this review is to evaluate the efficacy of group social skills interventions in improving social knowledge, social competency, and social participation in adolescents with acquired and developmental disabilities.

INTRODUCTION

Difficulties with social functioning and participation are commonly experienced by adolescents with a range of acquired and developmental disabilities. There is evidence for the use of group social skills interventions in youth with autism spectrum disorder, although less is known about their efficacy with youth with other disabilities.

INCLUSION CRITERIA

This review will include studies that evaluate group social skills interventions in adolescents with an acquired or developmental disability, excluding a primary mental health disorder. Randomized controlled trials will be the only experimental design included and group social skills interventions must have an available intervention manual to allow use in clinical practice. Primary outcomes will include measures of social knowledge, social competence, and social participation.

METHODS

PubMed, CINAHL, Embase, Cochrane Central Register of Controlled Trials, PsycINFO, and Web of Science will be searched for eligible studies published in English. Clinical Trials Registry, Google Scholar, and ProQuest Dissertations and Theses will also be searched. Screening, study selection, critical appraisal, and data extraction will be conducted by two independent reviewers using standardized tools. Studies will be pooled, where possible, with statistical meta-analysis and the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) Summary of Findings presented.

SYSTEMATIC REVIEW REGISTRATION NUMBER

PROSPERO CRD42020158189.

[Formula: see text] Cognitive and social/emotional influences on adaptive functioning in children with FASD: Clinical and cultural considerations

Fetal Alcohol Spectrum Disorder (FASD) is one of the leading causes of intellectual disability and learning difficulties around the world. Children with FASD often have extremely low adaptive behavior due to the severity of brain impairment, however there is limited understanding as to the important predictors of adaptive behavior. In a study of 39 children with FASD and 29 comparison children, we found that social cognition (specifically recognizing emotions) was the only significant independent predictor of teacher-rated adaptive functioning even after including IQ, executive functioning, and adverse childhood experiences into the model. In this current study, Māori (Indigenous people of Aotearoa New Zealand) were overrepresented; therefore, the research was supported by a strong partnership with Te Wāhanga Hauora Māori (Māori Health Service). Aotearoa New Zealand's colonized history is recognized and findings are discussed with regard to both the psychological literature and a Te Ao Māori worldview.

Developmental stage and genotype dependent behavioral effects of embryonic alcohol exposure in zebrafish larvae

Fetal Alcohol Spectrum Disorders (FASD) represent a worldwide problem. The severity and types of symptoms of FASD vary, which may be due to the genotype of the fetus and the developmental stage at which the fetus is exposed to alcohol. The most prevalent forms of FASD present less severe symptoms, including behavioral and cognitive abnormalities, and arise from exposure to low amounts of alcohol consumed infrequently. Treating or diagnosing FASD patients has been difficult because we do not understand the mechanisms underlying FASD. Animal models, including the zebrafish, have been suggested to answer this question. Here, we present a proof of concept analysis studying the behavioral effects of embryonic alcohol exposure in one-week old juvenile zebrafish. We exposed zebrafish embryos at one of five developmental stages (8, 16, 24, 32, or 40 hour post-fertilization) to 0% (control) or 1% (vol/vol) ethanol for 2 h, and tested the behavior of these fish at their age of 7-9 days post-fertilization. We employed two genetically distinct zebrafish populations, a quasi-inbred AB derivative strain, and a genetically variable WT population. We report significant developmental time and genotype dependent effects of alcohol on certain measures of motor function and/or anxiety-like responses. For example, we found embryonic alcohol exposed AB fish to swim faster, vary their speed more, stop moving more often and turn less compared to control fish, alcohol induced changes that were absent or less robust in WT fish. We conclude that our results open new avenues to the identification of genetic mechanisms that mediate or influence alcohol induced developmental alteration of brain function and behavior, which, on the long run, may allow us to identify diagnostic biomarkers and treatment options for human FASD.

Fetal alcohol spectrum disorder: the importance of assessment, diagnosis and support in the Australian justice context

Fetal alcohol spectrum disorder (FASD) is a neurodevelopmental condition with life-long implications. Individuals with FASD can experience communication, cognitive, behavioural, social and emotional difficulties that impact their functional capacity. Due to these brain-based impairments, previous research suggests that individuals with FASD are over-represented in the justice system. The current article outlines how individuals with FASD may experience inequities within the justice system, why assessment, diagnosis and intervention is important, and the role of health and justice partnerships in promoting more equitable outcomes for justice-involved individuals with FASD. Increased resources and collaborations between health and justice professionals are required to enable the provision of neurodevelopmental assessments for all complex presentations, including FASD.

