Reading impairment in adolescents with fetal alcohol spectrum disorders

Abstract

Purpose: To date, research on effects of prenatal alcohol exposure (PAE) has focused on a broad range of cognitive impairments, but relatively few studies have examined effects of PAE on development of reading skills. Although PAE has been linked to poorer reading comprehension, it remains unclear whether this impairment is attributable to deficits in phonological processing, word reading, oral language skills, and/or executive functioning.

Methods: A comprehensive reading battery was administered to 10 adolescents with fetal alcohol syndrome (FAS); 16 with partial FAS; 30 nonsyndromal heavily-exposed; 49 controls.

Results: PAE was related to poorer reading comprehension but not to single word reading or phonological processing, suggesting that the mechanics of reading are intact in adolescents with fetal alcohol spectrum disorders at this age. PAE-related impairment in reading comprehension was mediated, in part, by deficits in mastery of oral language skills, including vocabulary, language structure, and verbal fluency.

Conclusions: These results are consistent with research showing that reading comprehension in adolescence relies increasingly on linguistic comprehension abilities, especially once word reading becomes automatic and text complexity increases. Our findings suggest that reading-impaired adolescents with PAE will benefit from intervention programs targeting vocabulary knowledge, language structure, verbal fluency, and reading comprehension skills.

Figure 1.

Path models illustrating the effect of prenatal alcohol exposure on Reading Comprehension mediated by Verbal Fluency and by a Language composite variable (derived by averaging Sentence Structure, Vocabulary, and Verbal Fluency after conversion to z-scores). Values are standardized regression coefficients (β), adjusted for propensity score. AA = absolute alcohol. The propensity score was derived by regressing prenatal alcohol exposure (measured as log AA/day) on maternal education (years) and smoking during pregnancy (cigarettes/day) and participant’s sex and age at assessment. ^aAfter adjustment for propensity score. ^bAfter adjustment for propensity score and mediator. ^cAfter adjustment for AA/day and propensity score. ^†p<0.10; *p<0.05; **p<0.001.