Impairment of motor skills in children with fetal alcohol spectrum disorders in remote Australia: The Lililwan Project

Barbara R Lucas; Robyn Doney; Jane Latimer; Rochelle E Watkins; Tracey W Tsang; Genevieve Hawkes; James P Fitzpatrick; June Oscar; Maureen Carter; Elizabeth J Elliott

doi:10.1111/dar.12375

Impairment of motor skills in children with fetal alcohol spectrum disorders in remote Australia: The Lililwan Project

Drug Alcohol Rev. 2016 Nov;35(6):719-727. doi: 10.1111/dar.12375. Epub 2016 Feb 16.

Authors

Barbara R Lucas^{1

2

3

4}, Robyn Doney⁵, Jane Latimer², Rochelle E Watkins^{1

6}, Tracey W Tsang¹, Genevieve Hawkes⁷, James P Fitzpatrick^{1

2

6}, June Oscar^{8

9}, Maureen Carter¹⁰, Elizabeth J Elliott^{1

2

11}

Affiliations

¹ Discipline of Paediatrics and Child Health, The University of Sydney, The Children's Hospital at Westmead, Clinical School, Sydney, Australia.
² The George Institute for Global Health, Sydney Medical School, The University of Sydney, Sydney, Australia.
³ Poche Centre for Indigenous Health, Sydney Medical School, The University of Sydney, Sydney, Australia.
⁴ Physiotherapy Department, Royal North Shore Hospital, Sydney, Australia.
⁵ School of Public Health, Curtin University, Perth, Australia.
⁶ Telethon Kids Institute, The University of Western Australia, Perth, Australia.
⁷ Derby Allied Health Service, Western Australian Country Health Services, Derby, Australia.
⁸ Marninwarntikura Women's Resource Centre, Fitzroy Crossing, Australia.
⁹ University of Notre Dame, Broome, Australia.
¹⁰ Nindilingarri Cultural Health Services, Fitzroy Crossing, Australia.
¹¹ The Sydney Children's Hospital Networks (Westmead), Sydney, Australia.

PMID: 26879822
DOI: 10.1111/dar.12375

Abstract

Introduction and aims: We aimed to characterise motor performance in predominantly Aboriginal children living in very remote Australia, where rates of prenatal alcohol exposure (PAE) are high. Motor performance was assessed, and the relationship between motor skills, fetal alcohol spectrum disorders (FASD) and PAE was explored.

Design and methods: Motor performance was assessed using the Bruininks-Oseretsky Test of Motor Proficiency-Second Edition Complete Form, in a population-based study of children born in 2002 or 2003 living in the Fitzroy Valley, Western Australia. Composite scores ≥2SD (2nd percentile) and ≥1SD (16th percentile) below the mean were used respectively for FASD diagnosis and referral for treatment. FASD diagnoses were assigned using modified Canadian Guidelines.

Results: A total of 108 children (Aboriginal: 98.1%; male: 53%) with a mean age of 8.7 years was assessed. The cohort's mean total motor composite score (mean ± SD 47.2 ± 7.6) approached the Bruininks-Oseretsky Test of Motor Proficiency-Second Edition normative mean (50 ± 10). Motor performance was lower in children with FASD diagnosis than without (mean difference (MD) ± SD: -5.0 ± 1.8; confidence interval: -8.6 to -1.5). There was no difference between children with PAE than without (MD ± SE: -2.2 ± 1.5; confidence interval: -5.1 to 0.80). The prevalence of motor impairment (≥-2SD) was 1.9% in the entire cohort, 9.5% in children with FASD, 3.3% in children with PAE and 0.0% both in children without PAE or FASD.

Discussion and conclusions: Almost of 10% of children with FASD has significant motor impairment. Evaluation of motor function should routinely be included in assessments for FASD, to document impairment and enable targeted early intervention.[Lucas BR, Doney R, Latimer J, Watkins RE, Tsang TW, Hawkes G, Fitzpatrick JP, Oscar J, Carter M, Elliott EJ. Impairment of motor skills in children with fetal alcohol spectrum disorders in remote Australia: The Lililwan Project. Drug Alcohol Rev 2016;35:719-727].

Keywords: Aborigines; Australian; child development; culture; fetal alcohol spectrum disorders; motor skills.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Australia
Child
Child Development / physiology*
Disability Evaluation
Female
Fetal Alcohol Spectrum Disorders / diagnosis*
Fetal Alcohol Spectrum Disorders / physiopathology*
Humans
Male
Motor Skills / physiology*
Rural Population
Severity of Illness Index