Risk for Childhood Internalizing and Externalizing Behavior Problems in the Context of Prenatal Alcohol Exposure: A Meta-Analysis and Comprehensive Examination of Moderators

Prenatal alcohol exposure (PAE) is associated with a constellation of physical, neurocognitive, and behavioral abnormalities in offspring. The presence of internalizing (e.g., anxiety, mood disorders) and externalizing (e.g., oppositional defiant and conduct disorders) behavior problems has devastating and often long-lasting impacts on children, adolescents, and their families. The present meta-analysis explored the strength of the association between PAE and behavior problems, as well as factors that increase or mitigate risk. The current meta-analysis included 65 studies comparing children and adolescents with PAE to non- or light-exposed controls and attention-deficit/hyperactivity disorder (ADHD) samples, on a variety of internalizing and externalizing behavior outcomes. Results indicated that individuals with PAE are at increased risk for internalizing (d = 0.71, medium effect) and externalizing (d = 0.90, large effect) problems compared to control samples. The occurrence of total behavior problems was similar to that seen in ADHD samples. The strength of the association between internalizing and externalizing behavior problems and PAE was significantly moderated by several distinct sample characteristics, such as sample age, socioeconomic status, severity of exposure, and type of behavior problem. These findings further our understanding of the behavior problems experienced by children and adolescents with PAE.

Preliminary Findings that a Targeted Intervention Leads to Altered Brain Function in Children with Fetal Alcohol Spectrum Disorder

Children with fetal alcohol spectrum disorder (FASD) exhibit behavioral dysregulation, executive dysfunction, and atypical function in associated brain regions. Previous research shows early intervention mitigates these outcomes but corresponding brain changes were not studied. Given the Alert^® Program for Self-Regulation improves behavioral regulation and executive function in children with FASD, we asked if this therapy also improves their neural functioning in associated regions. Twenty-one children with FASD aged 8–12 years were randomized to the Alert^®-treatment (TXT; n = 10) or waitlist-control (WL; n = 11) conditions. They were assessed with a Go-NoGo functional magnetic resonance imaging (fMRI) paradigm before and after training or the wait-out period. Groups initially performed equivalently and showed no fMRI differences. At post-test, TXT outperformed WL on NoGo trials while fMRI in uncorrected results with a small-volume correction showed less activation in prefrontal, temporal, and cingulate regions. Groups also demonstrated different patterns of change over time reflecting reduced signal at post-test in selective prefrontal and parietal regions in TXT and increased in WL. In light of previous evidence indicating TXT at post-test perform similar to non-exposed children on the Go-NoGo fMRI paradigm, our findings suggest Alert^® does improve functional integrity in the neural circuitry for behavioral regulation in children with FASD.

Fetal alcohol spectrum disorders: Zebrafish in the analysis of the milder and more prevalent form of the disease

Fetal Alcohol Spectrum Disorders (FASD) represent a large unmet medical need. Exposure of the developing human embryo to alcohol can lead to life-long suffering. Despite the well documented deleterious effects of alcohol on the developing fetus, pregnant women continue to drink alcohol, and FASD remains the leading cause of preventable mental retardation and other behavioral abnormalities. Particularly prevalent are the milder forms of the disease cluster, representing children who do not show obvious physical signs and who may be undiagnosed or misdiagnosed. To develop treatment and diagnostic tools, researchers have turned to animal models. The zebrafish is becoming one of the leading biomedical research organisms that may facilitate discovery of the biological mechanisms underlying this disease and the identification of biomarkers that may be used for diagnosis. Here we review the latest advances of this field, mostly focussing on the discoveries made in our own laboratory and others with zebrafish employed to analyze the effects of moderate to low level of exposure to alcohol. We argue that the zebrafish represents unique advantages, and adding information obtained with this species to the mix of other animal models will significantly increase translational relevance of animal biomedical research for the analysis of human FASD.

Embryonic alcohol exposure leading to social avoidance and altered anxiety responses in adult zebrafish

Fetal Alcohol Spectrum Disorders (FASD) is a syndrome characterized by neurological and behavioral impairments. A recently discovered hallmark of FASD is impaired social behavior. Avoidance of social interaction typical of FASD may be the result of increased anxiety. Previously, the zebrafish was successfully used to model embryonic alcohol induced social abnormalities. Here, we analyzed both anxiety and social responses using a zebrafish FASD model, in adult fish. We exposed zebrafish embryos to low concentrations of ethanol (0.1%; 0.25%; 0.5% and 1% v/v) for 2h at, 24h post-fertilization, to mimic the most prevalent milder FASD cases, and investigated the ensuing alterations in adult, 4-month-old, zebrafish. We studied social interaction in the social preference task and anxiety in the novel tank task. We observed an ethanol dose dependent reduction of time spend in the conspecific zone compared to control, corroborating prior findings. We also found significant changes in the novel tank (e.g. increased bottom dwell time, increased distance to top) suggesting elevated anxiety to control, but we also found, using an anxiolytic drug buspirone, that reduction of anxiety is associated with reduced shoaling. Our results confirm that embryonic alcohol exposure disrupts social behavior, and also show that its effects on anxiety related phenotypes may be genotype, alcohol administration method, experimental procedure and test-context dependent.

