Written by Joyce Smith, BS. This study found that school-age children, who have been prenatally exposed to alcohol, performed significantly lower than typically developing peers particularly in math, reading and spelling.
Fetal Alcohol Spectrum Disorder (FASD) affects 4.8% of children in North America and is related to prenatal alcohol exposure during pregnancy. 1 Significant clinical repercussions, including academic difficulties, physical handicaps and behavioral issues become the fate of many children who are prenatally exposed1. An urgency exists to explore the neural correlates that may underlie academic performance and to understand and identify the needs of alcohol-exposed children with the goal of developing and providing evidence-based intervention.
Researchers Glass et al hypothesized that decreases in the thickness and surface area of the brain cortex would be associated with increased performance in non-exposed children, as cortical reductions are often associated with the development of more mature and efficient networks during adolescence.2 They postulated that, in alcohol-exposed children, a smaller surface area and thinner brain cortex would be related to poorer academic achievement and greater alcohol-induced congenital abnormalities.3 The objective of this study was to evaluate and compare the academic achievement of children (known to have been prenatally exposed to heavy maternal alcohol consumption) to their non-prenatally exposed peers, and to investigate the areas of the brain that may be responsible for academic achievement.4
Researchers assessed two groups of children: one group of 67 children, aged 8-16, with heavy prenatal alcohol exposure (44 boys, 23 girls) and a control group of 61 children with no prenatal alcohol exposure (33 boys, 28 girls). They analyzed group differences on standardized test scores of academic areas such as reading, spelling, and math. In a subsample of 42 underachievers, (29 boys, 13 girls), researchers, using MRI, did neuroimaging to examine a potential association between the thickness and surface area of the brain cortex and academic performance.
Brain imaging results revealed several brain surface areas that were linked to math and spelling performance. Alcohol-exposed youth performed significantly lower (ps≤.001) than control children in all tests. An academic area with particular weakness was math (ps<0.007) which was significantly lower than spelling and reading skills (ps<0.008) In fact, over half of the alcohol-exposed children (58.2%) demonstrated low achievement on one or more academic domains. However, the non- alcohol exposed control group demonstrated the anticipated developmental pattern of better scores associated with smaller brain surface areas. Studies have shown that during typical adolescent development, cortical surface area reductions occur as one ages, partially due to a process called synaptic pruning that occurs, thus suggesting a smaller cortical surface area that is more mature and efficient 5. In math, the lateral middle occipital gyrus was smaller in the control group suggesting a role in math functioning 6. It may be that alcohol exposed children have delayed brain development in areas contributing to poor performance 6,7. Generally, scores improved as brain surface area decreased in the non-alcohol exposed controls; whereas, in the alcohol-exposed group, a positive association was observed.
This study’s limitation of the cross-sectionally collected data does not prove that prenatal alcohol exposure causes learning impediments. Other factors such as quality of education, comorbid psychiatric or medical diagnosis, home environment, stress or trauma and classroom placement can impede learning and all should be addressed in future studies. However, this study does provide evidence that children with histories of prenatal alcohol exposure appear to have significantly higher rates of academic difficulties, which may be due in part to atypical brain development. These children merit additional attention and support.
Source: Leila Glass, Eileen M. Moore, Natacha Akshoomoff, Kenneth Lyons Jones, Edward P. Riley, and Sarah N. Mattson. “Academic difficulties in children with prenatal alcohol exposure: presence, profile, and neural correlates.” Alcoholism: Clinical and Experimental Research 41, no. 5 (2017): 1024-1034.
Posted May 31, 2019
Joyce Smith, BS, is a degreed laboratory technologist. She received her bachelor of arts with a major in Chemistry and a minor in Biology from the University of Saskatchewan and her internship through the University of Saskatchewan College of Medicine and the Royal University Hospital in Saskatoon, Saskatchewan. She currently resides in Bloomingdale, IL.
References:
- May PA, Baete A, Russo J, et al. Prevalence and characteristics of fetal alcohol spectrum disorders. Pediatrics. 2014;134(5):855-866.
- Sowell ER, Delis D, Stiles J, Jernigan TL. Improved memory functioning and frontal lobe maturation between childhood and adolescence: a structural MRI study. Journal of the International Neuropsychological Society : JINS. 2001;7(3):312-322.
- Meintjes EM, Narr KL, van der Kouwe AJ, et al. A tensor-based morphometry analysis of regional differences in brain volume in relation to prenatal alcohol exposure. NeuroImage Clinical. 2014;5:152-160.
- Glass L, Moore EM, Akshoomoff N, Jones KL, Riley EP, Mattson SN. Academic Difficulties in Children with Prenatal Alcohol Exposure: Presence, Profile, and Neural Correlates. Alcohol Clin Exp Res. 2017;41(5):1024-1034.
- Wierenga LM, Langen M, Oranje B, Durston S. Unique developmental trajectories of cortical thickness and surface area. Neuroimage. 2014;87:120-126.
- Ashkenazi S, Black JM, Abrams DA, Hoeft F, Menon V. Neurobiological underpinnings of math and reading learning disabilities. Journal of learning disabilities. 2013;46(6):549-569.
- Moore EM, Migliorini R, Infante MA, Riley EP. Fetal Alcohol Spectrum Disorders: Recent Neuroimaging Findings. Current developmental disorders reports. 2014;1(3):161-172.
