ABSTRACT

Effects of prenatal alcohol exposure (PAE) are rarely measured in preschool children due to relative insensitivity of assessment methods at this age. To examine the potential of a nonverbal battery in early identification of cognitive problems in alcohol-exposed children, 291 prospectively identified Ukrainian children were evaluated using a test battery focusing on early executive functioning (EF) and visuospatial skills, areas of cognitive development particularly sensitive to PAE in older children. Tests included the Differential Ability Scales, 2^nd Edition (DAS-2) and several NEPSY/NEPSY-II subtests, standardized in the United States. Others were adapted from commonly used non-standardized neuropsychological measures of EF (Preschool Spatial Span, Imitation Hand Game, A not B, Delayed Attention, Subject Ordered Pointing). Children in two sites in Ukraine, Rivne and Khmelnitsky, were tested at 3 ½-4 ½ years to identify effects of PAE. Although most children performed within the average range, Alcohol-Exposed preschoolers had lower scores on DAS-II Summary Scores as well as on specific subtests. To evaluate the effects of alcohol dose during the pre-pregnancy recognition period and during mid-gestation of pregnancy, generalized linear regression models were used controlling for demographic and individual variables. In addition to DAS-II variables, measures reflecting sustained attention, working memory and ability to shift cognitive set were impacted by alcohol dose. Early executive function appears to subsume these performance differences. In conclusion, findings indicate that the effects of PAE can be identified in the preschool period and reliably measured using tests assessing nonverbal and spatial skills supported by executive functioning.

摘要

由于这个年龄段的评估方法相对不敏感，因此很少在学龄前儿童中测量产前酒精暴露 (PAE) 的影响。为了检查非语言电池在早期识别酒精暴露儿童认知问题方面的潜力，使用专注于早期执行功能 (EF) 和视觉空间技能的测试电池对 291 名前瞻性确定的乌克兰儿童进行了评估，这些领域的认知发展对酒精特别敏感。大龄儿童的 PAE。测试包括差异能力量表，第 2^次版本 (DAS-2) 和几个 NEPSY/NEPSY-II 子测试，在美国标准化。其他人改编自常用的非标准化 EF 神经心理学测量（学龄前空间跨度、模仿手游戏、A 而非 B、延迟注意力、主题有序指向）。乌克兰两个地点 Rivne 和 Khmelnitsky 的儿童在 3 ½-4 ½ 岁时接受了测试，以确定 PAE 的影响。尽管大多数儿童的表现都在平均范围内，但接触酒精的学龄前儿童在 DAS-II 总结分数以及特定子测试中的分数较低。为了评估妊娠前识别期和妊娠中期酒精剂量的影响，使用广义线性回归模型控制人口统计学和个体变量。除了 DAS-II 变量，反映持续关注的措施，工作记忆和转移认知能力的能力受到酒精剂量的影响。早期的执行功能似乎包含了这些表现差异。总之，研究结果表明，PAE 的影响可以在学龄前阶段确定，并使用评估执行功能支持的非语言和空间技能的测试可靠地测量。