Normative data and psychometric properties of a farsi translation of the strange stories test

BACKGROUND AND OBJECTIVE

The Strange Stories test is one of the most commonly used tests to evaluate advanced "theory of mind," i.e. attribution of mental states. Normative data and psychometric properties of a new Farsi translation of this test were evaluated in a large community-based sample of Iranian school-aged children.

METHODS

Through randomized cluster sampling, 398 children aged 9-11 years studying at 20 elementary schools were recruited from 4 central regions of Tehran, Iran. The mean age of the students was 9.96 years (SD = 0.92), and 51% were girls (n = 202). The Child Behavior Checklist (CBCL) was completed by parents. The Strange Stories test was completed by all children and repeated for 20% of them after 2-4 weeks to assess the test-retest reliability.

FINDINGS

Students in upper grades had higher scores (P < .01); age predicted 2% of variance on the mental state score. Girls had significantly higher mentalizing scores than boys (P = .003). The split-half internal reliability coefficient was good (0.73). The test-retest reliability was fair to good. Item-scale score correlations were all significant (P < .01).

CONCLUSION

This new translation of the Strange Stories test is a reliable and valid instrument to evaluate higher level theory of mind abilities in community samples of Farsi speaking children. Autism Res 2017, 10: 1960-1967. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: "Mentalizing" or "theory of mind," the ability to recognize others' mental states, is a key aspect of social understanding. Mentalizing problems are characteristic of some clinical conditions such as autism. The Strange Stories is a test evaluating mentalizing in every day social situations. It was translated into Farsi language and administered to a group of Iranian school-aged children. The instrument was useful in assessing children's mind reading. Older children and girls were better in mentalizing ability.

Oral narrative of individuals with Fetal Alcohol Spectrum Disorder

Purpose

To investigate and compare the oral narrative of individuals with FASD and individuals with typical language development (TLD), as well as to correlate the narrative performance with the score from 4-Digit Diagnostic Code.

Methods

Participants were 20 individuals with FASD, of both genders, with chronological age between 6 and 16 years, and 20 individuals with TLD, same gender and similar to the FASD group in age and socioeconomic status. The oral narrative was elicited using the book Frog, where are you? and the data were analyzed in terms of macrostructure, microstructure and global coherence level. Measures regarding the macrostructure included the presence of typical structural elements of storytelling, while the microstructural aspects included words (total and different words), communication units (C-Units), lexical diversity, and mean length of C-Units.

Results

Low performance was found in the FASD group for all macrostructural aspects, with the exception of linguistic markers. Among the microstructural aspects, lexical diversity and incomplete C-Units were different between the FASD and TLD groups. The FASD group presented lower global coherence level compared to the TLD group. Negative correlations were found between macrostructural aspects, facial characteristics, and Central Nervous System impairment.

Conclusion

Restricted use of typical structural elements of storytelling with lower levels of coherence and reduced vocabulary distinguished the FASD from the TDL group. Future studies may explore whether the association between narrative performance and the 4-Digit Diagnostic Code items present predictive values in the narrative performance of individuals with FASD.

Emotional Understanding in School-Aged Children with Fetal Alcohol Spectrum Disorders: A Promising Target for Intervention

BACKGROUND

Children with fetal alcohol spectrum disorders (FASD) are at high risk for secondary conditions, including mental health difficulties. Data on both children with typical development and other clinical conditions suggest that limited emotional understanding (EU) raises risk for psychopathology, but little is known about EU in FASD.

OBJECTIVES

To determine if EU is a reasonable treatment target for children with FASD.

METHODS

56 children (6-13 years) with FASD completed the Kusche Affective Interview-Revised, a verbal interview measure of EU.

RESULTS

Children showed striking delays in EU (2-5 years delay) relative to published normative data, despite mean IQ (IQ=94.56) within normal limits. Individual variability was considerable even after accounting for age and verbal IQ.

CONCLUSIONS

Despite variability in individual differences, treatments targeting EU may benefit children with FASD as components within a comprehensive, tailored intervention focused on child self-regulation and caregiver behavior management.

Cohesive Referencing Errors During Narrative Production as Clinical Evidence of Central Nervous System Abnormality in School-Aged Children With Fetal Alcohol Spectrum Disorders

PURPOSE

Previous evidence suggests that cohesive referencing errors made during narratives may be a behavior that is revealing of underlying central nervous system abnormality in children with fetal alcohol spectrum disorders (FASD). The current research extends this evidence.

