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Betts JL, Eggins E, Chandler‐Mather N, Shelton D, Till H, Harnett P, Dawe S. Interventions for improving executive functions in children with foetal alcohol spectrum disorder (FASD): A systematic review. CAMPBELL SYSTEMATIC REVIEWS 2022; 18:e1258. [PMID: 36908848 PMCID: PMC9634003 DOI: 10.1002/cl2.1258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Background The consequences for children born with birth defects and developmental disabilities encompassed by foetal alcohol spectrum disorder (FASD) are profound, affecting all areas of social, behavioural and cognitive functioning. Given the strong evidence for a core deficit in executive functioning, underpinned by impaired self-regulation skills, there has been a growing focus on the development of interventions that enhance or support the development of executive functions (EFs). Objectives The primary objective of this review is to synthesise the evidence for structured psychological interventions that explicitly aim to improve EF in children. The review also sought to ascertain if the effectiveness of interventions were influenced by characteristics of the intervention, participants or type of EF targeted by the intervention. Search Methods Sixteen databases, 18 grey literature search locations and 9 trial registries were systematically searched to locate eligible studies (up to December 2020). These searches were supplemented with reference harvesting, forward citation searching, hand searches of topic-relevant journals and contact with experts. Selection Criteria Studies were included in the review if they reported on an impact evaluation of a psychological intervention aiming to improve EF in children 3-16 years who either had confirmed prenatal alcohol exposure or a formal diagnosis falling under the umbrella term of FASDs. Eligible study designs included randomised controlled trials (RCTs) and quasi-experimental designs with either no treatment, wait list control or an alternative treatment as a comparison condition. Single-group pre-post designs were also included. Data Collection and Analysis Standard methodological procedures expected by the Campbell Collaboration were used at all stages of this review. Standardised mean differences (SMDs) were used to estimate intervention effects, which were combined with random effects meta-analysis (data permitting). Risk of bias was assessed using the Cochrane Risk of Bias Tool (RoB2) and Cochrane Risk of Bias in Non-Randomised Studies-Interventions tool (ROBINS-I). Main Results The systematic search identified 3820 unique records. After title/abstract and full-text screening, 11 eligible studies (reported in 21 eligible documents) were deemed eligible, with a combined 253 participants. Of the 11 studies, 6 were RCTs, 1 was a quasi-experiment and 4 were single-group pre-post intervention designs. All studies were rated as having an overall high or serious risk of bias, with some variation across domains for RCTs. For RCT and quasi-experimental studies, the overall effect of EF interventions on direct and indirect measures of EF generally favoured the experimental condition, but was not statistically significant. There was no difference between intervention and comparison groups on direct measures of auditory attention (k = 3; SMD = 0.06, 95% confidence interval [CI] = -1.06, 1.18), visual attention (k = 2; SMD = 0.90, 95% CI = -1.41, 3.21), cognitive flexibility (k = 2; SMD = 0.23, 95% CI = -0.40, 0.86), attentional inhibition (k = 2; SMD = 0.04, 95% CI = -0.58, 0.65), response inhibition (k = 3; SMD = 0.47, 95% CI = -0.04, 0.99), or verbal working memory (k = 1; d = 0.6827; 95% CI = -0.0196, 1.385). Significant heterogeneity was found across studies on measures of auditory attention and visual attention, but not for measures of cognitive flexibility, attentional inhibition or response inhibition. Available data prohibited further exploration of heterogeneity. There was no statistical difference between intervention and comparison groups on indirect measures of global executive functioning (k = 