Hostname: page-component-cd9895bd7-lnqnp Total loading time: 0 Render date: 2024-12-28T04:38:06.506Z Has data issue: false hasContentIssue false

Social Perspective Taking and Empathy in Children with Fetal Alcohol Spectrum Disorders

Published online by Cambridge University Press:  26 January 2015

Sara A. Stevens*
Affiliation:
Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, Canada Department of Psychology, University of Toronto, Canada
Joanna Dudek
Affiliation:
Department of Psychology, University of Toronto, Canada
Kelly Nash
Affiliation:
Department of Psychology, University of Toronto, Canada The Ontario Institute of Studies in Education of the University of Toronto, Canada
Gideon Koren
Affiliation:
Department of Pediatrics, University of Toronto, Canada Motherisk Program, The Hospital for Sick Children, Toronto, Canada
Joanne Rovet
Affiliation:
Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, Canada Department of Psychology, University of Toronto, Canada
*
Correspondence and reprint requests to: Sara Stevens, The Hospital for Sick Children, 555 University Avenue, Toronto ON M5G1X8. E-mail: sara.stevens@sickkids.ca

Abstract

Children with fetal alcohol spectrum disorders (FASD) show sociobehavioral impairments; however, the social cognitive profile contributing to these impairments is poorly understood. This study compared social perspective taking and empathy in children with FASD versus typically developing controls (TDC). Thirty-seven children with FASD and 21 TDC participated. Measures included parent-rated CBCL and SSIS, and NEPSY-II Theory of Mind, Test of Social Cognition and Index of Empathy. Parents rated the FASD group higher than TDC on indices of behavior problems and lower on indices of social skills and empathy. Children with FASD scored significantly below TDC on tasks requiring complex social cognition. The majority of correlations between social cognition and parent-ratings were not significant in FASD and TDC, with the exception of a negative correlation between self-reported empathy and parent-rated behavior difficulties in TDC. FASD subgroup analyses revealed lower theory of mind and empathy scores among children with ARND than pFAS/FAS. With regard to sex, males with FASD were rated as having more behavior difficulties than females, whereas TDC females obtained higher empathy ratings than males. In both groups, females scored higher on theory of mind and empathy indices. On theory of mind tasks, older children with FASD performed below younger, whereas younger TDC children performed more poorly than older. Children with FASD show reduced functioning on indices of sociobehavioral and social cognition, and the effects are influenced by sex and age. These findings provide insight into the clinical and social profile of children with FASD. (JINS, 2015, 21, 74–84)

Type
Research Articles
Copyright
Copyright © The International Neuropsychological Society 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Achenbach, T. M. (2001). Child behavior checklist for 6-18 years. Burlington, VT: ASEBA Products.Google Scholar
Astley, S. J., & Clarren, S. K. (2000). Diagnosing the full spectrum of fetal alcohol-exposed individuals: Introducing the 4-digit diagnostic code. Alcohol and Alcoholism, 35, 400410.Google Scholar
Bishop, S., Gahagan, S., & Lord, C. (2007). Re-examining the core features of autism: A comparison of autism spectrum disorder and fetal alcohol spectrum disorder. Journal of Child Psychology and Psychiatry, 48, 11111121.Google Scholar
Brooks, B. L., Sherman, E. M. S., & Strauss, E. (2010). Test review: NEPSY-II: A developmental neuropsychological assessment, 2nd edition, Child Neuropsychology, 16, 80101.Google Scholar
Bryant, B. (1982). An index of empathy for children and adolescents. Child Development, 53, 413425.Google Scholar
Caldwell, S. (1993). Nurturing the delicate rose. In J. Kleinfeld & S. Westcott (Eds.), Fantastic Antone succeeds! Experiences in educating children with fetal alcohol syndrome (pp. 97129). Anchorage, AK: University of Alaska Press.Google Scholar
