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Current Opinion in Psychiatry:
doi: 10.1097/YCO.0000000000000038

Foetal alcohol spectrum disorder: identifying the neurobehavioural phenotype and effective interventions

Koren, Gideona; Zelner, Irenea; Nash, Kellyb; Koren, Gala

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aMotherisk Program, Division of Clinical Pharmacology-Toxicology, Department of Pediatrics

bDepartment of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada

Correspondence to Gideon Koren, MD, FRCPC, Motherisk Program, Hospital for Sick Children, 555 University Ave, Toronto, ON M5G 1X8, Canada. Tel: +1 416 813 5781; e-mail:

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Purpose of review: Since the first description of the foetal damage of alcohol in 1967, numerous studies have outlined different aspects of neurodevelopmental dysfunction, adversely affecting the lives of children worldwide. Although the cause of the syndrome is sorted out, the pathogenesis of brain damage is far from being clear. In contrast to children exhibiting the full facial dysmorphology, who are relatively easy to diagnose, in those presenting only with alcohol-related neurodevelopmental damage diagnosis is much more challenging due to poor specificity of the brain dysfunction. Hence, identifying the neurodevelopmental phenotype of foetal alcohol spectrum disorder (FASD) is a major challenge.

Recent findings: Recently, a behavioural phenotype of FASD has been described and validated using items from the Child Behaviour Checklist. This tool has high sensitivity and specificity in separating children with FASD from those with ADHD and from healthy controls. In parallel, a number of intervention studies show promise in improving the abilities of children and adolescents with the syndrome to cope with daily tasks and improve their quality of life.

Summary: The neurobehavioural screening test can facilitate screening for FASD and is an official screening tool in the FASD toolkit of the Public Health Agency of Canada. Promising new interventions may attenuate the long-term outcome of these children.

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Alcohol is a human teratogen with marked effects on the developing brain. The various presentations arising from prenatal alcohol exposure, such as the full-blown foetal alcohol syndrome (FAS) and alcohol-related neurodevelopmental disorder (ARND), are defined collectively as foetal alcohol spectrum disorder (FASD). FASD is characterized by a wide range of deficiencies, including reduced intelligence quotient (IQ) [1,2], cognitive and learning disabilities and severe behaviour problems [3,4]. Attention problems are prevalent, with approximately 70% of children with FASD having a clinically diagnosed attention disorder, with attention deficit/hyperactivity disorder (ADHD) being three to nine times higher in children with FASD than in the general population [5–8]. Of importance, children with FASD are characterized by oppositional defiant/conduct disorder (ODD/CD) being the next most common to ADHD [8–10], including deficits in moral development, lack of social judgement and failure to learn from experience [5]. A large proportion of individuals with FASD require extensive mental health services throughout their lifetime. Currently, the majority of children with FASD fail to receive a diagnosis because skilled professionals and adequate mental health services are often lacking, especially if children reside in rural and remote areas, which represents an important public health concern. Hence, children with FASD are often diagnosed with, and treated for, a comorbid disorder rather than for FASD itself, with the effects of the alcohol-related disorder being overlooked and not addressed. To be able to differentially diagnose children on the FASD spectrum from those with other psychiatric disturbances of childhood, appropriate tools have to be developed.

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The greatest challenge in developing a method to screen and identify the behavioural characteristics of FASD is the wide and nonspecific range of deficits exhibited by the children. As part of the effort to characterize a neurobehavioural phenotype of FASD, we have developed and validated a 10-item screening tool based on items from a standardized behaviour problems questionnaire known as the Child Behaviour Checklist (CBCL) developed by Achenbach and Rescolora [11]. The full CBCL tool includes 113 items filled by caretakers or teachers who know the child. Out of these items, factor analysis revealed a combination of 10 items that accurately separated children with FASD from the two comparison groups [12]. We compared children with FASD (n = 30) with children with ADHD (n = 30) and with typically developing children (n = 30) [12]. This neurobehavioural test has been shown to be 86% sensitive and 82% specific for FASD. Because 70% children with FASD also exhibit ADHD, we also defined a behavioural phenotype for those 30% who do not have symptoms of hyperactivity and attention deficit. Table 1 presents the full neurobehavioural screening test (NST) in details with two exemplary cases to allow readers to learn how to apply this tool. The NST, validated for children aged 6–13 years, can be completed by health or social workers interviewing the primary caretaker of the child. The NST has been endorsed by the Public Health Agency of Canada as a screening test for FASD as part of the agency-sponsored FASD Screening Toolkit [13].

