Skip to main content Accessibility help

Effects of prenatal alcohol exposure on language, speech and communication outcomes: a review longitudinal studies

  • Gaironeesa Hendricks (a1) (a2), Susan Malcolm-Smith (a3), Colleen Adnams (a1), Dan Joseph Stein (a4) and Kirsten Ann Mary Donald (a2)...



The aim of this paper was to provide a systematic review and update on the available longitudinal studies on the impact of prenatal alcohol exposure (PAE) on language, speech and communication development, as well as associated potential environmental confounders during the preschool period.


A literature search was restricted to English, full‐text, peer‐reviewed, longitudinal studies in from 1970 until present: PUBMed, Scopus, Web of Science {C-e Collection, Biological Abstracts, KCI-Kean Journal Database, Russian Science Citation Index, SciELO Citation Index, Zoological Rec-d}, Academic Search Premier (Africa-Wide Information, CINAHL, MEDLINE, PsycINFO. Keywords included: prenatal alcohol exposure (PAE); speech or language or communication outcomes; neurocognitive or neurodevelopment or neurobehavioral or neurobehavioural; infant or baby or toddler or preschooler; longitudinal or follow-up. The inclusion criteria included (i) longitudinal cohorts with at least 2 time-points; (ii) association of light, moderate or heavy PAE on language, speech or communication delay, development or disorder; (iii) environmental confounders; (iv) infants up to preschool age.


Six studies satisfied the threshold for inclusion. Three studies reported that PAE was significantly associated with receptive or expressive delay. These studies demonstrated lower scores on either receptive or expressive communication in the alcohol group in comparison to the non-alcohol group, even after controlling for environmental factors up to 36 months.


Evidence from the longitudinal studies reviewed suggest that PAE influenced delays in receptive and expressive communication up to 36 months. Contextual risk factors played a significant role in language development over time and especially as children approached school age.


Corresponding author

Author for correspondence: Gaironeesa Hendricks, Division of Developmental Paediatrics, Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, Klipfontein Road/Private Bag, Rondebosch, 7700/7701 Cape Town, South Africa. Tel: +27 21 6585530; Fax: +27 21 6585322; E-mail:


