The neuropsychological effects of prenatal exposure to alcohol

[摘要] ENGLISH ABSTRACT:The objective of this thesis is to review and synthesize the scientific literature oncognitive and neuropsychological deficits associated with children who wereexposed to alcohol prenatally and to highlight possible areas of future attention.High incidences of Fetal Alcohol Syndrome has been reported especially inpatients from low socio-economic areas. The highest reported incidence is foundin the Western Cape province in South Africa. The devastating part of FAS is thatits affects are entirely preventable. Alcohol is a physical and a behaviouralteratogen. Prenatal alcohol exposure causes structural damage to the centralnervous system and the brain that is vulnerable throughout the pregnancy. Adose-response association exist as exposure to heavier amounts of alcohol cancause more harm. The timing and pattern of alcohol consumption also plays arole. To date though, no safe level of alcohol consumption during pregnancycan be advocated.Various neuropsychological decrements are found in individuals with fetal alcoholsyndrome or alcohol related neuro-developmental deficits as evaluated onstandardized tests. Mental retardation is commonly found and even individualswith normal IQ's still display other learning disabilities. IQ's remain stable overthe life span. Along with impaired intellectual functioning they also struggle withmathematical tasks especially as their complexity increases. Speech and language development is also delayed in individuals with FAS.There is little variation in the pith and display poor language comprehension.Attentional deficits are also noted and especially impact on academic functioning.Clinically, children often present with ADHD but in-depth studies have revealedthat neurobiologically there is some differences as children with FAS strugglemore with encoding and shifting of attention as opposed to other patients withADHD.Difficulties with visual-spatial functioning has also been found. Verbal learningand memory are also impaired in individuals with FAS. Their poor verballearning are influenced by their shallow level of encoding. Problems with finemotor skills are also noted.It also appear that all executive functions are impaired. They demonstrate poorplanning skills, initiation, cognitive shifting, slow information processing, theirthinking is concrete and they have poor self-regulatory skills. Behaviouralproblems include impulsivity, hyperactivity, aggressiveness, poor social skills andimpaired judgement.Early intervention is thus essential to lessen the impact of neuro-psychologicaldeficits on functional adaptation. A sensitive battery of neuro-psychological testsare also required to identify all the impairments in affected individuals and to planmore focussed intervention strategies.

[发布机构] Stellenbosch University