Intelligence and fetal alcohol spectrum disorders A Review
Main Article Content
Keywords
Fetal Alcohol Spectrum Disorders, Fetal Alcohol Syndrome, Intellectual Functioning, Intelligence, Prenatal Alcohol Exposure
Abstract
Background
The studies on intelligence in individuals with fetal alcohol exposure are conflicting. Some have found a relevant impairment in this population, while others found results that were consistent with the population at large.
Objectives
Describe the results of studies on intelligence in individuals with Fetal Alcohol Spectrum Disorders.
Methods
Indexed articles of the last 10 years were selected for an integrative literature review. After inclusion and
exclusion criteria were satisfied 37 articles were selected.
Results
General intelligence, both verbal and non-verbal, is impaired in people who are prenatally exposed to alcohol. There is a tendency to a greater reduction in the Freedom from Distractibility/Working Memory Index of Wechsler Scales.
Conclusions
Reduction in intelligence seems to occur on a continuum similar to the fetal alcohol spectrum. The reduction of the Freedom from Distractibility/Working Memory Index appears to be a reflection of a greater impairment of mathematical ability.
The studies on intelligence in individuals with fetal alcohol exposure are conflicting. Some have found a relevant impairment in this population, while others found results that were consistent with the population at large.
Objectives
Describe the results of studies on intelligence in individuals with Fetal Alcohol Spectrum Disorders.
Methods
Indexed articles of the last 10 years were selected for an integrative literature review. After inclusion and
exclusion criteria were satisfied 37 articles were selected.
Results
General intelligence, both verbal and non-verbal, is impaired in people who are prenatally exposed to alcohol. There is a tendency to a greater reduction in the Freedom from Distractibility/Working Memory Index of Wechsler Scales.
Conclusions
Reduction in intelligence seems to occur on a continuum similar to the fetal alcohol spectrum. The reduction of the Freedom from Distractibility/Working Memory Index appears to be a reflection of a greater impairment of mathematical ability.
References
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2. Hoyme HE, May PA, Kalberg WO et al. A practical clinical approach to diagnosis of fetal alcohol spectrum disorders: clarification of the 1996 Institute of Medicine criteria. Pediatrics 2005;115(1):39–47.
3. Coriale G, Fiorentino D, Di Lauro F et al. Fetal Alcohol Spectrum Disorder (FASD): neurobehavioral profile, indications for diagnosis and treatment. Riv Psichiatr 2013;48(5):359–369.
4. Aragón AS, Kalberg WO, Buckley D, Barela-Scott LM, Tabachnick BG, May PA. Neuropsychological study of FASD in a sample of American Indian children: processing simple versus complex information. Alcohol Clin Exp Res 2008;32(12):2136–48.
5. Willoughby KA, Sheard ED, Nash K, Rovet J. Effects of prenatal alcohol exposure on hippocampal volume, verbal learning, and verbal and spatial recall in late childhood. J Int Neuropsychol Soc 2008;14(6):1022–33.
6. 6. Falgreen Eriksen H-L, Mortensen EL, Kilburn T. The effects of low to moderate prenatal alcohol exposure in early pregnancy on IO in 5-year-old children. BJOG 2012;119(10):1191–200.
7. Kesmodel US, Bertrand J, Støvring H et al. The effect of different alcohol drinking patterns in early to mid pregnancy on the child’s intelligence, attention, and executive function. BJOG 2012;119(10):1180–90.
8. Mukherjee RAS, Hollins S, Turk J. Fetal alcohol spectrum disorder: an overview. J Royal Soc Med 2006;99:298–302.
9. Mattson SN, Riley EP. A review of the neurobehavioral deficits in children with fetal alcohol syndrome or prenatal exposure to alcohol. Alcoholism: Clin Exper Res 1998;22(2):279-94.
10. Mendes KDS, Silveira RCCP, Galvão CM. Revisão Integrativa: Método de Pesquisa para a Incorporação de Evidências na Saúde e na Enfermagem. Texto Contexto Enferm 2008;17(4):758-64.
