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J Int Neuropsychol Soc. 2014 Aug;20(7):704-16. doi: 10.1017/S1355617714000599. Epub 2014 Jul 17.

The clinical utility and specificity of parent report of executive function among children with prenatal alcohol exposure.

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1Center for Behavioral Teratology,Department of Psychology,San Diego State University,San Diego,California.
2Department of Psychiatry and Behavior Sciences,Emory University School of Medicine,Atlanta,Georgia.
4Department of Nutrition,Gillings School of Global Public Health,University of North Carolina Nutrition Research Institute,Kannapolis,North Carolina.
5Center on Alcoholism,Substance Abuse and Addictions,The University of New Mexico,Albuquerque,New Mexico.
6Developmental Cognitive Neuroimaging Laboratory,Department of Pediatrics,Keck School of Medicine,University of Southern California,Los Angeles,California.
8Department of Pediatrics,School of Medicine,University of California,San Diego,California.


Prenatal alcohol exposure and attention-deficit/hyperactivity disorder (ADHD) result in behavioral issues related to poor executive function (EF). This overlap may hinder clinical identification of alcohol-exposed children. This study examined the relation between parent and neuropsychological measures of EF and whether parent ratings aid in differential diagnosis. Neuropsychological measures of EF, including the Delis-Kaplan Executive Function System (D-KEFS), were administered to four groups of children (8-16 years): alcohol-exposed with ADHD (AE+, n=80), alcohol-exposed without ADHD (AE-, n=36), non-exposed with ADHD (ADHD, n=93), and controls (CON, n=167). Primary caregivers completed the Behavior Rating Inventory of Executive Function (BRIEF). For parent ratings, multivariate analyses of variance revealed main effects of Exposure and ADHD and an interaction between these factors, with significant differences between all groups on nearly all BRIEF scales. For neuropsychological measures, results indicated main effects of Exposure and ADHD, but no interaction. Discriminant function analysis indicated the BRIEF accurately classifies groups. These findings confirm compounded behavioral, but not neuropsychological, effects in the AE+ group over the other clinical groups. Parent-report was not correlated with neuropsychological performance in the clinical groups and may provide unique information about neurobehavior. Parent-report measures are clinically useful in predicting alcohol exposure regardless of ADHD. Results contribute to a neurobehavioral profile of prenatal alcohol exposure.

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