Table 1
Table 1
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Some of the items in the NST reflect features of ODD/CD. We could not be certain whether these items reflected comorbidity with ODD/CD, or represented distinct features of FASD. To address these outstanding issues, we replicated our 2006 original article using a larger and different sample of children with FASD, children with ADHD and controls, and sought to further determine the specificity of our screening tool by also comparing the FASD group with children with ODD/CD.

The sample included 220 children aged 6–18 years, 56 with an FASD, 50 with ADHD, 60 with ODD/CD and 53 typically developing normal control children [14▪▪]. This study, using a different sample of children, corroborated the results of our previous findings. Examination of individual item scores revealed that children with FASD differed from healthy controls in behaviours reflecting immaturity, argumentativeness, inattention and general disobedience. Children with ADHD were less likely than those with FASD to have behaviour problems and act young; in contrast, children with ODD/CD were less likely than FASD to act young but were more cruel and disobedient at home. These findings indicate that the NST is highly discriminative between FASD and healthy controls groups and that certain combinations of items differentiate children with FASD from unexposed children with ADHD and ODD/CD. This consistency, across different samples of children with FASD, further validates this screening method. We found that children with FASD exhibited poor attention and behaviour suggestive of ADHD, but, unlike ADHD, they displayed a greater lack of guilt after misbehaving, cruelty, tendency to act young for their age and likelihood to steal. The latter finding supports previous and current research indicating poor social and moral development in children with FASD [10,15–17,18▪,19▪].

The results show that children with FASD are significantly more likely than ODD/CD to act young, while being somewhat less disobedient at home and cruel. This finding suggests that children with FASD may have a distinct profile of behaviour problems from that seen in ODD/CD. Our finding of greater immaturity in children with FASD than ODD/CD (as well as ADHD) is consistent with reports of arrested social development in this population [20].

It is critical to highlight the fact that the NST is intended for screening purposes only and is not a diagnostic tool. A number of limitations impede our having a full understanding of how prenatal alcohol exposure affects development, as is characteristic of most clinic-based research. In our studies, we could not adequately control for maternal smoking and drug use, depression and other mental illnesses common among alcohol-dependent women, as well as maternal history of abuse and neglect. Several methodological limitations are also specific to the current study. As data were collected retrospectively, certain background information was not available, and further studies are being conducted now to adequately fill these gaps.

In 2013, Mattson et al. [21▪] tried to characterize a neurobehavioural profile of FASD [12,19▪]. They compared several groups of children on a large neuropsychological test battery. The tests included in this battery were the Cambridge Neuropsychological Test Automated Battery (CANTAB: Delayed Matching to Sample, Intra-Extra Dimensional Shift, Choice Reaction Time, Simple Reaction Time, Spatial Working Memory subtests) (Cambridge Cognition Limited, 2006) and the Delis-Kaplan Executive Function System (D-KEFS: Colorword Interference, Trail Making, 20 Questions, Tower, Verbal Fluency Switching, Design Fluency subtests). Full-scale IQ (FSIQ) scores were obtained using the Wechsler Intelligence Scale for Children, fourth edition (WISC-IV; Wechsler, 2004).

They included 185 healthy controls, 74 children with ADHD and 209 children heavily exposed to alcohol in pregnancy (both diagnosed and undiagnosed with FASD). The healthy children differed from the alcohol-exposed children with high statistical power. However, classification accuracy was moderate across the groups, which is not surprising in light of the numerous tests included in the analysis, and the fact that not all children exposed to heavy alcohol were diagnosed with FASD.

In summary, the NST has allowed a set of behavioural characteristics to be identified that distinguish children with FASD from children with two commonly associated childhood disorders, namely ADHD and ODD/CD, as well as from healthy controls; clinicians and researchers working with children with FASD have long struggled to identify a behavioural phenotype characteristic of FASD. After the NST is further validated on a larger and more diverse sample, it may allow clinicians to employ this behavioural phenotype to diagnose FASD in cases with unclear maternal drinking history and lack of the pathognomonic facial features of FASD.

