Pregnancy Bliss | Reproductive Health Answers
Published: Saturday, March 19, 2011 - 19:42
Results of a study due to be published in the June 2011 issue of Alcoholism: Clinical & Experimental Research show that children with heavy prenatal alcohol exposure had initial problems with learning information, reflecting inefficient encoding of verbal material whilst children diagnosed with Attention Deficit/Hyperactivity Disorder (ADHD) had difficulty retaining information over time, reflecting a deficit in retrieval of learned material.
While children with fetal alcohol spectrum disorders (FASD) are known to have deficits
in verbal learning and recall, the specifics of these deficits remain unclear. This
study compared the verbal learning and memory performance of children with heavy
prenatal alcohol exposure (PAE) with that of children with attention-deficit/ hyperactivity
disorder (ADHD), finding that both groups of children have difficulty with learning
and memory but in different ways.
"Children with FASD
and ADHD can appear very similar,"
explained Sarah N. Mattson, a professor in the department of psychology at San Diego
State University and corresponding author for the study. "Both alcohol-exposed children
and those with ADHD demonstrate behavioural difficulties such as hyperactivity and
impulsivity, and children with FASD often meet diagnostic criteria for ADHD. Studies
that compare these groups can aid in accurate identification and appropriate diagnoses,
which are important as they have implications for the kinds of interventions and
resources provided to these children and their families."
"The broad range of neuro-developmental,
cognitive, and behavioural abnormalities that occur in FASD most likely result from
a combination of prenatal alcohol exposure and other factors such as other drug exposures,
disrupted home environment, abuse, and co-morbid conditions," added Jeffrey R. Wozniak,
assistant professor of psychiatry at the University of Minnesota. "This heterogeneity
or wide range of potential problems among this population remains a significant challenge
to researchers attempting to identify a 'profile' of abnormalities that are associated
with PAE."
Prenatal alcohol exposure and memory
"The children with alcohol exposure had problems with learning information initially,
but they were able to remember what they did learn later on," said Mattson. "The
children with ADHD, however, were better at recalling information immediately after
it had been presented but had difficulty retaining this information over time."
"This
pattern of results suggests that FASD may be associated with a specific deficit in
the initial encoding of verbal information while, in contrast, ADHD may be associated
with a deficit in retrieval," said Wozniak. "The authors speculate that the encoding
problems seen in FASD may be related to underlying difficulties in executive functioning
- those processes by which a child organizes and directs his/her own learning."
Mattson
explained that "inefficient encoding of verbal material" means that when children
are presented with verbal information, they have difficulty learning that information.
"If children have encoding deficits, it may be experienced as a memory problem as
they will recall less than their peers," she said. "They may also find it difficult
to remember and follow instructions given to them by teachers or parents and have
difficulty learning material presented in the classroom."
A "deficit in retrieval
of learned material," on the other hand, is related to memory but is different from
"forgetting," said Mattson.
Tackling learning difficulties
"If a child has a difficulty retrieving learned material, the problem is related
to accessing material that is stored in the brain," Mattson explained. "These children
won't be able to independently generate the material, but if you presented them with
some choices they could recognize the correct answer. 'Forgetting' refers to learned
information that is no longer available for recall."
"Children with FASD might need
additional repetition of the information as well as guidance about how to organize
the information as they are learning it," added Wozniak. "In contrast, children with
ADHD might benefit most from assistance in developing strategies for retrieving information
from memory, such as self-cueing."
"This research has important implications for
clinicians and educators," noted Mattson. "Understanding the profiles of learning
and memory impairments in these populations of children can allow for appropriate
intervention and remediation strategies to be implemented."
Wozniak agreed. "Both
educators and clinicians will benefit from knowing that children with FASD are, in
fact, struggling at the level of encoding information but that their retrieval mechanisms
are less affected. Individuals with FASD might benefit most from additional efforts
to improve their initial encoding, such as developing strategies for active learning
and techniques for 'deepening' their initial processing in order to improve encoding
of the information into memory."
Our main article on Alcohol in pregnancy can be found here: