Price, AD 2019, The impact of traumatic childhood experiences on cognitive and behavioural functioning in children with foetal alcohol spectrum disorders , PhD thesis, University of Salford.
Prenatal alcohol exposure (PAE) can cause lasting physical damage to the developing foetus including the brain. This brain damage can manifest as cognitive dysfunction and behavioural difficulties, which can be diagnosed as foetal alcohol spectrum disorders (FASD). FASD is thought to be common in the UK, with estimates ranging from 3.24% up to 17% of the population affected, although rates of diagnosis are much lower than this. Children with FASD are at increased risk of a range of traumatic or adverse childhood experiences, such as neglect or abuse. Studies into the longterm effects of neglect or abuse show a similar range of cognitive dysfunction and behavioural difficulties as those seen in FASD, but there is a lack of evidence on the impact of a dual exposure of PAE and trauma. This is especially necessary for clinicians, who may need to use the presence of trauma to inform and potentially exclude a diagnosis on the foetal alcohol spectrum. This aim of this thesis was to investigate the impact of childhood trauma on the cognitive and behavioural functioning of children with FASD. A wide-ranging overview of the literature on the effects of PAE and trauma as separate exposures was conducted and was followed by a systematic literature review of studies into the dual exposure of PAE and trauma. The reviews showed that only five studies had investigated the impact of both exposures, although one further study was published more recently. The literature reviews, including the one new study showed that, although there had only been a small number of studies conducted, a pattern was emerging that children with both FASD and trauma were more similar to children with just FASD than they were to children with just trauma, in terms of their cognitive and behavioural functioning.
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