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Although the primary alcohol-induced damage is thought to be, for the most part, permanent, studies have shown that factors such as early diagnosis (specifically before the age of 6), living in a stable and nurturing home, never having experienced violence, having been found eligible for developmental disability services and having basic needs met are protective in that they are associated with a decreased risk of developing secondary disabilities such as disrupted school experience, unemployment, institutionalization and trouble with the law [22]. Early diagnosis is associated with improved life outcomes in FASD-affected individuals, likely because it permits early intervention and access to specialized support and resources, all of which may help affected individuals lead more productive lives and lessen the impact that FASD has on the individual and society. Of interest, Streissguth et al.[1] noted that individuals who did not meet the criteria for a FAS diagnosis or those with an IQ greater than 70 were at a higher risk for delinquency, alcohol and drug problems, and school problems. This may be due to the fact that these individuals were less likely to be identified and qualify for services. Because the younger the age at which an affected child is identified, the lower the frequency of secondary disabilities [22], early diagnosis is of paramount importance for managing FASD in our society and reducing the tremendous economic burden associated with it.

In a systematic review of animal studies that examined interventions for the detrimental effects of prenatal alcohol exposure, Sussman and Koren [23] reported that, in rodents, postnatal environmental enrichment, postnatal handling, exercise and therapeutic motor training may attenuate and ameliorate ethanol-induced abnormalities and deficits such as learning, motor function and planning. For example, one study [24] showed that motor and spatial impairments in rat pups exposed to ethanol can be ameliorated by providing them with various objects to manipulate and play with and housing them with other pups. Another study [25] showed that providing ethanol-exposed rat pups with opportunities for voluntary exercise improved spatial memory (performance on Morris water maze test). In another series of studies, it was shown that postnatal choline supplementation attenuated the severity of ethanol-induced learning deficits and behavioural changes such as hyperactivity in rats prenatally exposed to ethanol [26–28]. These findings are encouraging and require further research in humans to determine whether such interventions could improve neurological performance and reduce the severity of foetal alcohol effects.

In humans, a number of interventions have been shown to improve outcomes in FASD-affected individuals, as well as provide the necessary supports to aid the development of necessary skills that will help the child become an independent adult. In terms of pharmacotherapy, Snyder et al.[29] found that stimulants (methylphenidate, pemoline or dexedrine) improved hyperactivity but not attention compared with placebo in a group of 12 children (6–16 years of age) with FAS and ADHD. In a retrospective study in which data were extracted from the medical records of 27 children with FASD who had been referred to an ADHD medication service, stimulants were found to improve hyperactivity/impulsivity and opposition/defiance but were not as effective at improving inattention [30]. The authors speculated that these findings suggest that inattention may be less responsive to ADHD medication.

In a recent systematic review of school-based interventions, Peadon et al.[31] evaluated and discussed interventions designed to improve the developmental outcomes of individuals with FASD, reduce secondary disabilities and improve the lives of families of individuals affected by FASD. As a diagnosis of FASD in and of itself does not provide enough information on the appropriate treatment that must be provided, a careful assessment of each individual is essential [31]. Different interventions must be specifically designed to target deficits such as memory, information processing, academic skills, social skills, attention, motor skills and executive functioning, as well as to address various behavioural and mental health issues. It is important to note that the majority of individuals with FASD do not have low IQ and thus may not qualify for many support services. As they nevertheless have impaired mental functioning that has a significant impact on social and academic functioning [32], individual in-depth assessments are important for identifying the specific deficits and providing these individuals with critical services that would otherwise be unavailable to them [31].

Numerous human studies have been carried out in recent years on the effectiveness of interventions focusing on math skills, behavioural regulation, peer relations and social communication, executive function, compliance, learning readiness and challenging behaviour of clinical concern in individuals affected by FASD (Table 2) [31,33–39,40▪,41,42▪]. Many of these were randomized controlled trials. Interventions and treatment typically focus on adapting the FASD-affected children to their environment by addressing their neurodevelopmental issues. The common technique used in these interventions is teaching by explicit instruction rather than relying on observational learning [31,33]. Interventions to support emotional and behavioural regulation focus on modifying the environment and providing structure and consistency through daily routines and rules. For example, minimizing visual and auditory distractions in classrooms and use of clearly organized material can aid learning in children with FASD [34]. Researchers have also suggested that, to be effective, interventions must not only aim to address the range of deficits exhibited by individuals with FASD but also focus on educating, training and providing resources and services to their caregivers [34]. In addition, biological parents of these children may be dealing with ongoing substance abuse problems and stigmatization, which must be addressed, as it could have a very detrimental effect on the child and intervention efforts.

