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-12-004). The proposed study is relevant to the overall goal of the CIFASD funding opportunity of further refining definitive diagnoses of FASD at different stages of the lifespan based on biological, physical, neurological, or behavioral assessment, or a combination thereof. It is also directly in line with three of the specific research areas identifed in the RFA: (1) Enhanced understanding of the neurobehavioral phenotype of FAS and ARND, (2) Diagnosis of FASD, and (3) Early case identification. Although nearly 40 years have passed since the initial clinical delineation of fetal alcohol syndrome (FAS), understanding of the full spectrum of effects of prenatal alcohol exposure (AE) is incomplete. Even though many children with AE experience significant neurobehavioral and adaptive difficulties that are related to their exposure history, for a majority of the cases, the link between those difficulties and AE may go unrecognized. Given that early identification has been linked to improved prognosis, it is critical to improve identification of alcohol-affected children with a sensitive, clinically utilizable neurobehavioral profile. Recent research, including that funded by CIFASD, has focused on the specificity of alcohol's effects by comparing children with AE and those with attention-deficit/hyperactivity disorder (ADHD). While this research has documented important similarities and differences between AE and ADHD, comparisons with a more heterogeneous contrast group may increase the generalizability of the profile as well as detect deficits that are common between neurodevelopmental conditions and those that are unique to the effects of prenatal alcohol exposure. Finally, previous work on the neurobehavioral profile has focused primarily on the executive function domain, however, preliminary data and previous research suggests that including measures of memory function may strengthen the existing profile. The overarching aim of the current proposal is to develop and implement clinically relevant and feasible measurement tools to accurately identify children who are affected by AE. The proposed study will build on our existing database derived from data collected from children between 8-16 years of age, across multiple clinical sites and expand it to include two age groups (5-7 years and 10-16 years) to improve early identification, as well as assess an additional neuropsychological domain (memory). Data will be collected from children with AE, non-exposed controls and heterogeneous clinical contrast subjects at both new and existing sites. This research will improve understanding of fetal alcohol spectrum disorders (FASD) by continuing ongoing efforts to develop and refine a sensitive and specific neurobehavioral profile. These data will be combined with data from other CIFASD projects to develop models that accurately capture the greatest number of affected children using multidisciplinary methodology.
This project is directly relevant to public health concerns surrounding the effects of heavy prenatal alcohol exposure, defining the profile of neurobehavioral effects that are specific to alcohol, and improving identification of alcohol-affected individuals at younger ages. Improved identification and delineation of these features, especially in younger children, will ultimately lead to improved treatment.
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