Questioning cognitive heterogeneity and intellectual functioning in fetal alcohol spectrum disorders from the Wechsler Intelligence Scale for Children.

IF 3 3区 心理学 Q2 CLINICAL NEUROLOGY Clinical Neuropsychologist Pub Date : 2024-07-01 Epub Date: 2023-11-16 DOI:10.1080/13854046.2023.2281703
Eliot Kerdreux, Justine Fraize, Pauline Garzón, Esther Chalain, Léa Etchebarren, Delphine Sitbon, Anna Maruani, Odile Boespflug-Tanguy, Lucie Hertz-Pannier, Marion Noulhiane, Charlotte Pinabiaux, David Germanaud
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Abstract

Introduction: Fetal Alcohol Spectrum Disorders (FASD) are characterized by a variety of multiple cognitive and behavioral impairments, with intellectual, attentional, and executive impairments being the most commonly reported. In populations with multiple neurodevelopmental disorders, the Full Scale Intelligence Quotient (FSIQ) may not be a proper measure of intellectual abilities, rarely interpreted in FASD clinical practice because the heterogeneity of the cognitive profile is deemed too strong. We propose a quantitative characterization of this heterogeneity, of the strengths and weaknesses profile, and a differential analysis between global cognitive (FSIQ) and elementary reasoning abilities in a large retrospective monocentric FASD sample. Methods: Using clinical and cognitive data (Wechsler Intelligence Scale for Children) from 107 children with FASD, we characterized subject heterogeneity (variance and scatter of scaled/composite scores), searched for strengths and weaknesses, and specified intellectual functioning in terms of FSIQ and elementary reasoning (General Abilities Index, Highest Reasoning Scaled Score), in comparison with standardization norms and a Monte-Carlo-simulated sample from normalization data. Results: Performance of children with FASD was lower on all subtests, with a significant weakness in working memory and processing speed. We found no increase in the variance and scatter of the scores, but a discordance between the assessment of global cognitive functioning (28% borderline, 23% deficient) and that of global and elementary reasoning abilities (23-9% borderline, 15-14% deficient). Conclusion: Our results question the notion of WISC profile heterogeneity in FASD and point to working memory and processing speed over-impairment, with global repercussions but most often preserved elementary reasoning abilities.

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从儿童韦氏智力量表对胎儿酒精谱系障碍的认知异质性和智力功能的质疑。
胎儿酒精谱系障碍(FASD)以多种认知和行为障碍为特征,以智力、注意力和执行障碍为最常见的报道。在患有多种神经发育障碍的人群中,全量表智商(FSIQ)可能不是智力能力的适当衡量标准,在FASD临床实践中很少被解释,因为认知特征的异质性被认为太强。我们提出了这种异质性的定量表征,优势和劣势概况,并在一个大型回顾性单中心FASD样本中,对全球认知(FSIQ)和基本推理能力进行差异分析。方法:利用107名FASD儿童的临床和认知数据(韦氏儿童智力量表),我们对受试者的异质性(量表/综合得分的方差和散点)进行了表征,寻找优势和劣势,并在FSIQ和基本推理(一般能力指数,最高推理量表得分)方面指定了智力功能,并与标准化规范和蒙特卡罗模拟样本进行了比较。结果:FASD儿童在所有子测试中的表现都较低,在工作记忆和处理速度上有明显的弱点。我们发现得分的方差和散点没有增加,但总体认知功能评估(28%边缘,23%缺陷)与总体和基本推理能力评估(23-9%边缘,15-14%缺陷)之间存在不一致。结论:我们的研究结果质疑了FASD中WISC谱异质性的概念,并指出工作记忆和处理速度过度损伤,具有全球性影响,但大多数情况下保留了基本的推理能力。
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来源期刊
Clinical Neuropsychologist
Clinical Neuropsychologist 医学-临床神经学
CiteScore
8.40
自引率
12.80%
发文量
61
审稿时长
6-12 weeks
期刊介绍: The Clinical Neuropsychologist (TCN) serves as the premier forum for (1) state-of-the-art clinically-relevant scientific research, (2) in-depth professional discussions of matters germane to evidence-based practice, and (3) clinical case studies in neuropsychology. Of particular interest are papers that can make definitive statements about a given topic (thereby having implications for the standards of clinical practice) and those with the potential to expand today’s clinical frontiers. Research on all age groups, and on both clinical and normal populations, is considered.
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