Table 2
Table 2
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Overall, there is increasing evidence in the literature that, although incurable, FASD can be managed, and individuals with prenatal alcohol exposure can lead productive lives if they can be identified and referred to intervention and support programmes. Unfortunately, conditions that fall under the FASD umbrella are vastly underdiagnosed and many individuals affected by in-utero alcohol exposure never receive specialized support and interventions that have been shown to be beneficial. For this reason, screening tools that may identify individuals at risk for FASD such that they can be referred for further assessments and diagnostic clinic need to be developed.

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Children spend a large part of their lives in school, and for children afflicted by FASD the school is the most challenging arena, both in terms of academic difficulties and in terms of adverse behaviour. Typically, these children experience disruptive school attendance, under-achievement and inability to stay in regular, or even special, education programmes [43]. Their low cognitive abilities, attention and hyperactive tendencies, coupled with maladaptive behaviour, make the school experience a nightmare for them and for their families.

In 2012, we commenced a pilot school programme for Grade 2–3 children diagnosed by us with FASD. In collaboration with the Toronto District School Board, nine children were enrolled in two classes, attended by a teacher and educational assistant in each class, aiming to address the specific educational needs of each student, and supported clinically by the Motherisk Program at The Hospital for Sick Children. At the end of the 2012–2013 academic year, all nine families asked to continue in the programme for the subsequent year, and many noted that this was the best year of their children's lives. Although analysis of the progress of the children in different domains by comparing pre and post measurements is still ongoing, quite a few of the children have shown marked progress, above what was expected of them.

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The newly described neurobehavioural screening test can facilitate screening for FASD and is an official screening tool in the FASD toolkit of the Public Health Agency of Canada. Although the primary brain damage of FASD appears to be irreversible, promising new interventions can attenuate the long-term outcome of these children.

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This work has been supported by grants from (1) the Public Health Agency of Canada through the Canadian Association for Pediatric Health Centres; (2) the Research Leadership for Better Pharmacotherapy during Pregnancy and Lactation; and (3) Shoppers Drug Mart.

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Conflicts of interest

There are no conflicts of interest.

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Papers of particular interest, published within the annual period of review, have been highlighted as:

▪ of special interest

▪▪ of outstanding interest

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1. Streissguth AP, Bookstein FL, Barr HM, et al. Risk factors for adverse life outcomes in fetal alcohol syndrome and fetal alcohol effects. J Dev Behav Pediatr 2004; 25:228–238.

2. Jacobson SW, Jacobson JL, Sokol RJ, et al. Maternal age, alcohol abuse history, and quality of parenting as moderators of the effects of prenatal alcohol exposure on 7.5-year intellectual function. Alcohol Clin Exp Res 2004; 28:1732–1745.

3. Rasmussen C. Executive functioning and working memory in fetal alcohol spectrum disorder. Alcohol Clin Exp Res 2005; 29:1359–1367.

4. Mattson SN, Riley EP. Parent ratings of behavior in children with heavy prenatal alcohol exposure and IQ-matched controls. Alcohol Clin Exp Res 2000; 24:226–231.

5. Niccols A. Fetal alcohol syndrome and the developing socio-emotional brain. Brain Cogn 2007; 65:135–142.

6. O’Malley KD, Nanson J. Clinical implications of a link between fetal alcohol spectrum disorder and attention-deficit hyperactivity disorder. Can J Psychiatry Rev Can Psychiatr 2002; 47:349–354.

7. Oesterheld JR, Kofoed L, Tervo R, et al. Effectiveness of methylphenidate in Native American children with fetal alcohol syndrome and attention deficit/hyperactivity disorder: a controlled pilot study. J Child Adolesc Psychopharmacol 1998; 8:39–48.

8. Steinhausen HC, Willms J, Spohr HL. Long-term psychopathological and cognitive outcome of children with fetal alcohol syndrome. J Am Acad Child Adolesc Psychiatry 1993; 32:990–994.

9. O’Connor MJ, Shah B, Whaley S, et al. Psychiatric illness in a clinical sample of children with prenatal alcohol exposure. Am J Drug Alcohol Abuse 2002; 28:743–754.

