Table 2 Educational and Learning Strategies
From: Systematic review of interventions for children with Fetal Alcohol Spectrum Disorders
Study quality | Participants (n), age, inclusion criteria and setting | Interventions and follow-up | Outcome measures |
|---|---|---|---|
Adnams et al, 2003 In: Riley et al, 2003[14] RCT: randomization method, allocation concealment, blinding, ITT analysis unclear; follow-up 100%; study power not given. | n = 10, Mean age: 8.5 years FAS[3] Selected from previous study of 64 South African children | CCT or usual classroom, 1 hour per week, 10 school months. Follow-up: 10 months | Behaviour: Personal Behaviours Checklist score: improvement in CCT group compared to controls (mean pre-intervention scores 21.4 vs 14.8 and mean post-intervention scores 7.6 vs 15.4). Neuropsychological profile: no significant difference. CCT battery: qualitative improvements in function but no significant difference |
Adnams et al, 2005 In: Stromland et al, 2005[15]& Adnams et al, 2007[16] RCT: randomization method, allocation concealment, ITT analysis unclear; outcome assessors blinded; follow-up 94%; study power not given. | n = 65, 9 to 10 years FAS or partial FAS[3] and "deferred diagnosis category" Exposed children selected from study of 105 South African children, | Language and literacy intervention, 1 hour per week for 38 weeks over 9 months Follow-up: 9 months | Pre-literacy, reading and spelling: FASD children in intervention group had significantly improved scores on Phonological Awareness and Early Literacy Test: Manipulating Syllables (t = 2.23, p = 0.034), Letter Sounds (t = 3.7, p = 0.001), Written Letters (t = 3.14, p = 0.004), Reading (t = 3.72, p = 0.001), Reading Non-Words (t = 3.65, p = 0.001) and Spelling Non-Words (t = 3.44, p = 0.002). General scholastic tests: No significant difference between FASD intervention and control group. |
Coles et al, 2007[17] RCT: randomization method, allocation concealment, ITT analysis unclear; outcome assessor blinded; follow-up 100%; study power not given. | n = 32 4 to 10 years FAS or partial FAS[28], excluded if IQ < 50. Recruited from a Fetal Alcohol Clinic, USA | Virtual reality game of fire safety or virtual reality game of street safety Follow-up: immediately 1-week post-intervention | Post-intervention: children exposed to the computer game had significantly greater knowledge gain of fire safety (F(1, 31) = 18.94, p < 0.000) or street safety (F(1, 31) = 16.3 p < 0.000). One week: children exposed to the computer game had significantly greater knowledge gain of fire safety (F(1, 31) = 15.56, p < 0.000) but not street safety (F(1, 31) = 3.13, p = 0.096). |
Kable et al, 2007[18] RCT: randomization method, allocation concealment, ITT analysis unclear; blinding (outcome assessors); follow-up 92%; sample size calculation provided. | n = 61, 3 to 10 years FAS, partial FAS, or alcohol related dysmorphology[28] Excluded if IQ < 50 or mental health problems prevented participation. Recruited: USA Fetal Alcohol Clinic and community. | Mathematics intervention (6 weeks tutoring) or a standard psycho-educational group. Follow-up: 6 weeks. | Mathematics: The mathematics intervention group had a significantly higher gain in mathematical knowledge (F(3, 43) = 2.97, p < 0.04) and were significantly more likely to demonstrate a clinical gain compared to the psychoeducational group (58.6 vs 23.1%, χ(1, 55) = 7.1, p < 0.008) |
Loomes et al, 2008[19] Controlled trial Allocation method unclear; unblinded; follow up 97%; ITT analysis unclear; study power not provided. | n = 33, 4.2 to 11.8 years ARND, Alcohol Exposed Neuro-behavioural Disorder or Static Encephalopathy (criteria not stated) From hospital/FASD clinics, schools, community, Canada | Rehearsal training following pretest Follow-up: at average 10.6 days (range 6–21) | Post-intervention: there was no significant difference between intervention and control groups (t = -0.49, p > 0.05) Follow-up: the intervention group had significantly increased digit span compared to the control group (t = -1.96, p < 0.05) |
Meyer, 1998[20] Pre-post intervention, No blinding. | n = 4, primary school age, USA. FAE & learning disabled (criteria not stated) | Four minute videotape of building task | Learning: No child could imitate the building block task |
Padgett et al, 2006[21] Pre- and post-intervention; No blinding; follow-up 100%. | n = 5, 4 to 7 years FAS, partial FAS (criteria not stated); USA Fetal Alcohol Clinic | Virtual reality game of home fire safety Follow-up:1 week | Post-intervention: 4 children correctly sequenced cards and 3 demonstrated all steps in response to an imaginary fire. One week: 3 children correctly sequenced the cards and 5 showed all steps in response to an imaginary fire |