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Soft neurological signs and prenatal alcohol exposure: a population‐based study in remote Australia
Author(s) -
Lucas Barbara R,
Latimer Jane,
Fitzpatrick James P,
Doney Robyn,
Watkins Rochelle E,
Tsang Tracey W,
Jirikowic Tracy,
Carmichael Olson Heather,
Oscar June,
Carter Maureen,
Elliott Elizabeth J
Publication year - 2016
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/dmcn.13071
Subject(s) - prenatal alcohol exposure , fetal alcohol , medicine , pediatrics , population , medical diagnosis , pregnancy , environmental health , pathology , genetics , biology
Aim To identify soft neurological signs ( SNS ) in a population‐based study of children living in remote Aboriginal communities in the Fitzroy Valley, Western Australia, born between 2002 and 2003 and explore the relationship between SNS , prenatal alcohol exposure ( PAE ), and fetal alcohol spectrum disorders ( FASD ). Method The presence of SNS was assessed using the Quick Neurological Screening Test, 2nd edition ( QNST ‐2), which has a total maximum score of 140. Higher scores indicated more SNS . ‘Severe discrepancy’ was defined as scores less than or equal to the fifth centile while ‘moderate discrepancy’ represented scores from the sixth to the 24th centile. Children were assigned FASD diagnoses using modified Canadian FASD diagnostic guidelines. Results A total of 108 of 134 (80.6%) eligible children (mean age 8y 9mo, SD =6mo, 53% male) were assessed. The median QNST ‐2 Total Score for all participants was within the normal category (19.0, range 4–66). However, the median QNST ‐2 Total Score was higher in children with than without (1) PAE ( r =0.2, p =0.045) and (2) FASD ( r =0.3, p =0.004). Half (8/16) of children scoring ‘moderate discrepancy’ and all (2/2) children scoring ‘severe discrepancy’ had at least three domains of central nervous system impairment. Interpretation SNS were more common in children with PAE or FASD , consistent with the known neurotoxic effect of PAE . The QNST ‐2 is a useful screen for subtle neurological dysfunction indicating the need for more comprehensive assessment in children with PAE or FASD .