Cohesive Referencing Errors During Narrative Production as Clinical Evidence of Central Nervous System Abnormality in School-Aged Children With Fetal Alcohol Spectrum Disorders

2016 ◽  
Vol 25 (4) ◽  
pp. 532-546 ◽  
Author(s):  
John C. Thorne ◽  
Truman E. Coggins
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Narrative Analysis ◽  
Fetal Alcohol Spectrum Disorders ◽  
Group Performance ◽  
Alcohol Exposure ◽  
Error Rates ◽  
Fetal Alcohol ◽  
Spectrum Disorders ◽  
Fetal Alcohol Spectrum

Purpose Previous evidence suggests that cohesive referencing errors made during narratives may be a behavior that is revealing of underlying central nervous system abnormality in children with fetal alcohol spectrum disorders (FASD). The current research extends this evidence. Method Retrospective analysis of narrative and clinical data from 152 children (ages 6 to 14), 72 of whom had confirmed FASD, was used. Narrative analysis was conducted blind to diagnostic status, age, or gender. Group performance was compared. The associations between measures of cohesive referencing and clinically gathered indices of the degree of central nervous system abnormality were examined. Results Results show clear associations between elevated rates of cohesive referencing errors and central nervous system abnormality. Elevated error rates were more common in children with FASD than those without, and prevalence increased predictably across groups with more severe central nervous system abnormality. Risk is particularly elevated for those with microcephaly or a diagnosis of fetal alcohol syndrome. Conclusion Cohesive referencing errors during narrative are a viable behavioral marker of the kinds of central nervous system abnormality associated with prenatal alcohol exposure, having significant potential to become a valuable diagnostic and research tool.

Accentuate the Negative: Grammatical Errors During Narrative Production as a Clinical Marker of Central Nervous System Abnormality in School-Aged Children With Fetal Alcohol Spectrum Disorders

2017 ◽  
Vol 60 (12) ◽  
pp. 3523-3537 ◽  
Author(s):  
John C. Thorne
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Fetal Alcohol Spectrum Disorders ◽  
Error Rates ◽  
Fetal Alcohol ◽  
Grammatical Errors ◽  
Grammatical Error ◽  
Spectrum Disorders ◽  
Grammatical Complexity ◽  
Fetal Alcohol Spectrum

Purpose The purpose of this study was to examine (a) whether increased grammatical error rates during a standardized narrative task are a more clinically useful marker of central nervous system abnormality in Fetal Alcohol Spectrum Disorders (FASD) than common measures of productivity or grammatical complexity and (b) whether combining the rate of grammatical errors with the rate of cohesive referencing errors can improve utility of a standardized narrative assessment task for FASD diagnosis. Method The method used was retrospective analysis of narrative and clinical data from 138 children (aged 7–12 years; 69 with FASD, 69 typically developing). Narrative analysis was conducted blind to diagnosis. Measures of grammatical error, productivity and complexity, and cohesion were used independently and in combination to predict whether a story was told by a child with an FASD diagnosis. Results Elevated grammatical error rates were more common in children with FASD, and this difference facilitated a more accurate prediction of FASD status than measures of productivity and grammatical complexity and, when combined with an accounting of cohesive referencing errors, significantly improved sensitivity to FASD over standard practice. Conclusion Grammatical error rates during a narrative are a viable behavioral marker of the kinds of central nervous system abnormality associated with prenatal alcohol exposure, having significant potential to contribute to the FASD diagnostic process.

Listening Difficulties in Children With Fetal Alcohol Spectrum Disorders: More Than a Problem of Audibility

2019 ◽  
Vol 62 (5) ◽  
pp. 1532-1548 ◽  
Author(s):  
Susan A. McLaughlin ◽  
John C. Thorne ◽  
Tracy Jirikowic ◽  
Tiffany Waddington ◽  
Adrian K. C. Lee ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Hearing Loss ◽  
Fetal Alcohol Spectrum Disorders ◽  
Fetal Alcohol ◽  
Auditory Dysfunction ◽  
Spectrum Disorders ◽  
Processing Deficits ◽  
Fetal Alcohol Spectrum ◽  
Auditory Behavior

Purpose Data from standardized caregiver questionnaires indicate that children with fetal alcohol spectrum disorders (FASDs) frequently exhibit atypical auditory behaviors, including reduced responsivity to spoken stimuli. Another body of evidence suggests that prenatal alcohol exposure may result in auditory dysfunction involving loss of audibility (i.e., hearing loss) and/or impaired processing of clearly audible, “suprathreshold” sounds necessary for sound-in-noise listening. Yet, the nexus between atypical auditory behavior and underlying auditory dysfunction in children with FASDs remains largely unexplored. Method To investigate atypical auditory behaviors in FASDs and explore their potential physiological bases, we examined clinical data from 325 children diagnosed with FASDs at the University of Washington using the FASD 4-Digit Diagnostic Code. Atypical behaviors reported on the “auditory filtering” domain of the Short Sensory Profile were assessed to document their prevalence across FASD diagnoses and explore their relationship to reported hearing loss and/or central nervous system measures of cognition, attention, and language function that may indicate suprathreshold processing deficits. Results Atypical auditory behavior was reported among 80% of children with FASDs, a prevalence that did not vary by FASD diagnostic severity or hearing status but was positively correlated with attention-deficit/hyperactivity disorder. In contrast, hearing loss was documented in the clinical records of 40% of children with fetal alcohol syndrome (FAS; a diagnosis on the fetal alcohol spectrum characterized by central nervous system dysfunction, facial dysmorphia, and growth deficiency), 16-fold more prevalent than for those with less severe FASDs (2.4%). Reported hearing loss was significantly associated with physical features characteristic of FAS. Conclusion Children with FAS but not other FASDs may be at a particular risk for hearing loss. However, listening difficulties in the absence of hearing loss—presumably related to suprathreshold processing deficits—are prevalent across the entire fetal alcohol spectrum. The nature and impact of both listening difficulties and hearing loss in FASDs warrant further investigation.

