New research from McGill University suggests that there may be excessive concern that a child with fetal alcohol spectrum disorder (FASD) also may have attention-deficit hyperactivity disorder (ADHD).
But now researchers have suggested that there may be an over-reporting of attention problems in children with FASD, simply because parents and teachers are using a misplaced basis for comparison.
That is, they are testing and comparing children with FASD with children of the same physical or chronological age, rather than with children of the same mental age — which is often quite a lot younger.
“Because the link between fetal alcohol syndrome and ADHD is so commonly described in the literature, both parents and teachers are more likely to expect these children to have attention problems,” said Dr. Jacob Burack, the senior author on a recent study on the subject.
“But what teachers often don’t recognize is that although the child they are dealing with is 11 years old in chronological terms, they are actually functioning at the developmental age of an eight year old.
“That’s a pretty big difference. And when you use mental age as the basis of comparison, many of the attention problems that have been described in children with FASD no longer seem of primary importance.”
The researchers recruited children with FASD whose average chronological age was just under 12 years old. But their average mental age, determined by standard tests, was actually closer to 9-1/2 years old.
These children were then compared with children who were developing typically and whose average chronological age was about 8-1/2 years old and whose average mental age was similar to that of the group of children diagnosed with FASD.
After using tests to measure specific aspects of attention, the researchers then compared the performance of children with FASD on these tests with the results of children of the same mental age.
What they found was that while children like Ellen had difficulties with certain kinds of attention skills, notably in terms of shifting attention from one object to another, there were other areas, such as focus, where they had no significant difficulties at all.
So, if we were to compare these aspects of attention to a hockey game, typically these children would have no difficulty focusing on the puck in the arena, but would have problems following the puck being passed from one player to another.
This suggests to Dr. Kimberly Lane, who conducted the research, that there is a need to develop a more nuanced understanding of attention skills.
“We use words like attention loosely, but it’s really an umbrella term that covers various aspects of attending to different people or events or environments,” said Lane.
“By using more complex assessment techniques of various aspects of attention it will be possible to get a better picture of the attention difficulties faced by children with FASD,” she said.
“But no matter what the tests say, it’s important for teachers and parents to understand that.the difficulties these children have with attention may be less important than their more general problems, and we need to work with them as they are.”