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Psycho-Social Characteristics of Children with Prenatal Alcohol Exposure, Compared to Children with Down Syndrome and Typical Children

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Abstract

The aim of this study was to extend the literature on cognitive and psychosocial adjustment and on facial processing in children with Prenatal Alcohol Exposure (PAE). Twenty-five children with PAE, 23 neurotypical children, and 13 children with Down syndrome matched on sex and mental age participated. Parents or guardians completed the Conners Comprehensive Behavior Rating Scale for Parents and the Social Responsiveness Scale; participants completed facial processing tasks. Using MANOVAs, the PAE group had substantially higher standard scores on all CBRS-P and SRS subscales compared with the typical group, and on almost all of them compared with the Down syndrome group. A large portion of individuals in the PAE group had clinically significant scores on the CBRS-P subscales, including ADHD, conduct and oppositional/defiant disorder, autism spectrum disorder, major depression, manic episodes, generalized and separation anxiety and phobias. Using a MANCOVA, no group differences were found in facial processing between the PAE and the neurotypical groups. Many children with PAE had scores that exceeded cut-offs for autism spectrum disorders, ADHD, conduct disorder, oppositional/defiant disorder, major depression, manic episodes, generalized and separation anxiety, and phobias. In addition, academic, language and mathematics problems were noted relative to typical children. Finally, children with PAE performed just as well on the facial processing tasks as a group of younger typical children of equal mental age. That means that facial processing by children with PAE was corresponded with their mental age.

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References

  • American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.

  • Aronson, M., Hagberg, B., & Gillberg, C. (1997). Attention deficits and autistic spectrum problems in children exposed to alcohol during gestation: a follow-up study. Developmental Medicine and Child Neurology, 39, 583–587.

    Article  PubMed  Google Scholar 

  • Bar-Haim, Y., Shulman, C., Lamy, D., & Reuveni, A. (2006). Attention to eyes and mouth in high functioning autism. Journal of Autism and Developmental Disorders, 36, 131–136.

    Article  PubMed  Google Scholar 

  • Behrmann, M., Avidan, G., Leonard, G. L., Kimchi, R., Luna, B., Humphreys, K., & Minshew, N. (2006). Configural processing in autism and its relationship to face processing. Neuropsychologia, 4, 110–129.

    Article  Google Scholar 

  • Bishop, S., Gahagan, S., & Lord, C. (2007). Re-examining the core features of autism: a comparison of autism spectrum disorder and fetal alcohol spectrum disorder. Journal of Child Psychology and Psychiatry, 48, 1111–1121. doi:10.1111/j.1469-7610.2007.01782.x.

    Article  PubMed  Google Scholar 

  • Brosgole, L., Kurucz, J., PlaHovinsak, T. J., Sprotte, C., & Haveliwala, Y. (1983). Facial and postural affect recognition in senile elderly persons. International Journal of Neuroscience, 22, 37–46.

    Article  PubMed  Google Scholar 

  • Burden, M. J., Jacobson, S. W., & Jacobson, J. L. (2005a). Relation of prenatal alcohol exposure to cognitive processing speed and efficiency in childhood. Alcoholism, Clinical and Experimental Research, 29, 1473–1483.

    Article  Google Scholar 

  • Burden, M. J., Jacobson, S. W., Sokol, R. J., & Jacobson, J. L. (2005b). Effects of prenatal alcohol exposure on attention and working memory at 7.5 years of age. Alcoholism, Clinical and Experimental Research, 29, 443–452.

    Article  Google Scholar 

  • Coggins, T. E., Olswang, L. B., Olson, H. C., & Timler, G. R. (2003). On becoming socially competent communicators: the challenge for children with fetal alcohol exposure. International Review of Research in Mental Retardation: Language and Communication is Mental Retardation, 27, 121–150.

    Article  Google Scholar 

  • Conners, C. K. (2008). Conners comprehensive behavior rating scales manual. Toronto: Multi-Health Systems Inc.

    Google Scholar 

  • Constantino, J. N., & Gruber, C. P. (2005). Social responsiveness scale manual. Los Angeles: Western Psychological Services.

