Principal Investigator: Nancy Grote, Ph.D. (University of Washington, Seattle, Washington)
Consultant: Therese Grant, Ph.D. (University of Washington, Seattle, Washington)
Funded by Mark Torrance Foundation
01/01/18 through 03/31/21
Women enrolled in the Washington State Parent Child Assistance Program (PCAP) have high rates of depression and PTSD, and are often at risk for loss of child custody because of inability to access and follow up with mental health services. This 18-month project, entitled Promoting Healthy Families (PHF), trained staff at PCAP sites in Clallam, Grays Harbor and Thurston counties to deliver an educational intervention based on principles of the evidence-based MOMCare Program. MOMCare is a collaborative care intervention (i.e., providing a choice of brief interpersonal psychotherapy and/or anti-depressant medication) for socially disadvantaged, pregnant women. In this naturalistic pilot implementation project over three years, we assessed the results of integrating PHF into PCAP over 18 months to reduce maternal depression and to improve the rate of positive child custody outcomes.
Data analysis is ongoing.
Partnership to Enhance Services for Residential Treatment for Pregnant and Postpartum Women (“Partnership for Families (PFF)”)
Principal Investigator: Therese Grant, Ph.D.
Funded by the Substance Abuse and Mental Health Services Administration (SAMHSA) Center for Substance Abuse Prevention (2012 – 2016)
Partnership for Families was designed to enhance the availability of trauma-informed, evidence-based intervention services for pregnant and parenting women and their children living at Perinatal Treatment Services (PTS) and later Evergreen Recovery Centers (ERC), long-term residential substance abuse treatment facilities in King County, Washington. The project provided: (1) Seeking Safety therapy to the mothers; (2) sensory-based and trauma-informed parenting education and training for the mothers with their children; and (3) case management and services linkage to nonresidential family members, modeled on the Parent-Child Assistance Program (PCAP) and included a male case manager who worked with fathers of the children. Over three years, project served 150 women and 75 children in residence at PTS/ERC, and provided case management services for 210 adult non-residential family members. The projects’ goals were to improve the health and well-being of family members by delivering high quality trauma-informed maternal therapy, parenting education that responds to the children’s trauma-based behavioral and self-regulation difficulties, and comprehensive case management that meets the needs of the family unit as a whole.
The PFF project made significant achievements at three levels:
- The individual woman and her child/ren
- The residential treatment facility (ERC)
- The King County community and surrounding area
At the individual level:
- 150 women in residence at Evergreen, along with their child/ren, were enrolled in PFF and received the Seeking Safety and Trauma-Informed Parenting services offered.
- Seeking Safety (SS). A total of 902 sessions were delivered to 131 women (mean 7 sessions). At 6-month follow-up, compared to their status at PFF intake women reported significantly fewer total number of trauma symptoms; decreased days (in the past 30) experiencing depression and anxiety; and reduced PTSD consequences in the following domains: family relationships, general life satisfaction, and overall functioning. In addition we observed a significant increase in participation in outpatient mental health treatment and recovery support groups. The mothers’ responses to the World Health Organization Quality of Life assessment also showed significant improvements in the psychological and environmental domains.
- Trauma-Informed Parenting (TIP). A total of 356 TIP sessions were delivered, either with the PFF client alone, or in parent-child sessions. The individualized TIP sessions provided mothers with developmental and sensory profile information on their child, along with practical strategies to help them successfully manage daily routines (e.g., eating, sleeping, dressing, and transitions) and child behaviors in light of the child’s sensory and regulatory needs. At 6-month follow-up we observed significant reductions in the percent of children who: screened positive for a developmental risk; were categorized as at-risk or high-risk in the areas of Problem Solving, Communication, Fine Motor; and Personal/Social; and who scored above the cut-off for social emotional and/or behavioral concerns. In terms of parenting stress, we observed decreases in the percent of mothers reporting moderate stress on the Difficult Child and Parent-Child Dysfunctional Interaction domains, and decreases in clinically elevated stress on the P-CDI domain. At exit there was a significant decrease in any of the mothers’ children living with someone other than her, due to a CPS order.
