Joseph Jacobson is a professor at Wayne State University School of Medicine and the corresponding author of a study that found while children with FASD may meet the behavioral criteria for ADHD, the attention difficulties in these individuals differ in subtle yet important respects.

"ADHD is clinically diagnosed primarily on the basis of observations by the parent, teacher, and clinician regarding the degree to which a child exhibits specific behavioral symptoms, such as difficulty sustaining attention to and completing tasks or play activities, failure to listen when spoken to directly, impulsivity, talking out of turn, or difficulty sitting still," explained Jacobson.

"A large proportion of children with a history of prenatal alcohol exposure exhibits these behavioral characteristics and, therefore, may meet the criteria for a diagnosis of ADHD."

Participants in Jacobson’s research who had been diagnosed with ADHD, regardless of their prenatal alcohol exposure, were less accurate at inhibiting responses. The ADHD group without prenatal alcohol exposure showed a unique ERP brain wave pattern. This reality could reflect a more effortful strategy related to inhibitory control.

"The data support the notion that information processing difficulties in children with prenatal alcohol exposure who exhibit ADHD symptoms may differ from those seen in children with idiopathic ADHD, even though behaviorally both groups may exhibit inattention and hyperactivity," said Jacobson.

"The ERP data suggest that different neurophysiological processes may be responsible for the attention problems seen in these two groups, which may explain why psychostimulant medication, which is often effective in treating idiopathic ADHD, is reported to be less effective in children with ADHD behavioral symptoms who were prenatally exposed to alcohol."
 

An examination of social-skills intervention called Children’s Friendship Training found that it led to a decrease in hostile attributions or perceptions of children with PAE.

"Children with PAE have a hard time making and keeping friends," explained the study’s corresponding author Vivien Keil, a staff research associate in the department of psychiatry and biobehavioral sciences at the David Geffen School of Medicine at UCLA . "More specifically, they tend to have difficulty understanding social cues and common social norms."

"These social problems are due, in part, to the neurological and cognitive deficits known to be associated with prenatal exposure to alcohol," said Joseph M. Price, a research scientist in the Children and Adolescent Services Research Center at Rady Children’s Hospital in San Diego.

Price also noted that such social problems could eventually lead to school problems, emotional and behavior problems, early school dropout, delinquency and drug and alcohol use. As a result, children with PAE are likely to benefit from intervention efforts designed to improve their social skills and their relationships with peers and adults.

In the course of this study, researchers found that when children were asked about other children’s intentions during the intervention period, they made fewer hostile attributions after the intervention. In other words, children’s hostile interpretations of peers’ social intentions can be modified by intervention efforts.