    Google Scholar 

  • Crocker, N., Vaurio, L., Riley, E. P., & Mattson, S. (2009). Comparison of adaptive behavior in children with heavy prenatal alcohol exposure or attention deficit/hyperactivity disorder. Alcoholism, Clinical and Experimental Research, 33, 2015–2023.

    Article  PubMed  Google Scholar 

  • Dunn, L. M., Dunn, L. M., Williams, K. T., & Wang, J. J. (1997). Peabody picture vocabulary test—III. Circle Pines: American Guidance Services.

    Google Scholar 

  • Farran, E. K., Branson, A., & King, B. J. (2011). Visual search for basic emotional expressions in autism; impaired processing of anger, fear and sadness, but a typical happy face advantage. Research in Autism Spectrum Disorders, 5, 455–462. doi:10.1016/j.rasd.2010.06.009.

    Article  Google Scholar 

  • Feinberg, T. E., Rifkin, A. A., Schaffer, C., & Walker, E. (1986). Facial discrimination and emotional recognition in schizophrenia and affective disorders. Archives of General Psychiatry, 43, 276–279.

    Article  PubMed  Google Scholar 

  • Fryer, S. L., McGee, C. L., Matt, G. E., Ripley, E. P., & Mattson, S. N. (2007). Evaluation of psychopathological conditions in children with heavy prenatal alcohol exposure. Pediatrics, 119, 733–741.

    Article  Google Scholar 

  • Garcia-Villamisar, D., Rojahn, J., Zaja, R. H., & Jodra, M. (2010). Facial emotion processing and social adaptation in adults with and without autism spectrum disorder. Research in Autism Spectrum Disorders, 4, 755–762.

    Article  Google Scholar 

  • Gerhards, F. (1998). Decoding of facially expressed emotions in patients with psychosomatic gastrointestinal disorders. Behavior Modification, 22, 184–191.

    Article  PubMed  Google Scholar 

  • Gilboa-Schechtman, E., Ben-Artzi, E., Jeczemien, P., Marom, S., & Hermesh, H. (2004). Depression impairs the ability to ignore the emotional aspects of facial expressions: evidence from the Garner task. Cognition and Emotion, 18, 209–231.

    Google Scholar 

  • Gilboa-Schechtman, E., Foa, E. B., & Amir, N. (1999). Attentional biases for facial expressions in social phobia: the face-in-the-crowd paradigm. Cognition and Emotion, 13, 305–318.

    Article  Google Scholar 

  • Greenbaum, P. E., Decrick, R. F., Prange, M. E., & Friedman, R. M. (1994). Parent, teacher, and child ratings of problem behaviors of youngsters with serious emotional disturbances. Psychological Assessment, 6, 141–148. doi:10.1037/1040-3590.6.2.141.

    Article  Google Scholar 

  • Greenbaum, R. L., Stevens, S. A., Nash, K., Koren, G., & Rovet, J. (2009). Social cognitive and emotion processing abilities of children with fetal alcohol spectrum disorders: a comparison with attention deficit hyperactivity disorder. Alcoholism, Clinical and Experimental Research, 33, 1656–1670. doi:10.1111/j.1530-0277.2009.01003.x.

    Article  PubMed  Google Scholar 

  • Gur, R. C., Erwin, R. J., Gur, R. E., Zwil, A. S., Heimberg, C., & Kraemer, H. C. (1992). Facial emotion discrimination: II. Behavioral findings in depression. Psychiatry Research, 42, 241–251.

    Article  PubMed  Google Scholar 

  • Halberstadt, A., Denham, S. A., & Dunsmore, J. (2001). Affective social competence. Social Development, 10, 79–119.

    Article  Google Scholar 

  • Harris, S. R., MacKay, L.L., & Osborn, J. A. (1995). Autistic behaviors in offspring of mothers abusing alcohol and other drugs: A series of case reports. Alcoholism: Clinical and Experimental Research, 19, 660–665.

    Google Scholar 

  • Hartman, C. A., Rhee, S. H., Willcutt, E. G., & Pennington, B. F. (2007). Modeling rater disagreement for ADHD: are parents or teachers biased? Journal of Abnormal Child Psychology, 35, 536–542. doi:10.1007/s10802-007-9110-y.

