Prenatal alcohol exposure (PAE) alters limb development that may lead to structural and functional abnormalities of the limb reported in children diagnosed with Fetal Alcohol Spectrum Disorder. To determine whether PAE alters the central representation of the forelimb we used the rodent barrel cortex as our model system where it was possible to visualize and quantitatively measure the size of the forepaw representation in the forepaw barrel subfield (FBS) in first somatosensory cortex. In the present study, we examined the effects of PAE on pattern and size of the forepaw and forepaw representation in FBS in neonatal rats at gestational day 32 that corresponds to postnatal day 9. Pregnant Sprague-Dawley rats were chronically intubated with binge doses of ethanol (6 g/kg) from gestational day 1 through gestational day 20. The offspring of the ethanol treated dams comprised the ethanol (EtOH) group. The effect of PAE on the EtOH group was compared with a nutritional-controlled pairfed (PF) group and a normal chowfed (CF) group. The ventral (glabrous) surface area of the forepaw digits, length of digit 2 through digit 5, and the corresponding glabrous forepaw digit representations in the FBS were measured and compared between treatment groups. In rats exposed to in utero alcohol, the sizes of the overall glabrous forepaw and forepaw digits were significantly reduced in EtOH pups compared to CF and PF pups; overall glabrous forepaw area was 11% smaller than CF controls. Glabrous digit lengths were also smaller in EtOH rats compared to CF controls and significantly smaller in digit 2 through digit 4. The glabrous digit representation in FBS was 18% smaller in the EtOH group when compared to the CF treatment. However, PAE did not produce malformations in the forepaw or alter the pattern of the forepaw representation in FBS; instead, PAE significantly reduced both body and brain weights compared to controls. Unexpectedly, little or no correlation was observed between the size of the glabrous forepaw compared to the size of the glabrous forepaw representation in the FBS for any of the treatment groups. The present findings of PAE-related alterations in sensory periphery and the central cortical representation may underlie deficits in sensorimotor integration reported among children with Fetal Alcohol Spectrum Disorder.

Thesis (MA)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Maternal drinking during pregnancy and its consequences are a growing health concern worldwide. It has also been identified as a significant problem in South African communities with some of the highest prevalence rates of Fetal Alcohol Spectrum Disorder (FASD) reported in South Africa. The primary aim of this study was to explore how women in a South African community in the Northern Cape Province perceive the personal and general risk of drinking during pregnancy. The secondary aims were to ascertain whether there was evidence of unrealistic optimism, to examine whether there were personal characteristics that are associated with high or low risk perception, and to examine women‟s knowledge of FASD. A total of 128 women from De Aar in the Northern Cape, an area with a high prevalence of FASD, and therefore drinking during pregnancy, were recruited to take part in the study. Participants had previously taken part in a FASD prevention programme. Questionnaires were administered assessing the perception of the risk posed to a participant‟s own child should she drink during pregnancy, and the risk posed to others‟ children should they drink during pregnancy. The questionnaire also contained questions on FASD knowledge and demographic variables. Participants were between 18 and 44 years of age and reported high rates of unemployment. Most women had more than one child and 7.8% had a child diagnosed with FASD. No evidence for unrealistic optimism was found. Multiple regression analyses revealed both FASD knowledge, and the perception of how easy it would be for oneself to stop drinking, were significant predictors for both personal and general risk. A model including the perception of general risk, FASD knowledge and the perception of how easily one could stop drinking accounted for the most variance in the perception of personal risk (66.4%). Perception of personal risk on its own was the strongest predictor of the perception of general risk accounting for 56.1% of variance. There was no significant correlation between passage of time and FASD knowledge, but possible gaps in FASD knowledge were identified. The study provides an overview of the perception of the risk of drinking during pregnancy in the target population. It also suggests improvements to the research design and materials for further research. / AFRIKAANSE OPSOMMING: Moederlike drankgebruik gedurende swangerskap en die gevolge daarvan word wêreldwyd met groeiende kommer beskou. Dit is ook as ʼn wesenlike probleem in Suid-Afrika geïdentifiseer, met van die hoogste voorkomssyfers van Fetale Alkohol Spektrumafwykings (FASA) wat in Suid-Afrika aangeteken is. Die primêre doel van hierdie studie was om, in ʼn Suid-Afrikaanse gemeenskap in die Noord Kaap provinsie, die persepsie van persoonlike en algemene risiko van drink tydens swangerskap onder vrouens, te ondersoek. Die sekondêre doelstellings was om vas te stel of daar bewyse van onrealistiese optimisme is; te bepaal of daar persoonlike eienskappe is wat korreleer met ʼn hoë of lae risiko-persepsie, en om ook die vroue se kennis van Fetale Alkohol Spektrumafwykings (FASA) te ondersoek. 