Ritfeld, G.J., Wang, M., Shapiro, Z., Kable, J.A. and Coles, C.D. (2023), Parenting with fetal alcohol spectrum disorders and neurobehavioral outcomes in offspring. Alcohol Clin Exp Res. Accepted Author Manuscript. https://doi.org/10.1111/acer.15256
Abstract
Background
The neurobehavioral health impairments associated with prenatal alcohol exposure (PAE) are now known to persist through adulthood. However, little is known about how these impairments affect parenting abilities and neurobehavioral health of offspring. This study compares parents with fetal alcohol spectrum disorder (FASD) with non-exposed parents and assessed the neurobehavioral health of their children.
Methods
49 parent-child dyads were recruited from a longitudinal cohort with a low socioeconomic status. Measures included the Parenting Styles and Dimensions Questionnaire, Family Support Scale, an in-depth psychosocial history, the Pediatric Symptom Checklist (PSC; parent and child reports), the Achenbach Child Behavior Checklist (CBCL), a screening psychiatric evaluation of the child, the NIH Toolbox Cognition Battery for Children, The Vineland Adaptive Behavior Scales-Third Edition caregiver rating form, and the Traumatic Events Screening Inventory (parent and child reports).
Results
Cognitive functioning was impaired for both offspring of parents with FASD (x̄=81.1, SD 13.0) and control parents (x̄=79.9, SD 16.1), but despite similar impairments, children of parents with FASD were less likely to have an Individualized Education Plan than controls. Adaptive functioning was adequate for both groups (x̄ =92.1, SD 15.4 in exposed vs x̄ =94.3, SD 12.3 in controls) and CBCL and PSC scores in both groups were within normal limits. Parents in both groups showed a predominantly authoritative parenting style. Despite similar adverse childhood event frequency in both groups, parents with FASD were less likely to recognize their child’s adverse experiences.
Conclusion
Parents with FASD display notable strengths including a predominantly authoritative parenting style. However, parents with FASD underrecognize child trauma and show an underutilization of developmental services compared to socioeconomically matched controls, despite similar neurocognitive impairments. Impairments in adaptive functioning in parents with FASD may translate into difficulties with child-parent communication, insight into neurobehavioral problems, and advocacy skills. There is a need to identify and support parents with FASD to optimize their parenting abilities in the context of their individual strengths and difficulties.