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Executive Function in Adolescents with Fetal Alcohol Spectrum Disorders: A Developmental Perspective
Objective: Children with fetal alcohol spectrum disorders (FASD) have well-documented deficits in executive function. However, few previous studies have examined executive deficits displayed by children with FASD within a developmental framework. This longitudinal study explored the manifestation of...
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| Format: | Thesis |
| Language: | Eng |
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Department of Psychiatry and Mental Health
2025
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| _version_ | 1867613166322581504 |
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| access_status_str | Open Access |
| author | Pomario, Tania |
| author2 | Gouse, Hetta; Thomas, Kevin |
| author_browse | Gouse, Hetta; Thomas, Kevin Pomario, Tania |
| author_facet | Gouse, Hetta; Thomas, Kevin Pomario, Tania |
| author_sort | Pomario, Tania |
| collection | Thesis |
| description | Objective: Children with fetal alcohol spectrum disorders (FASD) have well-documented
deficits in executive function. However, few previous studies have examined executive
deficits displayed by children with FASD within a developmental framework. This
longitudinal study explored the manifestation of executive function in both alcohol-exposed
and typically developing adolescents from a low socioeconomic community in a low-and
middle-income country. Method: 110 participants (48 with FASD, mean age 14.65 years, SD
= 0.65 and 62 controls, mean age 14.49 years, SD = 0.44) were assessed at two time points,
18 months apart. Participants completed a battery of neuropsychological tests to measure
executive function. Parents and teachers provided ratings of participants’ everyday executive
function on the Behavior Inventory of Executive Function (BRIEF). Principal component
analysis examined the underlying components of the neuropsychological measures of
executive function in the control group. Composite executive function test scores were
computed for both groups, and ANCOVA was used to examine whether a) cognitive
performance of the FASD group differed from that of the control group, and b) whether there
was a change in scores across the two time points. Chi-square and ANCOVA analyses
assessed group differences on the BRIEF. Finally, correlations and regressions investigated
whether composite cognitive scores were significant predictors of behaviour, as measured by
the BRIEF. Results: Neuropsychological measures of executive function clustered into four
distinct factors reflecting the domains of Generativity, Attentional Control, Working
Memory, and Processing Speed. The FASD group performed significantly worse than the
control group on the Working Memory domain (p < .01). On the BRIEF, a significantly
higher proportion of the FASD group was rated as having scores in the clinically impaired
range by both parents (p < .001) and teachers (p < .01) compared to controls. Significant
differences were found between the FASD and control groups on the Emotional Control and Organization of Materials scales of the BRIEF Teacher. Significant differences were found
for the Global Executive Composite and the Plan/Organize and Monitor scales on the BRIEF
Parent. The cognitive composites Attentional Control and Generativity were significantly
negatively correlated with scores on several of the BRIEF Teacher clinical scales for the
FASD group. Conclusion: Performance on working memory tasks emerged as the only
domain of executive function that distinguished the FASD group from the control group.
There was no notable developmental change in executive abilities over the course of the 18-
month period in either group. Both parents and teachers reported that the FASD group
displayed significantly more executive deficits, but only teacher ratings were correlated with
neuropsychological test results. This suggests that children with FASD have more difficulties
with executive functioning in their everyday lives than what is being detected on
neuropsychological measures alone.
