Accepted for/Published in: JMIR Formative Research
Date Submitted: May 26, 2020
Date Accepted: Mar 16, 2021
Executive functioning in prenatally alcohol exposed children in a South African population: Baseline findings from an RCT of a computer-based cognitive training program
ABSTRACT
Background:
Alcohol is a teratogen and its consumption during pregnancy can lead to negative birth outcomes collectively referred to as fetal alcohol spectrum disorders (FASDs). Neurodevelopmental delays in higher order cognitive functions are a common feature that affect development of executive functions. Studies of executive function in children have focused on children diagnosed with FASD and there is a lack of information on the impact on children not diagnosed but still exposed to alcohol.
Objective:
This paper compares development of executive functions between alcohol exposed and non-exposed children between 4 and 6 years of age.
Methods:
Children were recruited as part of a feasibility RCT evaluating a computer-based cognitive training program aimed at improving development of executive functions. The study was conducted in a low-SES community in South Africa with a high prevalence of FASD. Both exposed and non-exposed children were assessed using the NEPSY-II. Standardized scores for the executive function domains were compared using a MANOVA with group membership as predictor variable.
Results:
The alcohol exposed group (n=76) and the non-exposed group (n=40) showed no significant differences in executive functions assessments. Both groups showed moderate to severe delays in the domains measured. In all but one of the subtests the average score for both groups was below the 25th percentile of the expected norms.
Conclusions:
It was expected that alcohol exposure would have a measurable impact on executive function development. The lack of differences highlights the prevalence of developmental delays in low-SES communities in South Africa and suggests that children are exposed to various threats to cognitive development. Clinical Trial: ISRCTN17244156
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