Fetal alcohol syndrome (FAS) encompasses a broad range of disabilities involving both structural and functional changes. Among the most devastating effects are those caused by alterations in the central nervous system (CNS). These CNS changes result in the cognitive and behavioral deficits reported in most studies of FAS. In addition, there is a growing body of literature that suggests that brain and behavioral changes can occur in the absence of the facial features required for an FAS diagnosis. In our study, children with heavy prenatal exposure to alcohol (PEA), who do not have the obvious physical features of FAS, show changes in both brain and behavior similar to those seen in FAS. Previous work has documented broad, fairly general, deficits in general intellectual ability. More recently, attention has been paid to specific aspects of neuropsychological functioning, documenting deficits as well as relative strengths across various cognitive domains. Needed is greater understanding of the details of these strengths and weaknesses. This level of examination, coupled with brain imaging, will provide the framework for intervention and remediation strategies for alcohol-exposed children. The proposed project is multidisciplinary in nature, including neuropsychological assessment, magnetic resonance imaging (MRI), and electrophysiological evaluation. This proposal represents a continuation of work that we have been conducting for the last three years. We plan to continue our general evaluation and are proposing to expand the investigation of our three research domains. In the neuropsychological domain, in addition to our general test battery, we are proposing specific measures of learning, memory, and emotional functioning. In the MRI component, along with continuing to evaluate brain structure in children with FAS and PEA, we are proposing a study of developmental brain changes and a pilot study in functional MRI. Finally, in the electrophysiological component, we are proposing to continue to collect EEG and ERP data on children with PEA as well as a new component addressing emotional responses in alcohol-exposed children. We believe that our approach has been successful thus far, and that this multidisciplinary project will expand our understanding of the devastating effects of prenatal alcohol exposure, perhaps leading to new treatment strategies.
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