- Family Case Management (FCM). The family case managers (FCMs) worked with a total of 83 adult family members, not including fathers of the children whose data is below. They had an average of 5.4 face to face visits over an average span of 4 months with the purpose of connecting family members with community services in order to reduce family stresses and support the mother’s recovery process when she left treatment. The most common service connections made were for a healthcare provider, positive recreation/enrichment, food stamps, other health services, and medical coupons. In addition, the FCMs provided service connections on behalf of 94 children who were living with these family members. The most common service connections made for the children were for healthcare, positive recreation/enrichment, other health services, child welfare, and child care.
- The male FCM worked closely with the four female FCMs in serving the fathers of the children (including father figures, i.e. husbands and male partners). This strategy not only enhanced the skills of female team members in supporting fathers’ stability and recovery, but it also increased the willingness of men to enroll in family case management. The FCMs worked with a total of 33 fathers of children, doing an average of 4.9 face to face visits over an average span of 4 months. The most common service connections made were for food stamps, positive recreation/enrichment, healthcare provider, CPS services, and medical coupons.
At the residential treatment facility level
Evergreen Recovery Centers (ERC) is the largest residential treatment facility for pregnant and parenting women, and their children, in Washington State. This has given PFF the opportunity to make a positive impact on the type and quality of trauma-informed services delivered by a treatment staff to a large number of clients. PFF’s intensive training and consultation throughout the project helped assure that the interventions introduced will be sustained as part of the standard Evergreen treatment curriculum after the end of the grant.
- Seeking Safety (SS). The SS intervention has been successfully integrated into the Evergreen clinical program. Staff found that SS skills are highly relevant to the clients and can be delivered in a flexible way, and clients reported that they liked the skills and could readily apply them. High-quality training, training materials, and periodic phone consultation by Brenda Underhill, the national SS trainer, helped staff develop confidence in their SS skills and supported them in ongoing implementation of SS.
- Trauma-Informed Parenting (TIP). TIP training was provided to ERC staff at both their Seattle and Everett residential treatment sites. Staff trained included day care providers, administrators, residential counselors and chemical dependency counselors. A sustainable training module, using a train-the-trainer model, was developed by Tracy Jirikowic, Ph.D. and implemented by Evergreen staff that have early childhood education backgrounds (Karen Kinman and Amy Black).
- Family Case Management. The sustainability of the PFF family case management component, which was based on the Parent-Child Assistance Program (PCAP) evidence-based model, is now assured. In May 2015 Washington State DSHS Division of Behavioral Health and Recovery issued a RFQ to manage the PCAP contracts in King (Seattle) and Pierce (Tacoma) Counties. Evergreen was selected to operate these two PCAP sites, ensuring that Evergreen and PCAP will sustain their close collaboration via State funding. PCAP staff members housed at the Seattle ERC facility include a clinical supervisor and seven case managers (three who were formerly PFF case managers). The lessons learned from PFF family case management will continue to be incorporated into both PCAP and ERC procedures to ensure that women, their children, the fathers of the children, and family members receive coordinated and trauma-informed services.
At the community level
- Seeking Safety (SS). Over 200 King County area providers who serve high-risk, trauma-affected mothers and children have been trained in Seeking Safety. Some received follow-up consultation from national SS trainer Brenda Underhill, and they now comprise a network of providers who are able to offer Seeking Safety and/or reinforce the trauma-coping skills of ERC clients transitioning from residential care into outpatient community services (substance abuse, mental health, transitional housing). These providers are also able to confer with each other on the effective delivery of SS.
- Trauma-Informed Parenting (TIP). Numerous community trainings were held to share TIP information with staff from the Parent Child Assistance Programs in King, Pierce, Thurston and Cowlitz counties and with front line service providers from agencies serving the women during and post-treatment at ERC (e.g., Community Psychiatric Clinic; Willows transitional housing; early intervention programs).
- Family Case Management. As described above, during this grant cycle ERC assumed state-funded contracts to implement the PCAP model in King and Pierce Counties, allowing them to provide case management services to 206 women with substance-abuse disorders, and their families in the two most populous counties in Washington State. Under the direction of two highly qualified clinical supervisors, a total of 13 case managers have been trained in the PCAP model in these counties, are working with capacity caseloads, and are incorporating lessons learned from PFF into PCAP strategies.