128 vroue van De Aar in die Noord-Kaap is gewerf om aan die studie deel te neem. Die gebied het 'n hoë FASA voorkoms, en dus ook alkoholgebruik tydens swangerskap. Deelnemers het voorheen deelgeneem aan 'n FASA voorkomingsprogram. Vraelyste is voltooi rakende die persepsie van die risiko vir 'n deelnemer se eie kind sou sy tydens swangerskap drink, en die risiko vir ander se kinders, sou hulle tydens swangerskap drink. Die vraelys het ook vrae oor FASA kennis en demografiese veranderlikes ingesluit. Deelnemers was tussen 18 en 44 jaar oud en het hoë vlakke van werkloosheid gerapporteer. Meeste vrouens het meer as een kind gehad en 7.8% het ʼn kind wat met FASA gediagnoseer is gehad. Geen bewyse vir onrealistiese optimisme is gevind nie. Meervoudige regressie-ontleding het bevind dat beide FASA-kennis en die persepsie van hoe maklik dit vir ‟n deelnemer self sou wees om op te hou drink, beduidende voorspellers vir beide persoonlike en algemene risiko is. 'n Model wat die persepsie van algemene risiko, FASA-kennis en die persepsie van hoe maklik 'n deelnemer self kan ophou drink, het die grootste variansie in die persepsie van persoonlike risiko verduidelik (66,4 %). Persepsie van persoonlike risiko op sy eie, was die sterkste voorspeller van die persepsie van algemene risiko, opsigself verantwoordelik vir 56,1% van die variansie. Daar was geen beduidende korrelasie tussen die verloop van tyd en FASA kennis nie, maar moontlike gapings in die kennis van FASA is geïdentifiseer. Die studie bied 'n oorsig van die persepsie van die risiko van drankgebruik tydens swangerskap in die teikenbevolking. Dit stel ook verbeteringe vir die navorsingsmetodiek voor vir toekomstige navorsing.

The Ph.D. dissertation encompasses an interdisciplinary study exploring qualitative, holistic strategies for individuals with Fetal Alcohol Spectrum Disorder (FASD) in integrated areas of law, medicine, education, psychology and justice, through both inductive analysis of field research as well as through relevant documentary analysis, incorporating a global or comparative component. Compliance with Guidelines for Research Involving Aboriginal Peoples has been sustained through community partnerships with various First Nations and Métis Communities, Elders and Parents, as well as with an FASD Parental Advocacy Group, advised by a team of interdisciplinary researchers in the academy. Accordingly, emergent research protocols were co-constructed through ongoing collaboration with the various community partners. In Aboriginal research, it is essential not to parachute in and out of communities with the data, but rather to forge genuine, collaborative, long term partnerships, and to build capacity in those communities.<p> The dissertation format approved by the Student Advisory Committee is Manuscript Style, a format approved by the University of Saskatchewans College of Graduate Studies and Research (formerly referred to as X-Format) similar to a self-edited book or collection of articles with introduction, sub-text, intra-text and general discussion to link the manuscripts. The various manuscripts comprising the present thesis include:<p> 1.Framing the Research Anthology: A Vision Quest, Ékehohksimoht Ke-kiss-see Muya<p> Section One situates the research style, process, approach, substance and rationale of the dissertation. It is largely situated within holistic Indigenous epistemologies, which may require a paradigm shift, in contrast to more bounded western world views.<p> Interdisciplinary, holistic, community-based research on the topic of FASD, including a search for solutions, extends globally, across the lifespan, and across sectors.<p> II. Indigenous Disadvantage and Despair, An Evaluation of Recent Strategies and Alternatives: Healing and Transformation, Pluralism and Reconciliation, Ne wah kuma ka tik<p> Section Two explores historical and contextual factors leading to a high prevalence of FASD, as well as strategies to overcome disadvantage, including Reconciliation, Treaty Processes, and Research as Reconciliation. Local Narratives are privileged over Meta-narratives, to counter the power of global market forces usurping the sphere of family, community and culture.<p> III. Disjunctures and Discontinuities in the Law of Mental Intent: FASD as a Site of Resistance and Transformation, Esquiskuit<p> Section Three examines the disconnect between medical knowledge of FASD, on the one hand, and the Laws of Mental Intent, on the other, inspiring a search for a unified, integrated theory of mental disorder and criminal responsibility that takes into account modern neurocognitive conditions like FASD. Section Three further explores the present piecemeal and compartmentalized rules for fitness, responsibility, various levels of mental intent, and a resultant rationale, substance and process of law reform and systemic change.<p> IV. FASD and Holistic Literacies: A Talking or Sharing Circle, Wa-sa-cam-e-be-ke-skue<p> Section Fours inductive themes comprise model practice guidelines for the gestalt of Literacy and FASD, derived from inductive analysis of qualitative data collected in the field research. The data was collected using Sharing Circles with Aboriginal Elders, Parents, and Mentors of Individuals with FASD; Conversational Interviews with Parents and Children with FASD; as well as Interviews and Focus Groups with various Professionals who support individuals with FASD and their Families. Special protocols were followed in creating and participating in the Indigenous Research, Sharing Circles and Conversational Interviews. Meta-paradigmatic analysis situates Indigenous Research Methodologies among emerging, multi-disciplinary, inductive methodologies suitable for understanding the infinite complexity of natural phenomena, such as FASD.