2; SMD = 0.21, 95% CI = -0.40, 0.82), behavioural regulation (k = 2; SMD = 0.18, 95% CI = -0.43, 0.79), or emotional control (k = 3; SMD = 0.01, 95% CI = -0.33, 0.36). Effect sizes were positive and not significant for meta-cognition (k = 1; SMD = 0.23, 95% CI = -0.72, 1.19), shifting (k = 2; SMD = 0.04, 95% CI = -0.35, 0.43), initiation (k = 1; SMD = 0.04, 95% CI = -0.40, 0.49), monitoring (k = 1; SMD = 0.25, 95% CI = -0.20, 0.70) and organisation of materials (k = 1; SMD = 0.25, 95% CI = -0.19, 0.70). Effect sizes were negative and not statistically different for effortful control (k = 1; SMD = -0.53, 95% CI = -1.50, 0.45), inhibition (k = 2; SMD = -0.08, 95% CI = -0.47, 0.31), working memory (k = 1; SMD = 0.00, 95% CI = -0.45, 0.44), and planning and organisation (k = 1; SMD = -0.10, 95% CI = -0.55, 0.34). No statistically significant heterogeneity was found for any of the syntheses of indirect measures of EF. Based on pre-post single-group designs, there was evidence for small to medium sized improvements in EF based on direct measures (cognitive flexibility, verbal working memory and visual working memory) and indirect measures (behavioural regulation, shifting, inhibition and meta-cognition). However, these results must be interpreted with caution due to high risk of bias. Authors' Conclusions This review found limited and uncertain evidence for the effectiveness of interventions for improving executive functioning in children with FASD across 8 direct and 13 indirect measures of EF. The findings are limited by the small number of high-quality studies that could be synthesised by meta-analysis and the very small sample sizes for the included studies.
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Affiliation(s)
- Joseph Lee Betts
- School of Applied PsychologyGriffith UniversityBrisbaneAustralia
| | - Elizabeth Eggins
- School of Applied PsychologyGriffith UniversityBrisbaneAustralia
| | | | - Doug Shelton
- Child Development ServiceGold Coast Hospital and Health ServiceSouthportAustralia
| | - Haydn Till
- Child Development Service, Gold Coast Hospital and Health ServiceSouthportAustralia
| | - Paul Harnett
- School of Criminology and Criminal JusticeGriffith UniversityMount GravattAustralia
| | - Sharon Dawe
- School of Applied PsychologyGriffith UniversityBrisbaneAustralia
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Markovic A, Wengenroth L, Schlüter J, Kerber K, Parisi C, Strieker S, Bartelt A, Heinen F, Landgraf MN. 9/m mit unklaren Impulsdurchbrüchen. Monatsschr Kinderheilkd 2022. [DOI: 10.1007/s00112-022-01662-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Sappok T, Tergeist M, Kruse B, Wagner J. [Fetal Alcohol Spectrum Disorders in Adults - Results from a Diagnostic Outpatient Clinic]. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2022; 90:204-211. [PMID: 35008120 DOI: 10.1055/a-1669-8963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
AIM OF THE STUDY Fetal alcohol spectrum disorders (FASD) are quite common and, due to the risk of psychiatric comorbidities, highly relevant until adulthood. Diagnostic clarification in adulthood is a prerequisite for targeted treatment and needs-based support. METHODS In a German metropolitan region, 80 people with suspicion of FASD were assessed from May 2015 to July 2020. The results of this interdisciplinary diagnostic assessment were systematically evaluated and the clinical characteristics of the persons with or without FASD were analysed. RESULTS Approximately 70% of the population accessing relevant health care was diagnosed with an entity from the FAS spectrum. People with FASD were more likely to have learning disabilities (50 vs. 33%) or intellectual disabilities (40 vs. 10%), while there were no group differences for age and gender. Psychiatric comorbidities, particularly depression (39%) and addiction disorders (31%), were common in both groups. CONCLUSION As part of a multi-professional standardized diagnosis, FASD clarification is also possible and necessary in adulthood. The diagnostic criteria for FASD should be further evaluated and specified for adults.