Over the course of this grant, Shayne Rochester, the PFF male case manager/fatherhood coordinator, has been responsible for advocacy, training and consultation with local, regional, and statewide partners. His work emphasizes the value of including fathers in the dependency process and family intervention plans, outlines the services fathers need, and offers practical strategies for helping men connect to their families and communities. He has provided consultation and/or training to numerous agencies/groups, including: Washington State Parent Advocacy Network, Snohomish County Drug Court, WorkFirst, Basic Food, Employment and Training, and Opportunity Grants Programs at Edmonds Community College. For example, the King County ‘Table of Ten’, an initiative of the University of Washington Court Improvement Training Academy, includes judges, court professionals and others interested in improving the child welfare legal process. Mr. Rochester was invited to join the Table of Ten and his participation has raised awareness regarding the needs of fathers and ways courts and judges can effectively engage them. In July, 2015 Mr. Rochester participated in an invited presentation at the American Bar Association’s National Conference on Children in the Law/National Parent Attorney Conference (Washington D.C). He spoke to the audience of legal professionals about services needed by fathers involved in the child welfare system, complex issues facing incarcerated parents, and the value of specialized community supports such as father engagement groups.
Baby/Mom Study: A Pilot Infant Mental Health Intervention with Drug-Endangered Children and Their Mothers
Principal Investigator: Therese Grant, Ph.D.
Funded by the Substance Abuse and Mental Health Services Administration (SAMHSA) Center for Substance Abuse Prevention (2006 – 2013)
The Baby/Mom Study was conducted within the framework of the Washington State Parent Child Assistance Program (PCAP) to enhance the parent-child relationship of mothers and babies enrolled in the program. This project directed infant mental health resources to mothers who used methamphetamines during pregnancy whose children were at risk for compromised developmental and social-emotional outcomes. In this study, we supplemented standard 3-year PCAP intervention with a nested 12-month infant/mother mental health intervention delivered in the home by supervised infant mental health therapists. We compared outcomes from the enhanced infant/mother intervention group (N=40 infant/mother pairs) with data from a matched comparison group (N=40 infant/mother pairs) that received standard PCAP intervention alone. We hypothesized that mothers in the intervention group would demonstrate improved responsiveness to their children and greater improvement in the quality of infant/mother interaction, and that these indicators of improved relationship would be associated with: 1) fewer age-specific mental and motor development problems in the children and greater functional social-emotional competence; 2) reduced rates of maternal drug/alcohol use; 3) higher rates of permanent maternal child custody placement; and 4) fewer additional methamphetamine and other substance-exposed pregnancies.
Preliminary analysis of the videotaped infant-mother play interactions indicated that almost all the intervention mother-baby dyads evidenced troubled and maladaptive interactions. Common areas of improvement due to the intervention included the mothers’ increasing capacity to think about their baby’s experience (to “keep the baby in mind”) and to engage with their child in a developmentally-sensitive manner. There were few differences between groups with respect to maternal rates of drug/alcohol use or child development and social–emotional problems (based on screening assessment using the Ages and Stages Questionnaires). At intervention exit, more women in the comparison group had lost custody (either permanently or temporarily) during the study compared to mothers in the intervention group (15% vs. 10%). Women in the intervention group had a higher rate of subsequent births compared to comparison group mothers (24% vs. 14%). None of the women reported using methamphetamine during the pregnancy, so none of the subsequent births were prenatally exposed to methamphetamine.
This project received supplemental funding to conduct a year-long community-based infant mental health training program with masters’ level professionals interested in working with high-risk mothers and their infants/toddlers. The training was conducted in collaboration with the Michigan Association for Infant Mental Health (MI-AIMH) and was designed to help prepare participants for application to MI-AIMH as Level 3 Infant Mental Health Specialists.
Hildebrandt, U., Graham, J.C., & Grant, T.M. (2020). Predictors and moderators of improved social-emotional functioning in mothers with substance use disorders and their young children enrolled in a relationship-based case management program. Infant Mental Health Journal, 41(5), 677-696. Available at: https://doi.org/10.1002/imhj.21872
Fetal Alcohol Spectrum Disorders (FASD) Education & Technical Assistance
Principal Investigator: Therese Grant, Ph.D.