10. Famy C, Streissguth AP, Unis AS. Mental illness in adults with fetal alcohol syndrome or fetal alcohol effects. Am J Psychiatry 1998; 155:552–554.

11. Achenbach T, Rescolora A. Child behavior checklist for 6-18 years. 2001. [Accessed 29 December 2013]

12. Nash K, Rovet J, Greenbaum R, et al. Identifying the behavioural phenotype in fetal alcohol spectrum disorder: sensitivity, specificity and screening potential. Arch Womens Ment Health 2006; 9:181–186.

13. Goh YI, Chudley AE, Clarren SK, et al. Development of Canadian screening tools for fetal alcohol spectrum disorder. Can J Clin Pharmacol J Can Pharmacol Clin 2008; 15:e344–e366.

14▪▪. Nash K, Koren G, Rovet J. A differential approach for examining the behavioural phenotype of fetal alcohol spectrum disorders. J Popul Ther Clin Pharmacol 2012; 18:e440–e453.

This is a large validation study for the original neurobehavioural phenotype tool. In addition, it has also added the separation of children with FASD from those with ODD/CD, both of whom exhibit strong traits of social behaviour.

15. Fryer SL, McGee CL, Matt GE, et al. Evaluation of psychopathological conditions in children with heavy prenatal alcohol exposure. Pediatrics 2007; 119:e733–e741.

16. Greenbaum RL, Stevens SA, Nash K, et al. Social cognitive and emotion processing abilities of children with fetal alcohol spectrum disorders: a comparison with attention deficit hyperactivity disorder. Alcohol Clin Exp Res 2009; 33:1656–1670.

17. Rasmussen C, Talwar V, Loomes C, Andrew G. Brief report: lie-telling in children with fetal alcohol spectrum disorder. J Pediatr Psychol 2008; 33:220–225.

18▪. 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:e44–e52.

Using a large clinical database, this study further validates the behavioural characteristics that can distinguish children with HASD from children with FASD or other related neurobehavioural deficits.

19▪. Stevens SA, Nash K, Fantus E, et al. Towards identifying a characteristic neuropsychological profile for fetal alcohol spectrum disorders. 2. Specific caregiver-and teacher-rating. J Popul Ther Clin Pharmacol 2013; 20:e53–e62.

Using a large clinical database, this study, based on caregiver and teacher reports, further validates the behavioural characteristics that can distinguish children with HASD from children with FASD or other related neurobehavioural deficits. Because the new neurobehavioural tool is based on caregiver and teachers’ ratings, this is an important step in the validation of the tool.

20. Thomas SE, Kelly SJ, Mattson SN, Riley EP. Comparison of social abilities of children with fetal alcohol syndrome to those of children with similar IQ scores and normal controls. Alcohol Clin Exp Res 1998; 22:528–533.

21▪. Mattson SN, Roesch SC, Glass L, et al. Further development of a neurobehavioral profile of fetal alcohol spectrum disorders. Alcohol Clin Exp Res 2013; 37:517–528.

The study aimed to characterize a neurobehavioural profile of FASD. They compared several groups of children on a large neuropsychological test battery. Classification accuracy was moderate across the groups, which is not surprising in light of the numerous tests included in the analysis, and the fact that not all children exposed to heavy alcohol were diagnosed with FASD.

22. Streissguth AP. Understanding the occurrence of secondary disabilities in clients with fetal alcohol syndrome (FAS) and fetal alcohol effects (FAE). Seattle, WA:University of Washington School of Medicine; 1996.

23. Sussman R, Koren G. Attenuating the effects of prenatal alcohol exposure with postnatal interventions: critical review of animal studies and applications to clinical research. J FAS Int 2006; 4:e13.

24. Hannigan JH, Berman RF. Amelioration of fetal alcohol-related neurodevelopmental disorders in rats: exploring pharmacological and environmental treatments. Neurotoxicol Teratol 2000; 22:103–111.

25. Thomas JD, Sather TM, Whinery LA. Voluntary exercise influences behavioral development in rats exposed to alcohol during the neonatal brain growth spurt. Behav Neurosci 2008; 122:1264–1273.

26. Thomas JD, La Fiette MH, Quinn VR, Riley EP. Neonatal choline supplementation ameliorates the effects of prenatal alcohol exposure on a discrimination learning task in rats. Neurotoxicol Teratol 2000; 22:703–711.