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Affiliation(s)
- Tanja Sappok
- Behandlungszentrum für psychische Gesundheit bei Entwicklungsstörungen, Ev. Krankenhaus Königin-Elisabeth Herzberge, Berlin, Deutschland
| | - Marlene Tergeist
- Behandlungszentrum für psychische Gesundheit bei Entwicklungsstörungen, Ev. Krankenhaus Königin-Elisabeth Herzberge, Berlin, Deutschland
| | - Björn Kruse
- Behandlungszentrum für psychische Gesundheit bei Entwicklungsstörungen, Ev. Krankenhaus Königin-Elisabeth Herzberge, Berlin, Deutschland
| | - Jessica Wagner
- Behandlungszentrum für psychische Gesundheit bei Entwicklungsstörungen, Ev. Krankenhaus Königin-Elisabeth Herzberge, Berlin, Deutschland
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Ordenewitz LK, Weinmann T, Schlüter JA, Moder JE, Jung J, Kerber K, Greif-Kohistani N, Heinen F, Landgraf MN. Evidence-based interventions for children and adolescents with fetal alcohol spectrum disorders - A systematic review. Eur J Paediatr Neurol 2021; 33:50-60. [PMID: 34058625 DOI: 10.1016/j.ejpn.2021.02.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 02/02/2021] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Brain function deficits cause strong negative impacts for the everyday lives of children and adolescents with fetal alcohol spectrum disorders (FASD). Therefore, evidence-based intervention programs that are specifically designed for patients with FASD are needed but still scarce. The aim of the presented article is a systematic literature review of evidence-based intervention strategies for children and adolescents with FASD. MATERIALS AND METHODS A comprehensive systematic literature search was conducted in several relevant databases to identify randomized-controlled intervention studies for children and adolescents with FASD. RESULTS We identified 25 randomized-controlled studies regarding interventions in FASD. Overall, evidence indicating that some therapeutic interventions are effective in children and adolescents with FASD was found. Even though evidence-based interventions rarely lead to improvements of performance into a "normal range", those measures can alleviate negative consequences of prenatal alcohol exposure and relieve daily burdens. CONCLUSION There are only a few randomized-controlled trials regarding therapy research for children and adolescents with FASD. Their results indicate that especially the combination of parent and child sessions present a promising approach for the treatment of FASD. Positive treatment effects of interventions seem to be domain specific, except for interventions regarding self-regulation or social interaction.
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Affiliation(s)
- Lisa K Ordenewitz
- Department of Pediatric Neurology and Developmental Medicine, LMU Center for Development and Children with Medical Complexity, German FASD Competence Center Bavaria, Dr. von Hauner Children's Hospital, LMU University Hospital Munich, Ludwig-Maximilians-University, Munich, Germany
| | - Tobias Weinmann
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Julia A Schlüter
- Department of Pediatric Neurology and Developmental Medicine, LMU Center for Development and Children with Medical Complexity, German FASD Competence Center Bavaria, Dr. von Hauner Children's Hospital, LMU University Hospital Munich, Ludwig-Maximilians-University, Munich, Germany
| | - Judith E Moder
- Department of Pediatric Neurology and Developmental Medicine, LMU Center for Development and Children with Medical Complexity, German FASD Competence Center Bavaria, Dr. von Hauner Children's Hospital, LMU University Hospital Munich, Ludwig-Maximilians-University, Munich, Germany
| | - Jessica Jung
- Department of Pediatric Neurology and Developmental Medicine, LMU Center for Development and Children with Medical Complexity, German FASD Competence Center Bavaria, Dr. von Hauner Children's Hospital, LMU University Hospital Munich, Ludwig-Maximilians-University, Munich, Germany
| | - Katharina Kerber
- Department of Pediatric Neurology and Developmental Medicine, LMU Center for Development and Children with Medical Complexity, German FASD Competence Center Bavaria, Dr. von Hauner Children's Hospital, LMU University Hospital Munich, Ludwig-Maximilians-University, Munich, Germany
| | - Naschla Greif-Kohistani
- Department of Pediatric Neurology and Developmental Medicine, LMU Center for Development and Children with Medical Complexity, German FASD Competence Center Bavaria, Dr. von Hauner Children's Hospital, LMU University Hospital Munich, Ludwig-Maximilians-University, Munich, Germany
| | - Florian Heinen
- Department of Pediatric Neurology and Developmental Medicine, LMU Center for Development and Children with Medical Complexity, German FASD Competence Center Bavaria, Dr. von Hauner Children's Hospital, LMU University Hospital Munich, Ludwig-Maximilians-University, Munich, Germany
| | - Mirjam N Landgraf
- Department of Pediatric Neurology and Developmental Medicine, LMU Center for Development and Children with Medical Complexity, German FASD Competence Center Bavaria, Dr. von Hauner Children's Hospital, LMU University Hospital Munich, Ludwig-Maximilians-University, Munich, Germany.
