title: A state of double jeopardy: impact of prenatal alcohol exposure and adverse environments on the social communicative abilities of school-age children with fetal alcohol spectrum disorder.
abstract: OBJECTIVE
  This article is a retrospective examination of environmental risk, language performance, and narrative discourse data from a clinical database of school-age children with fetal alcohol spectrum disorder (FASD).
  
  
  METHODS
  A case-defined diagnostic approach for measuring and reporting the full spectrum of disabilities in children with prenatal alcohol exposure is presented. Demographic, environmental, language, and social communication (as reflected by narrative discourse) data are reported for a large cohort of children with FASD between the ages of 6;0 (years;months) and 12;0.
  
  
  RESULTS
  Children with FASD are a heterogeneous group with varying levels of compromise. The data demonstrate a substantial comorbidity between the effects of prenatal alcohol exposure and adverse caregiving environments. The data further reveal that school-age children with FASD often exhibit clinically meaningful deficits in language and social communication.
  
  
  CONCLUSIONS
  Children with FASD may be particularly vulnerable to language and social communication deficits as a result of prenatal alcohol exposure and atypical or adverse social interactive experiences. Comprehensive assessment is recommended. Dynamic and functional assessment paradigms may document the language and social communicative deficits in children with FASD and other clinical populations with complex neurodevelopmental profiles.
authors.affiliation: University of Washington, 1417 N.E. 42 Street, Seattle, WA 98105, USA. tec@u.washington.edu
authors.forename: Truman E
authors.initials: TE
authors.lastname: Coggins
authors.forename: Geralyn R
authors.initials: GR
authors.lastname: Timler
authors.forename: Lesley B
authors.initials: LB
authors.lastname: Olswang
mesh_terms: D002648:Child; D002649:Child Abuse / Q000175:diagnosis* / Q000523:psychology; D015897:Comorbidity; D005260:Female; D063647:Fetal Alcohol Spectrum Disorders / Q000175:diagnosis* / Q000523:psychology; D006801:Humans; D007398:Interpersonal Relations; D007805:Language Development Disorders / Q000175:diagnosis* / Q000523:psychology; D007807:Language Tests; D008297:Male; D018187:Personal Construct Theory; D011247:Pregnancy; D011340:Problem Solving; D012189:Retrospective Studies; D012307:Risk Factors; D012931:Social Environment; D014705:Verbal Behavior