Latent classes of neurodevelopmental profiles and needs in children and adolescents with prenatal alcohol exposure

• Published in: Alcohol (Hanover, York County, Pa.) Vol. 47; no. 4; pp. 772 - 785
• Main Authors: McLachlan, Kaitlyn, Minhas, Meenu, Ritter, Chantel, Kennedy, Kathleen, Joly, Vannesa, Faitakis, Martina, Cook, Jocelynn, Unsworth, Kathy, MacKillop, James, Pei, Jacqueline
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.04.2023
• Subjects: Adolescent; Adolescents; Attention; Canada - epidemiology; Child; Children; Cognitive ability; Cross-Sectional Studies; Developmental disabilities; Female; fetal alcohol spectrum disorder; Fetal Alcohol Spectrum Disorders - diagnosis; Fetal Alcohol Spectrum Disorders - epidemiology; Fetal Alcohol Spectrum Disorders - therapy; Fetal alcohol syndrome; Humans; Latent class analysis; Male; Neurodevelopmental disorders; Pregnancy; prenatal alcohol exposure; Prenatal experience; Prenatal Exposure Delayed Effects - diagnosis; Prenatal Exposure Delayed Effects - epidemiology; Retrospective Studies; Teenagers; Canada; fetal alcohol spectrum disorder; prenatal alcohol exposure; latent class analysis
• ISSN: 0145-6008; 1530-0277
• DOI: 10.1111/acer.15028

Background Fetal alcohol spectrum disorder (FASD) resulting from prenatal alcohol exposure (PAE) is a common neurodevelopmental disorder, but substantial interindividual heterogeneity complicates timely and accurate assessment, diagnosis, and intervention. The current study aimed to identify classes of children and adolescents with PAE assessed for FASD according to their pattern of significant neurodevelopmental functioning across 10 domains using latent class analysis (LCA), and to characterize these subgroups across clinical features. Methods Data from the Canadian National FASD Database, a large ongoing repository of anonymized clinical data received from diagnostic clinics across Canada, was analyzed using a retrospective cross‐sectional cohort design. The sample included 1440 children and adolescents ages 6 to 17 years (M = 11.0, SD = 3.5, 41.7% female) with confirmed PAE assessed for FASD between 2016 and 2020. Results Results revealed an optimal four‐class solution. The Global needs group was characterized by high overall neurodevelopmental impairment considered severe in nature. The Regulation and Cognitive needs groups presented with moderate but substantively distinguishable patterns of significant neurodevelopmental impairment. The Attention needs group was characterized by relatively low probabilities of significant neurodevelopmental impairment. Both the Global and Regulation needs groups also presented with the highest probabilities of clinical needs, further signifying potential substantive differences in assessment and intervention needs across classes. Conclusions Four relatively distinct subgroups were present in a large heterogeneous sample of children and adolescents with PAE assessed for FASD in Canada. These findings may inform clinical services by guiding clinicians to identify distinct service pathways for these subgroups, potentially increasing access to a more personalized treatment approach and improving outcomes. Findings from this study supported four latent subgroups differentiated based on patterns of neurodevelopmental impairment in a large sample of children and adolescents with PAE assessed for FASD across diagnostic clinics in Canada. Identifying common subgroups of children and adolescents with PAE seen for diagnostic assessment can inform personalized assessment and intervention needs and streamline services based on specific constellations of neurodevelopmental deficits and clinical needs.