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Assessing the needs of caregivers of children and adolescents with fetal alcohol spectrum disorders: Results from a survey among families and professionals in Germany. Eur J Paediatr Neurol 2021; 33:1-8. [PMID: 33971449 DOI: 10.1016/j.ejpn.2021.04.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 03/15/2021] [Accepted: 04/27/2021] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Caring for individuals with fetal alcohol spectrum disorders (FASD) puts a substantial and often life-long burden on affected families. Caregivers' specific needs and demands are, however, not well understood so far. We thus aimed at systematically collecting data on the needs of individuals caring for children and adolescents with FASD. MATERIALS AND METHODS Between May 2019 and November 2020, a quantitative survey among caregivers and professionals from across Germany was performed. Participants completed a questionnaire collecting information on the perceived support caregivers receive from various sources as well as the current fulfilment of caregivers' needs. Specifically, the fulfilment of a variety of specific needs summarised in five categories was rated by the participants on a scale ranging from 1 (very good) to 6 (insufficient). RESULTS Both caregivers and professionals rated the overall fulfilment of needs rather poorly (mean: 3.94 and 4.27, respectively). Caregivers indicated needs concerning coordination of support (4.74) and relief services (4.44) to be fulfilled the least while needs in the relief services category also received the lowest average grade among professionals (4.57). The needs that the caregivers regarded as most sufficiently fulfilled were their own knowledge about FASD (mean: 1.95) and their knowledge about the causes of their child's problems (mean: 1.87). CONCLUSIONS The results of the present study indicate that FASD caregivers are supported insufficiently, while most of their needs remain unmet. Health care planners and providers thus urgently need to identify and implement measures to better address FASD caregivers' needs and demands.
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Moder JE, Ordenewitz LK, Schlüter JA, Weinmann T, Altebäumer P, Jung J, Heinen F, Landgraf MN. [Fetal alcohol spectrum disorders-diagnosis, prognosis, and prevention]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2021; 64:747-754. [PMID: 33942146 PMCID: PMC8187172 DOI: 10.1007/s00103-021-03329-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 03/19/2021] [Indexed: 11/23/2022]
Abstract
Die Fetale Alkoholspektrumstörung ist eine der häufigsten bei Geburt bestehenden chronischen Erkrankungen, die zum Großteil nicht oder fehldiagnostiziert wird. Dies führt zu inadäquater, ineffektiver Förderung und Therapie der erkrankten Kinder sowie mangelnder Unterstützung der betroffenen Familien. Daraus resultiert nicht nur ein hohes Maß an Sekundärerkrankungen, sondern auch eine Einbuße in der Möglichkeit der Sekundär- und Tertiärprävention bei erkrankten Kindern und betroffenen Familien. Sekundär und Tertiärprävention sind jedoch bei richtiger und rechtzeitiger Diagnose möglich. Die Primärprävention im Bereich Alkoholkonsum in der Schwangerschaft und Fetale Alkoholspektrumstörung muss auch in Zukunft sowohl von medizinischer als auch politischer Seite strukturiert, interdisziplinär und wissenschaftlich basiert geplant und durchgeführt werden. Neben der Aufklärung der Allgemeinbevölkerung ist hierbei die Wissensvermittlung an ÄrztInnen und andere medizinisch-psychologisch-pädagogische Fachkräfte besonders relevant.