Funded by the Indian Health Service (IHS) and the Northwest Portland Area Indian Health Board (NPAIHB)
(1983 – 2017)
See Publications – (Indian Health Services FASD Project)
The Indian Health Service (IHS) (from 1983 to 1993) and The Northwest Portland Area Indian Health Board (from 1993 to 2017) funded the Fetal Alcohol and Drug Unit to provide FASD information and strategies for prevention and intervention to American Indian/Alaska Native (AI/AN) communities. These contracts enabled the unit to carry out the following activities:
- Provide consultation to AI/AN individuals with FASD and their families, and make referrals for FASD evaluation and diagnosis. Consultations include referrals to a wide range of professionals in the medical, education, legal, and social services systems, and to other service providers as appropriate.
- Provide technical support on FASD issues to service providers, professionals, and students working with AI/AN populations. This support is provided through phone and in person consultations, as well as through research/clinical internships. FADU provides technical support to AI/AN in developing FASD screening, prevention and intervention programs.
- Collaborate with the Northwest Portland Area Indian Health Board on FASD issues and training needs (see FASD Trainings below).
- Respond to requests for information on FASD and related topics by providing resources, referrals, and workshops. Presentation of research findings at invited talks and publication of research in scientific journals and other periodicals is ongoing.
- Summarize existing unidentified, aggregate FADU research data involving AI/AN participants, and report on recommended strategies for FASD prevention and treatment.
- Summer 2011 Lummi FASD Series
- September 2011 FASD Training
- September 2012 FASD Training
- September 2014 FASD Training
FASD Webinars (using Adobe Connect):
On July, 10, 2013, Julian Davies, MD, University of Washington Department of Pediatrics, and Pediatrician, UW Fetal Alcohol Syndrome Diagnostic and Prevention Network (FAS DPN), presented Understanding Fetal Alcohol Spectrum Disorders (FASD). Webinar | Slides
On May 28, 2014, Kathleen Mitchell, MHS, LCADC, National Organization on Fetal Alcohol Syndrome (NOFAS), and Daphne Colacion, MA, Lake County Tribal Health Consortium, presented FASD: Creating a Circle of Hope. Webinar | Slides-1 | Slides-2
On June 18, 2014, Dan Dubovsky, MSW, SAMHSA FASD Center for Excellence, and Michael McDonell, PhD, University of Washington Psychiatry and Behavioral Sciences, presented FASD and Addiction Treatment: Improving Outcomes. Webinar | Slides
On June 1, 2016, Therese Grant, PhD, University of Washington Alcohol and Drug Abuse Institute, and Morgan Fawcett, Founder of One Heart Creations, presented The Connection Between FASD and Suicide. Webinar | Slides
On June 15, 2016, Thea Wilshire, MD, San Carlos Apache Wellness Center, and Gerilyn Goselyn, BSW, San Carlos Apache Wellness Center, presented A Community Response to Suicide Prevention for At-Risk Populations. Webinar | Slides
On September 28, 2016, Sandra Radin, PhD, MSW, University of Washington Alcohol and Drug Abuse Institute, and Tessa Campbell-Evans, PhD, University of Washington School of Social Work, presented FASD and Historical Trauma Considerations to Improve Care for Native People: Focus on Child Welfare and Domestic Violence. Webinar | Slides
On January 11, 2017, Robin Harwick, PhD, University of Washington Alcohol and Drug Abuse Institute, and Elizabeth West, PhD, University of Washington College of Education, presented Understanding How FASD Impacts Students: Why Is It Important? Webinar | Slides
On April 5, 2017, Julian Davies, MD, University of Washington Department of Pediatrics, and Pediatrician, UW Fetal Alcohol Syndrome Diagnostic and Prevention Network (FAS DPN), presented Fetal Alcohol Spectrum Disorders for Educators. Webinar | Slides
Technical support for these Webinars was generously provided by the IHS Telebehavioral Health Center for Excellence. These and other webinars on FASD are housed in the IHS Telebehavioral Seminar Archive: https://www.ihs.gov/teleeducation/seminararchives/. Under ‘Advanced Search’ select FASD.
Neuroanatomic/Neuropsychologic Studies Among Adults and Infants
Principal Investigator: Ann Streissguth, Ph.D.
