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Jewell E, Dunleavy B, Faitakis M, Pun JW, Moss S, Pei J, Mela M, Flannigan K, Tremblay M, McLachlan K. Screening and identification of fetal alcohol spectrum disorder in criminal legal settings: A realist review. Crim Behav Ment Health 2024; 34:208-270. [PMID: 38660916 DOI: 10.1002/cbm.2336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 03/13/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Screening for fetal alcohol spectrum disorder (FASD) has been identified as a promising approach to improve recognition, understanding and effective response to the unique needs of those with FASD in criminal legal settings. However, to date, there has been limited synthesis of relevant screening tools, indicators, or implementation considerations in this context. AIMS The present review aimed to synthesise evidence and develop a conceptual framework for understanding how, when, why, for whom and by whom FASD screening tools, items and/or indicators and characteristics serve to accurately identify people with FASD in criminal legal contexts, with consideration of individual and system needs relevant to effective implementation and response. METHODS A preregistered search was conducted using a modified realist review framework for both peer-reviewed articles and grey literature. Included sources were available in English, which focused on individuals with prenatal alcohol exposure and/or FASD with criminal legal involvement and offered new empirical evidence. Sources were reviewed using the Quality Control Tool for Screening Titles and Abstracts by Second Reviewer framework, extracted using a structured coding form and narratively synthesised. RESULTS The search yielded 52 sources, 11 FASD screening tools designed for or applied in criminal legal settings and 38 potential FASD indicators or characteristics relevant to identifying people who may have FASD in criminal legal settings, organised into six conceptually related domains. There was limited evidence supporting the psychometric properties of screening tools across populations or settings, though growing evidence highlights the promise of some instruments. Although few studies characterised potential considerations to be made when implementing a screening tool or approach, both system and individual level needs related to recognising and effectively responding to FASD in criminal legal contexts were identified, and findings revealed strong support among legal and clinical professionals regarding the need for FASD screening in these settings. CONCLUSIONS Findings of this review can be used to inform the development, selection, implementation and evaluation of FASD screening tools in criminal legal settings and underscore a continued need for enhanced resources, policy and cross-sectoral response to better support the needs of people with FASD in the criminal legal contexts.
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Affiliation(s)
- Emma Jewell
- Department of Psychology, University of Guelph, Guelph, Ontario, Canada
- Canada FASD Research Network, Vancouver, British Columbia, Canada
| | - Bianka Dunleavy
- Department of Psychology, University of Guelph, Guelph, Ontario, Canada
| | - Martina Faitakis
- Department of Psychology, University of Guelph, Guelph, Ontario, Canada
| | - Jessica W Pun
- Department of Psychology, University of Guelph, Guelph, Ontario, Canada
| | - Sarah Moss
- Department of Psychology, University of Guelph, Guelph, Ontario, Canada
| | | | - Mansfield Mela
- University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | | | | | - Kaitlyn McLachlan
- Department of Psychology, University of Guelph, Guelph, Ontario, Canada
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2
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McLachlan K, Minhas M, Ritter C, Kennedy K, Joly V, Faitakis M, Cook J, Unsworth K, MacKillop J, Pei J. Latent classes of neurodevelopmental profiles and needs in children and adolescents with prenatal alcohol exposure. Alcohol Clin Exp Res 2023; 47:772-785. [PMID: 36799306 DOI: 10.1111/acer.15028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 01/26/2023] [Accepted: 01/28/2023] [Indexed: 02/18/2023]
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.
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Affiliation(s)
- Kaitlyn McLachlan
- Department of Psychology, University of Guelph, Guelph, Ontario, Canada
| | - Meenu Minhas
- Peter Boris Centre for Addictions Research, McMaster University & St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Chantel Ritter
- Department of Psychology, University of Guelph, Guelph, Ontario, Canada
| | - Kathleen Kennedy
- Department of Educational Psychology, University of Alberta, Edmonton, Alberta, Canada
| | - Vannesa Joly
- Department of Educational Psychology, University of Alberta, Edmonton, Alberta, Canada
| | - Martina Faitakis
- Department of Psychology, University of Guelph, Guelph, Ontario, Canada
| | - Jocelynn Cook
- The Society of Obstetricians and Gynaecologists of Canada, University of Ottawa, Ottawa, Ontario, Canada
| | - Kathy Unsworth
- Canada FASD Research Network, Vancouver, British Columbia, Canada
| | - James MacKillop
- Peter Boris Centre for Addictions Research, McMaster University & St. Joseph's Healthcare Hamilton, & Homewood Research Institute, Guelph, Ontario, Canada
| | - Jacqueline Pei
- Department of Educational Psychology, University of Alberta, Edmonton, Alberta, Canada
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Oza A, Lisyanskaya A, Fedenko A, de Melo A, Shparik Y, Bondarenko I, Colombo N, Lorusso D, Cibula D, Póka R, Oaknin A, Safra T, Maćkowiak-Matejczyk B, Ma L, Thomas D, Lin K, McLachlan K, Goble S, Kristeleit R. 518O Overall survival results from ARIEL4: A phase III study assessing rucaparib vs chemotherapy in patients with advanced, relapsed ovarian carcinoma and a deleterious BRCA1/2 mutation. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Flannigan K, Pei J, McLachlan K, Harding K, Mela M, Cook J, Badry D, McFarlane A. Responding to the Unique Complexities of Fetal Alcohol Spectrum Disorder. Front Psychol 2022; 12:778471. [PMID: 35145454 PMCID: PMC8821085 DOI: 10.3389/fpsyg.2021.778471] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 12/31/2021] [Indexed: 11/20/2022] Open
Abstract
Fetal alcohol spectrum disorder (FASD) is a multifaceted disability, characterized not only by brain- and body-based challenges, but also high rates of environmental adversity, lifelong difficulties with daily living, and distinct sociocultural considerations. FASD is one of the most common neurodevelopmental disabilities in the Western world and associated with significant social and economic costs. It is important to understand the complexities of FASD and the ways in which FASD requires unique consideration in research, practice, and policy. In this article, we discuss our perspectives on factors that distinguish FASD from other disabilities in terms of complexity, co-occurrence, and magnitude. We provide an overview of select literature related to FASD as a socially rooted disability with intergenerational impacts and multiple layers of stigma. These social issues are intertwined with notable experiences of adversity across the lifespan and high rates of co-occurring health concerns for individuals with FASD, all of which present unique challenges for individuals, caregivers, families, service providers, and policy makers. Understanding these factors is the first step in developing and implementing specialized initiatives in support of positive outcomes for individuals with FASD and their families. Future directions are proposed for advancing research, practice, and policy, and responding to the unique complexities of FASD.