11. Kodituwakku PW. Neurocognitive profile in children with fetal alcohol spectrum disorders. Dev Disabil Res Rev 2009;15(3):218–24.
12. Kodituwakku PW. Defining the behavioral phenotype in children with fetal alcohol spectrum disorders: a review. Neurosci Biobehav Rev 2007;31(2):192–201.
13. Dalen K, Bruarøy S, Wentzel-Larsen T, Laegreid LM. Cognitive functioning in children prenatally exposed to alcohol and psychotropic drugs. Neuropediatrics 2009;40(4):162–67.
14. Ferreira VKL, Ferreira GVD, Lima JMB, Cruz MS. Desempenho intelectual na exposição alcoólica fetal: relato de série de 10 casos. J Bras Psiquiatr 2013;62(3):234–39.
15. Raldiris TL, Bowers TG, Towsey C. Comparisons of Intelligence and Behaviour in Children With Fetal Alcohol Spectrum Disorder and ADHD. J Atten Disord 2014;1–12.
16. Woods KJ, Meintjes EM, Molteno CD, Jacobson SW, Jacobson JL. Parietal dysfunction during number processing in children with fetal alcohol spectrum disorders. Neuroimage Clin 2015;8:594–605.
17. Aragón AS, Coriale G, Fiorentino D et al. Neuropsychological characteristics of Italian children with fetal alcohol spectrum disorders. Alcohol Clin Exp Res 2008b;32(11):1909–19.
18. Boseck JJ, Davis AS, Cassady JC, Finch WH, Gelder BC. Cognitive and adaptive skill profile differences in children with attention-deficit hyperactivity disorder with and without comorbid fetal alcohol spectrum disorder. Appl Neuropsychol Child 2014;0:1–7.
19. Gautam P1, Lebel C, Narr KL et al. Volume changes and brain-behaviour relationships in white matter and subcortical gray matter in children with prenatal alcohol exposure. Hum Brain Mapp 2015;36(6):2318–29.
20. Howell KK, Lynch ME, Platzman KA, Smith GH, Coles CD. Prenatal alcohol exposure and ability, academic achievement, and school functioning in adolescence: a longitudinal follow-up. J Pediatr Psychol 2006;31(1):116–26.
21. Nash K, Stevens S, Rovet J et al. Towards identifying a characteristic neuropsychological profile for fetal alcohol spectrum disorders. 1. Analysis of the Motherisk FASD clinic. J Popul Ther Clin Pharmacol 2013;20(1):e44–52.
22. May PA, Tabachnick BG, Gossage JP et al. Maternal factors predicting cognitive and behavioral characteristics of children with fetal alcohol spectrum disorders. J Dev Behav Pediatr 2013;34(5):314–25.
23. Rasmussen C, Horne K, Witol A. Neurobehavioral functioning in children with fetal alcohol spectrum disorder. Child Neuropsychol 2006;12(6):453–68.
24. Carr JL, Agnihotri S, Keightley M. Sensory processing and adaptive behaviour deficits of children across the fetal alcohol spectrum disorder continuum. Alcohol Clin Exp Res 2010;34(6):1022–32.
25. Ervalahti N, Korkman M, Fagerlund A, Autti-Rämö I, Loimu L, Hoyme HE. Relationship between dysmorphic features and general cognitive function in children with fetal alcohol spectrum disorders. Am J Med Genet A 2007;143A(24):2916–23.
26. Fernández-Mayoralas DM, Fernández-Jaén A, Muñoz-Jareño N, Calleja Pérez B, Arroyo-González R. Fetal alcohol syndrome, Tourette syndrome, and hyperactivity in 9 adopted children. Pediatr Neurol 2010;43(2):110–6.
27. Foroud T, Wetherill L, Vinci-Booher S et al. Relation over time between facial measurements and cognitive outcomes in fetal alcohol-exposed children. Alcohol Clin Exp Res 2012;36(9):1634–46.