(See Publications – Neuroanatomic/Neuropsychologic Studies)
This research proposed to quantify and link the neuroanatomic and neuropsychological abnormalities in people with brain damage caused by prenatal alcohol exposure. Prior to this study, there were few methods for quantifying the brain damage caused by alcohol and its relation to dysfunctional behavior in the individual, and none that used modern morphometric methods measuring neuroanatomic shape variation as discernible from MRI scans. Traditionally the only “quantification” of this brain damage was indirect, and lay in the diagnostic category called Fetal Alcohol Syndrome (FAS). However, people with FAS vary widely in many channels of behavior, and many other heavily exposed people who do not meet criteria for an FAS diagnosis show neurobehavioral deficits that may be as severe as FAS. Such individuals are often referred to as having Fetal Alcohol Effects (FAE) or Alcohol Related Neurodevelopmental Disorders (ARND).
Although we hypothesized that our image analysis methods would reveal significant mean differences in brain form between FAS/FAE and controls, the most significant finding was a hypervariation in the form of the Corpus Callosum (CC; a white matter pathway connecting the two hemispheres of the brain). Subjects with FAS and FAE had CC that were generally thicker or thinner than control counterparts. In addition three of the subjects with FAS/FAE showed frank CC dysgenesis (incomplete development). This study also found that there was a complete intermingling of (lack of discrimination between) the alcohol exposed subjects with and without the facial features of FAS in terms of representations of the shape of the CC. There was no difference in CC neuroanatomy between subjects with FAS and those with FAE or ARND.
When the shape measurement of the CC was combined with results of neuropsychological testing, we found further surprising results. The variation in the shape of the CC was related to two specific patterns of neuropsychological performance. Those subjects with FAS/FAE whose CC were thinner than controls demonstrated deficits in motor coordination but had relatively normal executive function abilities. Conversely, those subjects with FAS/FAE whose CC were thicker than controls demonstrated relatively normal motor coordination but had deficits in executive function abilities. Utilizing neuroanatomy and neuropsychology together, we could discriminate between FAS/FAE subjects and control subjects; with 100% sensitivity and 93% specificity. Again the two exposed groups were completely intermingled demonstrating that there is no difference in neuroanatomy and neuropsychology between subjects diagnosed FAS and those with FAE or ARND. Future research will use the same methodology to study other brain regions thought to be associated with the damaging effects of prenatal alcohol exposure.
Our previous work with adolescent and adult brain imaging suggested that early imaging of the CC using ultrasound might be useful to evaluate central nervous system (CNS) abnormalities related to prenatal alcohol exposure in infant. Diagnostic ultrasound is widely available, easier to administer, and less expensive than structural MRI. An ultrasound protocol to detect neuroanatomic anaomalies would allow for very early identification of infants at risk for Fetal Alcohol Spectrum Disorders (FASD) and lead to early intervention. Our unit developed a postnatal cranial ultrasound protocol that can be administered from birth to four months of age. We conducted an exploratory study (N=44) and detected 12 babies out of 23 in a high alcohol exposed group, while misclassifying only one in 21 in the unexposed group. The detection was based on a “sickle-shaped” splenium angle in the corpus callosum (angle > 90o). Further research is needed to confirm the splenium angle’s sensitivity/specificity for detecting CNS abnormalities related to prenatal alcohol exposure and its use identifying infants at risk for FASD.
Prospective Longitudinal Study on Health and Pregnancy (“Seattle 500 Study”)
Principal Investigator: Ann Streissguth, Ph.D.
Jacobsen, J.L., Akkaya-Hocagil, T., Ryan, L.M., Dodge, N.C., Richardson, G.A., Carmichael Olson, H., Coles, C.D., Day, N.L, Cook, R.J. & Jacobson, S.W. (2021). Effects of prenatal alcohol exposure on cognitive and behavioral development: Findings from a hierarchical meta-analysis of data from six prospective longitudinal U.S. cohorts. Alcoholism: Clinical & Experimental Research, 45, 2040-2058.
Barr, H.M., Bookstein, F.L., O’Malley, K.O., Connor, P.D., Huggins, J.E., & Streissguth, A.P. (2006). Binge drinking during pregnancy as a predictor of psychiatric disorders on the Structured Clinical Interview for DSM-IV in young adult offspring. American Journal of Psychiatry, 163(6), 1061-1065.
