Article Summary: Effects of Prenatal Alcohol Exposure on ADHD Symptoms

This report summarizes the article "Effects of prenatal alcohol exposure at school age. II. Attention and behavior" by Brown et al. (1991), which investigates the link between prenatal alcohol exposure and the development of ADHD in children. The study examined 68 mother-child pairs, categorizing mothers based on their alcohol consumption during pregnancy. The methodology involved questionnaires, computerized vigilance tasks, and observational procedures to assess attention, impulsivity, and activity levels. The results indicated that children exposed to alcohol prenatally exhibited attention deficits and behavioral problems, supporting the hypothesis that prenatal alcohol exposure is associated with ADHD symptoms. The conclusion highlights the association between parental alcoholism, prenatal alcohol exposure, and ADHD symptoms, while acknowledging limitations such as a small sample size and potential biases. The study's findings are discussed in relation to previous research, emphasizing the importance of understanding the effects of prenatal alcohol exposure on children's psychopathology and behavior.

Running head: ARTICLE SUMMARY
Article Summary
Name of the Student
Name of the University
Author Note

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ARTICLE SUMMARY
Table of Contents
Introduction................................................................................................................................2
Methodology..............................................................................................................................3
Results........................................................................................................................................5
Conclusion..................................................................................................................................5
References..................................................................................................................................8

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Introduction
The teratogen affects behavior problems among the offspring (Loomans et al., 2012).
Prenatal and parental exposure of alcohol is found to generate Attention Deficit Hyperactivity
Disorder (ADHD) in children (Ware et al., 2012). ADHD causes over activity, impulsivity
and are unable to sustain attention under the stereotypic school settings (Getahun et al.,
2013). It also causes poor self-esteemed, mood swings, dysthymia and anxiety that tamper the
academic performance of the students. However, exposure of alcohol is not the only reason
behind the occurrence of ADHD among the children; there are also evidences of neurologic
etiology (Frodl & Skokauskas, 2012). At the time of the discovery of the disease, ADHD was
categorized as mild brain dysfunction (MBD) (Rubia et al., 2014). This is because, as the
memory related problems are linked with neurological dysfunction and the reported cases of
ADHD was mostly associated with the infants who are at the high-risk of pre and perinatal
problems or with mother of high-risk pregnancies (Cussen et al., 2012). However, recent
literature has reported the occurrence of ADHA among the children with no significant
discernible brain dysfunction thus overruling the neurological basis of the disease (Cubillo et
al., 2012). Therefore, the root cause of ADHD is confusing and varies in between stressful or
disorganized environment and childhood psychiatric disorder.
ADHD is common in the families with prenatal alcohol exposure or children who are
diagnosed with Fetal Alcohol Syndrome (FAS) or children born with alcoholic mothers or
mothers who have consumed significant amount of alcohol during their time of pregnancy
(Graham et al., 2013). However, the attempt made to link the etiology of ADHD with
prenatal alcohol faced several problems because it is difficult to conceptually discriminate the
prenatal effects from the other effects that are associated with the exposure of the postnatal
environment like parental alcohol abuse (Silva et al., 2014). Therefore, it is still unclear that

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whether ADHD among the children is due to the post natal alcohol exposure or direct
exposure of alcohol after birth. The main rationale of the study conducted by Brown et al., in
the year 1991 is to discriminate these two guiding factors behind the reason of occurrence of
ADHD among the children. The main hypothesis of the article entitled, Effects of prenatal
alcohol exposure at school age. II. Attention and behavior is the school students who are
exposed prenatal alcohol suffers from the ADHD.
Methodology
For the study, authors here has chosen 68 mother-child pair from a large cohort (n =
228) in order the study the prenatal alcohol exposure on children and generation of ADHD.
The age groups of the children include 10 months to 5 years. The population selected is black
people for comes from low socioeconomic background. The selection of the sample was
purely based on the study conducted in the research (Coles et al., 1991). The pool of subject
belonged to the same bracket of the high-risk population including women who have reported
consumption of alcohol during all the trimesters of pregnancy (n = 25) in spite of having
proper educational intervention at the time of recruitment of the large university teaching
hospital (1990 to 1983). Another group included randomly selected women who never
consumed alcohol during the time of pregnancy and their children were free from alcohol
intoxication (“never drank”, n = 21). Last and the final group included women who have
reported drinking alcohol during their first trimester of pregnancy (statistically significant)
but have stalled the consumption of alcohol altogether during rest of the tenure of pregnancy
following the education intervention (“stopped drinking”, n= 22).
The study was conducted via a group of students who are master level graduate in
psychology and the mode of study conduction was done with the help of disseminating
questionnaire among the mothers and the children. Moreover, the participating children were

