Identifying family environment profiles in families of children with prenatal alcohol exposure.

Background: Individuals with prenatal alcohol exposure (PAE) may face unique family environments that potentially influence adaptive functioning and behavioral challenges. This study aimed to identify profiles of families of children with PAE based on family characteristics, including cohesion, conflict, and organization, and to examine the relationship between family environment profiles and child outcomes.

Methods: Data were collected from caregivers of 283 youth (5-17 years) with histories of PAE. Caregivers completed several questionnaires, including the Child Behavior Checklist (CBCL), Vineland Adaptive Behavior Scales (VABS), and Family Environment Scale (FES). Latent profile analysis (LPA) was used to identify profiles in the family environment using three subscales from the FES (Cohesion, Conflict, and Organization). Model fit was determined by comparing 1-, 2-, 3-, 4-, and 5-profile solutions. One-way ANCOVA follow-up tests were conducted to explore differences in adaptive and behavioral functioning across family environment profiles.

Results: The 4-profile solution was considered the best fit for the data. Interpretation of conditional response probabilities indicated that Profile 1 was defined by low cohesion; Profile 2 was defined by low organization; Profile 3 was defined as high cohesion and organization; and Profile 4 was defined as high conflict. After controlling for race, sex, age, and ethnicity, there were significant profile differences on the Internalizing, Externalizing, and Total Problem Behavior scales of the CBCL. There were no significant differences in adaptive functioning across profiles.

Conclusions: The results of this study highlight the importance of the family environment in understanding the strengths and challenges experienced by children with PAE. Four unique profiles of family environments emerged in families of children with PAE. The high-conflict profile was associated with increased behavioral problems in children. These findings can be used to support families of children with PAE and to identify treatment targets for interventions for children with PAE and their caregivers.