Chasnoff, I. J., Wells, A. M., Telford, E., Schmidt, C., & Messer, G. (2010). Neurodevelopmental functioning in children with FAS, pFAS, and ARND. Journal of Developmental and Behavioral Pediatrics, 31, 192201.Google Scholar
Chudley, A. E., Conry, J., Cook, J. L., Loock, C., Rosales, T., & LeBlanc, N. (2005). Fetal alcohol spectrum disorder: Canadian guidelines for diagnosis. Canadian Medical Association Journal, 172, S1S21.Google Scholar
Coles, C. D., Platzman, K. A., Lynch, M. E., & Freides, D. (2002). Auditory and visual sustained attention in adolescents prenatally exposed to alcohol. Alcoholism: Clinical and Experimental Research, 26, 263271.Google Scholar
Coggins, T. (1997). Assessment of language and social communication in FAS. Presented at the meeting of Prevention and Management-Fetal Alcohol Syndrome and Prenatal Substance Abuse. Breckenridge.Google Scholar
Coggins, T. E., Timler, G. R., & Olswang, L. B. (2007). A state of double jeopardy: Impact of prenatal alcohol exposure and adverse environments on the social communicative abilities of school-age children with fetal alcohol spectrum disorder. Language, Speech, and Hearing Services in Schools, 38, 117127.Google Scholar
Davis, M. H. (1996). Empathy a social psychological approach. Boulder, CO: Westview Press.Google Scholar
Dennis, M., Francis, D. J., Cirino, P. T., Schachar, R., Barnes, M. A., & Fletcher, J. M. (2009). Why IQ is not a covariate in cognitive studies of neurodevelopmental disorders. Journal of the International Neuropsychological Society, 15, 331343.Google Scholar
Eisenberg, N., Spinrad, T., & Sadovsky, A. (2006). Empathy related responding in children. In M. Killen & J. Smetana (Eds.), Handbook of moral development (pp. 519549). New Jersey: Erlbaum.Google Scholar
Fast, D. K., Conry, J., & Loock, C. A. (1999). Identifying fetal alcohol syndrome among youth in the criminal justice system. Developmental and Behavioral Pediatrics, 20, 370372.Google Scholar
Fergusson, D., Woodward, L., & Horwood, J. (1998). Maternal smoking during pregnancy and psychiatric adjustment in late adolescence. Archives of General Psychiatry, 55, 721727.Google Scholar
Freshbach, N. (1997). Empathy: The formative years. Implications for clinical practice. In A. Bohart & L. Greenberg (Eds.), Empathy reconsidered: New directions in psychotherapy (pp. 3359). Washington, DC: American Psychological Association.CrossRefGoogle Scholar
Greenbaum, R. L., Stevens, S. A., Nash, K., Koren, G., & Rovet, J. (2009). Social cognitive and emotion processing abilities of children with fetal alcohol spectrum disorders: A comparison with attention deficit hyperactivity disorder. Alcoholism, Clinical and Experimental Research, 33, 16561670.Google Scholar
Gresham, F., & Elliott, S. (2008). Skills Improvement System (A. G. Services, Ed.). Circle Pines, TX: Pearson PsychCorp.Google Scholar
Gresham, F., Elliot, S., Vance, M. J., & Cook, C. R. (2011). Comparability of the Social Skills Rating System to the Social Skills Improvement System: Content and psychometric comparisons across elementary and secondary age levels. School Psychology Quarterly, 26, 2744.Google Scholar
Happe, F. G. E. (1995). The role of age and verbal ability in the theory of mind task performance of subjects with autism. Child Development, 66, 843855.CrossRefGoogle ScholarPubMed
Herman, L. E., Acosta, M. C., & Chang, P. N. (2008). Gender and attention deficits in children diagnosed with a fetal alcohol spectrum disorder. The Canadian Journal of Clinical Pharmacology, 15, e411e419.Google Scholar
Hollingshead, A. (1975). Social class and mental illness: A community study. New York: Wiley.Google Scholar
Keil, V., Paley, B., Frankel, F., & O’Connor, M. J. (2010). Impact of a social skills intervention on the hostile attributions of children with prenatal alcohol exposure. Alcoholism: Clinical and Experimental Research, 34, 231241.Google Scholar
