The Prevalence of Fetal Alcohol Spectrum Disorders in An American Indian Community

The prevalence of fetal alcohol spectrum disorders (FASD) differs among populations and is largely unknown among minority populations. Prevalence and characterization of FASD is necessary for prevention efforts and allocation of resources for treatment and support. However, prevalence data are lacking, including among many minority populations. The aim of this study was to obtain an FASD prevalence estimate in a Southern California American Indian community employing active case-ascertainment. In 2016, American Indian children aged 5–7 years and their caregivers were recruited in collaboration with Southern California Tribal Health Clinic. Children were assessed using physical examinations and neurobehavioral testing. Parent or guardian interviews assessed child behavior and prenatal exposures including alcohol. Of 488 children identified as eligible to participate, 119 families consented and 94 completed assessments to allow a classification for FASD. Participating children (n = 94) were an average of 6.61 ± 0.91 years old and half were female. Most interviews were conducted with biological mothers (85.1%). Less than one third (29.8%) of mothers reported consuming any alcohol in pregnancy and 19.1% met study criteria for risky alcohol exposure prior to pregnancy recognition. Overall 20 children met criteria for FASD, resulting in an estimated minimum prevalence of 41.0 per 1000 (4.1%). No cases of fetal alcohol syndrome (FAS) were identified; 14 (70.0%) met criteria for alcohol related neuro- developmental disorder (ARND). Minimum prevalence estimates found in this sample are consistent with those noted in the general population.

Parents’ adverse childhood experiences and parent–child emotional availability in an American Indian community: Relations with young children's social–emotional development

This study examined relations among parent adverse childhood experiences (ACEs), parent mental distress, child social–emotional functioning, and parent emotional availability (EA) among parents and children served by an Early Head Start program in an American Indian community. The majority of parents and children in the study were American Indian/Alaska Native. American Indian/Alaska Native communities experience relatively high rates of trauma, socioeconomic disparities, and mental health challenges. In this context, young children may be especially vulnerable to early life stress. Further, a strong body of literature demonstrates the long-term effects of ACEs on individuals’ mental health, as well as their child's social–emotional functioning. In this study we examined a model to test the relation of parent ACEs to children's social–emotional functioning, with an indirect effect via a latent “mental distress” variable consisting of parent depression, anxiety, and parenting-related distress. Results supported this model, suggesting that parent ACEs related to children's social–emotional problems by way of parent mental distress. However, when a categorical measure of parent EA was added as a moderator, the model only remained significant in the low EA parent group. These results provided evidence for a “buffering” effect of high parent EA on the relation between parent ACEs, parent mental distress, and children's social–emotional problems.