It has been known for over 4 decades that prenatal alcohol exposure (PAE) can adversely affect neurodevelopment and behavior (NDB). Yet, early detection of altered NDB due to PAE continues to present a major clinical challenge. Identification of altered NDB in the first 2 years of life, before higher-order cognitive processes develop, invites early interventions for affected children to improve long-term outcomes. Studies published in English from January of 1980 to July of 2018 were identified in PubMed/MEDLINE. The review focused on prospective birth cohort studies which used standardized NDB assessments in children up to 2 years of age, wherein PAE was the main exposure and NDB was the main outcome. NDB was categorized into the domains of neurocognitive, adaptive, and self-regulation based on the 2016 Updated Clinical Guidelines for Diagnosing fetal alcohol spectrum disorder. An initial search resulted in 1,867 articles for which we reviewed abstracts; 114 were selected for full-text review; and 3 additional abstracts were identified through review of references in eligible publications. Thirty-one publications met criteria and were included: of these, 24 reported neurocognitive outcomes, 24 reported adaptive behavior outcomes, and 12 reported outcomes in the domain of self-regulation. Although self-regulation was assessed in the fewest number of studies, 8/12 (75%) reported PAE-associated deficits. In contrast, results were mixed for the other 2 domains: 13/24 (54%) of the selected studies that included neurocognitive outcomes showed poorer performance following PAE, and 8/24 (33%) studies that assessed adaptive functioning found significant differences between PAE and comparison infants. There is considerable evidence to support the value of early-life assessments of infant NDB when PAE is known or suspected. More studies focusing on infant self-regulation, in particular, are needed to determine the utility of early evaluation of this critical developmental domain in infants with PAE.

This report reflects on the past, present, and potential future of community and citizen science (CCS) in the Elwha River watershed, with particular focus on the years before and after a major restoration event: the removal of two dams that had impacted the river system for a century. We ask: how does CCS feature in the Elwha story and how could it feature? We use the term CCS to reference the broad range of ways in which members of the public might participate in authentic science and monitoring processes, including students and both paid and unpaid interns: participants are individuals contributing to scientific projects without prior formal training in the topic. We present insights about Elwha CCS from an academic literature review and discussions with scientists and many others that have been working in the Elwha. We found that the history of CCS on the Elwha is important but understated, with few scientific papers acknowledging support by volunteers of various kinds. Recent and ongoing CCS projects on the Elwha tend to be focused on biological phenomena, and most are associated with educational opportunities (across many types of institutions) and paid internships. We also noted that most Elwha CCS projects required volunteers with particular pre-existing skill sets (e.g., botanical knowledge) or time to impart specialized training (e.g. boat use), leading many projects towards engagement with a smaller number of volunteers. Many new projects would broaden public involvement in terms of the opportunities available, and increase the variety of focal topics for research and monitoring. This increased breadth is promising: there are indications that the local community’s interests also range widely, from fish recovery after dam removal to dam removal impacts on humans. Elwha CCS projects have encountered some challenges and barriers, including the administrative burden of coordinating volunteers and managing liability concerns. But Elwha ScienceScape scientists are committed to the value that CCS brings both to the research itself as well as to those who participate in these projects. CCS can be a way to increase equity in science and engage people who would not otherwise participate in research, and in many cases the research simply wouldn’t be possible without their help. Support with project administration, volunteer management, and data management could help in expanding CCS efforts and broadening their inclusivity. More systematic tracking of CCS projects to assess how they contribute to research and to community and participant benefit could be helpful in establishing and maintaining a long-term CCS strategy in the Elwha.