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Affiliation(s)
- Katherine Flannigan
- Canada Fetal Alcohol Spectrum Disorder Research Network, Vancouver, BC, Canada
- *Correspondence: Katherine Flannigan,
| | - Jacqueline Pei
- Canada Fetal Alcohol Spectrum Disorder Research Network, Vancouver, BC, Canada
- Department of Educational Psychology, University of Alberta, Edmonton, AB, Canada
| | - Kaitlyn McLachlan
- Canada Fetal Alcohol Spectrum Disorder Research Network, Vancouver, BC, Canada
- Department of Psychology, University of Guelph, Guelph, ON, Canada
| | - Kelly Harding
- Canada Fetal Alcohol Spectrum Disorder Research Network, Vancouver, BC, Canada
- Department of Psychology, Laurentian University, Sudbury, ON, Canada
| | - Mansfield Mela
- Canada Fetal Alcohol Spectrum Disorder Research Network, Vancouver, BC, Canada
- Department of Psychiatry, University of Saskatchewan, Saskatoon, SK, Canada
| | - Jocelynn Cook
- Canada Fetal Alcohol Spectrum Disorder Research Network, Vancouver, BC, Canada
- Society of Obstetricians and Gynaecologists of Canada, Ottawa, ON, Canada
- Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, ON, Canada
| | - Dorothy Badry
- Canada Fetal Alcohol Spectrum Disorder Research Network, Vancouver, BC, Canada
- Faculty of Social Work, University of Calgary, Calgary, AB, Canada
| | - Audrey McFarlane
- Canada Fetal Alcohol Spectrum Disorder Research Network, Vancouver, BC, Canada
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Flannigan K, Wrath A, Ritter C, McLachlan K, Harding KD, Campbell A, Reid D, Pei J. Balancing the story of fetal alcohol spectrum disorder: A narrative review of the literature on strengths. Alcohol Clin Exp Res 2021; 45:2448-2464. [PMID: 34716704 PMCID: PMC9299043 DOI: 10.1111/acer.14733] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 09/27/2021] [Accepted: 10/21/2021] [Indexed: 11/29/2022]
Abstract
For many years, researchers have explored the complex challenges experienced by individuals with fetal alcohol spectrum disorder (FASD). This research has been important for documenting the brain‐ and body‐based impacts of prenatal alcohol exposure and the psychosocial vulnerabilities and environmental adversities frequently associated with FASD. It has also supported advocacy efforts and highlighted the necessity of providing FASD services and supports. However, with the focus on deficits and needs, there is a considerable gap in the literature on the strengths and successes of individuals with FASD. The lack of strengths‐based FASD research has likely perpetuated the stress and stigma experienced by individuals with FASD and their families. Thus, there is a critical need to shift the direction of the field. Here we provide a narrative review of the literature on strengths in FASD. Our goals are to: (1) understand the state of strengths‐based research related to individuals with FASD across the lifespan, and (2) describe positive characteristics, talents, and abilities of individuals with FASD that may be cultivated to promote their fulfillment and well‐being. We identified a total of 19 studies, most of which were conducted to explore the lived experiences of adults with FASD. This preliminary but critical body of evidence highlights the intrinsic strengths of individuals with FASD, including strong self‐awareness, receptiveness to support, capacity for human connection, perseverance through challenges, and hope for the future. Despite the importance of this emerging evidence, appraisal of the literature indicates a need for more intentional, methodologically rigorous, participatory, and theory‐driven research in this area. Findings from this study, including the identified gaps in the literature, can be used to inform research, practice, and policy to meaningfully advance the field of FASD and promote positive outcomes in this population.
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Affiliation(s)
| | - Andrew Wrath
- Canada FASD Research Network, Vancouver, British Columbia, Canada
| | - Chantel Ritter
- Department of Psychology, University of Guelph, Guelph, Ontario, Canada
| | - Kaitlyn McLachlan
- Canada FASD Research Network, Vancouver, British Columbia, Canada.,Department of Psychology, University of Guelph, Guelph, Ontario, Canada
| | - Kelly D Harding
- Canada FASD Research Network, Vancouver, British Columbia, Canada.,Psychology Department, Laurentian University, Sudbury, Ontario, Canada
| | - Alanna Campbell
- Northern Ontario School of Medicine, Sudbury, Ontario, Canada
| | - Dorothy Reid
- Canada FASD Research Network, Vancouver, British Columbia, Canada
| | - Jacqueline Pei
- Canada FASD Research Network, Vancouver, British Columbia, Canada.,Department of Educational Psychology, University of Alberta, Edmonton, Alberta, Canada.,Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
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6
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Grubb M, Golden A, Withers A, Vellone D, Young A, McLachlan K. Screening approaches for identifying fetal alcohol spectrum disorder in children, adolescents, and adults: A systematic review. Alcohol Clin Exp Res 2021; 45:1527-1547. [PMID: 34453340 DOI: 10.1111/acer.14657] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 04/30/2021] [Accepted: 06/08/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Fetal alcohol spectrum disorder (FASD) is a prevalent neurodevelopmental disorder that is caused by prenatal alcohol exposure (PAE) and associated with a range of cognitive, affective, and health concerns. Although the identification of FASD can facilitate the provision of interventions and support, and plays a protective role against adverse outcomes, there are high rates of missed detection. The identification of FASD via screening may improve its recognition across settings. The current systematic review examined the available evidence on FASD screening tools and approaches across age groups and settings. METHODS A systematic search was carried out for both peer-reviewed studies and gray literature sources published between January 1990 and May 2020 and was preregistered with PROSPERO (#CRD42019122077). Studies included in the review focused on human applications of FASD screening in children, adolescents, and adults. The quality of the studies was assessed using the QUADAS-2 and GRADE frameworks. RESULTS The search yielded 20 screening tools and approaches across 45 studies, broadly characterized in 2 groups. The first group included approaches currently in use that aim to identify individuals at risk of FASD using a range of markers (n = 19) or associated sentinel dysmorphic facial features (n = 6). Another group of studies, characterized as emerging, focused on identifying promising biomarkers of PAE/FASD (n = 20). Overall, we identified limited research supporting the psychometric properties of most screening approaches. The quality review provided evidence of bias due to the common use of case-control designs and lack of adequate reference standards. CONCLUSIONS Although several FASD screening tools and approaches are available for use across a range of age groups and settings, the overall evidence base supporting their psychometric properties is weak, with most studies demonstrating significant risk of bias. Service providers should exercise caution in selecting and implementing FASD screening tools given these limitations. It is critically important to accurately identify individuals with FASD across ages and settings to support healthy outcomes. Thus, there is a pressing need for additional research in this area, particularly validation studies in large and representative samples using robust methodological approaches.
