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This study evaluated the effectiveness of an internet accessed training program that included Theory of Mind-based guidance, video models, visual supports, and virtual reality practice sessions in teaching appropriate job interview skills to individuals with high functioning Autism Spectrum Disorders. In a randomized study, twenty-two youth, ages 16-19, were evaluated during two employment interviews. Half received a training intervention following the initial interview and the half who served as a contrast group did not. Their performance pre and post intervention was assessed by four independent raters using a scale that included evaluation of both Content and Delivery. Results suggest that youth who completed the JobTIPS employment program demonstrated significantly more effective verbal content skills than those who did not.

Different formats for delivering parent education designed to improve the functioning of children with FASD were evaluated. Participants were randomly assigned to a treatment condition: (1) Community Standard/Informational Packet, (2) Group Workshops, and (3) Internet Training. Overall satisfaction was high for all formats but the Workshop group received higher ratings on usefulness, understandability, amount, overall satisfaction, and willingness to recommend than did the Community group and higher ratings than did the Internet group on amount of information and overall satisfaction. All three groups improved in their knowledge of behavioral learning principles but only the Internet and Workshop groups made significant gains in knowledge of FAS and advocacy. Improved behavior was only found in the Workshop and Community conditions. The results suggest all forms of parent education have some benefits but the child's degree of alcohol-related impairment, severity of behavioral symptoms, and overall goals of the intervention may influence optimal choice.

The impact of prenatal alcohol exposure on memory and brain development was investigated in 92 African-American, young adults who were first identified in the prenatal period. Three groups (Control, n = 26; Alcohol-related Neurodevelopmental Disorder, n = 36; and Dysmorphic, n = 30) were imaged using structural MRI with brain volume calculated for multiple regions of interest. Memory was measured using the Verbal Selective Reminding Memory Test and its nonverbal counterpart, the Nonverbal Selective Reminding Memory Test, which each yielding measures of learning and recall. For both Verbal and Nonverbal Recall and Slope, linear trends were observed demonstrating a spectrum of deficits associated with prenatal alcohol exposure. Dysmorphic individuals performed significantly poorer than unexposed controls on 5 of 6 memory outcomes. Alcohol-exposed individuals demonstrated significantly lower total brain volume than controls, as well as lower volume in a number of specific regions including hippocampus. Mediation analyses indicated that memory performance associated with effects of prenatal alcohol exposure was mediated from dysmorphic severity through hippocampal volume, particularly right hippocampus. These results indicate that the association between the physical effects of prenatal alcohol exposure and deficits in memory are mediated by volumetric reduction in specific brain regions. (Contains 2 figures and 4 tables.)

Unintentional injuries are a leading cause of death and disability for children. Those with developmental disabilities, including children affected by prenatal alcohol exposure, are at highest risk for injuries. Although teaching safety skills is recommended to prevent injury, cognitive limitations and behavioral problems characteristic of children with fetal alcohol spectrum disorder make teaching these skills challenging for parents and teachers. In the current study, 32 children, ages 4-10, diagnosed with fetal alcohol syndrome (FAS) and partial FAS, learned fire and street safety through computer games that employed "virtual worlds" to teach recommended safety skills. Children were pretested on verbal knowledge of four safety elements for both fire and street safety conditions and then randomly assigned to one condition. After playing the game until mastery, children were retested verbally and asked to "generalize" their newly acquired skills in a behavioral context. They were retested after 1 week follow-up. Children showed significantly better knowledge of the game to which they were exposed, immediately and at follow-up, and the majority (72%) was able to generalize all four steps within a behavioral setting. Results suggested that this is a highly effective method for teaching safety skills to high-risk children who have learning difficulties.

This article describes an evolution of training programs to use first-person interaction in virtual reality (VR) situations to teach safety skills to children with autism spectrum disorder (ASD) and fetal alcohol spectrum disorder (FASD). Multiple VR programs for children aged 2 to 9 were built and tested between 1992 and 2007. Based on these results, a learning design evolved that uses practice in virtual space with guidance and correction by an animated character, strategic limitations on allowed actions to force correct patterning, and customization of worlds and responses to simplify user controls. This article describes program evolution by comparing design details and results as variations in behavioral responses between disorders, differences in skill set complexity between different safety skills being taught, and improved technology required changes in the virtual training methodology. A series of research projects are summarized in which the VR programs proved effective for teaching children with ASD and FASD new skills in the virtual space and, where measured, most children generalized the actions to the real world. (Contains 5 figures.)

Examined effects of prenatal drug exposure on infants born preterm and full-term to African American mothers. Found more extreme fetal growth deficits in later-born infants, and more extreme irritability increases in earlier-born infants. Gestation length did not moderate cardiorespiratory reactivity effects. Exposure effects occurred for cocaine-polydrug and alcohol-only users and could be unambiguously attributed to either drug alone. (Author)

