Kalberg Wendy O, Provost Beth, Tollison Sean J, Tabachnick Barbara G, Robinson Luther K, Eugene Hoyme H, Trujillo Phyllis M, Buckley David, Aragon Alfredo S, May Philip A
University of New Mexico, Center on Alcoholism, Substance Abuse and Addictions, Albuquerque, New Mexico 887106, USA.
Alcohol Clin Exp Res. 2006 Dec;30(12):2037-45. doi: 10.1111/j.1530-0277.2006.00250.x.
Researchers are increasingly considering the importance of motor functioning of children with fetal alcohol spectrum disorder (FASD). The purpose of this study was to assess the motor development of young children with fetal alcohol syndrome (FAS) to determine the presence and degree of delay in their motor skills and to compare their motor development with that of matched children without FAS.
The motor development of 14 children ages 20 to 68 months identified with FAS was assessed using the Vineland Adaptive Behavior Scales (VABS). In addition, 2 comparison groups were utilized. Eleven of the children with FAS were matched for chronological age, gender, ethnicity, and communication age to: (1) 11 children with prenatal alcohol exposure who did not have FAS and (2) 11 matched children without any reported prenatal alcohol exposure. The motor scores on the VABS were compared among the 3 groups.
Most of the young children with FAS in this study showed clinically important delays in their motor development as measured on the VABS Motor Domain, and their fine motor skills were significantly more delayed than their gross motor skills. In the group comparisons, the young children with FAS had significantly lower Motor Domain standard (MotorSS) scores than the children not exposed to alcohol prenatally. They also had significantly lower Fine Motor Developmental Quotients than the children in both the other groups. No significant group differences were found in gross motor scores. For MotorSS scores and Fine Motor Developmental Quotients, the means and standard errors indicated a continuum in the scores from FAS to prenatal alcohol exposure to nonexposure.
These findings strongly suggest that all young children with FAS should receive complete developmental evaluations that include assessment of their motor functioning, to identify problem areas and provide access to developmental intervention programs that target deficit areas such as fine motor skills. Fine motor delays in children with FAS may be related to specific neurobehavioral deficits that affect fine motor skills. The findings support the concept of an FASD continuum in some areas of motor development.
研究人员越来越重视胎儿酒精谱系障碍(FASD)患儿的运动功能。本研究的目的是评估胎儿酒精综合征(FAS)幼儿的运动发育情况,以确定其运动技能延迟的存在及程度,并将其运动发育与匹配的无FAS儿童进行比较。
使用文兰适应行为量表(VABS)评估14名年龄在20至68个月之间确诊为FAS的儿童的运动发育情况。此外,还使用了两个对照组。11名FAS儿童在年龄、性别、种族和沟通年龄方面进行匹配,分别与:(1)11名有产前酒精暴露但无FAS的儿童和(2)11名无任何产前酒精暴露报告的匹配儿童进行比较。比较三组儿童在VABS上的运动得分。
本研究中大多数患有FAS的幼儿在VABS运动领域量表上显示出临床上重要的运动发育延迟,且其精细运动技能的延迟明显大于大运动技能。在组间比较中,患有FAS的幼儿的运动领域标准(MotorSS)得分显著低于未产前暴露于酒精的儿童。他们的精细运动发育商也显著低于其他两组儿童。在大运动得分方面未发现显著的组间差异。对于MotorSS得分和精细运动发育商,均值和标准误表明从FAS到产前酒精暴露再到无暴露,得分呈连续变化。
这些发现强烈表明,所有患有FAS的幼儿都应接受全面的发育评估,包括对其运动功能的评估,以确定问题领域,并提供获得针对精细运动技能等缺陷领域的发育干预项目的机会。FAS患儿的精细运动延迟可能与影响精细运动技能的特定神经行为缺陷有关。这些发现支持了在运动发育的某些领域存在FASD连续体的概念。