A COMPARISON OF CHILDREN AFFECTED BY PRENATAL ALCOHOL EXPOSURE AND ATTENTION-DEFICIT, HYPERACTIVITY DISORDER

Behavioral deficits are often noted in children with fetal alcohol syn drome (FAS) and other individuals with prenatal alcohol exposure, incl uding mental retardation, learning problems, social problems, and defi cits in attention. Because attention deficit, hyperactivity disorder ( ADHD) has been diagnosed so frequently in children with FAS and other alcohol related birth defects, there has been speculation that alcohol is an etiological factor in ADHD. To examine the relationship between behavior characteristics of children with fetal alcohol exposure and those seen in children with a diagnosis of ADHD, 149 tow socioeconomic status (SES), African-American children (mean age = 7.63 years) were given a battery of neuropsychological and behavioral tests. One hundre d and twenty-two were a subsample from a longitudinal study of prenata l alcohol exposure, whereas twenty-seven were identified in an ADHD Cl inic. Children were given two sets of tests: (1) ''traditional model'' of conventional behavioral and psychiatric measures of ADHD and exter nalizing behavior; and (2) measures of neurocognitive functioning refl ecting a four-factor model of the neurological basis of the components of attention (Mirsky AF, in Integrated Theory and Practice in Clinica l Neuropsychology, Hillsdale, NJ, Lawrence Erlbaum Associates, 1989). Results indicated that children with the physical characteristics asso ciated with prenatal alcohol exposure and those with a diagnosis of AD HD had equivalent intellectual abilities with both clinical groups per forming more poorly than contrast children from the same SES and ethni c groups. However, there were clear distinctions on behavioral and neu rocognitive measures between the two clinical groups with those with A DHD performing more poorly on conventional tests sensitive to attentio nal problems and conduct disorder. When these two groups were compared on measures designed to measure the model of the four factors of atte ntion by Mirsky, they were noted to have distinct patterns of deficits . These results suggested that the alcohol-affected children did not h ave the same neurocognitive and behavioral characteristics as children with a primary diagnosis of ADHD.