Canada Fetal Alcohol Spectrum Disorder Research Network, PO Box 11364 Wessex PO, Vancouver BC, V5R 0A4, Canada.
University of Alberta, Educational Psychology, 6-131 Education North, 116 Street and 85 Avenue, Edmonton AB, T6G 2R3, Canada.
Child Abuse Negl. 2021 Feb;112:104888. doi: 10.1016/j.chiabu.2020.104888. Epub 2020 Dec 31.
Individuals with Fetal Alcohol Spectrum Disorder (FASD) and prenatal alcohol exposure (PAE) face elevated rates of postnatal environmental adversity across the lifespan.
We explored early adversity among children and adolescents with PAE.
Our sample included 333 children and adolescents with PAE assessed at a Canadian FASD diagnostic clinic, 66% of whom were diagnosed with FASD.
Data were collected retrospectively via record review, and adversity was measured using the Adverse Childhood Experiences Questionnaire (ACE-Q).
Participants experienced high levels of adversity (mean ACE score of 3.4), which increased with age, mental health comorbidity, and number of living placements. Common ACEs included: not being raised by both biological parents (97.3%), caregiver disruption (88.5%), and exposure to household substance use (69.7%). Females had significantly higher rates of sexual abuse than males (p < .001, ø = -0.18). There was no difference in total ACE scores between participants diagnosed with FASD versus those not diagnosed, but participants with FASD were less likely to live with both biological parents (p < .001, ø = .19) or to have been exposed to household mental health problems (p = .007, ø = -0.15).
Children and adolescents with PAE experience high rates of early adversity. Practice and policy initiatives are needed to improve early detection of ACEs among children with PAE, and of PAE among children with ACEs. Targeted supports are needed to strengthen the early caregiving environment and mitigate the risks of adversity to support healthy outcomes for individuals with PAE and FASD.
患有胎儿酒精谱系障碍（FASD）和产前酒精暴露（PAE）的个体在整个生命周期中都面临更高的产后环境逆境发生率。
我们探讨了有 PAE 的儿童和青少年的早期逆境经历。
我们的样本包括在加拿大 FASD 诊断诊所接受评估的 333 名有 PAE 的儿童和青少年，其中 66%被诊断为 FASD。
数据通过病历回顾收集，逆境使用童年期逆境问卷（ACE-Q）进行测量。
参与者经历了高水平的逆境（平均 ACE 得分 3.4），且随着年龄的增长、精神健康合并症和生活安置数量的增加而增加。常见的 ACE 包括：未被亲生父母共同抚养（97.3%）、照顾者中断（88.5%）和暴露于家庭药物滥用（69.7%）。女性遭受性虐待的比例显著高于男性（p <.001，ø = -0.18）。被诊断为 FASD 的参与者与未被诊断为 FASD 的参与者之间的 ACE 总得分没有差异，但 FASD 参与者与亲生父母共同生活的可能性较小（p <.001，ø =.19）或暴露于家庭心理健康问题的可能性较小（p =.007，ø = -0.15）。
有 PAE 的儿童和青少年经历了高比例的早期逆境。需要采取实践和政策举措，以提高对有 PAE 的儿童的 ACE 早期检测，以及对有 ACE 的儿童的 PAE 检测。需要有针对性的支持，以加强早期照护环境，减轻逆境风险，为有 PAE 和 FASD 的个体提供健康结果。
