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| Specialty Resource Contacts: | Fetal Alcohol Syndrome | ||||||||||||||||||
| Discipline(s): |
Education: Early Intervention/Early Childhood Human Development/Child Development Psychology |
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| AUCD Council Membership: |
No Council Membership |
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| Research: | The focus of my research over the past five years has been on answering the question of whether children with fetal alcohol syndrome exhibit a unique profile of cognitive, social, and motor characteristics or a behavioral phenotype. Our findings show that children with FAS are impaired at complex tasks and unimpaired at simple tasks across the board, suggesting a generalized pattern of deficits. I recently published an article in Neuroscience and Biobehavioral Reviews (2007) describing this hypothesis. The next logical step of this research program is to find neural correlates of the generalized deficit hypothesis using functional neuroimaging methods (fMRI, MEG). I am also in the process of developing specific teaching methods based on the generalized cognitive deficit model, which include use of concrete examples, visual aids, and repetition of information. Two related research projects in progress investigate experience-induced plasticity of the brain in children with FASD. In one project, we are investigating the effects of motor sequencing training on the motor system using high-density EEG and behavioral methods. The other project is concerned with the effects of a multi-modal intervention program (sensory integration therapy, mother-child interaction therapy, and environmental enrichment) on developmental trajectories of infants with FASD. Neural correlates of behavioral changes are assessed with magnetoencephalograpy (MEG). A second area of research interests concerns the effects of alcohol and drug abuse on the adolescent brain. I am currently investigating the effects of drug and alcohol abuse on voluntary eye movements (e.g. antisaccades) in adolescents with a history of combined use of alcohol and marijuana. To probe neuropsychological functioning in children with FAS and those with alcohol and drug abuse, I have also been involved in the development and validation of new tests that can be used in cross-cultural settings. Two of these tests are currently being used in the International Consortium on Fetal Alcohol Syndrome funded by NIH. One of these tests (Progressive Planning Test) has proven to be very sensitive in detecting the deleterious effects of alcohol on the brain. Therefore, I am in the process of developing a version of the test that can be used in a neuroimaging environment. This test would potentially allow detecting subtle signs of alcohol-related damage. | ||||||||||||||||||
| Education: | LICENSURE
EDUCATIONAL HISTORY PROFESSIONAL TRAINING
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| Service: | COMMUNITY SERVICE
Clinical Service | ||||||||||||||||||
Vita/Bio
HONORS
David Jackson Award for Excellence in Disability Research in New Mexico-Awarded by the Southwestern Disability Conference-2006
Visiting Scholar, La Sapienza, University of Rome School of Medicine, Rome, Italy. November, 2005
Eugene Mariani, New Mexico Psychological Association, Memorial Award, 1990
World Health Organization, British National Health Service, Dundee Fellowship in Mental Health, Scotland, 1979-1981
Sri-Lankan Government Scholarship- awarded for earning a first class honors degree, World Health Organization Fellowhip in Mental Health, 1970
MEMBERSHIP IN PROFESSIONAL SOCIETIES
International Neuropsychological Society
Research Society on Alcoholism
Neurobehavioral Teratology Society
Cognitive Development Society
Society for the Study of Behavioral Phenotypes
AD HOC REVIEWING FOR JOURNALS
Neuropsychologia
Journal of Studies on Alcohol
Alcoholism: Clinical and Experimental Research
Personality and Individual Differences
Drug and Alcohol Abuse
Alcohol
International Journal of Language and Communication Disorders
ORIGINAL RESEARCH IN REFEREED JOURNALS
Kodituwakku, P.W., Handmaker, N.S., Cutler, S.K., Weathersby, E.K., & Handmaker, S.D. Specific impairments in self-regulation in children exposed to alcohol prenatally. Alcoholism: Clinical and Experimental Research, 19, 1558-1564, 1995
Katapong, V.J., Brooks, W.M., Wesley, M.H., Kodituwakku, P.W., & Rosenberg, G.A. Proton magnetic resonance spectroscopy of vascular and Alzheimer type dementias. Archives of Neurology, 53, 1558-1564., 1996
Brooks, W.M., Wesley, M.H., Kodituwakku, P.W., Gary, P.J., & Rosenberg, G.A. (1997). H-MRS differentiates white matter hypersensitivities in subcortical arteriosclerotic encephalopathy from those in normal elderly. Stroke: A Journal of Cerebral Circulation, 28, 1940-1943., 1997
Lewine, J.D., Davis, J.T., Sloan, J.H., Kodituwakku, P.W., & Orrison, W.W. Neuromagnetic assessement of pathophysiology of brain activity induced by minor head trauma. American Journal of Neuroradiology, 20, 857-866, 1999.
