Many children in the remote Fitzroy Valley region of Western Australia have prenatal alcohol exposure (PAE). Individuals with PAE can have neurodevelopmental impairments and be diagnosed with one of several types of Fetal Alcohol Spectrum Disorder (FASD). Fine motor skills can be impaired by PAE, but no studies have developed a comprehensive profile of fine motor skills in a population-based cohort of children with FASD. We aimed to develop a comprehensive profile of fine motor skills in a cohort of Western Australian children; determine whether these differed in children with PAE or FASD; and establish the prevalence of impairment.
Children (n = 108, 7 to 9 years) were participants in a population-prevalence study of FASD in Western Australia. Fine motor skills were assessed using the Bruininks-Oseretsky Test of Motor Proficiency, which provided a Fine Motor Composite score, and evaluated Fine Manual Control (Fine Motor Precision; Fine Motor Integration) and Manual Coordination (Manual Dexterity; Upper-Limb Coordination). Descriptive statistics were reported for the overall cohort; and comparisons made between children with and without PAE and/or FASD. The prevalence of severe (≤ 2nd percentile) and moderate (≤16th percentile) impairments was determined.
Overall, Fine Motor Composite scores were ‘average’ (M = 48.6 ± 7.4), as were Manual Coordination (M = 55.7 ± 7.9) and Fine Manual Control scores (M = 42.5 ± 6.2). Children with FASD had significantly lower Fine Motor Composite (M = 45.2 ± 7.7 p = 0.046) and Manual Coordination scores (M = 51.8 ± 7.3, p = 0.027) than children without PAE (Fine Motor Composite M = 49.8 ± 7.2; Manual Coordination M = 57.0 ± 7.7). Few children had severe impairment, but rates of moderate impairment were very high.
Different types of fine motor skills should be evaluated in children with PAE or FASD. The high prevalence of fine motor impairment in our cohort, even in children without PAE, highlights the need for therapeutic intervention for many children in remote communities.
Fitzpatrick J, Elliott EJ, Latimer J, Carter M, Oscar J, Ferreira M, Carmichael Olson H, Lucas BR, Doney R, Salter C, et al. The Lililwan project: study protocol for a population-based active case ascertainment study of the prevalence of fetal alcohol Spectrum disorders (FASD) in remote Australian aboriginal communities. BMJ Open. 2012;2:1–11. https://doi.org/10.1136/bmjopen-2012-000968. CrossRef
Bertrand J, Floyd RL, Weber MK, O'Connor M, Riley EP, Johnson KA, Cohen DE. Fetal alcohol syndrome: guidelines for referral and diagnosis. 3rd ed; 2004. https://www.cdc.gov/ncbddd/fasd/documents/fas_guidelines_accessible.pdf. Accessed 15 Sept 2015.
Chudley AE, Conry J, Cook JL, Loock C, Rosales T, LeBlanc N. Fetal Alcohol Spectrum Disorder: Canadian guidelines for diagnosis. Can Med Assoc J. 2005; 172:1–21;doi: https://doi.org/10.1503/cmaj.1040302.
Wozniak JR, Muetzel RL, Mueller BA, McGee CL, Freerks MA, Ward EE, Nelson ML, Chang P-N, Lim KO. Microstructural corpus callosum anomalies in children with prenatal alcohol exposure: an extension of previous diffusion tensor imaging findings. Alcohol Clin Exp Res. 2009;33:1825–35. https://doi.org/10.1111/j.1530-0277.2009.01021.x. CrossRefPubMedPubMedCentral
Mattson SN, Crocker N, Nguyen TT. Fetal alcohol Spectrum disorders: neuropsychological and behavioral features. Neuropsychol Rev. 2011;21:81–101. https://doi.org/10.1016/0892-0362(91)90085-b. CrossRefPubMedPubMedCentral
Xie N, Yang Q, Chappell TD, Li C-X, Waters RS. Prenatal alcohol exposure reduces the size of the forelimb representation in motor cortex in rat: an intracortical microstimulation (ICMS) mapping study. Alcohol. 2010;44:185–94. https://doi.org/10.1016/j.alcohol.2009.10.2014. CrossRefPubMed
de los Angeles Avaria M, Mills JL, Kleinsteuber K, Aros S, Conley MR, Cox C, Klebanoff M, Cassorla F. Peripheral nerve conduction abnormalities in children exposed to alcohol in utero. J Pediatr. 2004;144:338–43. https://doi.org/10.1016/j.jpeds.2003.11.028. CrossRef
Chase CI. Essay test scoring: interaction of relevant variables. J Educ Meas. 1986;23:33–41. https://doi.org/10.1111/j.1745-3984.1986.tb00232.x. CrossRef
The Royal Children's Hospital Melbourne. Australian Early Development Index Community Profile 2012 West Kimberley, Western Australia. http://www.aedc.gov.au/. Accessed 5 May 2016.