Kodituwakku, P., May, P., Ballinger, P., Harris, M., Aase, J., & Aragon, A. (1997). Executive control functioning and theory of mind in children prenatally exposed to alcohol. Presented at the Meaning of Prevention and Management-Fetal Alcohol Syndrome and Prenatal Substance Abuse.Google Scholar
Kodituwakku, P. W. (2007). Defining the behavioral phenotype in children with fetal alcohol spectrum disorders: A review. Neuroscience and Biobehavioral Reviews, 31, 192201.Google Scholar
Kodituwakku, P. W. (2010). A neurodevelopmental framework for the development of interventions for children with fetal alcohol spectrum disorders. Alcohol, 44, 717728.Google Scholar
Korkman, M., Kirk, U., & Kemp, S. (2009). NEPSY II. London: Pearson Education Inc. Google Scholar
Marton, I., Wiener, J., Rogers, M., Moore, C., & Tannock, R. (2009). Empathy and social perspective taking in children with attention-deficit/hyperactivity disorder. Journal of Abnormal Child Psychology, 37, 107118.CrossRefGoogle ScholarPubMed
Mattson, S. N., Calarco, K. E., & Lang, A. R. (2006). Focused and shifting attention in children with heavy prenatal alcohol exposure. Neuropsychology, 20, 361369.CrossRefGoogle ScholarPubMed
Mattson, S. N., Riley, E. P., Gramling, L. J., Delis, D. C., & Jones, K. L. (1997). Heavy prenatal alcohol exposure with or without physical features of fetal alcohol syndrome leads to IQ deficits. Journal of Pediatrics, 131, 718721.Google Scholar
McGee, C. L., Bjorkquist, O. A., Price, J. M., Mattson, S. N., & Riley, E. P. (2009). Social information processing skills in children with histories of heavy prenatal alcohol exposure. Journal of Abnormal Child Psychology, 37, 817830.Google Scholar
McGee, C., Bjorkquist, O., Riley, E., & Mattson, S. (2009). Impaired language performance in young children with heavy prenatal alcohol exposure. Neurotoxicology and Teratology, 31, 7175.CrossRefGoogle ScholarPubMed
McGee, C. L., Fryer, S. L., Bjorkquist, O. A., Mattson, S. N., & Riley, E. P. (2008). Deficits in social problem solving in adolescents with prenatal exposure to alcohol. The American Journal of Drug and Alcohol Abuse, 34, 423431.CrossRefGoogle ScholarPubMed
Nakamura, B. J., Ebesutani, C., Bernstein, A., & Chorpita, B. F. (2009). A Psychometric analysis of the child behavior checklist DSM-oriented scales. Journal of Psychopathology and Behavioral Assessment, 31, 178189.CrossRefGoogle Scholar
Nash, K., Koren, G., & Rovet, J. (2011). A differential approach for examining the behavioural phenotype of fetal alcohol spectrum disorders. Journal of Population Therapeutics and Clinical Pharmacology, 18, 440453.Google Scholar
Nash, K., Rovet, J., Greenbaum, R., Fantus, E., Nulman, I., & Koren, G. (2006). Identifying the behavioural phenotype in fetal alcohol spectrum disorder: Sensitivity, specificity and screening potential. Archives Women’s Mental Health, 9, 181186.CrossRefGoogle ScholarPubMed
Nash, K., Stevens, S., Greenbaum, R., Weiner, J., Koren, G., & Rovet, J. (2014). Improving executive functioning in children with fetal alcohol spectrum disorders. Child Neuropsychology, 119.Google Scholar
O’Connor, M. J., Frankel, F., Paley, B., Schonfeld, A. M., Carpenter, E., Laugeson, E. A., & Marquardt, R. (2006). A controlled social skills training for children with fetal alcohol spectrum disorders. Journal of Consulting and Clinical Psychology, 74, 639648.CrossRefGoogle ScholarPubMed
Premack, D., & Woodruff, G. (1978). Chimpanzee problem-solving: A test for comprehension. Science, 202, 532535.Google Scholar
Rasmussen, C., Becker, M., McLennan, J., Urichuk, L., & Andrew, G. (2011). An evaluation of social skills in children with and without prenatal alcohol exposure. Child: Care, Health and Development, 37, 711718.Google Scholar
Rasmussen, C., Benz, J., Pei, J., Andrew, G., Schuller, G., Abele-Wester, L., … Lord, L. (2010). The impact of an ADHD co-morbidity on the diagnosis of FASD. Canadian Journal Clinical Pharmacology, 17, 165176.Google Scholar