Baer, J.S., Sampson, P.D., Barr, H.M., Connor, P.D., & Streissguth, A.P. (2003). A 21-Year Longitudinal Analysis of the Effects of Prenatal Alcohol Exposure on Young Adult Drinking. Arch Gen Psychiatry, 60, 377-385.
Barr, H.M. & Streissguth, A.P. (2001). Identifying maternal self-reported alcohol use associated with fetal alcohol spectrum disorders. Alcoholism: Clinical & Experimental Research, 25(2), 283-287.
Sampson, P.D., Streissguth, A.P., Bookstein, F.L., & Barr, H. (2000). On categorizations in analyses of alcohol teratogenesis. Environmental Health Perspectives, 108(supplement 3), 421-428.
Streissguth, A.P., Barr, H.M., Bookstein, F.L., Sampson, P.D., & Carmichael Olson, H. (1999). The long-term neurocognitive consequences of prenatal alcohol: A 14-year study. Psychological Science, 10(3), 186-190.
Bookstein, F.L., Sampson, P., Streissguth, A.P., & Barr, H. (1996). Exploiting redundant measurement of dose and developmental outcome: New methods from the Behavioral Teratology of Alcohol. Developmental Psychology, 32, 404-415.
Streissguth, A.P., Bookstein, F.L., Sampson, P.D., & Barr, H.M. (1995). Attention: Prenatal alcohol and continuities of vigilance and attentional problems from 4 through 14 years. Development and Psychopathology, 7, 419-446.
Sampson, P.D., Bookstein, F.L., Barr, H.M., & Streissguth, A.P. (1994). Prenatal alcohol exposure, birthweight, and measures of child size from birth to age 14 years. American Journal of Public Health, 84(9), 1421-1428.
Streissguth, A.P., Sampson, P.D., Carmichael Olson, H., Bookstein, F.L., Barr, H.M., Scott M., Feldman, J., & Mirsky, A.F. (1994). Maternal drinking during pregnancy and attention/memory performance in 14-year-old children: A longitudinal prospective study. Alcoholism: Clinical & Experimental Research, 18(1), 202-218.
Streissguth, A.P., Barr, H.M., & Sampson, P.D. (1990). Moderate prenatal alcohol exposure: Effects on child IQ and learning problems at age 7 1/2 years. Alcoholism: Clinical and Experimental Research, 14(5), 662-669.
Streissguth, A.P., Barr, H.M., Sampson, P.D., Bookstein, F.L., Darby, B.L. (1989). Neurobehavioral effects of prenatal alcohol. Parts I, II, & III. Neurotoxicology & Teratology, 11(5), 461-507.
Streissguth, A.P., Barr, H.M., Sampson, P.D., Parrish-Johnson, J.C., Kirchner, G.L., & Martin, D.C. (1986). Attention, distraction and reaction time at age 7 years and prenatal alcohol exposure. Neurobehavioral Toxicology and Teratology, 8(6), 717-725.
Streissguth, A.P., Martin, D.C., Barr, H.M., Sandman, B.M., Kirchner, G.L., & Darby, B.L. (1984). Intrauterine alcohol and nicotine exposure: Attention and reaction time in 4-year-old children. Developmental Psychology, 20(4), 533-541.
Secondary Disabilities Study: Fetal Alcohol Syndrome Follow-Up Project
Principal Investigator: Ann Streissguth, Ph.D.
Streissguth, A.P. & Kanter, J. (Eds.) (1997). The Challenge of Fetal Alcohol Syndrome: Overcoming Secondary Disabilities (300 pp.). Seattle: University of Washington Press.
Streissguth, A.P., Bookstein, F.L., Barr, H.M., Sampson, P.D., O’Malley, K., Young, J.K. (2004). Risk Factors for Adverse Life Outcomes in Fetal Alcohol Syndrome and Fetal Alcohol Effects. Journal of Developmental and Behavioral Pediatrics, 25(4), 228-238.
Streissguth, A.P., Bookstein, F.L., Barr, H.M., Press, S., & Sampson, P.D. (1998). A Fetal Alcohol Behavior Scale. Alcoholism: Clinical & Experimental Research, 22(2), 325-333.
Famy, C., Streissguth, A.P., Unis, A. (1998). Mental illness in adult patients with fetal alcohol syndrome and fetal alcohol effects. American Journal of Psychiatry, 155(4), 552-554.
