Our study has many strengths, including the large heterogeneous sample from multiple sites, however, there are also limitations to our study. As mentioned, we focused mainly on measures of executive function, which, while critical for everyday function, are limited in scope. Additional studies covering a broader array of neuropsychological domains and other types of data (e.g., including data on adaptive behavior, dysmorphology, or brain imaging) would enhance these results. Second, important differences resulted from our inclusion of the South African sample suggesting that variations on the profile may be more useful in accurately identifying alcohol-affected children at that site. Our groups were also not matched on demographic variables like race and ethnicity that were related to classification accuracy. However, the significant findings, in spite of such sample variability, make our results more powerful and generalizable. Further, the results of our follow up analyses including race, ethnicity, and age as covariates indicated that while important, these covariates did not change our ability to accurately classify AE subjects. An additional limitation is that we only included subjects without any missing neuropsychological data. However, our sample size is substantial even with this exclusionary criterion.
