This study presents important evidence of a unique etiology of ADHD in individuals prenatally exposed to alcohol. That the average LOR for ADHD in these studies was higher than the average LOR in studies of COA, and specifically, than in studies of mothers with AD, indicates that there is an insult above and beyond that attributable to a genetic liability inherited from an AD parent. This significant difference in risk of ADHD could provide empirical evidence to support the growing literature emphasizing cognitive and behavioral differences between children with a comorbid PAE and ADHD and children with ADHD but no PAE (Mattson et al., 2011; Mattson et al., 2013; O’Malley & Nanson, 2002).
