The Toronto experience: SUBJECTS AND METHODS (1)

Participants

Between 1994 and 1999, 52 children (31 boys) ranging in age from four to 18 years were referred to the Motherisk Follow-up Program by biological, foster or adoptive parents, or social agencies. Because most children were not in the care of their biological parent(s) at the time of the assessment, specific details about the history of alcohol exposure (timing, amount or polysubstance use) were not always available. However, in most cases, heavy alcohol use by the mother during pregnancy was highly suspected. A minority of children was exposed to cocaine alone or in addition to alcohol.

Procedures

In the formative stages of the Motherisk Follow-up Program, a list of criteria for ARND was compiled based on findings from the related research literature, descriptions by parents attending ARND support groups and previous clinical experience with these children. These analyses resulted in the identification of 21 areas of weakness or ‘deficits’ and six areas of relative strength or ‘assets’. These characteristics served subsequently as the diagnostic criteria checklist. Table 1 lists the deficits and assets constituting the checklist. It is important to emphasize that assets reflect personal strengths or areas of functioning in which the child is better than in his or her other aspects of neuropsychological functioning. This does not necessarily mean that the child is performing above standardized norms or other samples of nonclinically referred children. The judgement of an ability as an asset was based on clinical impression. birth control pills

TABLE 1 Alcohol-related neurodevelopmental disorder diagnostic criteria checklist

Deficits
Decreased intelligencePoor gross and fine motor skillsPoor mathematical skillsPoor time management/planning skillsPoor reading comprehensionPoor organization and planning skillsChattinessPoor memory

Anomia

Poor associative learning Poor comprehension Concrete thinking Problems with word meanings Poor social skills Difficulty with sentence structure Behavioural problems Problems with pragmatics

Poor attention/attention deficit hyperactivity disorder

Perseverative

Highly active

Poor adaptive skills

Assets
(Relatively) good visuospatial skillsGood fluencyGood face recognitionGood rote memoryGood immediate object memoryAir of competence and self confidence

About

So Many Advances in Medicine, So Many Yet to Come