Hide All
1. Whiteford, HA, Degenhardt, L, Rehm, J, Baxter, AJ, Ferrari, AJ, Erskine, HE, Charlson, FJ, Norman, RE, Flaxman, AD, Johns, N Burstein, R (2013) Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010. Lancet 382, 15751586.
2. Comasco, E, Rangmar, J, Eriksson, UJ Oreland, L (2018) Neurological and neuropsychological effects of low and moderate prenatal alcohol exposure. Acta Physiologica 222, 118.
3. Popova, S, Lange, S, Probst, C, Gmel, G Rehm, J (2017) Estimation of national, regional, and global prevalence of alcohol use during pregnancy and fetal alcohol syndrome: a systematic review and meta-analysis. Lancet Glob Health. 5, 290299.
4. World Health Organization (2014) Management of substance abuse unit. Global status report on alcohol and health (2014). World Health Organization. Available at Accessed April 10, 2018.
5. Roozen, S, Peters, GJ, Kok, G, Townend, D, Nijhuis, J Curfs, L (2016) Worldwide prevalence of fetal alcohol spectrum disorders: a systematic literature review including meta‐analysis. Alcohol Clin Exp Res 40, 1832.
6. Olivier, L, Viljoen, DL Curfs, LM (2016) Fetal alcohol spectrum disorders: prevalence rates in South Africa: the new millennium. South Afr Med J 106, 103106.
7. O’Leary, CM (2004) Fetal alcohol syndrome: diagnosis, epidemiology, and developmental outcomes. J Paediatr Child Health 40, 27.
8. Weinberg, NZ (1997) Cognitive and behavioral deficits associated with parental alcohol use. J Am Acad Child Adolesc Psychiatry 36, 11771186.
9. Gordon, S, Rotheram-Borus, MJ, Skeen, S, Perry, C, Bryant, K Tomlinson, M (2017) Research priorities for the intersection of alcohol and HIV/AIDS in low and middle-income countries: a priority setting exercise. AIDS Behav 21, 262273.
10. Iosub, S, Fuchs, M, Bingol, N Gromisch, DS (1981) Fetal alcohol syndrome revisited. Pediatrics 68, 475479.
11. Shaywitz, SE, Caparulo, BK Hodgson, ES (1981) Developmental language disability as a consequence of prenatal exposure to ethanol. Pediatrics 68, 850855.
12. Carney, LJ Chermak, GD (1991) Performance of American Indian children with fetal alcohol syndrome on the test of language development. J Commun Disord 24, 123134.
13. Glass, L, Graham, DM, Akshoomoff, N Mattson, SN (2015) Cognitive factors contributing to spelling performance in children with prenatal alcohol exposure. Neuropsychology 29, 817.
14. Thorne, JC, Coggins, TE, Olson, HC Astley, SJ (2007) Exploring the utility of narrative analysis in diagnostic decision making: picture-bound reference, elaboration, and fetal alcohol spectrum disorders. J Speech Lang Hear Res 50, 459474.
15. O’Connor, MJ Paley, B (2005) The relationship of prenatal alcohol exposure and the postnatal environment to child depressive symptoms. J Pediatr Psychol 31, 5064.
16. Coggins, TE, Timler, GR Olswang, LB (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. Lang Speech Hear Serv Schools 38, 117127.
17. McGee, CL, Bjorkquist, OA, Riley, EP Mattson, SN (2009) Impaired language performance in young children with heavy prenatal alcohol exposure. Neurotoxicol Teratol 31, 7175.
18. Sullivan, PM (2009) Violence exposure among children with disabilities. Clin Child Family Psychol Rev 12, 196216.
19. Abkarian, G (1992) Communication effects of prenatal alcohol exposure. J Commun Disord 25, 221240.
20. Cone-Wesson, B (2005) Prenatal alcohol and cocaine exposure: influences on cognition, speech, language, and hearing. J Commun Disord 38, 279302.
21. Menard, S (1991) Longitudinal research: Quantitative applications in the social sciences. Newbury Park, CA: Sage.
22. Wong, WC, Cheung, CS Hart, GJ (2008) Development of a Quality Assessment Tool for Systematic Reviews of Observational Studies (QATSO) of HIV prevalence in men having sex with men and associated risk behaviours. Emerg Themes Epidemiol 5, 23.
23. Popay, J, Roberts, H, Sowden, A, Petticrew, M, Arai, L, Rodgers, M, Britten, N, Roen, K Duffy, S (2006) Guidance on the conduct of narrative synthesis in systematic reviews. A product from the ESRC methods programme Version. Lancaster: Institute of Health Research 1, 92.
24. Fried, P Watkinson, B (1988) 12-and 24-month neurobehavioural follow-up of children prenatally exposed to marihuana, cigarettes and alcohol. Neurotoxicol Teratol 10, 305313.
25. Fried, PA Watkinson, B (1990) 36-and 48-month neurobehavioral follow-up of children prenatally exposed to marijuana, cigarettes, and alcohol. J Dev Behav Pediatr 11, 4958.
26. Fried, PA, O’connell, CM Watkinson, B (1992) 60-and 72-month follow-up of children prenatally exposed to marijuana, cigarettes, and alcohol: cognitive and language assessment. J Dev Behav Pediatr 13, 383391.
27. Davies, L, Dunn, M, Chersich, M, Urban, M, Chetty, C, Olivier, L Viljoen, D (2011) Developmental delay of infants and young children with and without fetal alcohol spectrum disorder in the Northern Cape Province, South Africa. Afr J Psychiatry 14, 298305.
28. Kaplan-Estrin, M, Jacobson, SW Jacobson, JL (1999) Neurobehavioral effects of prenatal alcohol exposure at 26 months. Neurotoxicol Teratol 21, 503511.
29. Greene, T, Ernhart, C, Ager, J, Sokol, R, Martier, S Boyd, T (1990) Prenatal exposure to alcohol and cognitive development. Neurotoxicol Teratol 13, 5768.
30. Melhuish, EC, Phan, MB, Sylva, K, Sammons, P, Siraj‐Blatchford, I Taggart, B (2008) Effects of the home learning environment and preschool center experience upon literacy and numeracy development in early primary school. J Soc Issues 64, 95114.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Acta Neuropsychiatrica
  • ISSN: 0924-2708
  • EISSN: 1601-5215
  • URL: /core/journals/acta-neuropsychiatrica
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed