By Dave DeFusco
At the 2026 Symposium on Science, Technology and Health, Shirah Niknam, a student in the Katz School鈥檚 M.S. in Speech-Language Pathology, presented research examining how prenatal alcohol exposure affects cognition and language from childhood through adulthood.
Niknam鈥檚 project, 鈥淭he Role of Prenatal Alcohol Exposure and Its Implications on Cognition and Language Across the Lifespan,鈥 focused on Fetal Alcohol Spectrum Disorders (FASD), a group of neurodevelopmental conditions caused by alcohol exposure before birth. These conditions include Fetal Alcohol Syndrome (FAS), Partial FAS and Alcohol-Related Neurodevelopmental Disorder (ARND).
鈥淲hile FASD has been extensively studied in children, there is still much to learn about how cognitive and language difficulties continue throughout a person鈥檚 life,鈥 said Niknam. 鈥淢y review examined research across different age groups and found that many of these challenges do not disappear with age. Instead, they evolve as individuals face new academic, social and everyday demands.鈥
People with FASD often experience difficulties with language processing, social communication, attention, memory and executive functioning鈥攖he mental skills that help individuals plan, organize, solve problems and regulate behavior. Prenatal alcohol exposure can also be associated with distinctive facial features, growth deficiencies and other neurocognitive impairments.
Niknam鈥檚 review found that language difficulties often become more noticeable as children grow older and face increasingly complex social and academic expectations. Receptive language鈥攖he ability to understand spoken information鈥攔emains one of the most persistent challenges throughout life. Expressive language skills, or the ability to speak and communicate ideas, can also be affected, although basic speech is often intact.
鈥淩esearch consistently shows that receptive language weaknesses remain significant across the lifespan,鈥 said Niknam. 鈥淢any individuals can communicate verbally, but they may struggle to understand complex information, follow conversations, interpret social cues or process language in real-world situations.鈥
The review also highlighted the broad cognitive effects of FASD. Executive functioning emerged as the most significantly affected area, accounting for many of the challenges individuals face in daily life. Difficulties with planning, organization, cognitive flexibility and self-control can affect success in school, employment and independent living.
Attention deficits and slower processing speed were also common findings, along with persistent problems in working memory, which is the ability to hold and manipulate information mentally. Together, these cognitive challenges can make learning, decision-making and everyday problem-solving more difficult.
As individuals with FASD enter adulthood, the nature of these challenges often shifts. Academic struggles may give way to difficulties managing finances, maintaining employment, organizing daily responsibilities and living independently.
鈥淭he research shows that FASD should be viewed as a lifelong condition,鈥 said Niknam. 鈥淭he challenges do not simply end after childhood. They often transition into difficulties with functional independence, social relationships and everyday decision-making.鈥
The findings have important implications for speech-language pathologists, who play a key role in identifying and supporting individuals with FASD. Niknam emphasized the importance of early detection and comprehensive assessment that extends beyond traditional language testing.
鈥淪tandardized language tests are valuable, but they do not tell the whole story,鈥 she said. 鈥淪peech-language pathologists need to evaluate social communication, attention, problem-solving, executive functioning and real-world communication skills in order to develop effective intervention plans.鈥
Treatment strategies should focus on practical skills that support success in everyday life, including language comprehension, self-monitoring, organization and problem-solving. Ongoing support is especially important during major developmental transitions, such as the move from childhood to adolescence or from school into adulthood.
Marissa Barrera, Niknam鈥檚 advisor and assistant dean of health sciences, said the research underscores the importance of taking a long-term view of developmental disorders.
鈥淪hirah鈥檚 work highlights why it is so important to understand FASD as a lifelong condition rather than a childhood diagnosis,鈥 she said. 鈥淏y recognizing the ongoing language, cognitive and functional challenges these individuals face, speech-language pathologists and other professionals can provide more effective support that promotes communication, independence and quality of life across every stage of development.鈥