28. Lewis CE, Thomas KG, Dodge NC et al. Verbal learning and memory impairment in children with fetal alcohol spectrum disorders. Alcohol Clin Exp Res 2015;39(4):724–32.
29. McGee CL, Schonfeld AM, Roebuck-Spencer TM, Riley EP, Mattson SN. Children with heavy prenatal alcohol exposure demonstrate deficits on multiple measures of concept formation. Alcohol Clin Exp Res 2008;32(8):1388–97.
30. Meintjes EM, Narr KL, van der Kouwe AJ et al. A tensor-based morphometry analysis of regional differences in brain volume in relation to prenatal alcohol exposure. Neuroimage Clin 2014;5:152–60.
31. Molteno CD, Jacobson JL, Carter RC, Jacobson SW. Infant symbolic play as an early indicator of fetal alcohol-related deficit. Infancy 2010;15(6):586–607.
32. Nash K, Sheard E, Rovet J, Koren G. Understanding Fetal Alcohol Spectrum Disorders (FASDs): toward identification of a behavioral phenotype. Scient World J 2008;8:873–82.
33. Nayak R, Murthy P, Girimaji S, Navaneetham J. Fetal alcohol spectrum disorders--a case-control study from India. J Trop Pediatr 2012;58(1):19–24.
34. Wozniak JR, Mueller BA, Bell CJ et al. Global functional connectivity abnormalities in children with fetal alcohol spectrum disorders. Alcohol Clin Exp Res 2013;37(5):748–56.
35. Wozniak JR, Muetzel RL, Mueller BA et al. Microstructural corpus callosum anomalies in children with prenatal alcohol exposure: an extension of previous diffusion tensor imaging findings. Alcohol Clin Exp Res 2009;33(10):1825–35.
36. Davis KM, Gagnier KR, Moore TE, Todorow M. Cognitive aspects of fetal alcohol spectrum disorder. Wiley Interdiscip Rev Cogn Sci 2013;4(1):81–92.
37. Kumada T, Jiang Y, Cameron DB, Komuro H. How does alcohol impair neuronal migration? J Neurosci Res 2007;25(3):465–70.
38. Nuñez CC, Roussotte F, Sowell ER. Focus on: structural and functional brain abnormalities in fetal alcohol spectrum disorders. Alcohol Res Health 2011;34(1):121–31.
39. Wacha VH, Obrzut JE. Effects of fetal alcohol syndrome on neuropsychological function. J Develop Phys Disabil 2007;19(3):217–26.
40. Chasnoff IJ, Wells AM, Telford E, Schmidt C, Messer G. Neurodevelopmental functioning in children with FAS, pFAS, and ARND. J Dev Behav Pediatr 2010;31(3):192–201.
41. Kalberg WO, May PA, Blankenship J, Buckley D, Gossage JP, Adnams CM. A practical testing battery to measure neurobehavioral ability among children with FASD. Int J Alcohol Drug Res 2013;2(3):51–60.
42. May PA, Gossage JP, Marais AS et al. The epidemiology of fetal alcohol syndrome and partial FAS in a South African community. Drug Alcohol Depend 2007;88(2–3):259–71.
43. Figueiredo VLM. WISC-III. In: Cunha JA, ed. Psicodiagnóstico V. Porto Alegre: Artmed, 2007:603–14.
44. Cunha JA. Escalas Wechsler. In: Cunha JA, ed. Psicodiagnóstico V. Porto Alegre: Artmed, 2007:529–602.
45. McGee CL, Bjorkquist OA, Riley EP, Mattson SN. Impaired language performance in young children with heavy prenatal alcohol exposure. Neurotoxicol Teratol 2009;31(2):71–75.