METHOD

Retrospective analysis of narrative and clinical data from 152 children (ages 6 to 14), 72 of whom had confirmed FASD, was used. Narrative analysis was conducted blind to diagnostic status, age, or gender. Group performance was compared. The associations between measures of cohesive referencing and clinically gathered indices of the degree of central nervous system abnormality were examined.

RESULTS

Results show clear associations between elevated rates of cohesive referencing errors and central nervous system abnormality. Elevated error rates were more common in children with FASD than those without, and prevalence increased predictably across groups with more severe central nervous system abnormality. Risk is particularly elevated for those with microcephaly or a diagnosis of fetal alcohol syndrome.

CONCLUSION

Cohesive referencing errors during narrative are a viable behavioral marker of the kinds of central nervous system abnormality associated with prenatal alcohol exposure, having significant potential to become a valuable diagnostic and research tool.

Behavioral Responses to Novelty or to a Predator Stimulus Are Not Altered in Adult Zebrafish by Early Embryonic Alcohol Exposure

BACKGROUND

Fetal alcohol spectrum disorders (FASD) may vary in symptoms and severity. In the milder and more prevalent forms of the disease, behavioral abnormalities may include impaired social behavior, for example, difficulty interpreting social cues. Patients with FASD remain often undiagnosed due to lack of biomarkers, and treatment is unavailable because the mechanisms of the disease are not yet understood. Animal models have been proposed to facilitate addressing these problems. More recently, short exposure of the zebrafish embryo to low concentrations of alcohol was shown to lead to significant and lasting impairment of behavior in response to social stimuli. The impairment may be the result of abnormal social behavior or altered fear/anxiety. The goal of the current study was to investigate the latter.

METHODS

Here, we employed the alcohol exposure regimen used previously (exposure of 24th hour postfertilization embryos to 0.00, 0.25, 0.50, 0.75, or 1.00% vol/vol alcohol for 2 hours), allowed the fish to reach adulthood, and measured the behavioral responses of these adults to a novel tank (anxiety-related behaviors) as well as to an animated image of a sympatric predator of zebrafish (fear-related behaviors).

RESULTS

We found behavioral responses of embryonic alcohol-exposed adult fish to remain statistically indistinguishable from those of controls, suggesting unaltered anxiety and fear in the embryonic alcohol-treated fish.

CONCLUSIONS

Given that motor and perceptual function was previously shown to be also unaltered in the adults after embryonic alcohol exposure, our current results suggest that the impaired response of these fish to social stimuli may be the result of abnormal social behavior.

Self-regulation therapy increases frontal gray matter in children with fetal alcohol spectrum disorder: evaluation by voxel-based morphometry

Children with fetal alcohol spectrum disorder show executive function (EF) deficits, particularly in self-regulation skills, and abnormalities in brain regions critical for these skills. None of the validated EF interventions for these children has been evaluated with regards to impacts on brain structure. Twenty-nine children with FASD were assigned to either an immediate-treatment (TX) or delayed-treatment control (DTC) group (DTC). Nineteen typically developing children served as healthy controls (CT). All received a structural MRI scan and baseline neuropsychological testing, following which the TX group underwent 12 weekly 1.5-h sessions of the Alert Program for Self-Regulation(®). After treatment or a period of ~14 weeks, all received a repeat scan and post-intervention testing. Whole-brain and region-of-interest analyses using voxel-based morphometry evaluated group differences and changes over time in gray matter (GM). Exploratory analyses revealed significant group changes: (1) At baseline, combined TX and DTC groups demonstrated global GM reductions compared with the CT group. (2) Region-of-interest analysis using a frontal mask, comparing post-intervention to pre-intervention results, showed significantly increased GM in the left middle frontal gyrus (BA10), right frontal pole (BA11), and right anterior cingulate (BA32) in the TX group. Similar results were not found in the DTC or CT groups. (3) At post-intervention, both TX and CT groups showed larger GM volumes than the DTC group in the left superior frontal gyrus (BA9), which was smaller in the FASD group at baseline. These results suggested that Alert led to improvements in post-intervention testing of self-regulation skills and typical brain development in treated children.

[Maternal alcoholism and its impact on child health]

Maternal alcoholism hinders the normal development of child and threatens his mental and physical health due to three factors: the hereditary transmission of predisposition to alcohol abuse; alcohol consumption during pregnancy; adverse family environment. The children of mothers suffering from alcoholism revealed are characterized by increased risk of depression, anxiety and other mental disorders, including alcohol and substance dependence. The adverse impact of maternal alcoholism (or, to speak more widely, parents' alcoholism) on the child health requires special preventive and treatment programs for both parents and children. Separation from the mother (even if the mother is addicted to alcohol) seriously injures the child, and therefore treatment programs for alcohol abusing women should be focused on the possible continuation of the parental rights of patients.