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kept blind about their maternal drinking status. The questionnaire was based on the Addiction
Severity Index (ASI) (McClelland, Luborsky, O'Brien, 1983). The Child Behavior Checklist
(CBL) accessed the internal and external behavior of the child (table 2 and table 3).
(Source: Brown et al., 1991)
(Source: Brown et al., 1991)
The sustained attention was analyzed via employing computerized vigilance task,
which was identical to the Computerized Performance Tasks (CPTs). Matching Familiar
Figures Test (MFFT) was employed to access the extent of impulsivity. Finally, in order to

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study the activity levels and interactional styles, videotaped observational procedure was
employed.
In this study, the researchers want to study the effect of prenatal and post natal alcohol
consumption on the development ADHD. Hence the amount and the extent of the alcohol
consumption can be termed as an independent variable as it can be varied in order to modify
the dependent variable which is the development of the ADHD among the school children.
Results
The results showed that the children who are exposed to alcohol throughout their
neonatal stage (pregnancy tenure) have deficits in their ability to maintain constant attention.
They also showed frequent behavioral and attention related problems, as reported by their
teachers. However, the reports recorded by their mother are not aligned with the teachers.
When the current alcohol exposure of the children was controlled, only change or the
modulation of the external behavior was observed with no effect on the internal behavior.
The statistical significance of the test results was validated via applying Multivariate analysis
of variance (MANOVA).
The hypothesis was aptly supported by the results as it showed that the children who
are exposed with alcohol during their neonatal life, while they in the womb of their mother
showed problem in maintaining attention, one of the principal symptoms of the ADHD.
Conclusion
From the research, Brown et al., (1991) concluded that the there lies an association of
the ADHD symptoms with the parental alcoholism and the argument was supported by both
postnatal environmental effects along with teratogenic affects. The results also showed that
the children who were exposed to the alcohol throughout the pregnancy has significantly

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more behavioral problems in the eternalizing and internalizing domains in comparison to the
mother who never consumed alcohol in their life or have ceased the intake of alcohol by the
second trimester of pregnancy. The results also showed that when the effects of the present
alcohol drinking were controlled, the internalizing effects weakened like withdrawal of
depression and anxiety. The defects in the externalizing behavior however remain the same
like cognitive performance and attention deficits.
The conclusion thus drawn from the research and obtained via the statistical analysis
aptly supported the hypothesis of the study.
The research findings showed that the children born to the alcoholic mother (during
the prenatal stages) are affected with the ADHD. Thus the research findings supported the
conclusion drawn via linking the dependent and independent variables.
The researcher conclusion are in sync with the previous findings too. For example,
Streissguth et al., (1986) showed that the heavily effected children commit more error in the
CPT and reacted more slowly in comparison to other unaffected individual. However, apart
from the attention related problems, no changes in their behavioral responses were reported.
On the other hand, the results obtained by Borwn et al. (1991) overruled the findings of the
Boyd et al. (1991) which showed no evidence of prenatal alcohol on the attention of the
children coming from the low-income countries.
The main strength of the study is lies in its statistical analysis and the use of the wide
range of the parameters in order to study the attention deficit problems among the children.
However, there are certain weakness in the study like the study has included a very small
group of respondents, 68 that might have led to the generation of biasness. Moreover, the
selection of the black people as the principal focus group who are residing under the poor

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socio-economic bracket is another main weakness of the study, again generating biasness in
the results.
The structure and the design of the study can be improved via including a large focus
group and via studying the neurological basis of the children who are suffering from the
ADHD in order to draw the a link between the alcohol exposure and the neurological
predisposition in the development of the ADHD (Graham et al., 2013).
The research findings are extremely useful in ascertain the effect of the alcohol
exposure during the prenatal tenure on the ADHD on the psychopathology and the behavior
of the children (Ware et al., 2013).

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References
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Falek, A. (1991). Effects of prenatal alcohol exposure at school age. II. Attention and
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Coles, C. D., Brown, R. T., Smith, I. E., Platzman, K. A., Erickson, S., & Falek, A. (1991).
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adults with attention deficit hyperactivity disorder indicates treatment effects. Acta

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