Comparison of Motor Delays in Young Children With Fetal Alcohol Syndrome to Those With Prenatal Alcohol Exposure and With No Prenatal Alcohol Exposure

University of New Mexico, Center on Alcoholism, Substance Abuse and Addictions, Albuquerque, New Mexico 887106, USA.
Alcoholism Clinical and Experimental Research (Impact Factor: 3.21). 01/2007; 30(12):2037-45. DOI: 10.1111/j.1530-0277.2006.00250.x
Source: PubMed


Researchers are increasingly considering the importance of motor functioning of children with fetal alcohol spectrum disorder (FASD). The purpose of this study was to assess the motor development of young children with fetal alcohol syndrome (FAS) to determine the presence and degree of delay in their motor skills and to compare their motor development with that of matched children without FAS.
The motor development of 14 children ages 20 to 68 months identified with FAS was assessed using the Vineland Adaptive Behavior Scales (VABS). In addition, 2 comparison groups were utilized. Eleven of the children with FAS were matched for chronological age, gender, ethnicity, and communication age to: (1) 11 children with prenatal alcohol exposure who did not have FAS and (2) 11 matched children without any reported prenatal alcohol exposure. The motor scores on the VABS were compared among the 3 groups.
Most of the young children with FAS in this study showed clinically important delays in their motor development as measured on the VABS Motor Domain, and their fine motor skills were significantly more delayed than their gross motor skills. In the group comparisons, the young children with FAS had significantly lower Motor Domain standard (MotorSS) scores than the children not exposed to alcohol prenatally. They also had significantly lower Fine Motor Developmental Quotients than the children in both the other groups. No significant group differences were found in gross motor scores. For MotorSS scores and Fine Motor Developmental Quotients, the means and standard errors indicated a continuum in the scores from FAS to prenatal alcohol exposure to nonexposure.
These findings strongly suggest that all young children with FAS should receive complete developmental evaluations that include assessment of their motor functioning, to identify problem areas and provide access to developmental intervention programs that target deficit areas such as fine motor skills. Fine motor delays in children with FAS may be related to specific neurobehavioral deficits that affect fine motor skills. The findings support the concept of an FASD continuum in some areas of motor development.