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Affiliation(s)
- Melissa Grubb
- Department of Psychology, University of Guelph, Guelph, ON, Canada
| | - Ariella Golden
- Department of Psychology, University of Guelph, Guelph, ON, Canada
| | - Abigail Withers
- Department of Psychology, University of Guelph, Guelph, ON, Canada
| | - Daniella Vellone
- Department of Psychology, University of Guelph, Guelph, ON, Canada
| | - Arlene Young
- Department of Psychology, University of Guelph, Guelph, ON, Canada
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7
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Gardiner E, Hutchison SM, McLachlan K, Rasmussen C, Pei J, Mâsse LC, Oberlander TF, Reynolds JN. Behavior regulation skills are associated with adaptive functioning in children and adolescents with prenatal alcohol exposure. Appl Neuropsychol Child 2021; 11:691-701. [PMID: 34155949 DOI: 10.1080/21622965.2021.1936528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Children with prenatal alcohol exposure (PAE) experience a range of adverse outcomes that impact multiple domains of functioning, including cognitive, physical, mental health, behavioral, social-emotional, communication, and learning. To inform tailored clinical intervention, the current study examined the relation between caregiver-reported cognitive skills (executive function; EF) and adaptive functioning. The study conducted a secondary analyses of data provided by caregivers of 87 children and adolescents (aged 5-18 years, M = 11.7; 52% male) with confirmed PAE, including a subset (n = 70) with Fetal Alcohol Spectrum Disorder (FASD), who reported on their child's EF (Behavior Rating Inventory of Executive Function) and adaptive function (Adaptive Behavior Assessment System, 2nd Edition) skills. Findings from the current study showed that caregivers reported significantly poorer EF and adaptive functioning skills for children with PAE as compared to normative samples. Poorer behavior regulation skills were associated with all aspects of adaptive functioning (i.e., practical, conceptual, and social skills). Specifically, shifting skills emerged as the best predictor of adaptive functioning among children with PAE. These results highlight the possibility that targeting particular EF domains among individuals with PAE may benefit behavior regulation, which may also extend to adaptive skills. This highlights the need to develop EF interventions for children and adolescents who have been prenatally exposed to alcohol.
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Affiliation(s)
- Emily Gardiner
- BC Children's Hospital Research Institute, Vancouver, Canada.,Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - Sarah M Hutchison
- BC Children's Hospital Research Institute, Vancouver, Canada.,Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | | | - Carmen Rasmussen
- Department of Pediatrics, University of Alberta, Alberta, Canada
| | - Jacqueline Pei
- Department of Educational Psychology, University of Alberta, Alberta, Canada
| | - Louise C Mâsse
- BC Children's Hospital Research Institute, Vancouver, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Tim F Oberlander
- BC Children's Hospital Research Institute, Vancouver, Canada.,Department of Pediatrics, University of British Columbia, Vancouver, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - James N Reynolds
- Centre for Neuroscience Studies, Queens University, Kingston, Canada
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8
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Kapasi A, Pei J, Kryska K, Joly V, Gill K, Thompson-Hodgetts S, McLachlan K, Andrew G, Rasmussen C. Exploring Self-Regulation Strategy Use in Adolescents with FASD. Journal of Occupational Therapy, Schools, & Early Intervention 2020. [DOI: 10.1080/19411243.2020.1822260] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Aamena Kapasi
- Department of Educational Psychology, University of Alberta, Edmonton, Canada
| | - Jacqueline Pei
- Department of Educational Psychology, University of Alberta, Edmonton, Canada
| | - Kathryn Kryska
- Department of Pediatrics, University of Alberta, Edmonton, Canada
| | - Vannesa Joly
- Department of Educational Psychology, University of Alberta, Edmonton, Canada
| | - Kamaldeep Gill
- Department of Rehabilitation Sciences, University of British Colombia, Vancouver, Canada
| | | | | | - Gail Andrew
- Glenrose Rehabilitation Hospital Edmonton, PAE Clinic, Edmonton, AB, Canada
| | - Carmen Rasmussen
- Department of Pediatrics, University of Alberta, Edmonton, Canada
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9
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McLachlan K, Zhou D, Little G, Rasmussen C, Pei J, Andrew G, Reynolds JN, Beaulieu C. Current Socioeconomic Status Correlates With Brain Volumes in Healthy Children and Adolescents but Not in Children With Prenatal Alcohol Exposure. Front Hum Neurosci 2020; 14:223. [PMID: 32714166 PMCID: PMC7344164 DOI: 10.3389/fnhum.2020.00223] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 05/19/2020] [Indexed: 11/24/2022] Open
Abstract
Individuals with prenatal alcohol exposure (PAE) exhibit neurological deficits associated with brain injury including smaller brain volumes. Additional risk factors such as lower socioeconomic status (SES) may also have an impact on brain development for this population. This study examined how brain volumes are related to SES in both neurotypically developing children and adolescents, and those with PAE. 3D T1-weighted MPRAGE images were acquired from 69 participants with PAE (13.0 ± 3.2 years, range 7.1–18.8 years, 49% female) and 70 neurotypical controls (12.4 ± 2.9 years, range 7.0–18.5 years, 60% female) from four scanning sites in Canada. SES scores calculated using Hollingshead’s Four-Factor Index of Social Status from current caregiver placement were not significantly different between groups, though more children with PAE had lower SES scores compared to controls. Psychometric data comprised 14 cognitive measures, including executive functioning, attention and working memory, memory, math/numerical ability, and word reading. All cognitive scores were significantly worse in children with PAE compared to controls, though SES was not correlated with cognitive scores in either group after correction for multiple comparisons. All 13 brain volumes were smaller in children with PAE compared to children in the control group. Higher SES was associated with larger hippocampus and amygdala volumes in controls, but there were no such associations in children with PAE. Direct evaluation of the interaction between SES and diagnostic group did not show a significant differential impact of SES on these structures. These findings support previous links between SES and brain volumes in neurotypically developing children, but the lack of such a relationship with SES in children with PAE may be due to the markedly smaller brain volumes resulting from the initial brain injury and postpartum brain development, regardless of later SES.
