Identification of FASD in South African Children

南非儿童 FASD 的鉴定

• 批准号: 6805821
• 负责人: SANDRA W. JACOBSON
• 金额: $ 16.21万
• 依托单位: WAYNE STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-09-30 至 2006-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6805821
• 关键词: Africa; age at pregnancy; attention; behavioral /social science research tag; child physical development; children; clinical research; cognition; congenital oral /facial /cranial defect; cooperative study; data collection methodology /evaluation; diagnosis quality /standard; embryo /fetus toxicology; ethnic group; face expression; fetal alcohol syndrome; mathematics; neuropsychological tests; neuropsychology; psychometrics; three dimensional imaging /topography

DESCRIPTION (provided by applicant): Early identification of children with FASD has been limited by the difficulty of reliably evaluating facial dysmorphology and because investigators have not yet identified a set of neurobehavioral deficits specifically related to prenatal alcohol exposure. However, a new generation of neurodevelopmental measures that have been linked more specifically to neural processes and pathways has the potential to improve FASD diagnosis. We have recently completed a prospective study of 159 infants born to mothers from the Cape Coloured (mixed race) community in South Africa, which has confimed the exceptionally high incidence of maternal alcohol abuse and dependence and FAS previously documented in this population. Arithmetic and executive function (EF) are among the most consistently affected domains in older children with FASD. In our Cape Town cohort, we were able to detect deficits in these domains in infancy using two innovative infant assessments: a numerosity test, which assesses magnitude representation, a precursor of arithmetic that has been linked to inferior parietal function, and the A-not-B test, an early precursor of EF. New data from our Detroit prenatal alcohol exposure cohort also provide evidence of a specific deficit in magnitude representation in older children and poorer conflict monitoring, an aspect of EF believed to be mediated by the anterior cingulate cortex. This component of the Collaborative Initiative on Fetal Alcohol Spectrum Disorders (CIFASD) will follow up our Cape Town cohort at 4 and 6 years of age. The specific aims are: (1) to administer new narrowband tests of arithmetic and EF to determine which elements of these domains appear to be core deficits of FASD; (2) to administer event-related potential (ERP) assessments of magnitude representation and recognition of facial emotional expression, two domains that are hypothesized to relate specifically to FASD; (3) to test the hypothesis that two moderator variables---maternal age and the absence of an ADH2*2 allele--can improve the identification of FASD in prenatally exposed children; (4) to assess the predictive validity of infant numerosity and A-not-B in relation to cognition and attention in early childhood; (5) to determine the degree to which measures of craniofacial variation derived from 3-D photography can improve FASD diagnosis; and (6) to administer additional neurobehavioral assessments in common with other CIFASD projects to provide data on the sequelae of FASD that can be pooled and compared across age, site and ethnic group. Improvement of diagnosis in infancy and early childhood and a better understanding of the specific domains of neurobehavioral function affected by fetal alcohol exposure are critically important for the development and implementation of targeted, effective interventions for FASD.

描述（由申请人提供）：FASD儿童的早期鉴定受到可靠评估面部畸形学的困难的限制，并且由于研究人员尚未确定一组与产前酒精相关的神经行为缺陷。但是，与神经过程更具体联系的新一代神经发育措施具有改善FASD诊断的潜力。我们最近完成了一项前瞻性研究，对南非开普色（Cape）有色人种（混合种族）社区的159名婴儿出生，这使孕产妇酒精滥用和依赖的发病率异常高，以及先前在该人群中记录的FAS。算术和执行功能（EF）是年龄较大的FASD儿童中受影响最一致的领域之一。在我们的开普敦队列中，我们能够使用两种创新的婴儿评估来检测婴儿期的缺陷：一种数字测试，评估幅度表示，这是算术的先驱，它与parietal骨下等方面的算术和A-NOT-B测试有关，这是EF的早期前体。我们底特律产前酒精暴露队的新数据还提供了较大儿童和较差冲突监测的特定幅度代表性缺陷的证据，这是EF的一个方面，该方面被认为是由前扣带回皮层介导的。 胎儿酒精谱系障碍合作计划（CIFASD）的这一组成部分将在4至6岁时跟进我们开普敦的同伙。具体目的是：（1）管理算术和EF的新窄带测试，以确定这些域的哪些元素似乎是FASD的核心缺陷； （2）管理与事件相关的电位（ERP）评估幅度表示和面部情绪表达的识别，这两个领域被认为是与FASD专门相关的； （3）检验两个主持人变量的假设---孕妇年龄和缺乏ADH2*2等位基因 - can改善了产前暴露的儿童中FASD的鉴定； （4）评估婴儿数字和a-not-b的预测有效性与儿童早期的认知和注意力有关； （5）确定从3-D摄影获得的颅面变异的度量可以改善FASD诊断的程度； （6）与其他CIFASD项目共同管理其他神经行为评估，以提供有关FASD后遗症的数据，这些数据可以在年龄，现场和种族组中进行汇总和比较。改善婴儿期和幼儿期的诊断，以及对受胎儿酒精暴露影响的神经行为功能的特定领域的更好理解对于开发和实施有效的FASD干预措施至关重要。