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    • "Prenatal alcohol exposure can lead to brain damage resulting in cognitive and behavioral impairments. Specific deficit areas in the population of individuals exposed to alcohol prenatally (Conry, 1990; Kodituwakku, 2006), include: general intelligence (Streissguth et al., 2004; Mattson and Riley, 1998; Jacobson, et al., 2004; Bailey, et al., 2004), executive functioning (Kodituwakku, et al.1995, 2001; Kopera-Frye, et al., 1996; Mattson, et al., 1999(a); Schonfeld, et al.. 2006), information processing (Aragon, et al., 2008; Burden ,et al., 2005; Streissguth, 2007), attention (Steinhausen and Spohr,1998; Coles, et al., 1997; Coles, et al., 2002; Mattson, et al., 2006), language (both receptive and expressive) (Mattson, et al.. 2002; McGhee, et al., 2008; Janzen, 1995), learning and memory (Mattson and Riley, 1999(b); Roebuck, Spencer and Mattson, 2004; Kaemingk, et al., 2003), motor skills (Kalberg, et al., 2006; Korkman, 2003; Adnams, 2001), and behavior (Nash, et al., 2006; Whaley, et al., 2001; Thomas, et al., 1998; Bishop, et al., 2007). Additionally, Mattson et al. (2010) indicated that tests of executive functioning and spatial processing distinguish children with prenatal alcohol-exposure and the physical features of FASD from children with no prenatal exposure. "
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    ABSTRACT: Aims: To determine a brief, practical battery of tests that discriminate between children with a fetal alcohol spectrum disorder (FASD) and unexposed controls. Design: Children received dysmorphology exams, a targeted battery of cognitive and behavioral tests, and their mothers were interviewed about maternal risk factors. Children diagnosed with an FASD and children unexposed to alcohol prenatally were compared on cognitive/behavioral test results. Setting: A community in The Western Cape Province of South Africa. Participants: Sixty-one, first grade children with FASD and 52 matched normal controls. Measures: Statistical analyses of maternal drinking behavior and their child's test performance. Findings: Self-reported maternal drinking patterns before during and after pregnancy were used to confirm prenatal exposures to alcohol in the group of children diagnosed with FASD. With this sample of children diagnosed with FASD and completely unexposed controls, the adverse effects of maternal drinking on children's performance are reported. Results of the battery of standardized cognitive and behavioral tests indicate highly significant differences (p ≤ .001) between groups on: intelligence, perceptual motor, planning, and logical, spatial, short term, long term, and working memory abilities. Furthermore, a binary logistical regression model of only 3 specific cognitive and behavioral tests, including Digit Span A+B (Wald = 4.10), Absurd Situation (Wald = 3.57), and Word Association (Wald = 4.30) correctly classified 79.1% of the child participants as FASD or controls. Conclusions: A brief, practical set of tests can discriminate children with and without FASD and provide useful information for interventions for affected children.
    Full-text · Article · Nov 2013
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    • "More recent studies have found that children prenatally exposed to heavy levels of alcohol exhibit impairment of both fine and gross motor skills. Young children with FAS show clinically important developmental delays in fine but not gross motor skills (Kalberg et al., 2006). Other findings of motor impairment in this clinical population include postural instability (Roebuck, Simmons, Richardson, Mattson, & Riley, 1998), atypical gait (Marcus, 1987), delayed motor reaction timing (Green, Mihic, Nikkel, et al., 2009; Simmons, Thomas, Levy, & Riley, 2010; Simmons, Wass, Thomas, & Riley, 2002; Wass, Simmons, Thomas, & Riley, 2002), impaired fine-motor speed and coordination (Chiodo, et al., 2009; Jirikowic, Carmichael Olson, et al., 2008; Mattson, et al., 1998), increased motor timing variability (Simmons, Levy, Riley, Madra, & Mattson, 2009), poor hand/eye coordination (Adnams et al., 2001), poor bimanual coordination (Roebuck-Spencer, Mattson, Marion, Brown, & Riley, 2004), dysfunctional force regulation (Simmons et al., 2011), atypical trajectories in goal-directed arm movements (Domellof, Fagard, Jacquet, & Ronnqvist, 2010), impaired oculomotor control (Green, Mihic, Brien, et al., 2009), poor sensory processing and sensorimotor performance (Jirikowic, Carmichael Olson, et al., 2008), and weak grasp (Conry, 1990). "
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    ABSTRACT: Heavy prenatal alcohol exposure can cause alterations to the developing brain. The resulting neurobehavioral deficits seen following this exposure are wide-ranging and potentially devastating and, therefore, are of significant concern to individuals, families, communities, and society. These effects occur on a continuum, and qualitatively similar neuropsychological and behavioral features are seen across the spectrum of effect. The term fetal alcohol spectrum disorders (FASD) has been used to emphasize the continuous nature of the outcomes of prenatal alcohol exposure, with fetal alcohol syndrome (FAS) representing one point on the spectrum. This paper will provide a comprehensive review of the neuropsychological and behavioral effects of heavy prenatal alcohol exposure, including a discussion of the emerging neurobehavioral profile. Supporting studies of lower levels of exposure, brain-behavior associations, and animal model systems will be included when appropriate.
    Preview · Article · Jun 2011 · Neuropsychology Review
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    • "Over the past three decades, extensive research has documented the teratogenic effects of alcohol in both animal and human studies, and such research has highlighted a range of cognitive, behavioral, and physical impairments associated with prenatal alcohol exposure. Intellectual and learning disabilities, executive dysfunction, speech and language delays, behavioral and emotional difficulties, poor social skills, and motor deficits have all been reported among people with FASD (Burd et al. 2003; Green et al. 2009; Guerri et al. 2009; Kalberg et al. 2006; Kodituwakku 2007, 2009; O’Connor and Paley 2009; Paley and O’Connor 2007; Rasmussen 2005; Rasmussen and Bisanz 2009; Riley and McGee 2005; Roebuck et al. 1998; Streissguth 2007; Streissguth et al. 2004; Walthall et al. 2008; Willoughby et al. 2008). "
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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.
    Preview · Article · Mar 2011 · Alcohol research & health: the journal of the National Institute on Alcohol Abuse and Alcoholism
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