This Article Summary is part of our new CanFASD Connect Top Articles Summary Series. Over the next several months, we will be bringing you summaries of all the recent research papers from our list of the Top FASD Articles of 2019. This is an overview of a recent research paper called Neurodevelopmental outcomes in individuals with fetal alcohol spectrum disorder (FASD) with and without exposure to neglect: Clinical cohort data from a national FASD diagnostic clinic.

Background

Prenatal alcohol exposure (PAE) is known to have a significant impact on fetal development. Various studies have shown that experiences of neglect can impact neurodevelopment. Recent research has also indicated that children with PAE who are maltreated (i.e. abused or neglected) are at a higher risk of neurodevelopmental deficits than just children with PAE or just children experiencing maltreatment. Therefore, it is important to understand how neglect can impact symptoms of FASD, especially considering individuals with PAE often experience neglect.

The authors of the current UK study compared clinical data from 99 people with FASD to understand the relative impacts of PAE and postnatal neglect, respectively, on neurodevelopment.

Main Findings

• 54% of the sample had experienced prolonged neglect, 32% had not history of neglect and 13% had only experienced neglect early in infancy
• PAE has an impact on neurodevelopmental difficulties, independent of neglect.
• In this sample, neglect did not appear to have any additional impact on the neurodevelopmental outcomes.
• PAE is responsible for more neurodevelopmental deficits than postnatal maltreatment or neglect in cases where a child experiences both factors

Recommendations

• Use caution when attributing neurodevelopmental difficulties to neglect in cases where you are examining a child with PAE
• Be cautious when generalizing the results of this study, as the limitations in study design may have impacted findings
• Professionals who support children with FASD should be aware that behavioural deficits are likely related to PAE and not parenting quality.
• Future research on neglect should take PAE into account as a potential confounding factor to exclude its effect.

Take-home message
Neglect and PAE can both negatively impact future success. However, his study indicates that PAE is the biggest risk factor when considering neurodevelopment, and neglect is not likely to have any additional impact in children who experience both neglect and PAE. Professionals who are supporting families of children with PAE need to understand that neurological damage may have occurred during pregnancy and these deficits are not an indication of parenting quality.

Authors: Raja A.S. Mukherjee, Penny A. Cook, Sarah H. Norgate, and Alan D. Price

Journal: Alcohol

Date: May 2019

Read the full article (available open access)