# Validation of the ND-PAE Diagnosis in Children with Heavy Prenatal Alcohol Exposure

## TL;DR

This study validates the diagnosis of neurobehavioral disorder due to prenatal alcohol exposure in children with heavy alcohol exposure.

## Contribution

The study expands the validation of ND-PAE criteria to children with heavier prenatal alcohol exposure and a broader age range.

## Key findings

- Impairment criteria at 1SD below normative average showed highest endorsement rates in both PAE and control groups.
- Current ND-PAE criteria effectively captured children with heavy prenatal alcohol exposure.
- Reducing adaptive functioning requirements increased sensitivity to PAE.

## Abstract

This study evaluated criteria for neurobehavioral disorder associated with prenatal alcohol exposure (ND-PAE). Kable et al. (Child Psychiatry Hum Dev 55:426, 2022) assessed the validity of this diagnosis in a sample with low exposure to alcohol. The current study expanded this assessment to a sample with a wider age range and heavier alcohol exposure. Data were collected from participants (5–17 years) with prenatal alcohol exposure (PAE) and typically developing controls at six Collaborative Initiative on Fetal Alcohol Spectrum Disorders sites using neuropsychological assessment and caregiver reports. Impairment was tested at 1SD, 1.5SD, and 2SD below the normative average and a modification of the adaptive functioning requirement was tested. Testing impairment at 1SD resulted in the highest endorsement rates in both groups. Our findings replicated the study by Kable et al. and show that current criteria captured a high rate of those with PAE and that requiring fewer adaptive functioning criteria resulted in higher sensitivity to PAE.