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Affiliation(s)
- Kaitlyn McLachlan
- Department of Psychology, College of Social & Applied Human Sciences, University of Guelph, Guelph, ON, Canada
| | - Dongming Zhou
- Department of Zoology, Kunming Medical University, Kunming, Yunnan, China.,Department of Biomedical Engineering, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Graham Little
- Department of Biomedical Engineering, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Carmen Rasmussen
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Jacqueline Pei
- Department of Educational Psychology, Faculty of Education, University of Alberta, Edmonton, AB, Canada
| | - Gail Andrew
- Glenrose Rehabilitation Hospital PAE Clinic, Edmonton, AB, Canada
| | - James N Reynolds
- Department of Biomedical and Molecular Sciences, School of Medicine, Faculty of Health Sciences, Queens University, Kingston, ON, Canada
| | - Christian Beaulieu
- Department of Biomedical Engineering, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
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10
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McLachlan K, Flannigan K, Temple V, Unsworth K, Cook JL. Difficulties in Daily Living Experienced by Adolescents, Transition-Aged Youth, and Adults With Fetal Alcohol Spectrum Disorder. Alcohol Clin Exp Res 2020; 44:1609-1624. [PMID: 32472600 DOI: 10.1111/acer.14385] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 05/19/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Individuals with fetal alcohol spectrum disorder (FASD) experience a range of problems in their cognitive, affective, and physical functioning following prenatal alcohol exposure (PAE), in addition to multiple complex difficulties in daily living that impact well-being. Using the Canadian National FASD Database, we sought to profile a range of difficulties in daily living, along with risk factors, in a large cross-sectional cohort of adolescents, transition-aged youth, and adults with PAE, of which a subset was ultimately diagnosed with FASD. METHODS We summarized data for 9 current difficulties in daily living reported at the time of diagnostic assessment for 726 individuals with PAE assessed at 26 FASD diagnostic clinics across Canada, including 443 adolescents (12 to 17 years), 135 transition-aged youth (18 to 24 years), and 148 adults (25 to 60 years). Difficulties included problems related to school disruption, employment, independent living needs, supportive or sheltered housing, legal problems with victimization, legal problems with offending, incarceration, alcohol misuse, and other substance misuse. Risk factors included age, gender, living placement, postnatal trauma, and neurodevelopmental impairment. RESULTS Across the full PAE sample, adolescents, transition-aged youth, and adults presented with high rates of difficulties in daily living, including independent living support needs (63%), alcohol misuse (38%), other substance misuse (46%), employment problems (37%), legal problems with offending (30%), assisted or sheltered housing (21%), school disruption (18%), legal problems with victimization (4%), and incarceration (3%). Difficulty rates were similar for those with FASD irrespective of diagnosis (e.g., with or without sentinel facial features), but rates greater for adults, and those with low overall intellectual functioning (IQ < 70). Controlling for age and IQ, cumulative difficulty was independently associated with gender, living placement, and neurodevelopmental impairment. CONCLUSIONS Adolescents, transition-aged youth, and adults with FASD experienced a range of substantial and complex difficulties at the time of their diagnostic assessment, signaling a high level of service needs. These findings underscore the importance of developmentally informed assessment continued through childhood, as well as ongoing functional and needs-based service provision as youth with FASD transition to adulthood and beyond.
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Affiliation(s)
- Kaitlyn McLachlan
- From the, Department of Psychology (KM), University of Guelph, Guelph, Ontario, Canada
| | - Katherine Flannigan
- Canada Fetal Alcohol Spectrum Disorder Research Network (KF, KU), Vancouver, British Columbia, Canada
| | | | - Kathy Unsworth
- Canada Fetal Alcohol Spectrum Disorder Research Network (KF, KU), Vancouver, British Columbia, Canada
| | - Jocelynn L Cook
- The Society of Obstetricians and Gynaecologists of Canada (JC), Ottawa, Ontario, Canada.,Department of Obstetrics, Gynaecology and Newborn Care (JC), University of Ottawa, Ottawa, Ontario, Canada
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11
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Vedelago L, Amlung M, Morris V, Petker T, Balodis I, McLachlan K, Mamak M, Moulden H, Chaimowitz G, MacKillop J. Technological advances in the assessment of impulse control in offenders: A systematic review. Behav Sci Law 2019; 37:435-451. [PMID: 31268203 DOI: 10.1002/bsl.2420] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 10/30/2018] [Accepted: 11/02/2018] [Indexed: 06/09/2023]
Abstract
Deficits in impulse control have been linked to criminal offending, risk of recidivism, and other maladaptive behaviours relevant to the criminal justice system (e.g. substance use). Impulse control can be conceptualized as encompassing the broad domains of response inhibition and impulsive/risky decision-making. Advancements in technology have led to the development of computerized behavioural measures to assess performance in these domains, such as go/no-go and delay discounting tasks. Despite a relatively large literature examining these tasks in offenders, findings are not universally consistent. This systematic review aims to synthesize the literature using computerized neurocognitive tasks to assess two domains of impulse control in offenders: response inhibition and impulsive/risky decision-making. The review included 28 studies from diverse geographic locations, settings, and offender populations. The results largely support the general conclusion that offenders exhibit deficits in impulse control compared with non-offenders, with studies of response inhibition more consistently reporting differences than studies using impulsive and risky decision-making tasks. Findings are discussed in the context of contemporary neuroimaging research emphasizing dysfunction in prefrontal cortex as a key contributor to impulse control deficits in offenders.
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Affiliation(s)
- Lana Vedelago
- Peter Boris Centre for Addictions Research, Department of Psychiatry and Behavioural Neurosciences, St. Joseph's Healthcare Hamilton and McMaster University, Hamilton, ON, Canada
| | - Michael Amlung
- Peter Boris Centre for Addictions Research, Department of Psychiatry and Behavioural Neurosciences, St. Joseph's Healthcare Hamilton and McMaster University, Hamilton, ON, Canada
- Michael G. DeGroote Centre for Medicinal Cannabis Research, McMaster University, Hamilton, ON, Canada
| | - Vanessa Morris
- Peter Boris Centre for Addictions Research, Department of Psychiatry and Behavioural Neurosciences, St. Joseph's Healthcare Hamilton and McMaster University, Hamilton, ON, Canada
| | - Tashia Petker
- Peter Boris Centre for Addictions Research, Department of Psychiatry and Behavioural Neurosciences, St. Joseph's Healthcare Hamilton and McMaster University, Hamilton, ON, Canada
| | - Iris Balodis
- Peter Boris Centre for Addictions Research, Department of Psychiatry and Behavioural Neurosciences, St. Joseph's Healthcare Hamilton and McMaster University, Hamilton, ON, Canada
- Michael G. DeGroote Centre for Medicinal Cannabis Research, McMaster University, Hamilton, ON, Canada
| | - Kaitlyn McLachlan
- Peter Boris Centre for Addictions Research, Department of Psychiatry and Behavioural Neurosciences, St. Joseph's Healthcare Hamilton and McMaster University, Hamilton, ON, Canada
- Department of Psychology, University of Guelph, Guelph, ON, Canada
| | - Mini Mamak
- Forensic Psychiatry Program, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Heather Moulden
- Forensic Psychiatry Program, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Gary Chaimowitz
- Forensic Psychiatry Program, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - James MacKillop
- Peter Boris Centre for Addictions Research, Department of Psychiatry and Behavioural Neurosciences, St. Joseph's Healthcare Hamilton and McMaster University, Hamilton, ON, Canada
- Michael G. DeGroote Centre for Medicinal Cannabis Research, McMaster University, Hamilton, ON, Canada
- Homewood Research Institute, Guelph, ON, Canada