Keywords: fetal alcohol spectrum disorder, executive function, Behavior Rating Inventory of
Executive Function, adolescents, longitudinal study
|
| format | Thesis |
| id | oai:open.uct.ac.za:11427/41468 |
| institution | University of Cape Town (South Africa) |
| language | Eng |
| last_indexed | 2026-06-10T12:31:48.735Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2025 |
| publishDateRange | 2025 |
| publishDateSort | 2025 |
| publisher | Department of Psychiatry and Mental Health |
| publisherStr | Department of Psychiatry and Mental Health |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/41468 Executive Function in Adolescents with Fetal Alcohol Spectrum Disorders: A Developmental Perspective Pomario, Tania Gouse, Hetta; Thomas, Kevin Medicine Objective: Children with fetal alcohol spectrum disorders (FASD) have well-documented deficits in executive function. However, few previous studies have examined executive deficits displayed by children with FASD within a developmental framework. This longitudinal study explored the manifestation of executive function in both alcohol-exposed and typically developing adolescents from a low socioeconomic community in a low-and middle-income country. Method: 110 participants (48 with FASD, mean age 14.65 years, SD = 0.65 and 62 controls, mean age 14.49 years, SD = 0.44) were assessed at two time points, 18 months apart. Participants completed a battery of neuropsychological tests to measure executive function. Parents and teachers provided ratings of participants’ everyday executive function on the Behavior Inventory of Executive Function (BRIEF). Principal component analysis examined the underlying components of the neuropsychological measures of executive function in the control group. Composite executive function test scores were computed for both groups, and ANCOVA was used to examine whether a) cognitive performance of the FASD group differed from that of the control group, and b) whether there was a change in scores across the two time points. Chi-square and ANCOVA analyses assessed group differences on the BRIEF. Finally, correlations and regressions investigated whether composite cognitive scores were significant predictors of behaviour, as measured by the BRIEF. Results: Neuropsychological measures of executive function clustered into four distinct factors reflecting the domains of Generativity, Attentional Control, Working Memory, and Processing Speed. The FASD group performed significantly worse than the control group on the Working Memory domain (p < .01). On the BRIEF, a significantly higher proportion of the FASD group was rated as having scores in the clinically impaired range by both parents (p < .001) and teachers (p < .01) compared to controls. Significant differences were found between the FASD and control groups on the Emotional Control and Organization of Materials scales of the BRIEF Teacher. Significant differences were found for the Global Executive Composite and the Plan/Organize and Monitor scales on the BRIEF Parent. The cognitive composites Attentional Control and Generativity were significantly negatively correlated with scores on several of the BRIEF Teacher clinical scales for the FASD group. Conclusion: Performance on working memory tasks emerged as the only domain of executive function that distinguished the FASD group from the control group. There was no notable developmental change in executive abilities over the course of the 18- month period in either group. Both parents and teachers reported that the FASD group displayed significantly more executive deficits, but only teacher ratings were correlated with neuropsychological test results. This suggests that children with FASD have more difficulties with executive functioning in their everyday lives than what is being detected on neuropsychological measures alone. Keywords: fetal alcohol spectrum disorder, executive function, Behavior Rating Inventory of Executive Function, adolescents, longitudinal study 2025-06-20T17:17:18Z 2025-06-20T17:17:18Z 2025 2025-06-20T16:57:20Z Thesis / Dissertation PHD PHD http://hdl.handle.net/11427/41468 Eng application/pdf Department of Psychiatry and Mental Health Health Science University of Cape town |
| spellingShingle | Medicine Pomario, Tania Executive Function in Adolescents with Fetal Alcohol Spectrum Disorders: A Developmental Perspective |
| title | Executive Function in Adolescents with Fetal Alcohol Spectrum Disorders:
A Developmental Perspective |
| title_full | Executive Function in Adolescents with Fetal Alcohol Spectrum Disorders:
A Developmental Perspective |
| title_fullStr | Executive Function in Adolescents with Fetal Alcohol Spectrum Disorders:
A Developmental Perspective |
| title_full_unstemmed | Executive Function in Adolescents with Fetal Alcohol Spectrum Disorders:
A Developmental Perspective |
| title_short | Executive Function in Adolescents with Fetal Alcohol Spectrum Disorders:
A Developmental Perspective |
| title_sort | executive function in adolescents with fetal alcohol spectrum disorders a developmental perspective |
| topic | Medicine |
| url | http://hdl.handle.net/11427/41468 |
| work_keys_str_mv | AT pomariotania executivefunctioninadolescentswithfetalalcoholspectrumdisordersadevelopmentalperspective |