Behavioral regulation as a predictor of response to Children's Friendship Training in children with fetal alcohol spectrum disorders.

Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA 90024-1759, USA.
The Clinical Neuropsychologist (Impact Factor: 1.58). 10/2008; 23(3):428-45. DOI: 10.1080/13854040802389177
Source: PubMed

ABSTRACT Children with fetal alcohol spectrum disorders (FASDs) evidence an array of structural brain abnormalities and neurocognitive deficits. Furthermore, previous research suggests that deficits in executive functioning (EF) may be associated with significant difficulties in the formation of positive peer relationships in this population. The purpose of the current study was to examine the role of EF as a predictor of treatment response to a controlled social skills intervention for children with FASDs. A total of 100 children between the ages of 6 and 12 received Children's Friendship Training (CFT). Prior to treatment, parents completed the Behavior Rating Inventory of Executive Functioning (BRIEF). Treatment outcome was measured using parent report on the Social Skills Rating System (SSRS). The results demonstrated that behavioral regulation as measured on the BRIEF predicted the effectiveness of CFT for children with FASDs, regardless of general intellectual functioning. Specifically, the ability to control impulses, solve problems flexibly, and monitor emotional responses significantly predicted improvement in social skills and reduction in problem behaviors following CFT.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Prenatal alcohol exposure (PAE) is one of the most prevalent and modifiable risk factors for somatic, behavioral, and neurological abnormalities. Affected individuals exhibit a wide range of such features referred to as fetal alcohol spectrum disorders (FASD). These are characterized by a more or less specific pattern of minor facial dysmorphic features, growth deficiency and central nervous system symptoms. Nevertheless, whereas the diagnosis of the full-blown fetal alcohol syndrome does not pose a major challenge, only a tentative diagnosis of FASD can be reached if only mild features are present and/or maternal alcohol consumption during pregnancy cannot be verified. The respective disorders have lifelong implications. The teratogenic mechanisms induced by PAE can lead to various additional somatic findings and structural abnormalities of cerebrum and cerebellum. At the functional level, cognition, motor coordination, attention, language development, executive functions, memory, social perception and emotion processing are impaired to a variable extent. The long-term development is characterized by disruption and failure in many domains; an age-adequate independency is frequently not achieved. In addition to primary prevention, individual therapeutic interventions and tertiary prevention are warranted; provision of extensive education to affected subjects and their caregivers is crucial. Protective environments are often required to prevent negative consequences such as delinquency, indebtedness or experience of physical/sexual abuse.
    European Child & Adolescent Psychiatry 06/2014; DOI:10.1007/s00787-014-0571-6 · 3.55 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: An extensive body of literature has documented executive function (EF) impairments in children with fetal alcohol spectrum disorders (FASD); however, few studies have aimed specifically at improving EF. One treatment program that shows promise for children with FASD is the Alert Program for Self-Regulation®, which is a 12-week treatment specifically designed to target self-regulation, a component of EF. The present study sought to examine if Alert would produce improvements in self-regulation that would generalize to other aspects of EF, behavior, and social skills in children with FASD. Twenty-five children aged 8-12 years diagnosed with an FASD were assigned in alternating sequence to either an immediate treatment (TXT) or a delayed treatment control (DTC) group. Both groups received a comprehensive evaluation of EF at baseline and upon completing therapy (TXT), or after a 12- to 14-week interval from baseline (DTC). Parents also completed questionnaires assessing EF and behavior at both time points. For the TXT group only, parent questionnaires were readministered at 6-month follow-up. At the 12-week follow-up, the TXT group displayed significant improvements in inhibitory control and social cognition. Parents of children in the TXT group reported improved behavioral and emotional regulation, as well as reduced externalizing behavior problems. These behavioral improvements along with further improved parent-rated inhibitory control was maintained at the 6-month follow-up. The EF disabilities in children with FASD can be remediated through a targeted treatment approach aimed at facilitating self-regulation skills.
    Child Neuropsychology 07/2014; DOI:10.1080/09297049.2014.889110 · 2.18 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Considerable efforts to educate women not to abuse alcohol during pregnancy have failed to reduce the incidence of fetal alcohol syndrome. Therefore, other approaches to limit the effects of prenatal alcohol exposure are under consideration, including the development of prevention programs and interventions. For these strategies to be as successful as possible, it also is important to improve methods for identifying affected children. The use of animal models in prenatal alcohol exposure research is critical because of the practical and ethical limitations of using human subjects for such studies. This article reviews the use of animal models in three areas of research: addressing basic questions about alcohol exposure during development; improving the identification of affected individuals; and developing approaches to reduce the impact of prenatal alcohol exposure. The various animal-model systems that have been used to study fetal alcohol spectrum disorders, each with their own specific strengths, have provided new findings that have been successfully extrapolated to human subjects, resulting in advancement of the research field and our understanding of fetal alcohol spectrum disorders.
    Alcohol research & health: the journal of the National Institute on Alcohol Abuse and Alcoholism 03/2011; 34(1):92-8. · 0.58 Impact Factor