FASD and Impaired Executive Function
Developmental Neuropsychology 2000;18(3):331-54
Direct and indirect
effects of prenatal alcohol damage on executive function.
Connor PD, Sampson PD, Bookstein FL, Barr HM, Streissguth AP.
Department of Psychiatry and Behavioral Sciences, University of Washington,
Fetal Alcohol and Drug Unit, 180 Nickerson Street, Suite 309, Seattle, WA 98109,
USA. cingulum@u.washington.edu
Patients with Fetal Alcohol Syndrome (FAS) and Fetal Alcohol Effects (FAE) often
have difficulty functioning appropriately in everyday life and seem to employ
poor problem-solving strategies. Tests of executive function are relevant for
quantifying the functional deficits and underlying real-life problems associated
with prenatal alcohol exposure. This study considers two pathways for the
effects of prenatal alcohol on executive function: a direct effect and an
indirect effect through prenatal alcohol's effect on IQ. We compared 30 men who
had been diagnosed with FAS or FAE with young adults participating in a
longitudinal prospective study (n = 419) and 15 control participants that
comprised a comparison group. This study is unique in its analysis of the same
battery of assessments of executive function in both a large low dose
longitudinal study sample and a clinically diagnosed group. Participants were
evaluated on 9 tests (including 58 scores) of executive function. For some but
not all of the tests in this executive function battery, the decrement in the
alcohol exposure group is greater than would be predicted from their IQ scores.
We found that 3 of 6 Stroop scores, 2 of 4 Trails scores, 9 of 16 Wisconsin Card
Sorting scores, 1 of 2 Ruff's Figural Fluency scores, and 2 of 4 Consonant
Trigrams scores appear to be particularly sensitive to the direct effects of
prenatal alcohol damage for patients with FAS and FAE. The findings suggest that
these executive function tests would be particularly useful in clinical
evaluations of persons suspected of fetal alcohol damage because they would not
simply reflect deficits in IQ or facial stigmata.
PubMed: http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?form=6&db=m&dopt=b&uid=11385829