46. Schonfeld AM, Paley B, Frankel F, O’Connor MJ. Behavioral regulation as a predictor of response to Children’s Friendship Training in children with fetal alcohol spectrum disorders. Clin Neuropsychol 2009;23(3):428–45
47. Vaurio L, Riley EP, Mattson SN. Neuropsychological comparison of children with heavy prenatal alcohol exposure and an iq-matched comparison group. J Internat Neuropsychol Soc 2011;17(3):463–73.
48. Primi R. Inteligência: Avanços nos Modelos Teóricos e nos Instrumentos de Medida. Avaliação Psicológica 2003;1:67–77.
49. Kodituwakku P, Coriale G, Fiorentino D et al. Neurobehavioral characteristics of children with fetal alcohol spectrum disorders in communities from Italy: Preliminary results. Alcohol Clin Exp Res 2006;30(9):1551–61.
50. Willford J, Leech S, Day N. Moderate prenatal alcohol exposure and cognitive status of children at age 10. Alcohol Clin Exp Res 2006;30(6):1051–9.
2. Hoyme HE, May PA, Kalberg WO et al. A practical clinical approach to diagnosis of fetal alcohol spectrum disorders: clarification of the 1996 Institute of Medicine criteria. Pediatrics 2005;115(1):39–47.
3. Coriale G, Fiorentino D, Di Lauro F et al. Fetal Alcohol Spectrum Disorder (FASD): neurobehavioral profile, indications for diagnosis and treatment. Riv Psichiatr 2013;48(5):359–369.
4. Aragón AS, Kalberg WO, Buckley D, Barela-Scott LM, Tabachnick BG, May PA. Neuropsychological study of FASD in a sample of American Indian children: processing simple versus complex information. Alcohol Clin Exp Res 2008;32(12):2136–48.
5. Willoughby KA, Sheard ED, Nash K, Rovet J. Effects of prenatal alcohol exposure on hippocampal volume, verbal learning, and verbal and spatial recall in late childhood. J Int Neuropsychol Soc 2008;14(6):1022–33.
6. 6. Falgreen Eriksen H-L, Mortensen EL, Kilburn T. The effects of low to moderate prenatal alcohol exposure in early pregnancy on IO in 5-year-old children. BJOG 2012;119(10):1191–200.
7. Kesmodel US, Bertrand J, Støvring H et al. The effect of different alcohol drinking patterns in early to mid pregnancy on the child’s intelligence, attention, and executive function. BJOG 2012;119(10):1180–90.
8. Mukherjee RAS, Hollins S, Turk J. Fetal alcohol spectrum disorder: an overview. J Royal Soc Med 2006;99:298–302.
9. Mattson SN, Riley EP. A review of the neurobehavioral deficits in children with fetal alcohol syndrome or prenatal exposure to alcohol. Alcoholism: Clin Exper Res 1998;22(2):279-94.
10. Mendes KDS, Silveira RCCP, Galvão CM. Revisão Integrativa: Método de Pesquisa para a Incorporação de Evidências na Saúde e na Enfermagem. Texto Contexto Enferm 2008;17(4):758-64.
11. Kodituwakku PW. Neurocognitive profile in children with fetal alcohol spectrum disorders. Dev Disabil Res Rev 2009;15(3):218–24.
12. Kodituwakku PW. Defining the behavioral phenotype in children with fetal alcohol spectrum disorders: a review. Neurosci Biobehav Rev 2007;31(2):192–201.
13. Dalen K, Bruarøy S, Wentzel-Larsen T, Laegreid LM. Cognitive functioning in children prenatally exposed to alcohol and psychotropic drugs. Neuropediatrics 2009;40(4):162–67.
14. Ferreira VKL, Ferreira GVD, Lima JMB, Cruz MS. Desempenho intelectual na exposição alcoólica fetal: relato de série de 10 casos. J Bras Psiquiatr 2013;62(3):234–39.
15. Raldiris TL, Bowers TG, Towsey C. Comparisons of Intelligence and Behaviour in Children With Fetal Alcohol Spectrum Disorder and ADHD. J Atten Disord 2014;1–12.