Kodituwakku, P.W., May, P.A., Clericuzio, C.L., & Weers, D. Emotion-related learning in individuals prenatally exposed to alcohol : An investigation of the relation between set shifting, extinction of responses, and behavior. Neuropsychologia, 39, 699-708, 2001
Adnams, C., Kodituwakku, P.W., May, P.A., & Viljoen, D. Patterns of cognitive-motor deficits in children with fetal alcohol syndrome from a community in South Africa. Alcoholism: Clinical and Experimental Research, 25, 192-198., 2001
Kodituwakku, P.W., Kalberg, W., & May, P.A. (2001). Effects of prenatal alcohol exposure on executive control functioning. Alcohol Research and Health, 25, 192-198, 2001.
Viljoen, D., Croxford, J., Gossage, J.P., Kodituwakku, P.W., & May, P.A. (2002). Characteristics of mothers of children with fetal alcohol syndrome in the Western Cape Province of South Africa. The Journal of Studies on Alcohol, 63, 6-17, 2002
Villarreal, G., Hamilton, D.A., Petropoulous, H., Driscol, I., Rowland, L.M., Griego, J.A., Kodituwakku, P.W., Hart, B.L., Escalona, R., & Brooks, W.M. Reduced hippocampal volume and total white matter volume in PTSD. Biological Psychiatry, 52,119-125, 2002.
Riley, E.P., Mattson, S.N., Li, T-K, Jacobson, S.W., Coles, C.D., Kodituwakku, P.W., Adnams, C.M., & Korkman, M.I.. Neurobehavioral consequences of prenatal alcohol exposure: An international persepective. Alcoholism: Clinical and Experimental Research., 27, 362-373, 2003.
Hamilton, D.A., Kodituwakku, P.W., Sutherland, R.J., & Savage, D. Children with fetal alcohol sydrome are impaired at place learning but not cued-navigation In virtual Morris water task. Behavioral Brain Research, 143, 85-94, 2003.
Kodituwakku, P.W., Piyadasa Kodituwakku comments on Sandra and Joseph Jacobson and Susan Astley on FAS/FAE. In R. E. Tremblay, R.G. Barr, & RdeV. Peters (Eds.). Encyclopedia on early child development [on line] (pp. 1-5), 2003.
Provost, E., Heimerl, S., McClain, C., Nae-Hwa, K, Lopez, B.R., Kodituwakku, P.W., Concurrent validity of the Bayley Scales of Infant development II Motor Scale and Peabody Developmental Motor Scales-II in children with developmental delays. Pediatric Physical Therapy, 16, 149-156., 2004
Hoyme, H.E., May, P.A., Kalberg, W.O., Kodituwakku, P.W., Gossage J.P., Truijillo, P.M., Buckley, D.G., Miller, J.H., Aragon, A.S., Khaole, N., Viljoen, D.L., Jones, K.L., & Robinson, L.K. A practical clinical approach to diagnosis of fetal alcohol spectrum disorders: clarification of the 1996 Institute of Medicine Criteria. Pediatrics., 115, 39-47., 2005
Viljoen, D.L., Gossage, J. Brooke, L., Adnams, C.M., Jones, K.L., Robinson, L.K., Hoyme, H.E., Snell, C., Khale, N.C., Kodituwakku, P.W. et al. (2005) Fetal alcohol syndrome epidemiology in a South African Community: A second study of a very high prevalence area. The Journal of Studies on Alcohol , 66, 593-604
Kodituwakku, P.W., Adnams, C.M., Hay, A., Kithching, A.E., Burger, E., Kalberg, W.O., Viljoen, D.L., & May, P.A. (2006) Letter and Category fluency in children with fetal alcohol syndrome from a community in South Africa, The Journal of Studies on Alcohol, 67, 502-509.
May, P.A., Fiorentino, D., Gossage, J.P., Kalberg, H.E., Hoyme, H. E., Robinson, L.K., Coriale, G., Lyon Jones, K., Del Campo, M., Tarani, L., Romeo, M., Kodituwakku, P.W., Deina, L., Buckley, D., & Ceccanti, M., (2006). The epidemiology of FASD in a province in Italy: Prevalence and characteristics of children in a random sample of schools. Alcoholism: Clinical and Experimental Research, 30, 1562-1575
Kodituwakku, P.W., Coriale, G., Fiorentino, D., Kalberg, W.O., Buckley, D., Gossage, J.P., Deina, L., Aragon, A.S., Ceccanti, M., & May, P.A. (2006). Neurobehavioral characteristics of children with fetal alcohol spetrum disorders in communities from Italy: preliminary results. Alcoholism: Clinical and Experimental Research, 30, 1551-1561.