Australian Curriculum Assessment and Reporting Authority. NAPLAN achievement in reading, persuasive writing, Language conventions and numeracy: national report for 2015. http://www.nap.edu.au/_resources/2015_NAPLAN_national_report.pdf. Accessed 28 Dec 2015.
Fried PA, Watkinson B. 36- and 48-month neurobehavioral follow-up of children prenatally exposed to marijuana, cigarettes, and alcohol. J Dev Behav Pediatr. 1990;11:49–58. https://doi.org/10.1097/00004703-199004000-00003. CrossRefPubMed
Larroque BB, Kaminski MM. Prenatal alcohol exposure and development at preschool age: main results of a French study. Alcohol Clin Exp Res. 1998;22:295–303. https://doi.org/10.1111/j.1530-0277.1998.tb03652.x. CrossRefPubMed
Adnams CM, Kodituwakku PW, Hay A, Molteno CD, Viljoen D, May PA. Patterns of cognitive-motor development in children with fetal alcohol syndrome from a community in South Africa. Alcohol Clin Exp Res. 2001;25:557–62. https://doi.org/10.1111/j.1530-0277.2001.tb02250.x. CrossRefPubMed
Griffiths R. Griffiths mental development scales. ARICD: Bucks, United Kingdom; 1984.
Barr HM, Streissguth AP, Darby BL, Sampson PD. Prenatal exposure to alcohol, caffeine, tobacco, and aspirin: effects on fine and gross motor performance in 4-year-old children. Dev Psychol. 1990;26:339–48. https://doi.org/10.1037/0012-16220.127.116.119. CrossRef
Conry J. Neuropsychological deficits in fetal alcohol syndrome and fetal alcohol effects. Alcohol Clin Exp Res. 1990;14:650–5. https://doi.org/10.1111/j.1530-0277.1990.tb01222.x. CrossRefPubMed
Janzen LA, Nanson JL, Block GW. Neuropsychological evaluation of preschoolers with fetal alcohol syndrome. Neurotoxicol Terato 1995;17:273-9; doi: https://doi.org/10.1016/0892-0362(94)00063-J.
Korkman M, Autti-Ramo I, Koivulehto H, Granstrom ML. Neuropsychological effects at early school age of fetal alcohol exposure of varying duration. Child Neuropsychol. 1998;4:199–212. https://doi.org/10.1076/chin.18.104.22.16871. CrossRef
Bay B, Kesmodel US. Prenatal alcohol exposure - a systematic review of the effects on child motor function. Acta Obstet Gyn Scan. 2011;90:210–26. https://doi.org/10.1111/j.1600-0412.2010.01039.x.
Doney R, Lucas BR, Jones T, Howat P, Sauer K, Elliott EJ. Fine motor skills in children with prenatal alcohol exposure or fetal alcohol Spectrum disorder. J Dev Behav Pediatr. 2014;35:598–609. https://doi.org/10.1097/dbp.0000000000000107. CrossRefPubMed
Morphy F. Population, people and place: the Fitzroy Valley population project. The Centre for Aboriginal Economic Policy Research: The Australian National University; 2010. http://caepr.anu.edu.au/sites/default/files/Publications/WP/CAEPRWP70.pdf. Accessed 10 May 2015.
Fitzpatrick JP, Latimer J, Ferreira M, Martiniuk AL, Peadon E, Carter M, Oscar J, Carter E, Kefford M, Shandley R. Development of a reliable questionnaire to assist in the diagnosis of fetal alcohol Spectrum disorders (FASD). BMC Pediatr. 2013;13:33. https://doi.org/10.1186/1471-2431-13-33. CrossRefPubMedPubMedCentral
Bush K, Kivlahan DR, McDonell MB, Fihn SD, Bradley KA. The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Arch Intern Med. 1998;158:1789–95. https://doi.org/10.1001/archinte.158.16.1789. CrossRefPubMed
Lucas BR, Doney R, Latimer J, Watkins RE, Tsang TW, Hawkes G, Fitzpatrick JP, Oscar J, Carter M, Elliott EJ. Impairment of motor skills in children with fetal alcohol Spectrum disorders in remote Australia: the Lililwan project. Drug and Alcohol Review. 2016;35:719–27. https://doi.org/10.1111/dar.12375. CrossRefPubMed
Lucas BR, Latimer J, Doney R, Watkins RE, Tsang TW, Hawkes G, Fitzpatrick JP, Oscar J, Carter M, Elliott EJ. Gross motor performance in children prenatally exposed to alcohol and living in remote Australia. J PaediatrChild Health. 2016;52:814–24. https://doi.org/10.1111/jpc.13240.
Bruininks RH, Bruininks BD. Bruininks-Oseretsky test of motor proficiency. 2nd ed. Minneapolis, MN: NCS Pearson; 2005.