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Affiliation(s)
- Judith E Moder
- Deutsches FASD KOMPETENZZENTRUM Bayern, LMU Zentrum für Entwicklung und komplex chronisch kranke Kinder - iSPZ Hauner, Dr. von Haunersches Kinderspital, LMU Klinikum München, Lindwurmstraße 4, 80337, München, Deutschland
| | - Lisa K Ordenewitz
- Deutsches FASD KOMPETENZZENTRUM Bayern, LMU Zentrum für Entwicklung und komplex chronisch kranke Kinder - iSPZ Hauner, Dr. von Haunersches Kinderspital, LMU Klinikum München, Lindwurmstraße 4, 80337, München, Deutschland.,Abteilung Neuropädiatrie, Entwicklungsneurologie und Sozialpädiatrie, LMU Zentrum für Entwicklung und komplex chronisch kranke Kinder - iSPZ Hauner, Dr. von Haunersches Kinderspital, LMU Klinikum München, München, Deutschland
| | - Julia A Schlüter
- Deutsches FASD KOMPETENZZENTRUM Bayern, LMU Zentrum für Entwicklung und komplex chronisch kranke Kinder - iSPZ Hauner, Dr. von Haunersches Kinderspital, LMU Klinikum München, Lindwurmstraße 4, 80337, München, Deutschland.,Abteilung Neuropädiatrie, Entwicklungsneurologie und Sozialpädiatrie, LMU Zentrum für Entwicklung und komplex chronisch kranke Kinder - iSPZ Hauner, Dr. von Haunersches Kinderspital, LMU Klinikum München, München, Deutschland
| | - Tobias Weinmann
- Deutsches FASD KOMPETENZZENTRUM Bayern, LMU Zentrum für Entwicklung und komplex chronisch kranke Kinder - iSPZ Hauner, Dr. von Haunersches Kinderspital, LMU Klinikum München, Lindwurmstraße 4, 80337, München, Deutschland.,Institut und Poliklinik für Arbeits‑, Sozial- und Umweltmedizin, LMU Klinikum München, München, Deutschland
| | - Philine Altebäumer
- Deutsches FASD KOMPETENZZENTRUM Bayern, LMU Zentrum für Entwicklung und komplex chronisch kranke Kinder - iSPZ Hauner, Dr. von Haunersches Kinderspital, LMU Klinikum München, Lindwurmstraße 4, 80337, München, Deutschland
| | - Jessica Jung
- Deutsches FASD KOMPETENZZENTRUM Bayern, LMU Zentrum für Entwicklung und komplex chronisch kranke Kinder - iSPZ Hauner, Dr. von Haunersches Kinderspital, LMU Klinikum München, Lindwurmstraße 4, 80337, München, Deutschland.,Abteilung Neuropädiatrie, Entwicklungsneurologie und Sozialpädiatrie, LMU Zentrum für Entwicklung und komplex chronisch kranke Kinder - iSPZ Hauner, Dr. von Haunersches Kinderspital, LMU Klinikum München, München, Deutschland
| | - Florian Heinen
- Deutsches FASD KOMPETENZZENTRUM Bayern, LMU Zentrum für Entwicklung und komplex chronisch kranke Kinder - iSPZ Hauner, Dr. von Haunersches Kinderspital, LMU Klinikum München, Lindwurmstraße 4, 80337, München, Deutschland.,Abteilung Neuropädiatrie, Entwicklungsneurologie und Sozialpädiatrie, LMU Zentrum für Entwicklung und komplex chronisch kranke Kinder - iSPZ Hauner, Dr. von Haunersches Kinderspital, LMU Klinikum München, München, Deutschland
| | - Mirjam N Landgraf
- Deutsches FASD KOMPETENZZENTRUM Bayern, LMU Zentrum für Entwicklung und komplex chronisch kranke Kinder - iSPZ Hauner, Dr. von Haunersches Kinderspital, LMU Klinikum München, Lindwurmstraße 4, 80337, München, Deutschland. .,Abteilung Neuropädiatrie, Entwicklungsneurologie und Sozialpädiatrie, LMU Zentrum für Entwicklung und komplex chronisch kranke Kinder - iSPZ Hauner, Dr. von Haunersches Kinderspital, LMU Klinikum München, München, Deutschland.