27. Thomas JD, Garrison M, O’Neill TM. Perinatal choline supplementation attenuates behavioral alterations associated with neonatal alcohol exposure in rats. Neurotoxicol Teratol 2004; 26:35–45.

28. Thomas JD, Biane JS, O’Bryan KA, et al. Choline supplementation following third-trimester-equivalent alcohol exposure attenuates behavioral alterations in rats. Behav Neurosci 2007; 121:120–130.

29. Snyder J, Nanson J, Snyder RE, Block GW. Streissguth AP, Kanter J. Stimulant efficacy in children with FAS. The challenge of fetal alcohol syndrome: overcoming secondary disabilities. Seattle, WA:University of Washington Press; 1997. 64–77.

30. Doig J, McLennan JD, Gibbard WB. Medication effects on symptoms of attention-deficit/hyperactivity disorder in children with fetal alcohol spectrum disorder. J Child Adolesc Psychopharmacol 2008; 18:365–371.

31. Peadon E, Rhys-Jones B, Bower C, Elliott EJ. Systematic review of interventions for children with fetal alcohol spectrum disorders. BMC Pediatr 2009; 9:35.

32. McGee CL, Fryer SL, Bjorkquist OA, et al. Deficits in social problem solving in adolescents with prenatal exposure to alcohol. Am J Drug Alcohol Abuse 2008; 34:423–431.

33. Bertrand J. Interventions for children with fetal alcohol spectrum disorders (FASDs): overview of findings for five innovative research projects. Res Dev Disabil 2009; 30:986–1006.

34. Paley B, O’Connor MJ. Intervention for individuals with fetal alcohol spectrum disorders: treatment approaches and case management. Dev Disabil Res Rev 2009; 15:258–267.

35. Grant T, Huggins J, Connor P, et al. A pilot community intervention for young women with fetal alcohol spectrum disorders. Community Ment Health J 2004; 40:499–511.

36. O’Connor MJ, Frankel F, Paley B, et al. A controlled social skills training for children with fetal alcohol spectrum disorders. J Consult Clin Psychol 2006; 74:639–648.

37. Loomes C, Rasmussen C, Pei J, et al. The effect of rehearsal training on working memory span of children with fetal alcohol spectrum disorder. Res Dev Disabil 2008; 29:113–124.

38. Coles CD, Kable JA, Taddeo E. Math performance and behavior problems in children affected by prenatal alcohol exposure: intervention and follow-up. J Dev Behav Pediatr 2009; 30:7–15.

39. Kable JA, Coles CD, Taddeo E. Socio-cognitive habilitation using the math interactive learning experience program for alcohol-affected children. Alcohol Clin Exp Res 2007; 31:1425–1434.

40▪. O’Connor MJ, Laugeson EA, Mogil C, et al. Translation of an evidence-based social skills intervention for children with prenatal alcohol exposure in a community mental health setting. Alcohol Clin Exp Res 2012; 36:141–152.

The effectiveness of Children's Friendship Training (CFT) was assessed in 85 children with and without pregnancy alcohol exposure in a community mental health centre. Children participating in CFT showed significantly improved knowledge of appropriate social skills, improved self-concept and improvements in parent-reported social skills compared with children in the system-on-a-chip testing condition.

41. Adnams CM, Sorour P, Kalberg WO, et al. Language and literacy outcomes from a pilot intervention study for children with fetal alcohol spectrum disorders in South Africa. Alcohol 2007; 41:403–414.

42▪. Wells AM, Chasnoff IJ, Schmidt CA, et al. Neurocognitive habilitation therapy for children with fetal alcohol spectrum disorders: an adaptation of the alert program. Am J Occup Ther 2012; 66:24–34.

The research evaluated the effectiveness of neurocognitive habilitation, a group therapy intervention for foster and adoptive caregivers and their children who had been prenatally exposed to alcohol. Significant differences between the treatment and control groups were demonstrated on the behavior rating inventory of executive function and on the Roberts appreciation test for children, suggesting an improvement of executive functioning and emotional problem-solving skills.

43. Koren G, Todorow M. Understanding FASD; A resource for education practitioners in Ontario. Toronto: The Motherisk Program; 2010.


child behaviour checklist; foetal alcohol spectrum disorder; foetal alcohol spectrum disorder neurobehavioural phenotype; intervention studies; school for foetal alcohol spectrum disorder children

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