This request for a renewal of funding is in response to the NIH/NIAAA funding opportunity entitled, ?Collaborative Initiative on Fetal Alcohol Spectrum Disorders (CIFASD)? (RFA-AA-17-007). The overarching aim of the current proposal is to develop, validate, and implement clinically novel and innovative measurement tools to accurately identify children who are affected by prenatal alcohol exposure. The proposed study is relevant to the overall objective of the CIFASD funding opportunity ?to accelerate specific areas of research related to the translation of new or improved capabilities in FASD clinical case recognition.? This is critical need. While there has been a concerted research effort since the initial clinical delineation of fetal alcohol syndrome (FAS), understanding the full spectrum of effects of prenatal alcohol exposure remains incomplete, hindering effective intervention. Although individuals with prenatal alcohol exposure may experience significantly impairing functional difficulties, identification of these individuals is inadequate. High rates of missed diagnoses and misdiagnosis result in lost opportunities for intervention and misunderstanding of the etiology of observed difficulties. Development of accurate and specific identification tools will improve diagnostic capability and clinical decision-making regarding treatment. To this end, during previous funding periods we substantially enhanced the understanding of the specificity of effects of prenatal alcohol exposure to increase identification of alcohol-affected youth. Our hierarchical CIFASD Decision Tree, developed and validated on over 800 subjects, indicates that administration of just 4 measures can distinguish alcohol-affected youth from nonexposed controls with and without behavioral concerns or conditions with accuracy rates of >80%. While a significant step forward, the Decision Tree was developed and validated in a research sample with a high risk of alcohol effects.
One aim of the current proposal is to develop and test an electronic version of the Decision Tree (the eTree) in lower risk, international, population-based, and clinic-based samples. Another aim of the proposal, in line with the specific RFA goal to use innovative technologies to screen for dysmorphology and/or neurobehavioral deficits to aid in the identification of alcohol-exposed individuals, is the development and implementation of the FASD Online Neurobehavioral Screen (FONS), a web-based neurobehavioral assessment tool for use with subjects recruited via a web portal (cf. Foroud U01). The FONS will measure domains known to be affected in FASD, including those represented in diagnostic criteria for neurobehavioral disorder associated with prenatal alcohol exposure (ND-PAE). The eTree and the FONS will be validated using laboratory-based in-person neuropsychological assessment of children with histories of prenatal alcohol exposure and non-exposed controls with and without behavioral concerns or conditions. The results of the proposed research will fulfill our research goals, improve recruitment, and most importantly accurately identify individuals affected by prenatal alcohol exposure, leading to improved clinical diagnosis and intervention.

Public Health Relevance

This project is directly relevant to public health concerns related to the effects of heavy prenatal alcohol exposure and improved identification of alcohol-affected individuals with novel electronic data collection techniques. Improved identification methods and delineation of features related to alcohol-exposure will ultimately lead to improved treatment and help alleviate the public health burden associated with prenatal alcohol exposure.

Agency
National Institute of Health (NIH)
Institute
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Type
Research Project--Cooperative Agreements (U01)
Project #
2U01AA014834-14
Application #
9391516
Study Section
Special Emphasis Panel (ZAA1)
Program Officer
Dunty, Jr, William
Project Start
2003-09-30
Project End
2022-05-31
Budget Start
2017-07-01
Budget End
2018-05-31
Support Year
14
Fiscal Year
2017
Total Cost
Indirect Cost
Name
San Diego State University
Department
Psychology
Type
Schools of Arts and Sciences
DUNS #
073371346
City
San Diego
State
CA
Country
United States
Zip Code
92182
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Infante, M Alejandra; Moore, Eileen M; Bischoff-Grethe, Amanda et al. (2017) Altered functional connectivity during spatial working memory in children with heavy prenatal alcohol exposure. Alcohol 64:11-21
Hendrickson, Timothy J; Mueller, Bryon A; Sowell, Elizabeth R et al. (2017) Cortical gyrification is abnormal in children with prenatal alcohol exposure. Neuroimage Clin 15:391-400
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Glass, Leila; Moore, Eileen M; Akshoomoff, Natacha et al. (2017) Academic Difficulties in Children with Prenatal Alcohol Exposure: Presence, Profile, and Neural Correlates. Alcohol Clin Exp Res 41:1024-1034
Gross, Lauren A; Moore, Eileen M; Wozniak, Jeffrey R et al. (2017) Neural correlates of verbal memory in youth with heavy prenatal alcohol exposure. Brain Imaging Behav :
Panczakiewicz, Amy L; Glass, Leila; Coles, Claire D et al. (2016) Neurobehavioral Deficits Consistent Across Age and Sex in Youth with Prenatal Alcohol Exposure. Alcohol Clin Exp Res 40:1971-81
Goh, Patrick K; Doyle, Lauren R; Glass, Leila et al. (2016) A Decision Tree to Identify Children Affected by Prenatal Alcohol Exposure. J Pediatr 177:121-127.e1
Wozniak, Jeffrey R; Mueller, Bryon A; Mattson, Sarah N et al. (2016) Functional connectivity abnormalities and associated cognitive deficits in fetal alcohol Spectrum disorders (FASD). Brain Imaging Behav :
Graham, Diana M; Glass, Leila; Mattson, Sarah N (2016) The Influence of Extrinsic Reinforcement on Children with Heavy Prenatal Alcohol Exposure. Alcohol Clin Exp Res 40:348-58

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