Intervention can reduce hostile perceptions in children with prenatal alcohol exposure

Results will be published in the February 2010 issue of Alcoholism: Clinical & Experimental Research.

"Children with PAE have a hard time making and keeping friends," explained the study's corresponding author Vivien Keil, who was a staff research associate in the department of psychiatry and biobehavioral sciences at the David Geffen School of Medicine at UCLA when the research was conducted.

"More specifically, they tend to have difficulty understanding social cues and common social norms," she said. "In order to make and keep friends, we must be able to read social cues such as facial expressions and other body language. If a child makes hostile attributions, this means that s/he is more likely to perceive that the people around them are hostile or negative and, as a result, s/he is likely to respond in a hostile manner, thus undermining successful social relationships."

"These social problems are due, in part, to the neurological and cognitive deficits known to be associated with prenatal exposure to alcohol," said Joseph M. Price, a research scientist in the Children and Adolescent Services Research Center at Rady Children's Hospital in San Diego. "However, children prenatally exposed to alcohol are also more likely to be exposed to negative early-life experiences -- such as unresponsive caregivers, maltreatment, disruptions in early parent-child interactions, and out-of-home placements -- all of which are known to contribute to behavior and social problems during childhood and adolescence."

Price also said, given that these social problems may eventually lead to school problems, emotional and behavior problems, early school dropout, delinquency, and drug and alcohol use, that children who were prenatally exposed to alcohol will likely benefit from intervention efforts designed to improve their social skills and their relationships with peers and adults.

Researchers assigned 100 children (51 boys, 49 girls) with PAE, between 6 to 12 years of age, to one of two groups: Children's Friendship Training or a Delayed Treatment Control condition.

"The Children's Friendship Training decreased the level of hostile attributions made by children with PAE in group- entry scenarios, or those situations in which they were asked to join a group of similarly aged children in play activities," said Keil. "This means that when the children were asked about other children's intentions, they made fewer hostile attributions after the intervention. These findings are encouraging because hostile attributions were not the focus or target of the intervention. Rather, the intervention sought to improve children's social skills more broadly; decreased hostile attributions were merely a positive side-effect of the intervention and perhaps a mechanism of change."

"In short," added Price, "it appears that children's hostile interpretations of peers' social intentions, which have been found to be associated with aggressive behavior and peer rejection, can be modified by intervention efforts. What will be exciting to see is if the Children's Friendship Training procedure also improves other aspects of children's social information-processing patterns, such as social problem-solving skills or their evaluation of behavior outcomes, and improves the social behavior and peer relationships of children who have been exposed to alcohol during prenatal development."

"There are many reasons to be hopeful that children with PAE can overcome their weaknesses and reach their full potential," said Keil. "It is encouraging that a psychological intervention such as social-skills training seems to have resulted in improvements in more objective measures of child functioning such as social information-processing like hostile attributions rather than relying on more subjective parent reports of child functioning. These findings suggest that although there are neurocognitive deficits associated with prenatal alcohol exposure, children with PAE can make meaningful improvements in their social skills and overall functioning with the use of effective evidence-based treatments."