16. Woods KJ, Meintjes EM, Molteno CD, Jacobson SW, Jacobson JL. Parietal dysfunction during number processing in children with fetal alcohol spectrum disorders. Neuroimage Clin 2015;8:594–605.
17. Aragón AS, Coriale G, Fiorentino D et al. Neuropsychological characteristics of Italian children with fetal alcohol spectrum disorders. Alcohol Clin Exp Res 2008b;32(11):1909–19.
18. Boseck JJ, Davis AS, Cassady JC, Finch WH, Gelder BC. Cognitive and adaptive skill profile differences in children with attention-deficit hyperactivity disorder with and without comorbid fetal alcohol spectrum disorder. Appl Neuropsychol Child 2014;0:1–7.
19. Gautam P1, Lebel C, Narr KL et al. Volume changes and brain-behaviour relationships in white matter and subcortical gray matter in children with prenatal alcohol exposure. Hum Brain Mapp 2015;36(6):2318–29.
20. Howell KK, Lynch ME, Platzman KA, Smith GH, Coles CD. Prenatal alcohol exposure and ability, academic achievement, and school functioning in adolescence: a longitudinal follow-up. J Pediatr Psychol 2006;31(1):116–26.
21. Nash K, Stevens S, Rovet J et al. Towards identifying a characteristic neuropsychological profile for fetal alcohol spectrum disorders. 1. Analysis of the Motherisk FASD clinic. J Popul Ther Clin Pharmacol 2013;20(1):e44–52.
22. May PA, Tabachnick BG, Gossage JP et al. Maternal factors predicting cognitive and behavioral characteristics of children with fetal alcohol spectrum disorders. J Dev Behav Pediatr 2013;34(5):314–25.
23. Rasmussen C, Horne K, Witol A. Neurobehavioral functioning in children with fetal alcohol spectrum disorder. Child Neuropsychol 2006;12(6):453–68.
24. Carr JL, Agnihotri S, Keightley M. Sensory processing and adaptive behaviour deficits of children across the fetal alcohol spectrum disorder continuum. Alcohol Clin Exp Res 2010;34(6):1022–32.
25. Ervalahti N, Korkman M, Fagerlund A, Autti-Rämö I, Loimu L, Hoyme HE. Relationship between dysmorphic features and general cognitive function in children with fetal alcohol spectrum disorders. Am J Med Genet A 2007;143A(24):2916–23.
26. Fernández-Mayoralas DM, Fernández-Jaén A, Muñoz-Jareño N, Calleja Pérez B, Arroyo-González R. Fetal alcohol syndrome, Tourette syndrome, and hyperactivity in 9 adopted children. Pediatr Neurol 2010;43(2):110–6.
27. Foroud T, Wetherill L, Vinci-Booher S et al. Relation over time between facial measurements and cognitive outcomes in fetal alcohol-exposed children. Alcohol Clin Exp Res 2012;36(9):1634–46.
28. Lewis CE, Thomas KG, Dodge NC et al. Verbal learning and memory impairment in children with fetal alcohol spectrum disorders. Alcohol Clin Exp Res 2015;39(4):724–32.
29. McGee CL, Schonfeld AM, Roebuck-Spencer TM, Riley EP, Mattson SN. Children with heavy prenatal alcohol exposure demonstrate deficits on multiple measures of concept formation. Alcohol Clin Exp Res 2008;32(8):1388–97.
30. Meintjes EM, Narr KL, van der Kouwe AJ et al. A tensor-based morphometry analysis of regional differences in brain volume in relation to prenatal alcohol exposure. Neuroimage Clin 2014;5:152–60.
31. Molteno CD, Jacobson JL, Carter RC, Jacobson SW. Infant symbolic play as an early indicator of fetal alcohol-related deficit. Infancy 2010;15(6):586–607.
32. Nash K, Sheard E, Rovet J, Koren G. Understanding Fetal Alcohol Spectrum Disorders (FASDs): toward identification of a behavioral phenotype. Scient World J 2008;8:873–82.
