Prenatal Alcohol Exposure, ADHD, and Sluggish Cognitive Tempo

Background—Children with heavy prenatal alcohol exposure often meet criteria for attentiondeficit/hyperactivity disorder (ADHD). ADHD research has examined subtype differences in symptomology, including sluggish cognitive tempo (SCT). This construct is defined by behavioral symptoms including, hypoactivity and daydreaming, and has been linked to increased internalizing behaviors. The current study examined if similar findings are displayed in children with prenatal alcohol exposure. Methods—As part of a multisite study, caregivers of 272 children (8–16y) completed the SCT scale and Child Behavior Checklist (CBCL). Four groups were included: alcohol-exposed children with ADHD (ALC+; n=75), alcohol-exposed children without ADHD (ALC−; n=35), nonexposed children with ADHD (ADHD; n=60), and non-exposed children without ADHD (CON; n=102). SCT and CBCL scores were analyzed using 2 (exposure) × 2 (ADHD) ANOVAs. Pearson *The Collaborative Initiative on Fetal Alcohol Spectrum Disorders (CIFASD) (E. Riley, San Diego State University, Principal Investigator) includes 16 different centers where data collection and analysis take place. The data collection sites and associated investigators described in this paper are: San Diego State University (S.N. Mattson), University of New Mexico and Northern Plains (P.A. May, W. Kalberg), University of California, Los Angeles (E.P. Sowell), Emory University, Atlanta, GA (C.D. Coles, J.A. Kable). Additional sites include the University of Cape Town, South Africa (C.M. Adnams). Address for Correspondence: Sarah N. Mattson, Ph.D., 6330 Alvarado Court, Suite 100, San Diego, California 92120 USA, Phone: 619-594-7228, Fax: 619-594-1895, [email protected]. NIH Public Access Author Manuscript Alcohol Clin Exp Res. Author manuscript; available in PMC 2014 January 01. Published in final edited form as: Alcohol Clin Exp Res. 2013 January ; 37(Suppl 1): E338–E346. doi:10.1111/j.1530-0277.2012.01886.x. N IH PA Athor M anscript N IH PA Athor M anscript N IH PA Athor M anscript correlations measured the relations between SCT, CBCL, and FSIQ. Discriminant function analysis (DFA) examined if SCT items could accurately classify groups. Results—Analyses revealed significant main effects of Exposure and ADHD on SCT, internalizing, and externalizing scores, and significant interaction effects on SCT and internalizing scores. SCT significantly correlated with internalizing, externalizing, and attention ratings in all groups and with FSIQ in ALC+. DFA indicated that specific SCT items could distinguish ALC− from CON. Conclusions—Alcohol-exposed children exhibited elevated SCT scores. Elevations were related to increased parent ratings of internalizing and externalizing behaviors and attention. These findings occurred in alcohol-exposed children regardless of ADHD symptoms and specific SCT items proved useful in distinguishing exposed children suggesting clinical utility for this measure in further defining the neurobehavioral profile related to prenatal alcohol exposure.