<p> V. Epilogue: An Honour Song, Kethou-ne-ka-mon<p> Circles of healing, transformation and reconciliation heal wounds, reconcile differences, and transform paradigms of justice, health, education and governance, through the incorporation of models of equitable, holistic relationships with one another and with Mother Earth. Multidisciplinary and cross-cultural perspectives, dialogues between local and global, and particular and universal, become matrices to support new paradigms embodying broader reflections of reality.

The Ph.D. dissertation encompasses an interdisciplinary study exploring qualitative, holistic strategies for individuals with Fetal Alcohol Spectrum Disorder (FASD) in integrated areas of law, medicine, education, psychology and justice, through both inductive analysis of field research as well as through relevant documentary analysis, incorporating a global or comparative component. Compliance with Guidelines for Research Involving Aboriginal Peoples has been sustained through community partnerships with various First Nations and Métis Communities, Elders and Parents, as well as with an FASD Parental Advocacy Group, advised by a team of interdisciplinary researchers in the academy. Accordingly, emergent research protocols were co-constructed through ongoing collaboration with the various community partners. In Aboriginal research, it is essential not to parachute in and out of communities with the data, but rather to forge genuine, collaborative, long term partnerships, and to build capacity in those communities.<p> The dissertation format approved by the Student Advisory Committee is Manuscript Style, a format approved by the University of Saskatchewans College of Graduate Studies and Research (formerly referred to as X-Format) similar to a self-edited book or collection of articles with introduction, sub-text, intra-text and general discussion to link the manuscripts. The various manuscripts comprising the present thesis include:<p> 1.Framing the Research Anthology: A Vision Quest, Ékehohksimoht Ke-kiss-see Muya<p> Section One situates the research style, process, approach, substance and rationale of the dissertation. It is largely situated within holistic Indigenous epistemologies, which may require a paradigm shift, in contrast to more bounded western world views.<p> Interdisciplinary, holistic, community-based research on the topic of FASD, including a search for solutions, extends globally, across the lifespan, and across sectors.<p> II. Indigenous Disadvantage and Despair, An Evaluation of Recent Strategies and Alternatives: Healing and Transformation, Pluralism and Reconciliation, Ne wah kuma ka tik<p> Section Two explores historical and contextual factors leading to a high prevalence of FASD, as well as strategies to overcome disadvantage, including Reconciliation, Treaty Processes, and Research as Reconciliation. Local Narratives are privileged over Meta-narratives, to counter the power of global market forces usurping the sphere of family, community and culture.<p> III. Disjunctures and Discontinuities in the Law of Mental Intent: FASD as a Site of Resistance and Transformation, Esquiskuit<p> Section Three examines the disconnect between medical knowledge of FASD, on the one hand, and the Laws of Mental Intent, on the other, inspiring a search for a unified, integrated theory of mental disorder and criminal responsibility that takes into account modern neurocognitive conditions like FASD. Section Three further explores the present piecemeal and compartmentalized rules for fitness, responsibility, various levels of mental intent, and a resultant rationale, substance and process of law reform and systemic change.<p> IV. FASD and Holistic Literacies: A Talking or Sharing Circle, Wa-sa-cam-e-be-ke-skue<p> Section Fours inductive themes comprise model practice guidelines for the gestalt of Literacy and FASD, derived from inductive analysis of qualitative data collected in the field research. The data was collected using Sharing Circles with Aboriginal Elders, Parents, and Mentors of Individuals with FASD; Conversational Interviews with Parents and Children with FASD; as well as Interviews and Focus Groups with various Professionals who support individuals with FASD and their Families. Special protocols were followed in creating and participating in the Indigenous Research, Sharing Circles and Conversational Interviews. Meta-paradigmatic analysis situates Indigenous Research Methodologies among emerging, multi-disciplinary, inductive methodologies suitable for understanding the infinite complexity of natural phenomena, such as FASD.<p> V. Epilogue: An Honour Song, Kethou-ne-ka-mon<p> Circles of healing, transformation and reconciliation heal wounds, reconcile differences, and transform paradigms of justice, health, education and governance, through the incorporation of models of equitable, holistic relationships with one another and with Mother Earth. Multidisciplinary and cross-cultural perspectives, dialogues between local and global, and particular and universal, become matrices to support new paradigms embodying broader reflections of reality.