Rasmussen, C., Horne, K., & Witol, A. (2006). Neurobehavioral functioning in children with fetal alcohol spectrum disorder. Child Neuropsychology, 12, 453468.Google Scholar
Rasmussen, C., McAuley, R., & Andrew, G. (2007). Parental ratings of children with Fetal Alcohol Spectrum Disorder on the behavioral rating inventory of executive function (BRIEF). Journal of Fetal Alcohol Syndrome International, 5, 18.Google Scholar
Rasmussen, C., Wyper, K., & Talwar, V. (2009). The relation between theory of mind and executive functions in children with fetal alcohol spectrum disorders. Canadian Journal of Pharmacology, 16, 370380.Google Scholar
Ruby, P., & Decety, J. (2004). How would you feel versus how do you think she would feel? A neuroimaging study of perspective-taking with social emotions. Journal of Cognitive Neuroscience, 16, 988999.Google Scholar
Saltzman-Benaiah, J., & Lalonde, C. E. (2007). Developing clinically suitable measures of social cognition for children: Initial findings from a normative sample. The Clinical Neuropsychologist, 21, 294317.Google Scholar
Schonfeld, A. M., Mattson, S. N., & Riley, E. P. (2005). Moral maturity and Deliquency after prenatal alcohol exposure. Journal of Studies on Alcohol, 66, 545554.CrossRefGoogle Scholar
Schonfeld, A. M., Paley, B., Frankel, F., & O’Connor, M. J. (2006). Executive functioning predicts social skills following prenatal alcohol exposure. Child Neuropsychology, 12, 439452.CrossRefGoogle ScholarPubMed
Stevens, S. A., Major, D., Rovet, J., & Desrocher, M. (2012). Social problem solving in children with fetal alcohol spectrum disorders. Journal of Population Therapeutics and Clinical Pharmacology, 19, 99110.Google Scholar
Stevens, S. A., Nash, K., Koren, G., & Rovet, J. (2012). Autism characteristics in children with fetal alcohol spectrum disorders. Child Neuropsychology, 1, 19.Google Scholar
Streissguth, A. P., Bookstein, F., Barr, H., Sampson, P., O’Malley, K., & Young, J. (2004). Risk factors for adverse life outcomes in fetal alcohol syndrome and fetal alcohol effects. Journal of Developmental and Behavioral Pediatrics, 25, 228238.CrossRefGoogle ScholarPubMed
Thomas, S. E., Kelly, S. J., Mattson, S. N., & Riley, E. P. (1998). Comparison of social abilities of children with fetal alcohol syndrome to those of children with similar IQ scores and normal controls. Alcoholism, Clinical and Experimental Research, 22, 528533.Google Scholar
Timler, G. R., Olswang, L. B., & Coggins, T. E. (2005). “Do I know what I need to do?” A social communication intervention for children with complex clinical profiles. Language, Speech, and Hearing Services in Schools, 36, 7385.Google Scholar
Weissman, M. M., Warner, V., Wickramaratne, P. J., & Kandel, D. B. (1999). Maternal smoking during pregnancy and psychopathology in offspring followed to adulthood. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 892899.Google Scholar
Wellman, H. M., Cross, D., & Watson, J. (2001). Meta-analysis of theory-of-mind development: The truth about false belief. Child Development, 72, 655684.CrossRefGoogle ScholarPubMed
Weschler, D. (1999). Wechsler Abbreviated Scale of Intelligence (WASI). San Antonio, TX: Pearson Corporation.Google Scholar
Whaley, S., O’Connor, M., & Gunderson, B. (2001). Comparison of the adaptive functioning of children prenatally exposed to alcohol to a nonexposed clinical sample. Alcoholism, Clinical and Experimental Research, 25, 10181024.Google Scholar
Wied, M., de Wied, C. G., & de van Boxtel, A. (2010). Empathy dysfunction in children and adolescents with disruptive behavior disorders. European Journal of Pharmacology, 626, 97103.Google Scholar
Willoughby, K., Sheard, E., Nash, K., & Rovet, J. (2008). Effects of prenatal alcohol exposure on hippocampal volume, verbal learning, and verbal and spatial recall in late childhood. Journal of the International Neuropsychological Society, 14, 10221033.CrossRefGoogle ScholarPubMed