Streissguth, A., Barr, H., Kogan, J., & Bookstein, F. (1997) Primary and secondary disabilities in Fetal Alcohol Syndrome. In: Streissguth, A.P. & Kanter J. (eds.) The Challenge of Fetal Alcohol Syndrome: Overcoming Secondary Disabilities (pp. 25-39). Seattle: University of Washington Press.
Connor, P.D., & Streissguth, A.P. (1996). Effects of prenatal exposure to alcohol across the lifespan. Alcohol Health & Research World, 20(3), 170-174. Streissguth, A.P. (1994). A long-term perspective of FAS. Alcohol Health and Research World, 18(1), 74-81.
Related Publications and Early Publications
Streissguth, A.P., & Connor, P.D. (2001). Fetal alcohol syndrome and other effects of prenatal alcohol: Developmental cognitive neuroscience implications. In Nelson, C.A. & Luciana, M. (eds). The Handbook of Developmental and Cognitive Neuroscience. Massachusetts: MIT Press.
Streissguth, A.P., & O’Malley, K. (2000). Neuropsychiatric implications and long-term consequences of fetal alcohol spectrum disorders. Seminars in Clinical Neuropsychiatry, 5(3), 177-190.
Kelly, S.J., Day, N., & Streissguth, A.P. (2000). Effects of prenatal alcohol exposure on social behavior in humans and other species. Neurotoxicology & Teratology, 22(2), 143-149.
Connor, P.D., Streissguth, A.P., Sampson, P.D., Bookstein, F.L., & Barr, H.M. (1999). Individual differences in auditory and visual attention in fetal alcohol-affected adults. Alcoholism: Clinical & Experimental Research, 23(8), 1395-1402.
Kerns, K.A., Don, A., Mateer, C.A., & Streissguth, A.P. (1997). Cognitive deficits in nonretarded adults with fetal alcohol syndrome. Journal of Learning Disabilities, 30(6), 685-693.
Kopera-Frye, K., Carmichael Olson, H., & Streissguth, A.P. (1997). Teratogenic effects of alcohol on attention. In J. Burack & J. Enns (Eds.). Attention, Development, & Psychopathology (pp. 171-204). New York: Guilford Press.
Kopera-Frye, K., Dehaene, S., & Streissguth, A.P. (1996). Impairments of number processing induced by prenatal alcohol exposure. Neuropsychologia, 34(12), 1187-1196.
Streissguth, A.P., & Dehaene, P. (1993) Fetal alcohol syndrome in twins of alcoholic mothers: Concordance of diagnosis and IQ. American Journal of Medical Genetics, 47, 857-861.
Wilber, E.W., Newell-Morris, L., & Streissguth, A.P. (1993). Dermatoglyphic asymmetry in fetal alcohol syndrome. Biology of the Neonate, 64(1), 1-6.
Streissguth, A.P., Aase, J.M., Clarren, S.K., Randels, S.P., LaDue, R.A., & Smith, D.F. (1991). Fetal alcohol syndrome in adolescents and adults. Journal of American Medical Association, 265(15), 1961-1967.
Streissguth, A.P., Randels, S.P., & Smith, D.F. (1991). A test-retest study of intelligence in patients with fetal alcohol syndrome: Implications for care. Journal of the American Academy of Child and Adolescent Psychiatry, 30(4), 584-587.
Streissguth, A.P., Clarren, S.K., & Jones, K.L. (1985). Natural history of the fetal alcohol syndrome: A ten-year follow-up of eleven patients. Lancet, 2, 85-91.
Streissguth, A.P., Herman, C.S., & Smith, D.W. (1978). Intelligence, behavior, and dysmorphogenesis in the fetal alcohol syndrome: A report on 20 patients. Journal of Pediatrics, 92(3), 363-367.
Jones, K.L., Smith, D.W., Streissguth, A.P., & Myrianthopoulos, N.C. (1974). Outcome in offspring of chronic alcoholic women. Lancet, 1(866), 1076-1078.
Jones, K.L., Smith, D.W., Ulleland, C.N., & Streissguth, A.P. (1973). Pattern of malformation in offspring of chronic alcoholic mothers. Lancet, 1(815), 1267-1271.