Sociocognitive habilitation using the Math Interactive Learning Experience (MILE) program for alcohol-affected children

Marcus Institute, an Affiliate of Kennedy Krieger Institute at Emory University, Atlanta, Georgia 30329, USA.
Alcoholism Clinical and Experimental Research (Impact Factor: 3.31). 09/2007; 31(8):1425-34. DOI: 10.1111/j.1530-0277.2007.00431.x
Source: PubMed

ABSTRACT Fetal alcohol syndrome (FAS) has been recognized as a disabling condition with a significant impact on the neurobehavioral functioning of affected individuals, including cognition, behavior, and academic functioning, but little research has been performed on targeted interventions for these children.
A socio-cognitive habilitative program focused on improving behavior and math functioning in children 3 to 10 years of age (n=61) was developed and evaluated. The intervention provided parental instruction on FAS, advocacy, and behavioral regulation via workshops and interactive math tutoring with children. All families received parental instruction and were then randomly assigned to either the math instruction or standard psychoeducational care groups.
Satisfaction with workshops was very high, with over 90% agreeing that trainers were knowledgeable and materials easy to understand and helpful. Significant gains in knowledge were found for information provided in the instructional groups. At posttesting, caregivers reported fewer problem behaviors on the Achenbach Child Behavior Checklist, Internalizing Problem Behavior, Externalizing Problem Behavior, and Total Problem Behavior summary scales. After 5 months, both groups of children demonstrated gains in math knowledge but significantly higher gains were found in the group receiving direct math instruction. The math treatment group was also more likely to demonstrate a gain of over 1 standard deviation on any of the 4 math outcome measures used.
These findings suggest that parents of children with fetal alcohol spectrum disorders (FAS(D)) benefit from instruction in understanding their child's alcohol-related neurological damage and strategies to provide positive behavioral supports and that targeted psychoeducational programs may be able to remediate some of the math deficits associated with prenatal alcohol exposure.

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Available from: Claire Coles, Jul 17, 2014
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    • "Thus, when a child whose mother is suspected of heavy alcohol use during pregnancy presents with ADHD-like symptoms, assessment of magnitude comparison can aid in a differential diagnosis that may lead to a different pharmacological treatment, since methylphenidate and other psychostimulants often prescribed for ADHD have not proven to be as effective with children with FASD (see Kodituwakku and Kodituwakku 2011). The Math Learning Experience (MILE) intervention developed by Kable and Coles (Kable et al. 2007) is particularly well suited for remediating the specific fetal alcohol-related deficits in magnitude comparison. "
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    ABSTRACT: Identification of children with fetal alcohol spectrum disorders (FASD) is difficult because information regarding prenatal exposure is often lacking, a large proportion of affected children do not exhibit facial anomalies, and no distinctive behavioral phenotype has been identified. Castellanos and Tannock have advocated going beyond descriptive symptom-based approaches to diagnosis to identify biomarkers derived from cognitive neuroscience. Classical eyeblink conditioning and magnitude comparison are particularly promising biobehavioral markers of FASD-eyeblink conditioning because a deficit in this elemental form of learning characterizes a very large proportion of alcohol-exposed children; magnitude comparison because it is a domain of higher order cognitive function that is among the most sensitive to fetal alcohol exposure. Because the neural circuitry mediating both these biobehavioral markers is well understood, they have considerable potential for advancing understanding of the pathophysiology of FASD, which can contribute to development of treatments targeted to the specific deficits that characterize this disorder.
    Neuropsychology Review 06/2011; 21(2):148-66. DOI:10.1007/s11065-011-9169-7 · 5.40 Impact Factor
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    • "research on FASD interventions such as adaptive strategies, behavior, friendship, and mathematics skills focus on children aged 3 to 9 years (Kable et al., 2007; Frankel et al., 2006; Olson, Oti, Gelo, & Beck, 2009; O'Connor et al., 2006), further underscoring the importance of identification of FASD risk in EI. "
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    Infants and young children 03/2011; 24(2):193–206. DOI:10.1097/IYC.0b013e31820d97c9 · 0.91 Impact Factor
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    • "Additionally, some of these approaches may be enhanced by more actively involving parents or caregivers in the child’s treatment. Notably, the math intervention conducted by Kable and colleagues (2007) and Coles and colleagues (2009), which yielded positive effects at both posttreatment and at the 6-month followup, included coaching parents and caregivers in how to promote their child’s skill acquisition at home. Having consistent and motivated caregivers and professionals who can advocate effectively for these children seems likely to contribute to more positive long-term outcomes. "
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    ABSTRACT: Exposure to alcohol in utero is considered to be a leading cause of developmental disabilities of known causation. The most severe consequence of such exposure, fetal alcohol syndrome (FAS), is characterized by a distinct constellation of facial anomalies, growth retardation, and central nervous system dysfunction. Both animal and human studies, however, suggest that there may be considerable variability in the manifestations of in utero alcohol exposure across individuals, and, consequently, the term fetal alcohol spectrum disorders (FASD) has come into usage to reflect the entire continuum of effects associated with such exposure. In addition to FAS, this term encompasses the conditions of partial FAS, alcohol-related neurodevelopmental disorder, and alcohol-related birth defects. Despite extensive evidence of significant cognitive, behavioral, and social deficits in people with FASD, research on behavioral interventions for FASD has lagged behind. However, in recent years there has been a marked increase in efforts to design and test interventions for this population. This article will review current empirically tested interventions, methodological challenges, and suggestions for future directions in research on the treatment of FASD.
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