Telethon Kids Institute, Perth Children's Hospital, Perth, WA, Australia.
Curtin School of Allied Health, Curtin University, Perth, WA, Australia.
Int J Lang Commun Disord. 2021 Jul;56(4):694-718. doi: 10.1111/1460-6984.12644. Epub 2021 Jun 16.
Prenatal alcohol exposure (PAE) is associated with growth deficits and neurodevelopmental impairment including foetal alcohol spectrum disorder (FASD). Difficulties with oral and written communication skills are common among children with PAE; however, less is known about how communication skills of adolescents who have PAE compare with those who do not. Adolescence is a critical time for development, supporting the transition into adulthood, but it is considered a high-risk period for those with FASD.
We conducted a systematic review to synthesize evidence regarding oral and written communication skills of adolescents with PAE or FASD and how they compare with those with no PAE.
METHODS & PROCEDURES: A comprehensive search strategy used seven databases: Cochrane Library, Cinahl, Embase, Medline, PsycInfo, Eric and Web of Science. Included studies reported on at least one outcome related to oral and written communication for a PAE (or FASD) group as well as a no/low PAE group, both with age ranges of 10-24 years. Quality assessment was undertaken.
Communication skills most often assessed in the seven studies included in this review were semantic knowledge, semantic processing, and verbal learning and memory. These communication skills, in addition to reading and spelling, were commonly weaker among adolescents with PAE compared with those with no/low PAE. However, the findings were inconsistent across studies, and studies differed in their methodologies.
CONCLUSIONS & IMPLICATIONS: Our results emphasize that for adolescents with PAE, communication skills in both oral and written modalities should be comprehensively understood in assessment and when planning interventions. A key limitation of the existing literature is that comparison groups often include some participants with a low level of PAE, and that PAE definitions used to allocate participants to groups differ across studies.
What is already known on the subject PAE and FASD are associated with deficits in oral and written communication skills. Studies to date have mostly focused on children with a FASD diagnosis as well as combined groups of children and adolescents with FASD or PAE. There is a gap in what is known about oral and written communication skills of adolescents, specifically, who have PAE or FASD. This has implications for the provision of assessment and supports during a period of increased social and academic demands. What this study adds to existing knowledge This review provides systematic identification, assessment and synthesis of the current literature related to oral and written communication skills of adolescents with PAE compared with those with no/low PAE. The review revealed a small knowledge base with inconsistent methodologies and findings across studies. However, the findings overall highlight that adolescents with PAE have weaker skills in oral and written language than those with no/low PAE. Results are discussed in relation to education, social and emotional well-being, and forensic contexts. What are the potential or actual clinical implications of this work? Findings emphasize that for adolescents with PAE, comprehensive assessment of both oral and written communication skills, through both standardized and functional tasks, should be undertaken. Speech-language pathologists have a key role in assessment with individuals who have PAE.
产前酒精暴露（PAE）与生长缺陷和神经发育障碍有关，包括胎儿酒精谱系障碍（FASD）。PAE 儿童常见口语和书面沟通技能困难；然而，对于 PAE 青少年的沟通技能如何与没有 PAE 的青少年相比，了解较少。青春期是发展的关键时期，支持向成年期过渡，但对于 FASD 患者来说，这是一个高风险时期。
我们进行了一项系统评价，以综合关于 PAE 或 FASD 青少年的口语和书面沟通技能的证据，以及他们与没有 PAE 的青少年相比如何。
使用七个数据库的全面搜索策略：Cochrane 图书馆、CINHAL、Embase、Medline、PsycInfo、Eric 和 Web of Science。纳入的研究报告了 PAE（或 FASD）组和无/低 PAE 组至少一项与口语和书面沟通相关的结果，年龄范围均为 10-24 岁。进行了质量评估。
本综述中纳入的七项研究中最常评估的沟通技能包括语义知识、语义处理、言语学习和记忆。与没有/低 PAE 的青少年相比，PAE 青少年的这些沟通技能以及阅读和拼写能力通常较弱。然而，研究结果不一致，研究方法也存在差异。
我们的研究结果强调，对于 PAE 青少年，在评估和计划干预时，应全面了解口头和书面两种方式的沟通技能。现有文献的一个主要限制是，对照组通常包括一些 PAE 水平较低的参与者，并且不同研究使用的 PAE 定义来分配参与者到组中。
关于该主题的现有知识 PAE 和 FASD 与口语和书面沟通技能缺陷有关。迄今为止的研究主要集中在 FASD 诊断的儿童以及 FASD 或 PAE 的儿童和青少年混合组上。对于有 PAE 或 FASD 的青少年的口语和书面沟通技能知之甚少，这对社交和学术需求增加期间的评估和支持提供了影响。本研究对现有知识的贡献这篇综述系统地确定、评估和综合了目前关于 PAE 青少年与无/低 PAE 青少年口语和书面沟通技能的文献。综述发现，由于研究方法和发现不一致，知识基础较小。然而，总体而言，研究结果强调，PAE 青少年的口语和书面语言技能比没有/低 PAE 青少年弱。结果与教育、社会和情感健康以及法医背景有关。这项工作有什么潜在或实际的临床意义？研究结果强调，对于 PAE 青少年，应通过标准化和功能性任务，全面评估口语和书面沟通技能。言语病理学家在评估有 PAE 的个体方面发挥着关键作用。
