Neurodevelopmental outcomes in individuals with fetal alcohol spectrum disorder (FASD) with and without exposure to neglect : clinical cohort data from a national FASD diagnostic clinic

Mukherjee, RAS; Cook, PA; Norgate, SH; Price, Alan

Abstract

Disentangling the relative developmental impact of prenatal alcohol exposure from postnatal
neglect is clinically valuable for informing future service provision. In this study developmental
outcomes across groups are compared in a ‘natural experiment’.
Methods: Clinical data from 99 persons with fetal alcohol spectrum disorder (FASD) diagnoses were
audited. Developmental outcomes (diagnosis of attention deficit hyperactivity disorder, ADHD; social
and communication disorder, SCD; or autism spectrum disorder, ASD; Short Sensory Profile, SSP;
Vineland II Adaptive Behaviour Scales) were compared across two exposure groups: prenatal alcohol
only; and mixed prenatal alcohol and neglect.
Results: ADHD (74%) and ASD/SCD (68%) were common, with no significant difference between
groups (ADHD, P=0.924; ASD, P=0.742). Vineland age equivalence scores were lower than
chronological age (11.1y—prenatal alcohol only—and 12.7y—neglect) across all domains, especially
receptive language (3.7y for both groups). Age equivalence did not differ between groups, with the
exception of domestic daily living (neglect: 7.7y vs prenatal alcohol only: 5.8y, P=0.027). A
probable/definite difference on SSP was more common in the prenatal alcohol only (96% vs 67%,
P=0.006). For the individual subscales of SSP, there were no significant differences by neglect
category.
Discussion: Postnatal neglect in this group did not make the developmental outcome any worse,
suggesting that prenatal alcohol influences these outcomes independently. Professionals who
support families looking after a child with both FASD and a history of neglect should be aware that
the behavioural difficulties are likely to be related to prenatal alcohol exposure and not necessarily
reflective of parenting quality.

Citation

Mukherjee, R., Cook, P., Norgate, S., & Price, A. (2019). Neurodevelopmental outcomes in individuals with fetal alcohol spectrum disorder (FASD) with and without exposure to neglect : clinical cohort data from a national FASD diagnostic clinic. Alcohol, 76, 23-28. https://doi.org/10.1016/j.alcohol.2018.06.002

• Journal Article Type: Article
• Acceptance Date: Jun 5, 2018
• Online Publication Date: Jun 12, 2018
• Publication Date: May 1, 2019
• Deposit Date: Jun 7, 2018
• Publicly Available Date: Jul 18, 2018
• Journal: Alcohol
• Print ISSN: 0741-8329
• Publisher: Elsevier
• Volume: 76
• Pages: 23-28
• DOI: https://doi.org/10.1016/j.alcohol.2018.06.002
• Publisher URL: https://doi.org/10.1016/j.alcohol.2018.06.002
• Related Public URLs: https://www.journals.elsevier.com/alcohol/