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Wagner JC, Tergeist M, Kruse B, Sappok T. [Fetal alcohol spectrum disorders in adults]. DER NERVENARZT 2020; 91:1069-1079. [PMID: 33104818 DOI: 10.1007/s00115-020-01015-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Fetal alcohol spectrum disorders (FASD) are a common cause of a congenital developmental disability acquired in the womb due to alcohol consumption by the mother during pregnancy. The physical and mental consequences persist into adulthood. The 4‑digit code is an evidence-based method for diagnosing the full spectrum of outcomes, i.e. the full picture of fetal alcohol syndrome (FAS), partial fetal alcohol syndrome (pFAS), alcohol-related neurodevelopmental disorder (ARND) and alcohol-related birth defects (ARBD). The four key diagnostic features are (1) growth disorder, (2) facial dysmorphia, (3) central nervous system (CNS) structural and functional abnormalities and (4) prenatal alcohol exposure. Even if the disorder cannot be cured, supportive therapeutic interventions can improve the quality of life and independence and psychiatric comorbidities can be treated.
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Affiliation(s)
- Jessica Christine Wagner
- Behandlungszentrum für psychische Gesundheit bei Entwicklungsstörungen, Evangelisches Krankenhaus Königin Elisabeth Herzberge, Herzbergstr. 79, 10365, Berlin, Deutschland.
| | - Marlene Tergeist
- Behandlungszentrum für psychische Gesundheit bei Entwicklungsstörungen, Evangelisches Krankenhaus Königin Elisabeth Herzberge, Herzbergstr. 79, 10365, Berlin, Deutschland
| | - Björn Kruse
- Behandlungszentrum für psychische Gesundheit bei Entwicklungsstörungen, Evangelisches Krankenhaus Königin Elisabeth Herzberge, Herzbergstr. 79, 10365, Berlin, Deutschland
| | - Tanja Sappok
- Behandlungszentrum für psychische Gesundheit bei Entwicklungsstörungen, Evangelisches Krankenhaus Königin Elisabeth Herzberge, Herzbergstr. 79, 10365, Berlin, Deutschland
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Römer P, Reinelt T, Petermann F, Teickner C. Alkoholkonsum während der Schwangerschaft. KINDHEIT UND ENTWICKLUNG 2019. [DOI: 10.1026/0942-5403/a000267] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Kinder sind bereits im Mutterleib sensitiv für Umwelteinflüsse. Pränataler Alkoholkonsum zählt dabei zu den einflussreichsten Risikofaktoren für die frühkindliche Entwicklung. Das Ziel ist es, einen Überblick über die aktuelle Forschungslage zum Thema Alkoholkonsum während der Schwangerschaft zu geben. Darüber hinaus wird der Forschungsstand zu Belastungen und Folgeschäden für die frühkindliche Entwicklung durch pränatale Alkoholexposition, aber auch zu weiteren Risikofaktoren zusammengefasst. Es wird gezeigt, dass das Wissen um die Prävalenz für Alkoholkonsum während der Schwangerschaft sowohl für die Erforschung der Folgen als auch für das Umsetzen von präventiven Maßnahmen ausschlaggebend ist. Die Prävalenzen unterscheiden sich nicht nur regional, sondern können auch durch andere Faktoren beeinflusst werden. Es wird deutlich, dass der Risikofaktor Alkohol und dessen mögliche Auswirkungen auf die frühkindliche Entwicklung nicht isoliert, sondern in Abhängigkeit von weiteren genetischen und Umweltfaktoren betrachtet werden müssen. Denn auch Folgen von weiteren perinatalen Risikofaktoren machen sich in den ersten beiden Lebensjahren bemerkbar. Beispiele für Entwicklungsstörungen in dieser Entwicklungsspanne sind externalisierendes Verhalten und kognitive Beeinträchtigungen. Inwieweit sich perinatale Risikofaktoren jedoch auf Entwicklungsverläufe von Kindern, die durch pränatalen Alkoholkonsum belastet sind, auswirken, erfasst eine umfassende Diskussion. Diese Lücke gilt es zu schließen um das Zusammenspiel perinataler Risiken genauer zu verstehen und adäquat entgegenwirken zu können.