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McLachlan K, Vavasour I, MacKay A, Brain U, Oberlander T, Loock C, Reynolds JN, Beaulieu C. Myelin Water Fraction Imaging of the Brain in Children with Prenatal Alcohol Exposure. Alcohol Clin Exp Res 2019; 43:833-841. [PMID: 30889291 DOI: 10.1111/acer.14024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 03/10/2019] [Indexed: 01/20/2023]
Abstract
BACKGROUND Prenatal alcohol exposure (PAE) is linked to alterations of cerebral white matter, including volume and nonspecific diffusion magnetic resonance imaging (MRI) indices of microstructure in humans. Some animal models of PAE have demonstrated myelination deficiencies, but myelin levels have not yet been evaluated in individuals with PAE. Multiecho T2 MRI offers a quantitative method to estimate myelin water fraction (MWF; related to myelin content) noninvasively, which was used here to evaluate brain myelination in children with PAE. METHODS Participants with PAE (n = 10, 6 females, mean age 13.9 years, range 7 to 18 years) and controls (n = 14, 11 females, mean age 13.2 years, range 9 to 16 years) underwent 3T MRI of the brain. T2 images (15 minutes acquisition for 32 echoes) were used to create MWF maps from which mean MWF was measured in 12 regions of interest (ROIs) including 8 in white matter and 4 in deep gray matter. RESULTS As expected, across the combined sample, MWF was highest for major white matter tracts such as the internal capsule and genu/splenium of the corpus callosum (10 to 18%) while the caudate and putamen had MWF less than 5%. Mean MWF was similar across 11/12 brain white and gray matter regions for the PAE and control groups (L/R internal capsule, major forceps, putamen, caudate nucleus, L minor forceps, genu and splenium of corpus callosum). In the PAE group, MWF was positively correlated with age in the genu of corpus callosum and right minor forceps, notably 2 frontal tracts. CONCLUSIONS Given comparable MRI-derived myelination fraction measures in PAE relative to controls, white matter alterations shown in other imaging studies, such as diffusion tensor imaging, may reflect microstructural anomalies related to axon caliber and density.
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Affiliation(s)
| | - Irene Vavasour
- Department of Radiology , University of British Columbia, Vancouver, BC, Canada
| | - Alex MacKay
- Department of Radiology , University of British Columbia, Vancouver, BC, Canada.,Department of Physics and Astronomy , University of British Columbia, Vancouver, BC, Canada
| | - Ursula Brain
- Department of Pediatrics , University of British Columbia, Vancouver, BC, Canada
| | - Tim Oberlander
- Department of Pediatrics , University of British Columbia, Vancouver, BC, Canada
| | - Christine Loock
- Department of Pediatrics , University of British Columbia, Vancouver, BC, Canada
| | - James N Reynolds
- Department of Biomedical and Molecular Sciences , Queens University, Kingston, ON, Canada
| | - Christian Beaulieu
- Department of Biomedical Engineering , University of Alberta, Edmonton, AB, Canada
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13
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McLachlan K, McNeil A, Pei J, Brain U, Andrew G, Oberlander TF. Prevalence and characteristics of adults with fetal alcohol spectrum disorder in corrections: a Canadian case ascertainment study. BMC Public Health 2019; 19:43. [PMID: 30626356 PMCID: PMC6325737 DOI: 10.1186/s12889-018-6292-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 12/03/2018] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Individuals with fetal alcohol spectrum disorder (FASD) experience a range of cognitive, affective, and physical deficits following prenatal alcohol exposure. They are thought to be overrepresented in criminal justice settings. However, limited evidence is available to inform prevalence. We sought to estimate the prevalence of FASD in a Northern Canadian correctional population. METHODS Using an active case ascertainment approach we recruited a representative sample of 80 justice-involved adults (ages 18-40, 85% male) over an 18-month period from 2013 to 2015. Participants completed interdisciplinary clinical assessments comprising medical and psychological evaluations that adhered to the 2005 Canadian FASD Diagnostic Guidelines. RESULTS We identified a high rate of FASD (17.5, 95% CI [9.2, 25.8%]) in this sample, and this rate could have been as high as 31.2% with confirmation of prenatal alcohol exposure. Most participants in this study presented with significant neurodevelopmental and cognitive deficits in at least two domains of functioning, irrespective of diagnosis, with only five of 80 participants (6.3%) demonstrating no cognitive impairment. CONCLUSIONS Findings showed disproportionately high estimated FASD prevalence in this representative sample compared to general population estimates in both Canada and the U.S. (2-5%), underscoring the need for improved FASD screening and diagnosis in correctional settings, and education for clinicians working in the justice context. Strengthened health prevention and intervention efforts to support the needs of individuals with FASD outside the criminal justice context are needed.
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Affiliation(s)
- K McLachlan
- Department of Psychology, University of Guelph, 50 Stone Road East, Guelph, Ontario, N1G 2W1, Canada.
| | - A McNeil
- Educational Psychology, University of Alberta, Edmonton, Alberta, Canada
| | - J Pei
- Educational Psychology, University of Alberta, Edmonton, Alberta, Canada
| | - U Brain
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - G Andrew
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - T F Oberlander
- Division of Developmental Pediatrics, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
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McLachlan K, Gray AL, Roesch R, Douglas KS, Viljoen JL. An evaluation of the predictive validity of the SAVRY and YLS/CMI in justice-involved youth with fetal alcohol spectrum disorder. Psychol Assess 2018; 30:1640-1651. [PMID: 29952591 DOI: 10.1037/pas0000612] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Despite the high prevalence of fetal alcohol spectrum disorder (FASD) in youth criminal justice settings, there is currently no research supporting the use of violence risk assessment tools in this population. This study examined the predictive validity of the Structured Assessment of Violence Risk in Youth (SAVRY) and the Youth Level of Service/Case Management Inventory (YLS/CMI) in justice-involved youth with FASD. Participants were 100 justice-involved youth (ages 12-23; 81% male), including 50 diagnosed with FASD and 50 without FASD or prenatal alcohol exposure. The SAVRY and YLS/CMI were prospectively coded based on interview and file review, with recidivism (both any and violent specifically) coded 1-year post-baseline assessment. Results provide preliminary support for the validity of the SAVRY and YLS/CMI in predicting recidivism in justice-involved youth with FASD. Higher ratings across SAVRY and YLS/CMI domains were found in youth with FASD, underscoring a critical need for assessments and interventions to buffer recidivism risk and address clinical needs. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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15
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Oberle E, McLachlan K, Catherine NLA, Brain U, Schonert-Reichl KA, Weinberg J, Oberlander TF. Afternoon cortisol provides a link between self-regulated anger and peer-reported aggression in typically developing children in the school context. Dev Psychobiol 2017; 59:688-695. [PMID: 28542739 DOI: 10.1002/dev.21522] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 04/01/2017] [Indexed: 01/16/2023]
Abstract
Aggression jeopardizes positive development in children and predicts social and academic maladjustment in school. The present study determined the relationships among anger dysregulation (a marker of emotion regulation), cortisol activity (a biomarker of stress), and peer-nominated aggression in typically developing children in their everyday classroom setting (N = 151, Mean age = 10.86, SD =.74). Salivary cortisol was collected at 09:15, 11:45, and 14:45 hr across 4 consecutive days. Children provided self-reports of anger regulation; peers reported proactive and reactive aggressive behaviors. Hierarchical linear regression analyses, followed by a bootstrapping analysis identified basal afternoon cortisol as a significant mediator between anger regulation and peer-reported aggression. More dysregulated anger significantly predicted lower afternoon cortisol, which in turn predicted increased peer-reported aggression. These results align with previous research on links among hypocortisolism, emotional regulation, and behavior, and suggest a possible meditational pathway between emotion and behavior regulation via decreased afternoon cortisol levels.
