Sleep Education and Research Laboratory (SERL), UCL Institute of Education, WC1H 0AL London, UK.
Psychology and Human Development Department, IOE Faculty of Society and Education, University College London, WC1E 6BT London, UK.
J Integr Neurosci. 2023 May 16;22(3):77. doi: 10.31083/j.jin2203077.
The term Fetal Alcohol Spectrum Disorders (FASD) describes a range of neurodevelopmental conditions, the direct result of prenatal alcohol exposure. FASD encompasses a range of behavioural, cognitive and sleep patterns that are sometimes indiscernible from other neurodevelopmental conditions, one in particular being Autism Spectrum Disorders (ASD). This study aimed to provide a comparison of behavioural, cognitive, affect-related and sleep profiles in children aged between 6 and 15 years with diagnoses of FASD or ASD, in contrast to typically developing (TD) children.
We compared 29 children with FASD, 21 children with ASD and 45 typically developing (TD) children on parental-reported questionnaires measuring behaviour and executive functioning: the Child Behaviour Checklist (CBCL), the Spence Children's Anxiety Scale (SCAS) and the Behaviour Rating Inventory for Executive Function (BRIEF). Additionally, parents completed the Children's Sleep Habits Questionnaire (CSHQ), and children wore actigraphy watches while sleeping to objectively capture their sleep habits. The three groups were compared using ANCOVA, controlling for age effects.
Children with FASD scored significantly higher than the other two groups on the CBCL subscales of attention problems, somatic complaints, social problems, delinquency, and aggressive behaviour, as well as the panic subscale of the SCAS. Children with FASD also scored higher on all measures of the BRIEF than the ASD and TD groups, indicating greater problems with working memory and more difficulty shifting between tasks, planning, organising, inhibiting their behaviour and exercising emotional control. Nocturnal sleep duration in children with FASD was reported as one hour less than TD children and 46 minutes less than children with ASD per night.
The findings in this study highlight several syndrome specific features (shorter sleep duration, executive functioning difficulties, and higher levels of social and behavioural problems and panic) that potentially contribute to the unique phenotype of FASD. Whilst this research highlights the need for further work in this area, initial clinical screening for FASD should take such data on discernible characteristics, particularly the syndrome specificity of the BRIEF, into consideration.
胎儿酒精谱系障碍（FASD）这一术语描述了一系列神经发育状况，这些状况是产前酒精暴露的直接结果。FASD 包括一系列行为、认知和睡眠模式，这些模式有时与其他神经发育状况难以区分，其中一种是自闭症谱系障碍（ASD）。本研究旨在比较 6 至 15 岁 FASD 或 ASD 诊断儿童与正常发育（TD）儿童之间的行为、认知、情感相关和睡眠特征。
我们比较了 29 名 FASD 儿童、21 名 ASD 儿童和 45 名正常发育（TD）儿童，使用父母报告的问卷评估行为和执行功能：儿童行为检查表（CBCL）、斯宾塞儿童焦虑量表（SCAS）和行为评定量表执行功能（BRIEF）。此外，父母还填写了儿童睡眠习惯问卷（CSHQ），并让孩子在睡觉时佩戴活动记录仪，客观地记录他们的睡眠习惯。使用 ANCOVA 比较三组，控制年龄效应。
FASD 儿童在 CBCL 的注意力问题、躯体抱怨、社会问题、违法行为和攻击行为子量表以及 SCAS 的惊恐子量表上的得分显著高于其他两组。FASD 儿童在 BRIEF 的所有测量指标上的得分也高于 ASD 和 TD 组，表明他们在工作记忆方面存在更大的问题，并且在任务切换、计划、组织、抑制行为和控制情绪方面更困难。FASD 儿童的夜间睡眠时间比 TD 儿童少 1 小时，比 ASD 儿童少 46 分钟。
本研究的结果强调了一些综合征特异性特征（睡眠时间较短、执行功能困难、社交和行为问题以及惊恐水平较高），这些特征可能导致 FASD 的独特表型。虽然这项研究强调了在这一领域需要进一步的工作，但对 FASD 的初步临床筛查应该考虑到这种可识别特征的数据，特别是 BRIEF 的综合征特异性。