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Affiliation(s)
- Pia Römer
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
| | - Tilman Reinelt
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
| | - Franz Petermann
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
| | - Claudia Teickner
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
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Landgraf MN, Albers L, Rahmsdorf B, Vill K, Gerstl L, Lippert M, Heinen F. Fetal alcohol spectrum disorders (FASD) - What we know and what we should know - The knowledge of German health professionals and parents. Eur J Paediatr Neurol 2018; 22:507-515. [PMID: 29551660 DOI: 10.1016/j.ejpn.2018.02.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 01/05/2018] [Accepted: 02/25/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVE The objective of our study was to evaluate the knowledge about fetal alcohol spectrum disorders (FASD) and the implementation of the German guideline for FASD among different professionals in the health and social system and among parents with children with FASD. METHODS A questionnaire about FASD, containing 20 items, was sent by post to all children's hospitals (n = 287), all hospitals for child and adolescent psychiatry (n = 173), all social paediatric centres (n = 162), all neuropaediatricians (n = 129) and all youth welfare offices (n = 672) in Germany. Furthermore a link to the questionnaire as online version was put in the member's newsletter by 14 relevant professional societies. Besides, the questionnaire was distributed personally to the attendees of the annual national FASD conference (n = 363). RESULTS Altogether 428 persons took part in the survey. 273 participants were professionals and 155 parents of children with FASD. More than 95% of the professionals and parents knew that alcohol consumption during pregnancy constitutes a risk for the child. The prevalence of maternal alcohol consumption and of FASD was underestimated. Although approx. 70% of the professionals knew which disorders belong to FASD just a few could tell their specific deficits. Questions regarding effective intervention for children with FASD and the long-term outcome were only partially answered correctly. DISCUSSION Professionals in the German health and social system are aware of FASD but underestimate the level of damage and the impact on every day functioning of the affected people.
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Affiliation(s)
- Mirjam N Landgraf
- Department of Paediatric Neurology and Developmental Medicine, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University LMU, Lindwurmstrasse 4, 80337, Munich, Germany.
| | - Lucia Albers
- Institute of Social Paediatrics and Adolescent Medicine, Ludwig-Maximilians-University LMU, Haydnstrasse 5, 80335, Munich, Germany
| | - Birte Rahmsdorf
- Department of Paediatric Neurology and Developmental Medicine, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University LMU, Lindwurmstrasse 4, 80337, Munich, Germany
| | - Katharina Vill
- Department of Paediatric Neurology and Developmental Medicine, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University LMU, Lindwurmstrasse 4, 80337, Munich, Germany
| | - Lucia Gerstl
- Department of Paediatric Neurology and Developmental Medicine, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University LMU, Lindwurmstrasse 4, 80337, Munich, Germany
| | - Michaela Lippert
- Department of Paediatric Neurology and Developmental Medicine, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University LMU, Lindwurmstrasse 4, 80337, Munich, Germany
| | - Florian Heinen
- Department of Paediatric Neurology and Developmental Medicine, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University LMU, Lindwurmstrasse 4, 80337, Munich, Germany
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Fegert JM, Harsch D, Plener PL. [Reducing barriers for participation of children with disability]. ZEITSCHRIFT FUR KINDER- UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2017; 45:95-97. [PMID: 28320251 DOI: 10.1024/1422-4917/a000514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Jörg M Fegert
- 1 Klinik für Kinder- und Jugendpsychiatrie und Psychotherapie, Universitätsklinik Ulm
| | - Daniela Harsch
- 1 Klinik für Kinder- und Jugendpsychiatrie und Psychotherapie, Universitätsklinik Ulm
| | - Paul L Plener
- 1 Klinik für Kinder- und Jugendpsychiatrie und Psychotherapie, Universitätsklinik Ulm
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