Neuropsychological Study of FASD in a Sample of American Indian Children: Processing Simple Versus Complex Information
Neuropsychological Study of FASD in a Sample of American Indian Children: Processing Simple Versus Complex Information
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DOI：
10.1111/j.1530-0277.2008.00802.x
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发表时间：
2008-12-01
影响因子：
3.2
通讯作者：
May, Philip A.
中科院分区：
文献类型：
--
作者：
Aragon, Alfredo S.;Kalberg, Wendy O.;May, Philip A.
虽然大量的文献存在于酒精暴露的儿童的认知功能，目前还不清楚是否有一个签名的神经心理学特征与胎儿酒精谱系障碍（FASD）的儿童。本研究评估了来自北方平原州几个美洲印第安人保留区的FASD儿童的认知功能，并采用简单与复杂信息处理的分层模型进一步检查认知功能。我们假设复杂的测试可以区分FASD儿童和文化相似的对照组，而FASD儿童在相对简单的测试中表现与对照组相似。我们的样本包括32名对照组儿童和24名FASD儿童[胎儿酒精综合征（FAS）= 10，部分胎儿酒精综合征（PFAS）= 14]。该测试组合测量一般认知能力、语言流畅性、执行功能、记忆力和精细运动技能，许多神经心理学测试的结果与简单与复杂处理的分层模型一致。测试的复杂性是根据参与测试的认知过程的数量“先验”确定的。多维尺度被用来统计分析的准确性分类的神经认知测试成一个简单的与复杂的二分法。分层逻辑回归模型，然后被用来定义复杂与简单的测试在预测FASD儿童和对照组之间的显着差异所作出的贡献。复杂的测试项目比简单的测试项目更好地区分。符合该模型的测试是言语流畅性，渐进式计划测试（PPT），Lhermitte记忆任务，和槽钉板测试（GPT）。与对照组相比，FASD组的儿童在字母流畅性方面表现出受损的表现，而他们在类别流畅性方面的表现相似。在更复杂的PPT测试（问题5 - 8）以及Lhermitte逻辑任务中，FASD组的表现最差，在各种神经心理学测量中，FASD组和对照组的表现差异明显。与对照组相比，FASD儿童在复杂任务上的表现明显更差。产前酒精暴露儿童的神经行为特征的识别将有助于临床医生识别和诊断FASD儿童。
Although a large body of literature exists on cognitive functioning in alcohol-exposed children, it is unclear if there is a signature neuropsychological profile in children with Fetal Alcohol Spectrum Disorders (FASD). This study assesses cognitive functioning in children with FASD from several American Indian reservations in the Northern Plains States, and it applies a hierarchical model of simple versus complex information processing to further examine cognitive function. We hypothesized that complex tests would discriminate between children with FASD and culturally similar controls, while children with FASD would perform similar to controls on relatively simple tests.Our sample includes 32 control children and 24 children with a form of FASD [fetal alcohol syndrome (FAS) = 10, partial fetal alcohol syndrome (PFAS) = 14]. The test battery measures general cognitive ability, verbal fluency, executive functioning, memory, and fine-motor skills.Many of the neuropsychological tests produced results consistent with a hierarchical model of simple versus complex processing. The complexity of the tests was determined "a priori" based on the number of cognitive processes involved in them. Multidimensional scaling was used to statistically analyze the accuracy of classifying the neurocognitive tests into a simple versus complex dichotomy. Hierarchical logistic regression models were then used to define the contribution made by complex versus simple tests in predicting the significant differences between children with FASD and controls. Complex test items discriminated better than simple test items. The tests that conformed well to the model were the Verbal Fluency, Progressive Planning Test (PPT), the Lhermitte memory tasks, and the Grooved Pegboard Test (GPT). The FASD-grouped children, when compared with controls, demonstrated impaired performance on letter fluency, while their performance was similar on category fluency. On the more complex PPT trials (problems 5 to 8), as well as the Lhermitte logical tasks, the FASD group performed the worst.The differential performance between children with FASD and controls was evident across various neuropsychological measures. The children with FASD performed significantly more poorly on the complex tasks than did the controls. The identification of a neurobehavioral profile in children with prenatal alcohol exposure will help clinicians identify and diagnose children with FASD.