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Affiliation(s)
- Eva Oberle
- School of Population and Public Health, The Human Early Learning Partnership, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Kaitlyn McLachlan
- Department of Psychiatry, University of Guelph, Guelph, Ontario, Canada
| | - Nicole L A Catherine
- Simon Fraser University, Children's Health Policy Center, Vancouver, British Columbia, Canada
| | - Ursula Brain
- Department of Pediatrics, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Kimberly A Schonert-Reichl
- Department of Educational and Counselling Psychology, and Special Education, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Joanne Weinberg
- BC Children's Hospital Research Institute, Department of Pediatrics, School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Tim F Oberlander
- Department of Pediatrics, The University of British Columbia, Vancouver, British Columbia, Canada
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16
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McLachlan K, Vavasour I, MacKay A, Reynolds J, Oberlander T, Loock C, Beaulieu C. ISDN2014_0381: Brain myelin water imaging of children with prenatal alcohol exposure: Findings from the NeuroDevNet FASD Study. Int J Dev Neurosci 2015. [DOI: 10.1016/j.ijdevneu.2015.04.301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Affiliation(s)
- K. McLachlan
- University of AlbertaCanada
- University of British ColumbiaCanada
| | | | - A. MacKay
- University of British ColumbiaCanada
| | | | | | - C. Loock
- University of British ColumbiaCanada
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17
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McLachlan K, Pei J, Kully‐Martens K, Paolozza A, Oberlander TF, Loock C, Andrew G, Reynolds J, Rasmussen C. ISDN2014_0204: Performance‐ and questionnaire‐based tools for the evaluation of executive function in children and adolescents with fetal alcohol spectrum disorder. Int J Dev Neurosci 2015. [DOI: 10.1016/j.ijdevneu.2015.04.168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Kaitlyn McLachlan
- Department of PediatricsUniversity of AlbertaEdmontonABCanada
- Department of PediatricsUniversity of British ColumbiaVancouverBCCanada
| | - Jacqueline Pei
- Department of Educational PsychologyUniversity of AlbertaEdmontonABCanada
| | | | | | - Tim F. Oberlander
- Department of PediatricsUniversity of British ColumbiaVancouverBCCanada
| | - Christine Loock
- Department of PsychiatryUniversity of British ColumbiaVancouverBCCanada
| | - Gail Andrew
- Glenrose Rehabilitation HospitalEdmontonABCanada
| | - James Reynolds
- Centre for Neuroscience StudiesQueens UniversityKingstonONCanada
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18
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LaFrance MA, McLachlan K, Nash K, Andrew G, Loock C, Oberlander TF, Koren G, Rasmussen C. Evaluation of the neurobehavioral screening tool in children with fetal alcohol spectrum disorders (FASD). J Popul Ther Clin Pharmacol 2014; 21:e197-e210. [PMID: 24897061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND There is a growing need for validated tools to screen children at risk of fetal alcohol spectrum disorders (FASD). The Neurobehavioral Screening Tool (NST) is one of several promising screening measures for FASD, though further evidence is needed to establish the tool's psychometric utility. OBJECTIVE To assess the predictive accuracy of the NST among children with an FASD diagnosis, with prenatal alcohol exposure (PAE) but no FASD diagnosis, and typically developing controls. METHOD The NST was completed by caregivers of children ages 6 to 17, including 48 with FASD, 22 with PAE, and 32 typically developing non-exposed controls. Predictive accuracy coefficients were calculated using Nash et al. (2006) criteria, and compared against controls. An alternative scoring scheme was also investigated to determine optimum referral thresholds using item-level total scores. RESULTS The NST yielded 62.5% sensitivity for participants with FASD and 50% for PAE. Specificity values were 100% with no typically developing control scoring positive. Within the FASD group there was a trend for higher sensitivity among adolescents aged 12 to17 (70.8%) compared with children aged 6 to 11 years (54.2%), p = 0.23. CONCLUSION The findings support a growing body of literature evidencing psychometric promise for the clinical utility of the NST as an FASD screening tool, though further research on possible age-effects is warranted. The availability of a validated clinical screening tool for FASD, such as the NST, would aid in accurately screening a large number of children and lead to a timelier diagnostic referral.
