BRAIN-online: An online cognitive and behavioral screening tool for fetal alcohol spectrum disorders

Fetal alcohol spectrum disorders (FASD) are among the most common developmental disorders but are underdiagnosed in part because of the inaccessibility of valid screening tools. The goal of this study was to test the ability of a novel online cognitive and behavioral screening tool to accurately distinguish youth with histories of prenatal alcohol exposure (PAE) from the comparison group.

Children were tested at home with an online cognitive and behavioral test battery, Brief Assessment of Individual Neurobehavior-online version (BRAIN-online). Participants included children with (n = 239) and without (n = 89) histories of PAE between the ages of 5 and 17 years. BRAIN-online includes a parent/caregiver-completed behavioral questionnaire and seven cognitive tasks completed by the child. Performance data were analyzed using ANOVA, ROC analysis, and logistic regression.

Children in the alcohol-exposed group had more behavioral problems, as indicated by higher scores on the behavior rating, and performed more poorly on the cognitive tasks than children in the comparison group. Logistic regression results indicated that performance on BRAIN-online distinguished the groups with a high degree of accuracy (accuracy = 80%, sensitivity = 79%, specificity = 83%, positive predictive value = 92%, negative predictive value = 60%). Results were not affected by attention-deficit/hyperactivity disorder (ADHD) or overall intellectual ability.

BRAIN-online is a novel online screening tool that can distinguish individuals affected by prenatal alcohol exposure from typically developing children with a high degree of accuracy. The availability of an accessible, low-cost, efficient screening tool for fetal alcohol spectrum disorders (FASD) will improve diagnostic efficiency and reduce wait times and assessment costs.