Questioning cognitive heterogeneity and intellectual functioning in fetal alcohol spectrum disorders from the Wechsler intelligence scale for children

Eliot Kerdreux (1, 2) , Justine Fraize (1, 2) , Pauline Garzón (1, 2) , Esther Chalain (3) , Léa Etchebarren (3) , Delphine Sitbon (3) , Anna Maruani (3) , Odile Boespflug-Tanguy (2) , Lucie Hertz-Pannier (2, 1) , Marion Noulhiane (1, 2) , Charlotte Pinabiaux (4) , David Germanaud (1, 2)

1 UNIACT - Unité de recherche en NeuroImagerie Applicative Clinique et Translationnelle
2 NeuroDiderot (UMR_S_1141 / U1141) - Maladies neurodéveloppementales et neurovasculaires
3 AP-HP Hôpital universitaire Robert-Debré [Paris]
4 DysCo - Fonctionnement et Dysfonctionnement Cognitifs : Les âges de la vie

Introduction: Fetal Alcohol Spectrum Disorders (FASD) are characterized by a variety of multiple cognitive and behavioral impairments, with intellectual, attentional, and executive impairments being the most commonly reported. In populations with multiple neurodevelopmental disorders, the Full Scale Intelligence Quotient (FSIQ) may not be a proper measure of intellectual abilities, rarely interpreted in FASD clinical practice because the heterogeneity of the cognitive profile is deemed too strong. We propose a quantitative characterization of this heterogeneity, of the strengths and weaknesses profile, and a differential analysis between global cognitive (FSIQ) and elementary reasoning abilities in a large retrospective monocentric FASD sample. Methods: Using clinical and cognitive data (Wechsler Intelligence Scale for Children) from 107 children with FASD, we characterized subject heterogeneity (variance and scatter of scaled/composite scores), searched for strengths and weaknesses, and specified intellectual functioning in terms of FSIQ and elementary reasoning (General Abilities Index, Highest Reasoning Scaled Score), in comparison with standardization norms and a Monte-Carlo-simulated sample from normalization data. Results: Performance of children with FASD was lower on all subtests, with a significant weakness in working memory and processing speed. We found no increase in the variance and scatter of the scores, but a discordance between the assessment of global cognitive functioning (28% borderline, 23% deficient) and that of global and elementary reasoning abilities (23–9% borderline, 15–14% deficient). Conclusion: Our results question the notion of WISC profile heterogeneity in FASD and point to working memory and processing speed over-impairment, with global repercussions but most often preserved elementary reasoning abilities.

Domaines: Psychologie

Eliot Kerdreux, Justine Fraize, Pauline Garzón, Esther Chalain, Léa Etchebarren, et al.. Questioning cognitive heterogeneity and intellectual functioning in fetal alcohol spectrum disorders from the Wechsler intelligence scale for children. The Clinical neuropsychologist, 2023, ⟨10.1080/13854046.2023.2281703⟩. ⟨hal-04441261⟩