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19
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Racine E, Bell E, Yan A, Andrew G, Bell LE, Clarke M, Dubljevic V, Goldowitz D, Janvier A, McLachlan K, Muhajarine N, Nicholas D, Oskoui M, Rasmussen C, Rasmussen LA, Roberts W, Shevell M, Wade L, Yager JY. Ethics challenges of transition from paediatric to adult health care services for young adults with neurodevelopmental disabilities. Paediatr Child Health 2014; 19:65-8. [PMID: 24596475 DOI: 10.1093/pch/19.2.65] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2013] [Indexed: 11/13/2022] Open
Affiliation(s)
- Eric Racine
- Neuroethics Research Unit; ; Département de médecine, Université de Montréal; ; Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, Montreal, Quebec
| | - Emily Bell
- Neuroethics Research Unit; ; Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, Montreal, Quebec
| | | | - Gail Andrew
- Neurodevelopmental/Neuromotor Division, Department of Pediatrics, University of Alberta, Glenrose Rehabilitation Hospital, Edmonton, Alberta
| | - Lorraine E Bell
- Department of Pediatrics, Division of Nephrology, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec
| | - Margaret Clarke
- Departments of Pediatrics/Psychiatry, Alberta Children's Hospital, Calgary, Alberta
| | - Veljko Dubljevic
- Neuroethics Research Unit; ; Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, Montreal, Quebec
| | - Dan Goldowitz
- NeuroDevNet, Centre for Molecular Medicine and Therapeutics, Child and Family Research Institute, Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia
| | - Annie Janvier
- Division of Neonatology and Clinical Ethics, Department of Pediatrics, CHU Sainte-Justine, Montreal, Quebec
| | | | - Nazeem Muhajarine
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan
| | - David Nicholas
- Faculty of Social Work, University of Calgary, Calgary, Alberta
| | - Maryam Oskoui
- Departments of Pediatrics and Neurology, McGill University, Montreal Children's Hospital
| | - Carmen Rasmussen
- Department of Pediatrics, University of Alberta, Edmonton, Alberta
| | - Lisa Anne Rasmussen
- Departments of Pediatrics and Neurology, McGill University, Montreal Children's Hospital, Montreal, Quebec
| | - Wendy Roberts
- Department of Paediatrics, University of Toronto, Toronto, Ontario
| | | | - Lucie Wade
- Ethics Program Office, Jewish General Hospital, Montreal, Quebec
| | - Jerome Y Yager
- Section of Pediatric Neurosciences, Department of Pediatrics, University of Alberta, Edmonton, Alberta
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20
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McLachlan K, Roesch R, Viljoen JL, Douglas KS. Evaluating the psycholegal abilities of young offenders with fetal alcohol spectrum disorder. Law Hum Behav 2014; 38:10-22. [PMID: 23834387 DOI: 10.1037/lhb0000037] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Individuals with a diagnosis of fetal alcohol spectrum disorder (FASD) experience a range of physical, cognitive, and behavioral deficits thought to interfere with their ability to competently navigate the arrest, interrogation, and trial process. This study examined the psycholegal abilities of young offenders with FASD, including their understanding and appreciation of Miranda rights, and adjudication capacities (factual knowledge of criminal procedure, appreciation of the nature and object of the proceedings, ability to participate in a defense and communicate with counsel). Two groups of young offenders (50 with FASD and 50 without prenatal alcohol exposure) completed Grisso's Instruments for Assessing Understanding and Appreciation of Miranda rights and the Fitness Interview Test-Revised to assess overall rates of impairment in youth with FASD, as well as differences between the groups. Potentially important predictors of psycholegal abilities were also evaluated. Results indicated the majority of young offenders with FASD (90%) showed impairment in at least one psycholegal ability, and rates of impairment were significantly higher than the comparison group. However, considerable within-group variability was observed. IQ and reading comprehension emerged as robust predictors of participants' psycholegal abilities, while the FASD diagnosis differentiated participants' scores on the FIT-R. These findings underscore the importance of individualized and comprehensive forensic assessments of psycholegal abilities in this population when warranted. Additional system level strains for this population are discussed, including problems in approaching competency remediation, and the potentially growing need for accommodation and forensic assessments in the face of limited financial and professional resources in legal settings.
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22
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Hubbard G, McLachlan K, Forbat L, Munday D. Recognition by family members that relatives with neurodegenerative disease are likely to die within a year: a meta-ethnography. Palliat Med 2012; 26:108-22. [PMID: 21586618 DOI: 10.1177/0269216311402712] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To synthesize evidence of family members recognizing that their relative is likely to die within the year, and identifying the need for palliative care. DESIGN A meta-ethnography of studies of family members in multiple sclerosis (MS), Parkinson's disease (PD) and motor neuron disease (MND). REVIEW METHODS Systematic search in electronic databases; thematic synthesis guided by the principles of meta-ethnography, which is a method for thematic synthesis of qualitative studies. RESULTS Nine articles were included. The results of the synthesis identified two key themes. First, family members are intimately aware of changes in their relative's health and well-being. Sub-themes include family member awareness of different and progressive stages of the disease, noticing deterioration, noticing decline in functional abilities and recognizing that their relative will die. The second key theme is dilemmas of being involved in prognostication. Sub-themes include family member ambivalence toward hearing about prognostication, health professionals not being knowledgeable of the disease and family reluctance to receive palliative care. CONCLUSIONS Family members monitor and recognize changes in their relative with PD, MND and MS and in themselves. Thus, drawing on the expertise of family members may be a useful tool for prognostication.
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Affiliation(s)
- G Hubbard
- Cancer Care Research Centre, School of Nursing, Midwifery and Health, University of Stirling, Stirling FK9 4LA, UK
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23
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McLachlan K, Roesch R, Douglas KS. Examining the role of interrogative suggestibility in Miranda rights comprehension in adolescents. Law Hum Behav 2011; 35:165-177. [PMID: 20127277 DOI: 10.1007/s10979-009-9198-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
This study aimed to further clarify the association between interrogative suggestibility and Miranda rights comprehension in adolescents; in particular, we examined whether intellectual ability (IQ) serves as a mediator of this relationship. Participants completed Grisso's Miranda Instruments, the Wechsler Abbreviated Scale of Intelligence, and the Gudjonsson Suggestibility Scale. Many youth demonstrated poor comprehension of their rights, particularly younger and less intellectually capable adolescents. Both yield and shift components of interrogative suggestibility were inversely related to rights comprehension; however, IQ fully mediated these relationships. Neither demographic variables (gender, ethnicity, socio-economic status after controlling for IQ, and English as a second language (ESL) status) nor previous police experience were significantly associated with rights comprehension in the present sample. The implications of these findings are discussed.
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Affiliation(s)
- Kaitlyn McLachlan
- Department of Psychology, Simon Fraser University, Burnaby, BC, Canada.
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24
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Scalici J, Harrer C, Atkins K, McLachlan K, Duska L, Slack-Davis J. Thinking outside of the tumor: Targeting the ovarian cancer microenvironment. Gynecol Oncol 2011. [DOI: 10.1016/j.ygyno.2010.12.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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25
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Viljoen JL, McLachlan K, Wingrove T, Penner E. Defense attorneys' concerns about the competence of adolescent defendants. Behav Sci Law 2010; 28:630-646. [PMID: 20740506 DOI: 10.1002/bsl.954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Research indicates that a sizable proportion of adolescent defendants have difficulty understanding and participating in legal proceedings against them, and may be incompetent to stand trial. To examine attorneys' experience in defending adolescents with competence-related difficulties, 214 juvenile attorneys were surveyed. Findings indicated that attorneys have doubts about the competence of approximately 10% of adolescent defendants, and that they find these cases particularly challenging to defend. Most attorneys appear to recognize that developmental factors may contribute to adolescents' competence-related difficulties, and believe that the law should accept developmental immaturity as a basis for incompetence findings. In approximately half of the cases in which attorneys had doubts about competence, attorneys did not request a competence evaluation but instead made other efforts to address competence issues, such as by teaching adolescents about legal proceedings and further involving their parents. The implications of these findings are discussed.