Rodger S, Brown GT, Brown A. Profile of paediatric occupational therapy practice in Australia. Aust Occup Ther J. 2005;52:311–25. https://doi.org/10.1111/j.1440-1630.2005.00487.x. CrossRef
Lucas BR, Latimer J, Doney R, Ferreira ML, Adams R, Hawkes G, Fitzpatrick JP, Hand M, Oscar J, Carter M. The Bruininks-Oseretsky test of motor proficiency-short form is reliable in children living in remote Australian aboriginal communities. BMC Pediatr. 2013;13:135. https://doi.org/10.1186/1471-2431-13-135. CrossRefPubMedPubMedCentral
Portney LG, Watkins MP. Foundations of clinical research: applications to practice. 2nd ed. Prentice Hall Health: Upper Saddle River, NJ; 2000.
Fitzpatrick JP, Latimer J, Ferreira ML, Carter M, Oscar J, Martiniuk ALC, Watkins RE, Elliott EJ. Prevalence and patterns of alcohol use in pregnancy in remote western Australian communities: the Lililwan project. Drug and Alcohol Review. 2015;34:329–39. https://doi.org/10.1111/dar.12232. CrossRefPubMed
Bracken B, McCallum S. Universal nonverbal intelligence test. Itasca, IL: Riverside Publishing; 1998.
Tsang, TW, Carmichael Olson, H, Latimer, J, Fitzpatrick, J, Hand, M, Oscar, J, Carter, M, Elliott, EJ. Behavior in children with Fetal Alcohol Spectrum Disorders in remote Australia: A population-based study. J Dev Behav Pediatr 2017;published online ahead of print; doi: https://doi.org/10.1097/DBP.0000000000000463.
Korkman M, Kirk U, Kemp S. NEPSY: a developmental neuropsychological assessment manual. 2nd ed. San Antonio, TX: Psychological Corporation; 2007.
Henderson SE, Sugden DA. Movement assessment battery for children: manual. London, United Kingdom: The Psychological Corporation; 1992.
Beery KE, Beery NA. The beery-Buktenica developmental test of visual-motor integration. 6th ed. Pearson Assessments: Minneapolis, MN; 2010.
Zhou D, Lebel C, Lepage C, Rasmussen C, Evans A, Wyper K, Pei J, Andrew G, Massey A, Massey D, Beaulieu C. Developmental cortical thinning in fetal alcohol Spectrum disorders. NeuroImage. 2011;58:16–25. https://doi.org/10.1016/j.neuroimage.2011.06.026. CrossRefPubMed
Bay B, Støvring H, Wimberley T, Denny CH, Mortensen EL, Eriksen H-LF, Kesmodel US. Low to moderate alcohol intake during pregnancy and risk of psychomotor deficits. Alcohol Clin Exp Res. 2012;36:807–14. https://doi.org/10.1111/j.1530-0277.2011.01657.x. CrossRefPubMed
Kooistra L, Ramage B, Crawford S, Cantell M, Wormsbecker S, Gibbard B, Kaplan BJ. Can attention deficit hyperactivity disorder and fetal alcohol Spectrum disorder be differentiated by motor and balance deficits? Hum Mov Sci. 2009;28:529–42. https://doi.org/10.1016/j.humov.2009.01.007. CrossRefPubMed
Coles CD, Platzman KA, Raskind-Hood CL, Brown RT, Falek A, Smith IEA. Comparison of children affected by prenatal alcohol exposure and attention deficit, hyperactivity disorder. Alcohol Clin Exp Res. 1997;21:150–61. https://doi.org/10.1111/j.1530-0277.1997.tb03743.x. CrossRefPubMed
Mattson SN, Riley EP, Gramling L, Delis DC, Jones KL. Neuropsychological comparison of alcohol-exposed children with or without physical features of fetal alcohol syndrome. Neuropsychology. 1998;12:146–53. https://doi.org/10.1037/0894-422.214.171.124. CrossRefPubMed
Uecker A, Nadel L. Spatial locations gone awry: object and spatial memory deficits in children with fetal alcohol syndrome. Neuropsychologia. 1996;34:209–23. https://doi.org/10.1016/0028-3932(95)00096-8. CrossRefPubMed
Doney R, Lucas BR, Watkins RE, Tsang TW, Sauer K, Howat P, Latimer J, Fitzpatrick JP, Oscar J, Carter M, Elliott EJ. Visual-motor integration, visual perception, and fine motor coordination in a population of children with high levels of fetal alcohol Spectrum disorder. Res Dev Disabil. 2016;55:346–57. https://doi.org/10.1016/j.ridd.2016.05.009. CrossRefPubMed
- Fine motor skills in a population of children in remote Australia with high levels of prenatal alcohol exposure and Fetal Alcohol Spectrum Disorder
Barbara R. Lucas
Rochelle E. Watkins
Tracey W. Tsang
James P. Fitzpatrick
Elizabeth J. Elliott
- BioMed Central
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