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Behavior in Children with Fetal Alcohol Spectrum Disorders in Remote Australia: A Population-Based Study
Tracey W Tsang1, Heather Carmichael Olson, Jane Latimer
1*The University of Sydney, Discipline of Child and Adolescent, Sydney Medical School, New South Wales, Australia; †Musculoskeletal Division, The George Institute for Global Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia; ‡Department of Psychiatry and Behavioral Sciences, Seattle Children's Research Institute, University of Washington School of Medicine, Seattle, WA; §Alcohol and Pregnancy & FASD, Telethon Kids Institute, Perth, Western Australia, Australia; ‖Fitzroy Valley District High School, Fitzroy Crossing, Western Australia, Australia; ¶Marninwarntikura Women's Resource Centre, Fitzroy Crossing, Western Australia, Australia; **Nindilingarri Cultural Health Services, Fitzroy Crossing, Western Australia, Australia; ††The Sydney Children's Hospital Networks (Westmead), Westmead, New South Wales, Australia; ‡‡The Australian Paediatric Surveillance Unit, Kids' Research Institute, Westmead, New South Wales, Australia.
Objective:
To document behavior in children residing in very remote Western Australian communities as rated by parent/caregivers and teachers. We hypothesized that children with fetal alcohol spectrum disorders (FASD) would have higher rates of problematic behavior than children without FASD.
Methods:
The Child Behavior Checklist (CBCL; n = 97), and Teacher Report Form (TRF; n = 106) were used in this population-based study. Raw scores, proportions scoring within "Normal/Borderline/Clinical" ranges, and frequencies of Critical items were determined. Mann-Whitney U and χ tests were used for between-group comparisons.
Results:
Children were aged from 7.5 to 9.6 years, and 19% had FASD. Academic performance was commonly rated in the "Borderline/Clinical" range (73%). Teacher-rated scores were poorer in the FASD group on 15 scales encompassing total and internalizing problems, adaptive function, academic performance, attention, withdrawn/depressed, social problems, posttraumatic stress, thought problems, and sluggish cognitive tempo (p < .05). More children in the FASD group had scores in the "Borderline/Clinical" range on 11 TRF scales (p < .05). "Physically attacks people" was the most prevalent Critical item endorsed by teachers for the total cohort (22%). "Talks about killing self" was endorsed by teachers more often in the FASD group (14%) than the Non-FASD group (1%; p = .03). There were no significant differences between groups in parent-reported CBCL scores after adjustment for multiple comparison testing.
Conclusion:
This study demonstrates that children with FASD have more teacher-reported behavioral impairment than children without FASD. In remote Australian communities, academic performance is poor.
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