    Article  PubMed  Google Scholar 

  • Heimberg, C., Gur, R. E., Erwin, R. J., Shtasel, D. L., & Gur, R. C. (1992). Facial emotion discrimination: III. Behavioral findings in schizophrenia. Psychiatry Research, 42, 253–265.

    Article  PubMed  Google Scholar 

  • Hodapp, A. F., & Gerken, K. C. (1999). Correlations between scores for Peabody picture vocabulary test-III and the Wechsler intelligence scale for children-iii. Psychological Reports, 84, 1139–1142. doi:10.2466/PR0.84.3.1139-1142.

    Google Scholar 

  • Howell, K. K., Lynch, M. E., Platzman, K. A., Smith, G. H., & Coles, C. D. (2006). Prenatal alcohol exposure and ability, academic achievement, and school functioning in adolescence: a longitudinal follow-up. Journal of Pediatric Psychology, 31, 116–126.

    Article  PubMed  Google Scholar 

  • Jacobson, J. L., & Jacobson, S. W. (2002). Effects of prenatal alcohol exposure on child development. Alcohol Research & Health, 26, 282–286.

    Google Scholar 

  • Karmiloff-Smith, A., Klima, E., Bellugi, U., Grant, J., & Baron-Cohen, S. (1995). Is there a social module? Language, face processing, and theory of mind in individuals with Williams Syndrome. Journal of Cognitive Neuroscience, 7, 196–209.

    Article  Google Scholar 

  • Karmiloff-Smith, A., Thomas, M., Annaz, D., Humphreys, K., Ewing, S., Brace, N., VanDuuren, M., Pike, G., Grice, S., & Campbell, R. (2004). Exploring the Williams syndrome face-processing debate: the importance of developmental trajectories. Journal of Child Psychology and Psychiatry, 45, 1258–1274.

    Article  PubMed  Google Scholar 

  • Kasari, C., Freeman, S. F., & Hughes, M. A. (2001). Emotion recognition by children with Down syndrome. American Journal on Intellectual Disabilities, 106, 59–72.

    Article  Google Scholar 

  • Kasari, C., & Sigman, M. (1996). Expression and understanding of emotion in atypical development: Autism and Down syndrome. In M. Lewis & M. W. Sullivan (Eds.), Emotional development in atypical children (pp. 109–130). Hillsdale: Erlbaum.

    Google Scholar 

  • Kelly, S., Day, N., & Streissguth, A. P. (2000). Effects of prenatal alcohol exposure on social behavior in humans and other species. Neurotoxicology and Teratology, 22, 143–149.

    Article  PubMed  Google Scholar 

  • Kodituwakku, P. W., Kalberg, W., & May, P. A. (2001a). The effects of prenatal alcohol exposure on executive functioning. Alcohol Research & Health, 25, 192–198.

    Google Scholar 

  • Kodituwakku, P. W., May, P. A., Clericuzio, C. L., & Weers, D. (2001b). Emotion-related learning in individuals prenatally exposed to alcohol: an investigation of the relation between set shifting, extinction of responses, and behavior. Neuropsychologia, 39, 699–708.

    Article  Google Scholar 

  • Lane, R. D., Sechrest, L., Reidel, R., Weldon, V., Kaszniak, A., & Schwartz, G. E. (1996). Impaired verbal and nonverbal emotion recognition in alexithymia. Psychosomatic Medicine, 58, 203–210.

    PubMed  Google Scholar 

  • Lord, C., Rutter, M., & Couteur, A. (1994). Autism diagnostic interview-revised: a revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. Journal of Autism and Developmental Disorders, 24, 659–685. doi:10.1007/BF0217214.

    Article  PubMed  Google Scholar 

  • Mattson, S. N., Calarco, K. E., & Lang, A. R. (2006). Focused and shifting attention in children with heavy prenatal alcohol exposure. Neuropsychology, 20, 361–369.

    Article  PubMed  Google Scholar 

  • Mattson, S. N., Crocker, N., & Nguyen, T. T. (2011). Fetal alcohol spectrum disorders: neuropsychological and behavioral features. Neuropsychological Review, 21, 81–101.

    Article  Google Scholar 

  • McDonald, P. W., & Prkachin, K. M. (1990). The expression and perception of facial emotion in alexithymia: a pilot study. Psychosomatic Medicine, 52, 199–210.

