Project Details

Early Career

Status: Funded - Open

Attention management trial for children with FASD – a N-of-1 control trial of prescribed stimulants for ADHD in FASD

Alison Crichton, PhD

Summary

BACKGROUND: Fetal Alcohol Spectrum Disorder (FASD) is a neuro-developmental disorder caused by alcohol exposure during pregnancy that occurs in around 1.8% of school aged children. Children with FASD experience disruption to their neurodevelopment, and attention if often affected. GAP: Attention problems are a hallmark feature of prenatal alcohol exposure. Between 50-94 % of children with FASD meet diagnostic criteria for ADHD and experience difficult with concentration and focus. Despite the frequency of this comorbidity, there is a paucity of sufficient evidence on best psychotropic medication choice in the treatment of those with FASD (which) is unsatisfactory and leaves patients vulnerable. HYPOTHESIS: We anticipate behavioral ratings of child hyperactivity will be significantly lower on Psychostimulant than placebo conditions, but that child cognitive assessment of attention will be less sensitive to medication effects. We further anticipate that risk factors such as attention skill deficits that are atypical to ADHD and greater extent/breadth of neurodevelopmental impairment, greater neurotoxin exposure (high alcohol exposure and exposure to other neurotoxins), and lower socioeconomic status will be associated with less response to treatment. METHODS: This is an investigator-initiated cross-over randomized control trial of existing ADHD stimulant medication in children with diagnosed FASD and ADHD. RESULTS: Pending IMPACT: ADHD symptoms are a common comorbidity for children with FASD, yet management of this issue is not well informed by current available evidence. Findings from this study will help inform medication management of ADHD in FASD, and will provide important preliminary data towards future studies and research collaborations in this area. Website Link: https://research.monash.edu/en/persons/alison-crichton