scholarly journals Language Development Disorder in Fetal Alcohol Spectrum Disorders (FASD), a Case Study

Languages ◽  
2020 ◽  
Vol 5 (4) ◽  
pp. 37
Author(s):  
Yuri E. Vega-Rodríguez ◽  
Elena Garayzabal-Heinze ◽  
Esther Moraleda-Sepúlveda
Keyword(s):  
Fetal Alcohol Spectrum Disorders ◽  
Early Stage ◽  
Alcohol Exposure ◽  
Fetal Alcohol ◽  
Foster Home ◽  
Language Development Disorder ◽  
Spectrum Disorders ◽  
And Behavior ◽  
Fetal Alcohol Spectrum

Prenatal alcohol exposure can cause developmental damage in children. There are different types and ranges of alterations that fall under the name of fetal alcohol spectrum disorders (FASD). Disabilities in learning, cognition, and behavior are observed. Environmental conditions are an influencing factor in this population since they are generally adverse and are either not diagnosed at an early stage or given the appropriate support and approach. We present a case study of a 9-year-old child, in which all the variables affecting his development (FASD diagnosis and socioenvironmental conditions) were observed and analyzed. His early childhood under institutional care, the move to a foster home at the age of 6, and several measures of evaluation from foster care to the present are described. Difficulties in vocabulary, access to vocabulary, morphology, syntax, grammar, oral narrative, pragmatics, speech, and communication were observed, along with cognitive difficulties in memory, perception and executive functioning, social adaptation, learning, and behavior. An early diagnosis and approach enable this population to develop skills in different dimensions to address early adversity despite their neurological and behavioral commitment. Speech-language pathologist services are crucial for the diagnosis and treatment of the language and communication difficulties that characterize this syndrome.

scholarly journals Screening in treatment programs for Fetal Alcohol Spectrum Disorders that could affect therapeutic progress

2013 ◽  
Vol 2 (3) ◽  
pp. 37-49 ◽  
Author(s):  
Therese M Grant ◽  
Natalie Novick Brown ◽  
J. Christopher Graham ◽  
Nancy Whitney ◽  
Dan Dubovsky ◽  
...  
Keyword(s):  
Life History ◽  
Fetal Alcohol Spectrum Disorders ◽  
Prenatal Alcohol Exposure ◽  
Cognitive Impairments ◽  
Alcohol Exposure ◽  
Treatment Programs ◽  
Fetal Alcohol ◽  
Prenatal Alcohol ◽  
Spectrum Disorders ◽  
Fetal Alcohol Spectrum

Grant, T., Novick Brown, N., Graham, J., Whitney, N., Dubovsky, D. , & Nelson, L. (2013). Screening in treatment programs for Fetal Alcohol Spectrum Disorders that could affect therapeutic progress. The International Journal Of Alcohol And Drug Research, 2(3), 37-49. doi:10.7895/ijadr.v2i3.116 (http://dx.doi.org/10.7895/ijadr.v2i3.116)Aims: While structured intake interviews are the standard of care in substance abuse treatment programs, these interviews often do not screen for cognitive impairments, such as those found in fetal alcohol spectrum disorders (FASD) and other brain-based developmental disorders. The research reported here supports a brief interview protocol, the Life History Screen (LHS), that screens clients unobtrusively for adverse life-course outcomes typically found in FASD, so as to guide follow-up assessments and treatment planning.Design: Two-group observational study.Setting: A three-year case management intervention program in Washington State for high-risk women who abuse alcohol and/or drugs during pregnancy.Participants: Group 1: No prenatal alcohol exposure (N = 463); Group 2: Diagnosed with FASD (Fetal Alcohol Syndrome, Alcohol Related Neurodevelopmental Disorder, fetal alcohol effects, or static encephalopathy) by a qualified physician (N = 25), or suspected of having FASD (reported prenatal alcohol exposure and displayed behaviors consistent with a clinical diagnosis of FASD) (N = 61).Measures: The Addiction Severity Index (ASI) was administered to participants at intake. We analyzed eleven ASI items that corresponded to questions on the LHS in order to assess the potential of the LHS for identifying adults with possible FASD. The Life History Screen itself was not administered.Findings: Analysis of group differences between the diagnosed FASD and suspected FASD groups supported our decision to collapse the two groups for the main analysis. The Life History Screen shows promise as an efficient pre-treatment screen, in that core items are significantly associated with FASD group membership on factors involving childhood history, maternal drinking, education, substance use, employment, and psychiatric symptomatology.Conclusions: The Life History Screen may have utility as a self-report measure that can be used at the outset of treatment to identify clients with cognitive impairments and learning disabilities due to prenatal alcohol exposure.

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