Brain Development: Normal Processes and the Effects of Alcohol ...

8
Prenatal Alcohol Exposure
and Human Development
Although a relationshi p betwee n materna l drinkin g
and reproductiv e problem s had bee n suspecte d lon g
ago (Warner and Rosett , 1975 ; Abel, 1984) , it was the
description o f fetal alcoho l syndrom e (FAS ) in 197 3
(Jones and Smith, 1973 ; Jones et al, 1973 ) that initi -
ated comprehensiv e studie s of the effect s o f prenatal
alcohol exposur e on human development . Researc h
over the las t 3 0 years ha s confirmed the origina l observations
that affected childre n sho w growth retardation;
birth defects , particularly a characteristic facia l
dysmorphia; and behaviora l deficits indicative of central
nervous system (CNS) damage (Fig . 8.1). Animal
models as well as epidemiological and clinical studies
in humans hav e provided evidence o f the effect s o n
both physica l an d behaviora l characteristic s o f ex -
posed offspring , bu t th e CN S effect s an d thei r per -
sonal and social consequences have received the most
study in human samples . There have been a number
of comprehensive reviews of the result s of prenatal alcohol
exposure on development, particularl y in earl y
childhood (e.g. , Coles , 1992 , Stratto n e t al. , 1996 ;
Claire D. Coles
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Streissguth, 1997 ; Mattso n an d Riley , 1998 ; U S De -
partment o f Health and Huma n Services , 2000). Recently,
publication s i n thi s are a hav e increase d s o
much that it is now impossible to review the entire literature
in a single chapter. For that reason, this chapter
refer s briefl y t o earlier findings and deal s in mor e
detail with recent studies.
A decad e ago , th e followin g area s wer e amon g
those tha t seeme d t o hav e th e mos t researc h poten -
tial: threshold effects , neuroimaging , long-term development
i n affected individuals , specific versus global
effects, an d wha t i s now calle d "translation " amon g
the different discipline s studying this problem (Coles ,
1992). These areas have remained active. In addition,
several other issues have come to the fore. With better
diagnosis and identificatio n of affected individual s by
professionals and increasin g demand fo r services and
resources by families, th e nee d fo r improving education
an d remediatio n o f affecte d individual s has be -
come evident . Also , a s clinica l an d longitudina l
research cohort s hav e matured , differen t area s o f