Description
Fetal alcohol spectrum disorders (FASD) are characterized by a wide array of neurobehavioral impairments, including executive function. Understanding the nature of these deficits could contribute to the development of interventions tailored towards individuals affected by FASD by identifying specific targets for treatment. However, defining the executive function construct has proven difficult, due in part to inconsistencies in categorizing executive function as a single unitary process or a diverse group of cognitive functions. These ambiguities have hindered the development of interventions aimed at deficits in executive function. The current study aimed to address these issues by examining the contribution of two aspects of behavioral function, adaptive behavior and disruptive behavior, on executive function impairment. Interventions aimed at these more accessible domains could have positive downstream implications for multiple executive processes. Three groups of subjects in two age ranges (Child: 5-7y, Adolescent: 10-16y) were included in the current study: subjects with histories of heavy prenatal alcohol exposure (AE, N=227), non-exposed subjects with clinical cognitive or behavior conditions or concerns (BCON, N=227), and typically developing controls (T-CON, N=254). Caregivers completed the Vineland Adaptive Behavior Scales-II (VABS-II), the Behavior Rating Inventory of Executive Function (BRIEF), and the Conners 3rd Edition (Conners3). The aggregate and individual contributions of VABS-II adaptive behavior and Conners3 disruptive behavior to differences in BRIEF executive function between groups (AE vs. B-CON; AE vs. T-CON) were analyzed using multiple mediation analyses. Results of the mediation analyses indicated that across age ranges and group comparisons, the aggregate effects of adaptive behavior and disruptive behavior significantly mediated group differences in executive function. Analyses of the specific mediating effects revealed that adaptive behavior was a significant mediator across all group comparisons and age ranges. Disruptive behavior was a significant mediator across all group comparisons and age ranges, except in the Child AE vs. B-CON comparison. Results of the current study provide support for directional relationships between multiple domains of neurobehavioral impairment in children and adolescents with prenatal alcohol exposure. Further research assessing these relationships could provide insight into the nature and development of deficits associated with prenatal alcohol exposure and refine the neurobehavioral profile.