Kodituwakku, P.W. (2007). Defining the behavioral phenotype in children with fetal alcohol spectrum disorders: A review. Neuroscience and Biobehavioral Reviews , 31, 192-201 (4 papers published since July 2006; 100 hours for each paper)
SCHOLARLY PRODUCTS
Progressive Planning Test (PPT, Copyright 1993). This is a "look-ahead" puzzle designed to assess cognitive planning ability. The PPT consists of 12 problems of increasing difficulty. Each problem involves moving a number of colored beads from an initial position to a goal position following specific rules. Results from a large validation study (N=350) have revealed that the PPT is a valid and reliable test and that it is sensitive frontal lobe functioning. The test is currently being used in a large international study involving samples from Russia, Finland, Italy, South Africa and the US. It is also being used in a large-scale study of autism at the Child Study Center, Yale University. The results from various studies show that the PPT is the most sensitive test of executive functioning to the effects of chronic alcohol abuse or acute alcohol intoxication (Results submitted).
Reversal Learning Test (Kodituwakku et al., 2001). This is a test designed to assess the ability to alter behavior in response to the changes in reinforcement and is known to be sensitive to orbito-frontal functioning. In this test, the child is required to respond to one of two images presented on the computer screen and withhold responding to the other one. The child is awarded a point for each correct response and penalized a point for each incorrect response. Once the child has reached a learning criterion, the reinforcement schedule is reversed (rewarding image becomes non-rewarding and vice versa), requiring the child to alter his or her responses.
Mental Calculation Test (Kodituwakku, 2005). In this test, we teach subjects to mentally calculate squares for selected numbers between 10 and 100 using a specific strategy, which is derived from the mathematical identity, x2 - a2 = (x+a) (x-a). Successful performance on this test requires the ability to hold and manipulate information in working memory. We plan to conduct a study to determine the utility of this test as a measure of mathematical ability. The computerized version of the test is now available.
Present Patient Care Activities
My primary clinical responsibility (.5 FTE) is conducting neuropsychological assessments of children referred to the Indian Children Program, which is a part of a federally funded consortium. We receive referrals from reservations and schools throughout New Mexico and Northern Arizona. For example, we have received referrals from Flagstaff and Page Arizona. We typically perform our evaluations at referral sites as some parents do not have transportation. After completing the evaluation, we provide technical support for developing intervention programs. For example, we attend IEP (Individualized Education Plan) meetings at schools and help teachers develop intervention programs. Over the last three years, I have evaluated about 120 children referred to the program.
I also work as a Neuropsychologist on the multidisciplinary evaluation team of the Southwestern Autism Network. I have evaluated approximately 150 children referred to the autism clinic for evaluation.
I have responded to the requests from the community to evaluate patients with special needs or legal involvement (e.g. adult with fetal alcohol syndrome involved in the legal system) and served as an expert witness. Over the past year, I have evaluated about 10 patients referred from the community.
Past Patient Care
I served as a clinical Neuropsychologist in the Department of Psychiatry from 1990 to 1998. I was one of co-founders of the Clinical Neuropsychological Service in the Department of Psychiatry.
SOM Committees
American Disability since 2003
Department Committees
Professional Leave Committee
Research Committee (5 hours)
National Committees
Neurobehavior Test Development Committee- International Consortium on Fetal Alcohol Syndrome; San Diego State University (funded by NIAAA, NIH)
Other Services
I am involved in the development of neuropsychological services in Sri-Lanka. Currently, there exist no facilities or services for children with neurodevelopmental disorders. Drs. Deepika Attygala and Nalika Gunawardane, who visited UNM in 2004. I have taken leadership role in the development and validation of instruments for use in early identification of neurodevelopmental disorder. These two physicians are interested in receiving technical support from the University of New Mexico.
I am also working with Ms. Chandanie Senadheera (Psychiatry), Dr. Kithsiri Pathirana (Neurology), and Dr. Ruvin Kumar (Biochemistry) of the University of Ruhuna in the development of test batteries for the assessment of neuropsychological functioning in children and adults in Sri-Lanka. Dr. Pathirana and I are working toward developing a neuroscience curriculum at the University of Ruhuna. Ms. Chandanie Senadheera visited UNM on a 4-month fellowship awarded by UNICEF in 2006. Drs Pathirna and Kumar also visited UNM in 2006.