%0 Journal Article %@ 2561-326X %I JMIR Publications %V 5 %N 7 %P e20658 %T Executive Function After Prenatal Alcohol Exposure in Children in a South African Population: Cross-sectional Study %A Louw,Jacobus Gidion %A van Heerden,Alastair %A Olivier,Leana %A Lambrechts,Tersius %A Broodryk,Mandi %A Bunge,Liska %A Vosloo,Martlé %A Tomlinson,Mark %+ Foundation for Alcohol Related Research, 42 Bloemhof Street, Bellville, Cape Town, 7535, South Africa, 27 216862646, jl@farrsa.org.za %K fetal alcohol spectrum disorders %K FASD %K cognitive %K executive function %K experimental games %K brain drug effects %K child development %K serious games %K games %K alcohol %K training %D 2021 %7 2.7.2021 %9 Original Paper %J JMIR Form Res %G English %X Background: Alcohol is a teratogen; its consumption during pregnancy can lead to negative birth outcomes, collectively referred to as fetal alcohol spectrum disorders. Neurodevelopmental delays in higher-order cognitive functions that affect development of executive functions are a common feature. Studies on executive function in children have focused on children diagnosed with fetal alcohol spectrum disorder, and there is a lack of information on the impact on children not diagnosed with fetal alcohol spectrum disorder but who had been exposed to alcohol. Objective: The aim of this study was to compare the development of executive function in children between 4 and 6 years of age with and without prenatal exposure to alcohol. Methods: Children both exposed and not exposed to alcohol were recruited as part of a feasibility RCT evaluating a computer-based cognitive training program for improving executive function development. The study was conducted in a low–socioeconomic status community in South Africa with a high prevalence of fetal alcohol spectrum disorder. Neurodevelopment was assessed in participating children; NEPSY-II standardized scores for executive function domains were compared using a multivariate analysis of variance with group membership as the predictor variable. Results: No significant differences in executive functions assessments (P=.39) were found between children in the alcohol-exposed group (n=76) and those in the nonexposed group (n=40). Both groups showed moderate to severe delays in domains. In all but one subtest, the average score for both groups was below the 25th percentile of expected norms. Conclusions: We expected that alcohol exposure would have a measurable impact on executive function development. The lack of differences highlights the prevalence of developmental delays in low–socioeconomic status communities in South Africa and suggests that children are exposed to various threats to cognitive development. International Registered Report Identifier (IRRID): RR2-10.2196/14489 %M 34255647 %R 10.2196/20658 %U https://formative.jmir.org/2021/7/e20658 %U https://doi.org/10.2196/20658 %U http://www.ncbi.nlm.nih.gov/pubmed/34255647