Reinforcement Learning in Children with Fetal Alcohol Spectrum Disorder
J Popul Ther Clin Pharmacol Vol 18 (1):e17-e27; January 28, 2011
Original Research
Jennifer A Engle, Kimberly A Kerns

It is often said that children with Fetal Alcohol Spectrum Disorder (FASD) have difficulty learning from reinforcement. However, there is little empirical evidence to support or deny this claim. 

To examine reinforcement learning in children with FASD, specifically: (1) the rate of learning from reinforcement; and (2) the impact of concreteness of the reinforcer.

Participants included 18 children with FASD (IQ ≥ 70), ages 11-17, and 18 age- and sex-matched controls. Participants each completed a novel reinforcement learning discrimination task that involved visual probabilistic learning (70% contingent feedback). The task was completed twice, once with tokens, and once with points (counterbalanced). 

The control group demonstrated significantly stronger overall reinforcement learning, although rates of improvement and effect of concreteness of the reinforcer (tokens vs. points) were not different between groups. The FASD group’s responses were more likely to be guided by the most recent information, rather than based on integration of reward status over multiple trials.

Reinforcement learning does not appear to occur in a functionally different manner in children with FASD, but does take longer, and is more impacted by recent reward than an integration of overall reinforcement information. Children with FASD without an intellectual disability may be able to learn from reinforcement given sufficient consistent repetition. However, other failures associated with learning difficulties such as the complexity of the material, transfer of learning, or impulsivity were not addressed in this study.

Key Words: Prenatal alcohol exposure; reinforcement learning; neuropsychology; behavior problems;  behavioral interventions; Fetal Alcohol Spectrum Disorder

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