Prevalence of externalizing disorders and Autism Spectrum Disorders among children with Fetal Alcohol Spectrum Disorder: systematic review and meta-analysis
Open accessAbstract
Owing to their central nervous system impairments, children with Fetal Alcohol Spectrum Disorder (FASD) commonly exhibit externalizing behaviours such as hyperactivity, impulsivity, and (or) delinquency. The purpose of this study was to estimate the prevalence of neurodevelopmental disorders with prominent externalizing behaviours, namely Attention-Deficit Hyperactivity Disorder (ADHD), Conduct Disorder (CD), Oppositional Defiant Disorder (ODD), as well as Autism Spectrum Disorders (ASD) among children with FASD. A comprehensive systematic literature search was performed, followed by disorder-specific random-effects meta-analyses. Of the disorders investigated, ADHD was found to be the most common co-morbid disorder among children with FASD (52.9%), followed by ODD (12.9%), CD (7.0%), and ASD (2.6%). When compared with the general population of the USA, these rates are notably higher: 15 times higher for ADHD, 2 times higher for ASD, 3 times higher for CD, and 5 times higher for ODD. The results call attention to the need for identifying a distinct neurodevelopmental profile to aid in the accurate identification of children with FASD and the discrimination of FASD from certain idiopathic neurodevelopmental disorders.
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A further narrative review identified additional high-risk groups for ADHD, including people with foetal alcohol spectrum disorder, extremely low birth weight, eating disorders such as binge eating disorder, sleep disorders, or problem gambling.
“A further narrative review identified additional groups, for example, people with foetal alcohol spectrum disorder (Lange et al., 2018), extremely low birth weight (Momany et al., 2018), eating disorders such as binge eating disorder (Wentz et al., 2005; Yates et al., 2009), sleep disorders (Cortese et al., 2009; Sedky et al., 2014), or problem gambling (Dowling et al., 2015).”
From The Australian evidence-based clinical practice guideline for attention deficit hyperactivity disorder (2023) · cites this paper as Lange et al., 2018
The Abstract reports that ADHD affected 52.9% of children with FASD, a rate 15 times higher than in the comparison general population. This supports identifying children with FASD as a high-risk group for ADHD, but the cited paper does not establish the claim for people with FASD across all ages. (LLM, conf=0.82)
Experimental — accuracy not yet measuredMedical conditions, such as epilepsy, can co-occur with ADHD.
“Medical conditions, such as epilepsy, can co-occur with ADHD (Ilie et al., 2015; Lange et al., 2018).”
From The Australian evidence-based clinical practice guideline for attention deficit hyperactivity disorder (2023) · cites this paper as Lange et al., 2018
The pooled-prevalence section reports that ADHD co-occurs with fetal alcohol spectrum disorder in children. The paper does not report that epilepsy co-occurs with ADHD; its References section mentions epilepsy in relation to fetal alcohol spectrum disorder, not ADHD. No page number is available in our copy. (LLM, conf=0.79)
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Cites
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May, T., Birch, E., Chaves, K., Cranswick, N., Culnane, E., Delaney, J., Derrick, M., Eapen, V., Edlington, C., Efron, D., et al. (2023) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/00048674231166329 · Cited by 87 · see citing works
“…with a family history of ADHD •• People with suicidal ideation/behaviour A further narrative review identified additional groups, for example, people with foetal alcohol spectrum disorder (Lange et al., 2018), extremely low birth weight (Momany et al., 2018), eating disorders such as binge…”
Background
- Authors
- Lange, S., Rehm, J., Anagnostou, E., & Popova, S.
- Affiliations
- Centre for Addiction and Mental Health (CA)
- University of Toronto (CA)
- Venue
- Biochemistry and Cell Biology
- Publisher
- Canadian Science Publishing
- Published
- 2018-04
- Volume
- 96
- Issue
- 2
- Pages
- 241-251
- ISSN
- 0829-8211 (ISSN-L)
- 1208-6002
- OpenAlex
- W2615800830
- Cited by
- 91
- References
- 4
- Citations by year
- 2026: 7 · 2025: 11 · 2024: 15 · 2023: 13 · 2022: 14 · 2021: 7 · 2020: 11 · 2019: 5 · 2018: 5 · 2017: 3
- FWCI
- 1.23
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Locations
- Biochemistry and Cell Biology (publishedVersion)
- PubMed (publishedVersion)
- TSpace (University of Toronto) (acceptedVersion)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Keywords
- fetal alcohol spectrum disorders, externalizing disorders, autism spectrum disorder, attention deficit hyperactivity disorder, conduct disorder, oppositional defiant disorder, comorbidities, prevalence, neurodevelopmental disorders, children, hyperactivity, impulsivity, delinquency
- MeSH terms
- Autism Spectrum Disorder, Attention Deficit Disorder with Hyperactivity, Child, Child, Preschool, Female, Humans, Male, Comorbidity, Prevalence, Conduct Disorder, Fetal Alcohol Spectrum Disorders
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