title: Further development of a neurobehavioral profile of fetal alcohol spectrum disorders.
abstract: BACKGROUND
  Heavy prenatal alcohol exposure (AE) results in a broad array of neurobehavioral deficits. Recent research has focused on identification of a neurobehavioral profile or profiles that will improve the identification of children affected by AE. This study aimed to build on our preliminary neurobehavioral profile to improve classification accuracy and test the specificity of the resulting profile in an alternate clinical group.
  
  
  METHODS
  A standardized neuropsychological test battery was administered to 3 groups of children: subjects with AE (n = 209), typically developing controls (CON, n = 185), and subjects with attention-deficit/hyperactivity disorder (ADHD, n = 74). We assessed a large sample from 6 sites in the United States and South Africa, using standardized methodology. Data were analyzed using 3 latent profile analyses including (i) subjects with fetal alcohol syndrome (FAS) and controls, (ii) subjects with AE without FAS and controls, and (iii) subjects with AE (with or without FAS) and subjects with ADHD.
  
  
  RESULTS
  Classification accuracy was moderate but significant across the 3 analyses. In analysis 1, overall classification accuracy was 76.1% (77.2% FAS, 75.7% CON). In the second analysis, overall classification accuracy was 71.5% (70.1% AE/non-FAS, 72.4% CON). In the third analysis, overall classification accuracy was 73.9% (59.8% AE, 75.7% ADHD). Subjects that were misclassified were examined for systematic differences from those that were correctly classified.
  
  
  CONCLUSIONS
  The results of this study indicate that the neuropsychological effects of AE are clinically meaningful and can be used to accurately distinguish alcohol-affected children from both typically developing children and children with ADHD. Further, in combination with other recent studies, these data suggest that approximately 70% of children with heavy prenatal alcohol exposure are neurobehaviorally affected, while the remaining 30% are spared these often-devastating consequences, at least those in the domains under study. Refining the neurobehavioral profile will allow improved identification and treatment development for children affected by prenatal alcohol exposure.
authors.affiliation: Center for Behavioral Teratology, San Diego State University, San Diego, California, USA. sarah.mattson@sdsu.edu
authors.forename: Sarah N
authors.initials: SN
authors.lastname: Mattson
authors.forename: Scott C
authors.initials: SC
authors.lastname: Roesch
authors.forename: Leila
authors.initials: L
authors.lastname: Glass
authors.forename: Benjamin N
authors.initials: BN
authors.lastname: Deweese
authors.forename: Claire D
authors.initials: CD
authors.lastname: Coles
authors.forename: Julie A
authors.initials: JA
authors.lastname: Kable
authors.forename: Philip A
authors.initials: PA
authors.lastname: May
authors.forename: Wendy O
authors.initials: WO
authors.lastname: Kalberg
authors.forename: Elizabeth R
authors.initials: ER
authors.lastname: Sowell
authors.forename: Colleen M
authors.initials: CM
authors.lastname: Adnams
authors.forename: Kenneth Lyons
authors.initials: KL
authors.lastname: Jones
authors.forename: Edward P
authors.initials: EP
authors.lastname: Riley
mesh_terms: D000293:Adolescent; D002648:Child; D002652:Child Behavior / Q000523:psychology*; D056344:Executive Function / Q000502:physiology; D005260:Female; D063647:Fetal Alcohol Spectrum Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D013019:South Africa / Q000453:epidemiology; D014481:United States / Q000453:epidemiology