Despite the anecdotal evidence of social difficulties in children with Fetal Alcohol Spectrum Disorders (FASD), and the risk for secondary disabilities as a result of these social difficulties, very little research has examined social-emotional functioning in children with FASD. The majority of the research conducted thus far has relied on parent and teacher reports to document social impairments. These parent and teacher reports provide a broad measure of social functioning but are unable to elucidate the specific aspects of social functioning that this group of children might find difficult. As a result, it has been very difficult to develop effective social interventions for children with FASD because it is unclear what aspects of social functioning should be targeted. The current study aimed to examine emotion recognition abilities in children with FASD, as recognition of emotions is an important precursor for appropriate social interaction. The study included 22 participants with diagnosed FASD (ages 8-14), with age- and gender- matched typically developing controls. Participants were assessed using computerized measures of emotion recognition from three nonlinguistic modalities: facial expressions (static and dynamic, child and adult faces), emotional tone of voice (child and adult voices), and body positioning and movement (postures and point-light walkers). In addition, participants completed a task assessing emotion recognition in real-life scenarios. Finally, caregivers completed measures of behavioural functioning, adaptive functioning, FASD symptomatology, and a demographics questionnaire. Overall, findings suggest that children with FASD do have more difficulties than age-matched typically developing peers in aspects of emotion recognition, with particular difficulties in recognizing emotions from adult facial expressions and adult emotional prosody. In addition, children with FASD had more difficulty perceiving differences in facial expressions. When the effect of age was examined, it was found that some aspects of emotion recognition were more impaired in children with FASD between age eight and ten years compared to same-age typically developing peers and compared to children with FASD age 11-14. This finding suggests that younger children with FASD may demonstrate a delay in the acquisition of some aspects of emotion recognition or may be more vulnerable to the information processing demands of some tasks compared to older children with FASD. The types of emotion recognition difficulties found in the current study supported a pattern where children with FASD make more errors on emotion recognition tasks when the complexity of the task is increased and consequently demands greater information processing. As such, it is anticipated that children with FASD would be likely to have the most difficulty with emotion recognition abilities embedded within complex, rapidly changing, real-world social situations, and in recognizing more subtle emotional displays. Caregivers, teachers, and professionals living and working with children and youth with FASD should be aware of possible emotion recognition difficulties in complex social situations and should help foster stronger emotion recognition skills when difficulties are detected.

Objective: This study examined various dimensions of reinforcement learning in children with Fetal Alcohol Spectrum Disorder (FASD). Specific investigations included (1) speed of learning from reinforcement; (2) impact of concreteness of the reinforcer; (3) comparison of response to two types of shifts in reinforcement; and (4) relationship of reinforcement learning to parent reported social and behavioral functioning. Participants & Methods: Participants included 19 children with FASD without an intellectual disability, ages 11 to 17, and 19 age- and sex-matched Control participants (11 male, 8 female per group). Each participant completed two novel visual reinforcement learning discrimination tasks (counterbalanced), each administered twice. The first task involved categorical learning followed by either a reversal or a nonreversal shift. The second task involved a computerized probabilistic paradigm (70% contingent feedback) administered using either tokens or points, redeemable for a prize. Parents completed a history questionnaire, the Children’s Learning Questionnaire (McInerney, 2007), and the Child Behavior Checklist (Achenbach & Rescorla, 2001). Results: The Control group demonstrated significantly stronger probabilistic reinforcement learning, although the groups showed similar rates of between-condition improvement (learning savings). Furthermore, the concreteness of the reinforcer (tokens vs. points) made no significant difference in learning characteristics for either group. In contrast to probabilistic reinforcement learning, there were no significant group differences in categorical discrimination or shift learning. The FASD group demonstrated the age-appropriate pattern of reversals faster than nonreversals, while there was no difference between the two types of shifts in the Control group. A priori identified parent reports were not significantly correlated with task performance when each group was examined separately. Conclusions: There was no support for the hypothesis that reinforcement learning occurs in a functionally different manner in children with FASD. Rather, reinforcement learning may take longer, paralleling the generally slower speed of all learning in these children, and be more dependent on recent information. This suggests that children with FASD without intellectual disability are able to learn from reinforcement if given sufficient consistent repetition. However, failure of reinforcement learning may occur for a variety of reasons not addressed in this study, including difficulty with transfer of learning or impulsivity.