    PubMed  Google Scholar 

  • McGee, C. L., Bjorkquist, O. A., Price, J. M., Mattson, S. N., & Riley, E. P. (2009). Social information processing skills in children with histories of heavy prenatal alcohol exposure. Journal of Abnormal Child Psychology, 37, 817–830. doi:10.1007/s10802-009-9313-5.

    Article  PubMed  Google Scholar 

  • Mick, E., Biederman, J., Faraone, S. V., Sayer, J., & Kleinman, S. (2002). Case–control study of attention-deficit hyperactivity disorder and maternal smoking, alcohol use, and drug use during pregnancy. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 378–385.

    Article  PubMed  Google Scholar 

  • Mukherjee, R., Layton, M., Yacoub, E., & Turk, J. (2011). Autism and autistic traits in people exposed to heavy prenatal alcohol: data from a clinical series of 21 individuals and nested case control study. Advances in Mental Health and Intellectual Disabilities, 5, 42–49.

    Article  Google Scholar 

  • O’Connor, M. J., Kogan, N., & Findlay, R. (2002). Prenatal alcohol exposure and attachment behavior in children. Alcoholism, Clinical and Experimental Research, 26, 1592–1602.

    Article  PubMed  Google Scholar 

  • O’Connor, M. J., & Paley, B. (2006). The relationship of prenatal alcohol exposure and the postnatal environment to child depressive symptoms. Journal of Pediatric Psychology, 31, 50–64.

    Article  PubMed  Google Scholar 

  • O’ Leary, C. M. (2004). Fetal alcohol syndrome: diagnosis, epidemiology, and developmental outcomes. Journal of Pediatric Child Health, 40, 2–7.

    Article  Google Scholar 

  • Plesa-Skewerer, D., Faja, S., Schofield, C., Verbalis, A., & Tager-Flusberg, H. (2005). Perceiving facial and vocal expressions of emotion in individuals with Williams syndrome. American Journal on Mental Retardation, 111, 15–26.

    Article  Google Scholar 

  • Riley, E. P., Infante, M. A., & Warren, K. R. (2011). Fetal alcohol spectrum disorders: an overview. Neuropsychological Review, 21, 73–80.

    Article  Google Scholar 

  • Rojahn, J., Esbensen, A. J., & Hoch, T. A. (2006). Relationships between facial discrimination and social adjustment in mental retardation. American Journal of Mental Retardation, 111, 366–377.

    Article  PubMed  Google Scholar 

  • Rojahn, J., Rabold, D. E., & Schneider, F. (1995). Emotion specificity in mental retardation. American Journal on Mental Retardation, 99, 477–486.

    PubMed  Google Scholar 

  • Ryan, S., & Ferguson, D. L. (2006). On, yet under, the radar: students with fetal alcohol syndrome disorder. Exceptional Children, 72, 363–379.

    Google Scholar 

  • Siklos, S. (2010). Emotion recognition in children with fetal alcohol spectrum disorders. Dissertation Abstracts International: Section B: The Sciences and Engineering, 7221.

  • Smith, M. C., & Dodson, D. G. (1996). Facial expression in adults with Down’s syndrome. Journal of Abnormal Psychology, 105, 602–608.

    Article  PubMed  Google Scholar 

  • Sprengelmeyer, R., Young, A. W., Sprenglemeyer, A., Calder, A. J., Rowland, D., Perrett, D., Hoemberg, V., & Lange, H. (1997). Recognition of facial expressions: selective impairment of specific emotions in Huntington’s disease. Cognitive Neuropsychology, 14, 839–879.

    Article  Google Scholar 

  • Steinhausen, H.-C., Wilms, J., Metzke, C. W., & Spohr, H.-L. (2003). Behavioural phenotype in fetal alcohol syndrome and foetal alcohol effects. Developmental Medicine and Child Neurology, 45, 179–182. doi:10.1017/S0012162203000343.

    Article  PubMed  Google Scholar 

  • Streissguth, A. P., Aase, J. M., Clarren, S. K., Randels, S. P., LaDue, R. A., & Smith, D. F. (1991). Fetal alcohol syndrome in adolescents and adults. Journal of the American Medical Association, 265, 1961–1967.