Background: The vascular system may be particularly vulnerable to prenatal alcohol exposure (PAE). Alterations in angiogenesis and epigenetic changes to vascular development have been implicated as a probable mechanism for this vulnerability. Methods: We assessed the long‐term impact of prenatal alcohol exposure (PAE) on adult vascular health using a prospective cohort first identified while in utero. Participants with no PAE (n = 37, mean age = 36.7 [SD = 1.6] years) were compared to participants with PAE (n = 51, mean age = 36.3 [SD = 1.7] years). Their vascular health was assessed by arterial blood pressure (BP) and peripheral arterial tonometry, which yields an index of endothelial function (reactive hyperemia index) and a measure of arterial stiffness (augmentation index). Blood samples were collected to assess cholesterol levels and insulin resistance (glucose, hemoglobin A1C, and insulin). Path analysis was used to examine the direct and indirect effects of PAE on vascular health after adjusting for other known physical outcomes. Results: Participants with a history of PAE weighed less, trended towards being shorter, had smaller body mass, and had more alcohol‐related dysmorphic features than those without PAE. Path analysis suggested that the impact of PAE on BP was through its indirect relationships with height, body mass index, and dysmorphic features and resulted in protective effects relative to the Contrast group who were disproportionately overweight. PAE was also found to have a direct negative effect on endothelial function. An index of total alcohol‐related dysmorphic features was negatively had both a direct effect on arterial stiffness and an indirect effect on endothelial function. Conclusions: Prenatal alcohol exposures' impact on vascular function is not independent of other common physical and environmental factors but endothelial function and arterial stiffness seemed most compromised after controlling for these other factors. Level of alcohol‐related dysmorphic features seems to be predictive of more adverse effects than endothelial function and vascular stiffness. [ABSTRACT FROM AUTHOR]

Fetal alcohol syndrome (FAS) and the other conditions making up the fetal alcohol spectrum disorders (FASD) are the most common, preventable, developmental disorders in the United States and are estimated [...]

Objective: An association has been reported between prenatal alcohol exposure and delinquent behavior in adolescents. Problems are believed to be particularly significant for those who were exposed prenatally but do not have full fetal alcohol syndrome (FAS). The goals of this study were (1) to examine the relation between a range of levels of prenatal exposure and delinquent behavior in a community sample and (2) to examine the effect of other current risk factors, in addition to prenatal exposure, on delinquent behavior. Method: In this study, 250 low income, predominantly black youths (mean age = 15.1 years) and their primary caregivers participated in an evaluation that included measures of delinquency, life stress, substance use, behavior problems, parenting practices, negative peer influence, caregiver substance use and the dysmorphia characteristic of FAS. Three groups were drawn from a sample initially seen at birth: Alcohol-exposed and dysmorphic (n = 39), alcohol-exposed, nondysmorphic (n = 77) and nonexposed controls (n = 48). A special education contrast group (n = 84) was recruited at adolescence to control for disability status. Results: The exposure groups did not differ from controls on measures of variety and frequency of delinquent behavior; boys engaged in a wider range of delinquent acts than girls did. Regression analysis for the full sample revealed that higher adolescent life stress, higher self-reported drug use and lower parental supervision were significantly related to a wider range of delinquent acts. Conclusions: Other current influences should be considered in addition to prenatal alcohol exposure in interpreting the development of delinquency in alcohol-exposed adolescents. These results demonstrate the importance of examining risk factors and controlling effects of socio-cultural influences and disability status when working with clinical samples., STUDIES OF ALCOHOL-EXPOSED adolescents report numerous developmental and behavioral problems. Adolescents with fetal alcohol syndrome (FAS) are characterized by deficits in intellectual functioning, dysmorphic physical characteristics (e.g., microcephaly, slow physical [...]

Background: Although the effects of prenatal alcohol exposure (PAE) have been studied extensively, there is relatively little information available on adult mental health functioning among exposed individuals. The current study compares the self‐reported midlife mental health status of individuals who were prenatally exposed to alcohol and diagnosed in childhood with the effects of this exposure with that of unexposed individuals. Methods: Participants (N = 292) were recruited from two longitudinal cohorts in Atlanta and Seattle and asked to complete an Adult Health Questionnaire that surveyed their current health and mental health status. The questionnaire was completed either in‐person or remotely and included questions about current symptoms of depression and anxiety and mental health disorder diagnoses. The analysis compared a Nonexposed Contrast group to those in two exposure groups: (1) Alcohol Exposed with Fetal Alcohol Effect but not meeting criteria for Fetal Alcohol Syndrome (FAS) and (2) Alcohol Affected and meeting criteria for FAS. Results: Both alcohol‐exposed groups reported higher levels of current depressive symptoms and a higher prevalence of diagnoses of depression, anxiety, bipolar disorder, and/or attention deficit/hyperactivity disorder. No differences were noted for psychotic disorders. PAE was also associated with greater environmental stressors, including higher levels of adverse childhood events and lower current socioeconomic status. Path analyses suggested that PAE was indirectly related to mood disorders with its effects being mediated by other environmental factors. Conclusions: PAE is associated with greater rates of mental health disorders in middle adulthood. These outcomes appear to result from multiple stressors that affect individuals made vulnerable by their early alcohol exposure. Clinical outcomes could be improved by prevention efforts directed at preventing prenatal alcohol use and reducing environmental stressors later in life, and by the early identification of PAE and its effects. [ABSTRACT FROM AUTHOR]

Clinical descriptions of children with feral alcohol syndrome (FAS) and other alcohol-related disabilities (1) often cite attention deficit hyperactivity disorder (ADHD) (American Psychiatric Association [MA] 1994) as a central feature [...]