title: Prospective Memory Impairment in Children with Prenatal Alcohol Exposure.
abstract: Prenatal alcohol exposure (PAE) is linked to impaired performance on tests of retrospective memory, but prospective memory (PM; the ability to remember and act on delayed intentions) has not been examined in alcohol-exposed children. We investigated event-based PM in children with heavy PAE and the degree to which associations between PAE and PM are influenced by IQ, executive functioning (EF), retrospective memory, and attention deficit/hyperactivity disorder (ADHD).
  
  
  
  We administered a computerized PM task to 89 children (Mage = 11.1 years) whose mothers were recruited prenatally: 29 with fetal alcohol syndrome (FAS) or partial FAS (PFAS), 32 nonsyndromal heavily exposed (HE), and 28 Controls. We examined effects of diagnostic group, cue focality, and task difficulty on PM performance. The association between a continuous measure of alcohol exposure and PM performance was also examined after controlling for sociodemographic confounders. Mediation of alcohol effects on PM by IQ, EF, and retrospective memory scores was assessed as was the effect of ADHD on PM performance.
  
  
  
  Children with FAS/PFAS made more PM errors than either HE or Control children. PAE was negatively related to PM performance even after adjusting for sociodemographic confounders, EF, and retrospective memory. This relation was only partially mediated by IQ. PAE was related to ADHD, but ADHD was not related to PM performance.
  
  
  
  Fetal alcohol-related impairment in event-based PM was seen in children with FAS/PFAS. The effect of PAE on PM was not attributable to impaired EF and retrospective memory and was not solely attributable to lower IQ. Consistent with previous studies, we found no effect of ADHD on event-based PM performance at this age. This is the first study documenting PM impairment in children with heavy PAE and identifies a new domain of impairment warranting attention in diagnosis and management of fetal alcohol spectrum disorders.
authors.affiliation: ACSENT Laboratory, Department of Psychology, University of Cape Town, Cape Town, South Africa.
authors.forename: Catherine E
authors.initials: CE
authors.lastname: Lewis
authors.affiliation: ACSENT Laboratory, Department of Psychology, University of Cape Town, Cape Town, South Africa.
authors.forename: Kevin G F
authors.initials: KG
authors.lastname: Thomas
authors.affiliation: Department of Psychiatry and Mental Health, University of Cape Town Faculty of Health Sciences, Cape Town, South Africa.
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Molteno
authors.affiliation: School of Psychology, University of Geneva, Geneva, Switzerland.
authors.forename: Matthias
authors.initials: M
authors.lastname: Kliegel
authors.affiliation: Department of Human Biology, University of Cape Town Faculty of Health Sciences, Cape Town, South Africa.
authors.forename: Ernesta M
authors.initials: EM
authors.lastname: Meintjes
authors.affiliation: Department of Psychiatry and Mental Health, University of Cape Town Faculty of Health Sciences, Cape Town, South Africa.|Department of Human Biology, University of Cape Town Faculty of Health Sciences, Cape Town, South Africa.|Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, Michigan.
authors.forename: Joseph L
authors.initials: JL
authors.lastname: Jacobson
authors.affiliation: Department of Psychiatry and Mental Health, University of Cape Town Faculty of Health Sciences, Cape Town, South Africa.|Department of Human Biology, University of Cape Town Faculty of Health Sciences, Cape Town, South Africa.|Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, Michigan.
authors.forename: Sandra W
authors.initials: SW
authors.lastname: Jacobson
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000523:psychology; D016022:Case-Control Studies; D002648:Child; D056344:Executive Function; D005260:Female; D063647:Fetal Alcohol Spectrum Disorders / Q000175:diagnosis / Q000523:psychology*; D006801:Humans; D007361:Intelligence Tests; D008297:Male; D061212:Memory, Episodic; D011939:Mental Recall; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000523:psychology*
keywords: Attention Deficit/Hyperactivity Disorder; Executive Function; Fetal Alcohol Spectrum Disorders; Fetal Alcohol Syndrome; IQ; Prenatal Alcohol Exposure; Prospective Memory