Impairments go beyond definition for fetal alcohol syndrome

Most children born to alcohol-abusing women appear to have a variety of neuropsy-chological impairments, even though they don?t meet the formal diagnostic criteria for fetal alcohol syndrome (FAS), new research indicates.

The findings demonstrate the importance of collecting alcohol-exposure histories on cognitively impaired children, says psychologist Sarah Mattson, PhD, and the team of San Diego psychologists who conducted the study involving 50 children. Diagnosticians may be ruling out prenatal alcohol exposure as a cause of a child?s cognitive impairment simply because the child lacks the physical features of full FAS, they say. (Facial and cranial deformities and stunted growth are among the physical manifestations of FAS.) The findings are important because more alcohol-exposed children are born with no physical abnormalities than with FAS, the team says. Less than 40 percent of alcoholic women give birth to children with full FAS, they note.

The researchers say they?re surprised at the extent of the neuropsychological deficits they found in the alcohol-exposed children who didn?t have FAS. Although they expected those children to show some neurocognitive deficits, they thought the level of performance would fall somewhere between that of the FAS group and the controls.

?Not only were they different from the [control] group, but they were very similar to the FAS group in the pattern and magnitude of their deficits,? the psychologists write in the January issue of Neuropsychology (Vol. 12, No. 1, p. 146?153).

The sample of 50 children, ages 5 to 16, were gleaned from a larger multidisciplinary study of IQ performance in alcohol-exposed youth. Fifteen of the 50 children had been diagnosed with FAS, and 10 others had been exposed to large amounts of alcohol in the womb but didn?t meet the FAS diagnostic criteria. (The alcohol exposure was identified through mothers? self-reports and through medical records.) The mothers of the remaining children reported little or no alcohol use during their pregnancies.

The children were given a battery of neuropsychological tests. All the alcohol-exposed children?both those with FAS and those who didn?t meet the diagnosis?showed similar deficits in word comprehension, academic skills, fine-motor speed and coordination.