Treatments for fetal alcohol

syndrome may be inappropriate

A new study overturns the notion that children with fetal alcohol syndrome have the same learning problems as children with attention deficit disorders.

The surprising findings by Emory researchers offer guidance on developing new teaching methods and drug treatments for children with FAS. Those now used may be the opposite of what children with FAS need, the study suggested.

The new work, published in the February issue of Alcoholism, examined how children with FAS learn compared to children with attention deficit, hyperactivity disorder. FAS affects children whose mothers drank heavily during pregnancy. Children with FAS have behavioral and learning problems in addition to brain damage and facial abnormalities.

"FAS was never before looked at in this way," according to the study's lead researcher, Claire Coles, an associate professor of psychology. "We just assumed that the kids with FAS have ADHD and gave them Ritalin." The Emory team expected the new study to confirm that notion. Instead, they uncovered major differences in how children with FAS learn, as opposed to children with ADHD.

Their work found that children with ADHD are like impatient commuters who are frustrated by traffic and impulsively switch lanes or try detours in their rush to get where they're going. Conversely, children with FAS behave like drivers who patiently inch forward through traffic, content to stay in line and pass up other, unfamiliar routes.

The study compared the learning capabilities and brain function of 122 teens ages 14 and 15 with FAS to a group of 27 teens of the same age with ADHD. The teens participated in several tests designed to look at their ability to focus attention, sustain that attention, switch focus and then use new information they have learned.

The tests-sorting cards, responding to computer commands, verbally repeating series of numbers-revealed sharp differences in the two groups of teens. Children with FAS could focus on tasks, but had trouble using the newly learned information and switching their attention to a new task, Coles found. "They had trouble learning new material, but once they did they were as good as anyone else," she said.

The teens with ADHD had different trouble with the tests. "The ADHD kids could not focus well and keep their attention on things. They could not keep focus on the computer [tasks], but the FAS kids were just happy at the computer doing the same thing over and over," Coles said.

Those differences may explain why drugs like Ritalin, which help focus attention, do not help children with FAS, who can focus but need help changing focus, Coles explained.

If the Emory findings are confirmed, they should point the way to new teaching methods or drugs designed to overcome the learning problems associated with FAS, Coles said.

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