Appendix B: Assessment and diagnosis of FASD among adults: a national and international systematic review – Evaluation and management of frontal lobe functions

Appendix B: Evaluation and management of frontal lobe functions

Source: Grafman, & Litvan (1999, p. 1922)

**Evaluation and management of frontal lobe functions**
Prefrontal cortical area	Cognitive domain	Neurobehavioral probe ^{Footnote *} (always compared with premorbid behavior)	Management
*If screening identified potential areas of impairment, specialized testing by a neuropsychologist, neuropsychiatrist, or behavioral neurologist is usually required.
Ventromedial	Social skills	Does the patient make inappropriate sexual remarks, eat excessively, or disobey other types of social rules of behavior?	Pharmacological agents; behavioural management
	Inhibition of prepotent	Does the patient exhibit stereotyped behaviors such as repeating the same phrase or activities over and over again?	Pharmacological agents; behavioural management
	Motivation and reward	Does the patient still enjoy the same activities or items that they used to?	Pharmacological agents; behavioural management
Medial	Allocation of attention	Is the patient's concentration distracted by irrelevant sounds or sights in the environment?	Environmental control: Pharmacological agents?
Medial	Predictive planning	Can the patient do routine activities, such as using an automatic bank teller or using a tea kettle to make a cup of tea?	Environmental control
Frontopolar	Adaptive planning	Can the patient be interrupted in the middle of a conversation to answer the telephone and then after hanging up the telephone appropriately resume the conversation without cueing?	Environmental control
Dorsolateral	Rehearsing short-term plans	Can the patient remember a telephone number after a very brief pause?	Cognitive strategies
	Reasoning	Can the patient explain how two objects are similar (e.g. table and chair are both furniture), deduce an answer to a mystery, or adjust to an unforeseen demand or event?	Cognitive strategies
	Thematic understanding	Can the patient read a short article or watch a brief television programme and get the point or theme of what they read or watched?	Cognitive strategies