1. CIFASD Meeting
Santa Barbara June 2005

2. Progress Report:
Pilot Multi-method Intervention Study in Children in South Africa who are Alcohol Exposed

3. Rationale of Intervention Study
No systematic study evaluating the effectiveness of intervention methods for children with FASD has yet been published.
The study of effectiveness of behavioral and pharmacological interventions is envisioned as a primary goal of this consortium.
Access to a large group of well-diagnosed children with FAS / FASD has provided the opportunity to undertake a systematic intervention

4. Specific Aims
To determine the nature and degree to which 3 interventions improve academic skills and behavior in alcohol-exposed children.
1. Cogntive Control Therapy
2. Language and literacy training
3. Family interventions
To assess the effects of three mediating variables (self-efficacy, attention, meta-cognitive skills) and three moderating variables (child’s IQ, life stress, maternal education) on therapeutic outcomes.

5. Research Team
Phil May, Wendy Kalberg, PW Kodituwakku, University of New Mexico
Colleen Adnams, Bernice Castle, Sean September, School of Child and Adolescent Health, UCT
Petra Engelbrecht, Marechen Perold, Department of Educational Psychology and Specialised Education, University of Stellenbosch
Pharyn Sorour, Division of Communication Sciences and Disorders, UCT
Rubin Adams, Western Cape Department of Education

6. Interventionalists Ellick Williams, Ed. Psych.
Anna Kotze, Sp. and L. Therapist
Wilma Rossouw, Ed. Psych

7. Methodology
104 Grade 2/3 participants at 10 schools from Wellington 3 Epidemiology study (extensive demographic data)
65 FAS/PFAS; 15 ‘deferred’ on initial diagnosis; confirmed exposure to alcohol; 23 non-exposed controls
FASD randomised to 3 intervention, 1 control group.
Baseline assessment; 18 mths intervention; mid, post intervention assessment.
Analysis focus on clinically, statistically significant improvements and scale of change.

8. Core Intervention battery
1. Reading test:
a. Single word: UCT Graded (video/audiotape)
b. Reading passages: Paarl Passages (video/audiotape)
2. Spelling Test:
UCT Single Word Spelling
3. Mathemathics:
a. S-SAIS Number Problems
b. Ballard Addition, subtraction
4. Language tests:
a. FROG expressive narrative (video/audiotape)
b. TROG receptive grammar
5. Cognitive Control Battery
Teacher Questionnaires:
a. Open questions and checklist
b. Self Efficacy Questionnaire
c. Achenbach Teacher checklist

9. Intervention Core Battery cont:
Parent Questionnaires:
Mental Pain
Alcoholism Screening - RAPS-4
Achenbach CBCL
Classroom observation:
Qualitative observations and checklist
Snellen’s Visual Acuity Screening
Auditory Screening: Otoacoustic Emissions (OAE) and
Tympanogram
The different intervention groups were administered
further specific tests. All children will also be
administered the Neuropsychological Battery.

10. Accomplishments
2003 – March 2004: planning, development of core and specific test batteries SA + UNM co-researchers
March /May 2004 – recruitment and training psychometrist. Translation of tests, questionnaires
May, June participant recruitment via field worker visits to parents → 99%.
June, July 2004 – commencement of baseline testing, interviews, questionnaires. Recruitment of co-ordinator.
August 2004 – randomisation of FASD participants to intervention groups; preparation for interventions
August reports to schools
September commenced interventions
June 2005 completed 28 weeks classroom interventions

13. Some Baseline Data FASD N=81 Mean age =113m N/exp Controls
Test
P <0.01 *
FASD N=81
Mean age =113m
N/exp Controls
n=23 Mean age =113m
Reading * MA mths (SD)
89.2 (13.8)
104.7 (14.4)
Spelling * MA mths (SD)
87.3 (10.7)
100.3 (15.2)
Maths Add * MA mths SD)
77.1 (11.6)
95.3 (15.2)
Maths Sub * MA mths (SD)
75.2 (12.1)
94.3 (14.9)
Maths Gen. * scale score
3.8 (2.7)
6.1 (2.4)
Syllable Identification * %
43.9 (34.4)
73.4 (16.9)
Syllable segmentation * %
59.8 (28.6)
81.2 (18.7) *

14. Baseline Data Reading passages comprehension % correct FASD Mean (SD)
N/E Control
P-value
Level 1
37.0 (33.3)
66.12 (30.9)
.000
Level 2
19.26 (29.4)
41.74 (34.6)
Level 3
4.89 (18.7)
23.47 (27.2)

15. Correlation with dysmorphology scores, head circumference measures at diagnosis with baseline cognitive data