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Affiliation(s)
- Jodi L Viljoen
- Department of Psychology, Simon Fraser University, Burnaby, British Columbia, Canada.
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Viljoen JL, McLachlan K, Vincent GM. Assessing violence risk and psychopathy in juvenile and adult offenders: a survey of clinical practices. Assessment 2010; 17:377-95. [PMID: 20124429 DOI: 10.1177/1073191109359587] [Citation(s) in RCA: 105] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study surveyed 199 forensic clinicians about the practices that they use in assessing violence risk in juvenile and adult offenders. Results indicated that the use of risk assessment and psychopathy tools was common. Although clinicians reported more routine use of psychopathy measures in adult risk assessments compared with juvenile risks assessments, 79% of clinicians reported using psychopathy measures at least once in a while in juvenile risk assessments. Extremely few clinicians, however, believe that juveniles should be labeled or referred to as psychopaths. Juvenile risk reports were more likely than adult reports to routinely discuss treatment and protective factors, and provide recommendations to reevaluate risk. The implications of these findings are discussed.
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Affiliation(s)
- Jodi L Viljoen
- Simon Fraser University, Burnaby, British Columbia, Canada.
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Watsford M, Murphy A, McLachlan K, Bryant A, Cameron M, Crossley K, Spurrs R. The role of musculotendinous stiffness in hamstring injuries in professional footballers. J Sci Med Sport 2010. [DOI: 10.1016/j.jsams.2009.10.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Shaikh MG, McLachlan K, Stirling H. Renal and hepatic dysfunction in hypothyroid children. Acta Paediatr 2007; 96:605-6. [PMID: 17274804 DOI: 10.1111/j.1651-2227.2006.00160.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Murphy A, Watsford M, Bryant A, McLachlan K, Cameron M. The effect of previous lower limb injury on leg stiffness in AFL players. J Sci Med Sport 2006. [DOI: 10.1016/j.jsams.2006.12.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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30
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McLachlan K, Jones R, Bell G, McGhee S. Cures at the touch of a key. Health Serv J 1990; 100:441. [PMID: 10104366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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31
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Cooley MA, McLachlan K, Atkinson K. Cytokine activity after human bone marrow transplantation. III. Defect in IL2 production by peripheral blood mononuclear cells is not corrected by stimulation with Ca++ ionophore plus phorbol ester. Br J Haematol 1989; 73:341-7. [PMID: 2481490 DOI: 10.1111/j.1365-2141.1989.tb07750.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Previous studies have shown that interleukin 2 (IL2) production by peripheral blood mononuclear cells (PBMC) is severely impaired post allogeneic bone marrow transplantation, whereas production of interferon-gamma (IFN-gamma) is at most marginally depressed. To investigate the mechanisms behind this apparently differential inhibition of lymphokine production, we stimulated PBMC from recipients of HLA-identical sibling bone marrow transplants with phytohaemagglutinin (PHA), PHA + phorbol ester (PMA) (to bypass accessory cell requirements) or Ca++ ionophore + PMA (to bypass both accessory cell and T cell surface receptor (CD2 and/or CD3/Ti interactions). Increasing the potency of the stimulus increased the amount of IL2 and IFN produced by PBMC from both normal volunteers and from marrow transplant recipients, but for each stimulus the amount of IL2 produced by marrow transplant recipient PBMC remained 10-100-fold lower than that produced by normal PBMC, suggesting an underlying defect in IL2 production by marrow transplant recipient T cells, not due to accessory cell or CD2 defects. Selection experiments showed that CD3+ cells were the primary IL2 producers, and we were unable to demonstrate presence of suppressor cells in marrow transplant PBMC. Statistical analysis of the clinical factors possibly affecting lymphokine synthesis showed that in vivo cyclosporin A did not affect the in vitro capacity of PBMC to produce cytokines, although steroid therapy had a negative effect on IL2 production. The only variable significantly affecting IL2 and IFN production in marrow transplant recipients was increasing time post transplant. It is suggested that the defect in IL2 but not IFN production could be due to either a selective reduction in the frequency of IL2 producing cells as opposed to IFN producing cells, or to a reduction in the amount of IL2 produced per cell in marrow transplant recipients.
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Affiliation(s)
- M A Cooley
- Department of Haematology, St Vincent's Hospital, Sydney, Australia
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Cooley MA, McLachlan K, Atkinson K. Defective interleukin 2 (IL2) production by peripheral blood mononuclear cells (PBMC) of bone marrow transplant recipients is not due to accessory cell or T cell receptor defects. Transplant Proc 1989; 21:3060-1. [PMID: 2650425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- M A Cooley
- Centre for Immunology, St Vincent's Hospital, Sydney, Australia
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Abstract
Retention and stress concentration factors can be improved if a good mechanical bond exists between smooth retention pins and an amalgam restoration. It is shown that, by silver-plating pins and by using a rubbing technique during condensation of the amalgam, a good mechanical bond is produced. Mechanical tests of this bond show that its shear strength is adequate to withstand the stresses likely to be produced by occlusal forces. The form of the tests was: (a) torsion, to demonstrate the performance of the bond in shear and (b) push-through, to provide stress distributions more closely allied to those found under clinical conditions. Plain stainless steel and plated stainless steel pins were compared for their performance and sterling silver pins were used for checking the validity of the torsion test methods. It is concluded from these tests that, with the plating and "rubbing" techniques mentioned, a good mechanical bond is produced which is likely to have value in clinical dentistry.
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Abstract
A silver-plating technique was developed in an effort to produce good mechanical bonding characteristics between stainless steel pins and amalgam. Metallographic microscope and scanning electron microscope (SEM) studies were made to assess the presence, or otherwise, of such a bond between (a) the silver layer plating and the surface of the stainless steel pins, and (b) and silver plating and the amalgam. Unplated stainless steel and sterling silver pins were used as a control and as a comparison, respectively. A "rubbing" technique of condensation was devised closely adapt amalgam to the pins. It is concluded that there is strong evidence for the existence of a good bond between the plated pins and amalgam. The mechanical performance of the bond is discussed elsewhere.
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Abstract
Axial deflections of pins, anchored in specimens of human dentin by five different procedures, were measured by a specially constructed apparatus to an accuracy of 0.1 mu. Axial stiffness values calculated from these measurements were found to be significantly different for different methods of anchorage. Cemented pins displayed the lowest axial stiffness when compared with friction-locked and self-threading pins.
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Abstract
Photoelastic models of pin-amalgam restorations were constructed to simulate different pin-dentin-amalgam relationships. The stress-raising effect of a pin is influenced by the axial stiffness of the pin and its capability of bonding with the amalgam. The stress produced by a very stiff non-bonded pin could cause failure of the restoration.
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