Despite the anecdotal evidence of social difficulties in children with Fetal Alcohol Spectrum Disorders (FASD), and the risk for secondary disabilities as a result of these social difficulties, very little research has examined social-emotional functioning in children with FASD. The majority of the research conducted thus far has relied on parent and teacher reports to document social impairments. These parent and teacher reports provide a broad measure of social functioning but are unable to elucidate the specific aspects of social functioning that this group of children might find difficult. As a result, it has been very difficult to develop effective social interventions for children with FASD because it is unclear what aspects of social functioning should be targeted. The current study aimed to examine emotion recognition abilities in children with FASD, as recognition of emotions is an important precursor for appropriate social interaction. The study included 22 participants with diagnosed FASD (ages 8-14), with age- and gender- matched typically developing controls. Participants were assessed using computerized measures of emotion recognition from three nonlinguistic modalities: facial expressions (static and dynamic, child and adult faces), emotional tone of voice (child and adult voices), and body positioning and movement (postures and point-light walkers). In addition, participants completed a task assessing emotion recognition in real-life scenarios. Finally, caregivers completed measures of behavioural functioning, adaptive functioning, FASD symptomatology, and a demographics questionnaire. Overall, findings suggest that children with FASD do have more difficulties than age-matched typically developing peers in aspects of emotion recognition, with particular difficulties in recognizing emotions from adult facial expressions and adult emotional prosody. In addition, children with FASD had more difficulty perceiving differences in facial expressions. When the effect of age was examined, it was found that some aspects of emotion recognition were more impaired in children with FASD between age eight and ten years compared to same-age typically developing peers and compared to children with FASD age 11-14. This finding suggests that younger children with FASD may demonstrate a delay in the acquisition of some aspects of emotion recognition or may be more vulnerable to the information processing demands of some tasks compared to older children with FASD. The types of emotion recognition difficulties found in the current study supported a pattern where children with FASD make more errors on emotion recognition tasks when the complexity of the task is increased and consequently demands greater information processing. As such, it is anticipated that children with FASD would be likely to have the most difficulty with emotion recognition abilities embedded within complex, rapidly changing, real-world social situations, and in recognizing more subtle emotional displays. Caregivers, teachers, and professionals living and working with children and youth with FASD should be aware of possible emotion recognition difficulties in complex social situations and should help foster stronger emotion recognition skills when difficulties are detected.

This institutional ethnography relies on observations, interviews, and textual analyses to explore the experiences of mothers and children who attend a women-centered agency in Vancouver, Canada where a hot lunch, child care in the emergency daycare, and participation in group activities are vital forms of support. Mothers who come to the centre have many concerns related to their need for safe housing, a sustainable income, adequate food, child care, and support. And like mothers anywhere, they have concerns about their children. While many of the children, the majority of them First Nations, have never had a diagnostic assessment for fetal alcohol syndrome (FAS) or for the relatively new umbrella category, ‘fetal alcohol spectrum disorder’ (FASD), a number of the mothers were concerned or even knew that their children had FAS. This thesis asks – how does it happen that mothers have come to know their children in this way? The study critically examines how FASD knowledge and practices actually work in the setting and what they accomplish. My analysis traces how ruling practices for constructing and managing ‘problem’ mothers and children coordinate work activities for identifying children deemed to be ‘at risk’ for FASD. In their efforts to help their children and improve their opportunities for a better life, mothers become willing participants in group activities where they learn how to attach the relevancies of the FASD discourse to their children’s bodies or behaviours. They also gain instruction which helps them to confess their responsibility for children’s problems. While maternal alcohol use as the cause of FASD is contested in literature and in some work sites it is, in this setting, taken as a fact. This study discovers how institutional work processes involving government, medicine, and education actually shape and re-write women’s and children’s experiences into forms of knowledge that make mothers and children institutionally actionable. It is only by exposing the relations of power organizing mothers’ work that it may be possible to re-direct attention to mothers’ and children’s embodied concerns and relieve mothers of the overwhelming responsibility for which they are held and hold themselves to be accountable. / Graduate

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