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The article explores the association between structural MRI findings and mental health in children with and without fetal alcohol spectrum disorder (FASD). The study by Nakhid et al. reveals differences in limbic region volumes, particularly in the hippocampus and thalamus, between the two groups and highlights the need for brain-based interventions in addressing mental health symptoms associated with prenatal alcohol exposure.

Background: Children with fetal alcohol spectrum disorder (FASD) often experience delayed, missed, or incorrect diagnosis due to low FASD awareness and diagnostic capacity. Current strategies to expand awareness and diagnostic capacity are insufficient or impractical. Methods: This project examined the feasibility of Extension for Community Healthcare Outcomes (ECHO) tele‐mentoring to train community clinicians about FASD. Participants attended ten 1‐h weekly ECHO sessions that included presentations, vignettes, and discussions. Measurement utilized Bowen's feasibility domains. Results: Robust webpage traffic yielded 19 participants (demand). Fidelity scores, hub team field notes, and participant ratings indicated feasibility based on acceptability, implementation, practicality, and adaptation. Clinicians' knowledge and confidence improved and case‐based diagnostic accuracy was high (limited efficacy). Conclusions: ECHO FASD is a feasible training method that shows promise in increasing diagnostic capacity across many geographic regions. [ABSTRACT FROM AUTHOR]

Introduction: Fetal alcohol spectrum disorder (FASD), a life-long condition resulting from prenatal alcohol exposure (PAE), is associated with structural brain anomalies and neurobehavioral differences. Evidence from longitudinal neuroimaging suggest trajectories of white matter microstructure maturation are atypical in PAE. We aimed to further characterize longitudinal trajectories of developmental white matter microstructure change in children and adolescents with PAE compared to typically-developing Controls using diffusion-weighted Neurite Orientation Dispersion and Density Imaging (NODDI). Materials and methods: Participants: Youth with PAE (n = 34) and typicallydeveloping Controls (n = 31) ages 8-17 years at enrollment. Participants underwent formal evaluation of growth and facial dysmorphology. Participants also completed two study visits (17 months apart on average), both of which involved cognitive testing and an MRI scan (data collected on a Siemens Prisma 3 T scanner). Age-related changes in the orientation dispersion index (ODI) and the neurite density index (NDI) were examined across five corpus callosum (CC) regions defined by tractography. Results: While linear trajectories suggested similar overall microstructural integrity in PAE and Controls, analyses of symmetrized percent change (SPC) indicated group differences in the timing and magnitude of age-related increases in ODI (indexing the bending and fanning of axons) in the central region of the CC, with PAE participants demonstrating atypically steep increases in dispersion with age compared to Controls. Participants with PAE also demonstrated greater increases in ODI in the mid posterior CC (trend-level group difference). In addition, SPC in ODI and NDI was differentially correlated with executive function performance for PAE participants and Controls, suggesting an atypical relationship between white matter microstructure maturation and cognitive function in PAE. Discussion: Preliminary findings suggest subtle atypicality in the timing and magnitude of age-related white matter microstructure maturation in PAE compared to typically-developing Controls. These findings add to the existing literature on neurodevelopmental trajectories in PAE and suggest that advanced biophysical diffusion modeling (NODDI) may be sensitive to biologicallymeaningful microstructural changes in the CC that are disrupted by PAE. Findings of atypical brain maturation-behavior relationships in PAE highlight the need for further study. Further longitudinal research aimed at characterizing white matter neurodevelopmental trajectories in PAE will be important. [ABSTRACT FROM AUTHOR]

Fetal alcohol spectrum disorder (FASD) affects 2–5% of the children in the United States. In the preschool age-range, inhibitory deficits frequently manifest as impaired ability to delay gratification, which is associated with deficits in cognitive flexibility in these children. The goal of this longitudinal study was to determine whether the ability to delay gratification in preschool children with FASD is (1) associated with broader manifestations in temperament and behavior; (2) predictive of later inhibitory control, cognitive flexibility and working memory in middle childhood; and (3) predictive of later parent-reported behavioral problems and school functioning in middle childhood. Forty-seven children with FASD, ages 2.5–5 years were administered a delay of gratification task in which they chose between receiving 2 snacks immediately or 10 snacks after waiting for 10 min. Two groups were defined based on a median split of waiting time. Four years later, 29 children completed measures of inhibitory control (Flanker task), cognitive flexibility (Dimensional Change Card Sort Test), and working memory (Stanford–Binet Intelligence Scales), and their parents completed the Child Behavior Checklist as a measure of the child's behavioral problems and school functioning. Children with longer wait times on the delay of gratification task in preschool showed better inhibitory control on the Flanker task in middle childhood and better parent-reported school functioning in English. These findings indicate that early inhibitory capacity persists into middle childhood in those with FASD, and may be a promising target for early intervention to improve later cognitive outcomes in these children. [ABSTRACT FROM AUTHOR]

Fetal alcohol spectrum disorders (FASD) are among the most common neurodevelopmental disabilities. Individuals with FASD experience postnatal adversity (PA; i.e., child maltreatment or other potentially traumatic events) at exceedingly high rates. This adversity is connected to increased internalizing and externalizing symptomatology. The current systematic review aimed to synthesize the literature regarding the intersectionality of FASD/prenatal alcohol exposure (PAE) and postnatal adversity utilizing the developmental psychopathology (DP) framework. Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards, systematic identification of studies through PsycInfo, PubMed, and Web of Science was conducted. Primary data on PAE, postnatal adversity, individual functioning (biological, cognitive, and affective), external systems, and familial and cultural contexts were extracted. Furthermore, quality assessment information was extracted for all studies. Thirty-one studies met the inclusion criteria. Overall, individuals with FASD experience a weighted mean of 4.44 adverse childhood experiences. Multifinality in developmental outcomes was evident, as FASD and postnatal exposure impact mental health, cognitive ability, and biological processes. Cultural context and familial settings contribute to risk and resilience factors. The quality assessment points to unique strengths and areas for improvement within the literature. Aligning with the DP framework, the intersection of FASD and postnatal adversity is complex and impacts various developmental processes. Systems and cultural context add to this complexity. Intervention development taking into consideration these multiple factors is necessary., (© 2024 Research Society on Alcohol.)