33. Nayak R, Murthy P, Girimaji S, Navaneetham J. Fetal alcohol spectrum disorders--a case-control study from India. J Trop Pediatr 2012;58(1):19–24.
34. Wozniak JR, Mueller BA, Bell CJ et al. Global functional connectivity abnormalities in children with fetal alcohol spectrum disorders. Alcohol Clin Exp Res 2013;37(5):748–56.
35. Wozniak JR, Muetzel RL, Mueller BA et al. Microstructural corpus callosum anomalies in children with prenatal alcohol exposure: an extension of previous diffusion tensor imaging findings. Alcohol Clin Exp Res 2009;33(10):1825–35.
36. Davis KM, Gagnier KR, Moore TE, Todorow M. Cognitive aspects of fetal alcohol spectrum disorder. Wiley Interdiscip Rev Cogn Sci 2013;4(1):81–92.
37. Kumada T, Jiang Y, Cameron DB, Komuro H. How does alcohol impair neuronal migration? J Neurosci Res 2007;25(3):465–70.
38. Nuñez CC, Roussotte F, Sowell ER. Focus on: structural and functional brain abnormalities in fetal alcohol spectrum disorders. Alcohol Res Health 2011;34(1):121–31.
39. Wacha VH, Obrzut JE. Effects of fetal alcohol syndrome on neuropsychological function. J Develop Phys Disabil 2007;19(3):217–26.
40. Chasnoff IJ, Wells AM, Telford E, Schmidt C, Messer G. Neurodevelopmental functioning in children with FAS, pFAS, and ARND. J Dev Behav Pediatr 2010;31(3):192–201.
41. Kalberg WO, May PA, Blankenship J, Buckley D, Gossage JP, Adnams CM. A practical testing battery to measure neurobehavioral ability among children with FASD. Int J Alcohol Drug Res 2013;2(3):51–60.
42. May PA, Gossage JP, Marais AS et al. The epidemiology of fetal alcohol syndrome and partial FAS in a South African community. Drug Alcohol Depend 2007;88(2–3):259–71.
43. Figueiredo VLM. WISC-III. In: Cunha JA, ed. Psicodiagnóstico V. Porto Alegre: Artmed, 2007:603–14.
44. Cunha JA. Escalas Wechsler. In: Cunha JA, ed. Psicodiagnóstico V. Porto Alegre: Artmed, 2007:529–602.
45. McGee CL, Bjorkquist OA, Riley EP, Mattson SN. Impaired language performance in young children with heavy prenatal alcohol exposure. Neurotoxicol Teratol 2009;31(2):71–75.
46. Schonfeld AM, Paley B, Frankel F, O’Connor MJ. Behavioral regulation as a predictor of response to Children’s Friendship Training in children with fetal alcohol spectrum disorders. Clin Neuropsychol 2009;23(3):428–45
47. Vaurio L, Riley EP, Mattson SN. Neuropsychological comparison of children with heavy prenatal alcohol exposure and an iq-matched comparison group. J Internat Neuropsychol Soc 2011;17(3):463–73.
48. Primi R. Inteligência: Avanços nos Modelos Teóricos e nos Instrumentos de Medida. Avaliação Psicológica 2003;1:67–77.
49. Kodituwakku P, Coriale G, Fiorentino D et al. Neurobehavioral characteristics of children with fetal alcohol spectrum disorders in communities from Italy: Preliminary results. Alcohol Clin Exp Res 2006;30(9):1551–61.
50. Willford J, Leech S, Day N. Moderate prenatal alcohol exposure and cognitive status of children at age 10. Alcohol Clin Exp Res 2006;30(6):1051–9.
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Sep 16, 2019
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de L. Ferreira, V. K., & Cruz, M. S. . (2019). Intelligence and fetal alcohol spectrum disorders: A Review. Journal of Population Therapeutics and Clinical Pharmacology, 24(3), e1-e18. https://doi.org/10.15586/jptcp.v24i3.643
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