    Article  PubMed  Google Scholar 

  • Streissguth, A. P., Bookstein, F. L., Barr, H. M., Press, S., & Sampson, P. D. (1998). A fetal alcohol behavior scale. Alcoholism, Clinical and Experimental Research, 22, 325–333.

    Article  PubMed  Google Scholar 

  • Thomas, S. E., Kelly, S. J., & Mattson, S. N. (1998). Comparison of social abilities of children with fetal alcohol syndrome to those of children with similar IQ scores and normal controls. Alcoholism, Clinical and Experimental Research, 22, 528–533.

    Article  PubMed  Google Scholar 

  • Tottenham, N., Tanaka, J., Leon, A. C., McCarry, T., Nurse, M., Hare, T. A., Marcus, D. J., Westerlund, A., Casey, B. J., & Nelson, C. A. (2009). The NimStim set of facial expressions: judgments from untrained research participants. Psychiatry Research, 168, 242–249.

    Article  PubMed  Google Scholar 

  • Venn, J. J. (2007). Test review of the social responsiveness scale. In K. F. Geisinger, R. A. Spies, J. F. Carlson & B. S. Plake (Eds.), The seventeenth mental measurements yearbook [Electronic version]. Retrieved May 27, 2008, from the Buros Institute’s Test Reviews Online website: http://www.unl.edu/buros

  • Volkmar, F. R., Sparrow, S. S., Rende, R. D., & Cohen, D. J. (1989). Facial perception in autism. Child Psychology and Psychiatry, 30, 591–598.

    Article  Google Scholar 

  • Webb, S. J., Dawson, G., Bernier, R., & Panagiotides, H. (2006). ERP evidence of atypical face processing in young children with autism. Journal of Autism and Developmental Disorder, 36, 881–890. doi:10.1007/s10803-006-0126-x.

    Article  Google Scholar 

  • Weinberg, N. Z. (1997). Cognitive and behavioral deficits associated with parental alcohol use. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 1177–1186.

    Article  PubMed  Google Scholar 

  • Whaley, S. E., O’Connor, M. J., & Gunderson, B. (2001). Comparison of the adaptive functioning of children prenatally exposed to alcohol to a nonexposed clinical sample. Alcoholism, Clinical and Experimental Research, 25, 1018–1024. doi:10.1111/j.1530-0277.2001.tb02311.x.

    Article  PubMed  Google Scholar 

  • Williams, K. R., Wishart, J. G., Pitcairn, T. K., & Willis, D. S. (2005). Emotion recognition by children with Down syndrome: investigation of specific impairments and error patterns. American Journal on Mental Retardation, 110, 378–392.

    Article  PubMed  Google Scholar 

  • Wishart, J. G., Cebula, K. R., Willis, D. S., & Pitcairn, T. K. (2007). Understanding of facial expressions of emotion by children with intellectual disabilities of differing etiology. Journal of Intellectual Disability Research, 51, 551–563.

    Article  PubMed  Google Scholar 

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Acknowledgments

The authors wish to thank all the families and the children who volunteered to participate. We also wish to acknowledge the support from the following organizations that were integral in participant recruitment: National Organization for Fetal Alcohol Syndrome (NOFAS), Double ARC NOFAS of Ohio, the Fullerton Genetics Center in Ashville, North Carolina, the International Adoption Center in Fairfax, Virginia, and the Washington, D.C. chapter of the Families for Russian and Ukrainian Adoption (FRUA), Down Syndrome Network of Montgomery County (DSNMC), the Down Syndrome Association of Greater Richmond (DSAGR), the Northern Virginia chapter of Parents of Down Syndrome, the Triangle Down Syndrome Network (TDSN) in Raleigh, NC, and the Down Syndrome Awareness Group of East Tennessee, Northern Virginia Jewish Community Center (JCCC), the George Mason University Child Development Center, and the Fairfax United Methodist Church Preschool. Thank you also to the Western Psychological Services (WPS) and George Mason University Center for Psychological Services for providing the standardized measures used in this study at discounted or no cost.

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Way, E.L., Rojahn, J. Psycho-Social Characteristics of Children with Prenatal Alcohol Exposure, Compared to Children with Down Syndrome and Typical Children. J Dev Phys Disabil 24, 247–268 (2012). https://doi.org/10.1007/s10882-012-9269-1

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