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      Efectos de la neurorrehabilitación sobre el trastorno del espectro alcohólico fetal: un estudio de caso único Translated title: Neurorehabilitation effects on fetal alcohol spectrum disorders: a single case study

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          Abstract

          Resumen: La presente investigación consistió en un estudio de caso único de un niño de 10 años, procedente de adopción internacional, con síntomas compatibles con trastorno del espectro alcohólico fetal (TEAF). Debido a la complejidad sintomatológica del trastorno y de su diagnóstico, en la actualidad no existen tratamientos contrastados. El estudio comenzó con una evaluación neurocognitiva donde se observaron alteraciones en atención, memoria y funciones ejecutivas, que se manifestaron en una gran impulsividad, así como en dificultades para la autorregulación. Se diseñó un programa de neurorreha- bilitación, de 96 sesiones, centrado en el abordaje multidisciplinar de los aspectos cognitivos, conductuales y funcionales alterados. La aplicación del programa de rehabilitación produjo mejora general en la capacidad funcional del paciente, destacando los procesos de atención y en la capacidad de autorregulación. Los resultados obtenidos ponen en valor la aplicación de programas de neurorrehabilitación multidisciplinares al revelarse como una herramienta eficaz en el tratamiento de la sintomatología clínica del TEAF y la mejora en la adaptación de los pacientes a las exigencias de su vida diaria.

          Translated abstract

          Abstract: The present investigation consisted of a single case study of a 10-year-old child from international adoption with symptoms of Fetal Alcohol Spectrum Disorder (FASD). Due to the symptomatological complexity of the disorder and its diagnosis, currently there are no effective treatments. The study started with a neurocognitive evaluation where alterations in attention, memory and executive functions were observed, which manifested themselves in great impulsivity, as well as in difficulties in self-regulation. A 96-ses- sion neurorehabilitation program was designed, focusing on a multidisciplinary approach to the altered cognitive, behavioral and functional aspects. The application of the rehabilitation program produced a general improvement in the patient's functional capacity, specially in attention processes and the capacity for self-regulation. The results obtained highlight the value of the application of multidisciplinary neurorehabilitation programs as an effective tool in the treatment of the clinical symptoms of FASD and the improvement in the adaptation of patients to the demands of their daily lives.

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          Most cited references80

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          Studies of interference in serial verbal reactions.

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            Interactions between attention and working memory.

            Studies of attention and working memory address the fundamental limits in our ability to encode and maintain behaviorally relevant information, processes that are critical for goal-driven processing. Here we review our current understanding of the interactions between these processes, with a focus on how each construct encompasses a variety of dissociable phenomena. Attention facilitates target processing during both perceptual and postperceptual stages of processing, and functionally dissociated processes have been implicated in the maintenance of different kinds of information in working memory. Thus, although it is clear that these processes are closely intertwined, the nature of these interactions depends upon the specific variety of attention or working memory that is considered.
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              Updated Clinical Guidelines for Diagnosing Fetal Alcohol Spectrum Disorders.

              The adverse effects of prenatal alcohol exposure constitute a continuum of disabilities (fetal alcohol spectrum disorders [FASD]). In 1996, the Institute of Medicine established diagnostic categories delineating the spectrum but not specifying clinical criteria by which diagnoses could be assigned. In 2005, the authors published practical guidelines operationalizing the Institute of Medicine categories, allowing for standardization of FASD diagnoses in clinical settings. The purpose of the current report is to present updated diagnostic guidelines based on a thorough review of the literature and the authors' combined expertise based on the evaluation of >10 000 children for potential FASD in clinical settings and in epidemiologic studies in conjunction with National Institute on Alcohol Abuse and Alcoholism-funded studies, the Collaborative Initiative on Fetal Alcohol Spectrum Disorders, and the Collaboration on FASD Prevalence. The guidelines were formulated through conference calls and meetings held at National Institute on Alcohol Abuse and Alcoholism offices in Rockville, MD. Specific areas addressed include the following: precise definition of documented prenatal alcohol exposure; neurobehavioral criteria for diagnosis of fetal alcohol syndrome, partial fetal alcohol syndrome, and alcohol-related neurodevelopmental disorder; revised diagnostic criteria for alcohol-related birth defects; an updated comprehensive research dysmorphology scoring system; and a new lip/philtrum guide for the white population, incorporating a 45-degree view. The guidelines reflect consensus among a large and experienced cadre of FASD investigators in the fields of dysmorphology, epidemiology, neurology, psychology, developmental/behavioral pediatrics, and educational diagnostics. Their improved clarity and specificity will guide clinicians in accurate diagnosis of infants and children prenatally exposed to alcohol.
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                Author and article information

                Journal
                neuropsiq
                Revista de la Asociación Española de Neuropsiquiatría
                Rev. Asoc. Esp. Neuropsiq.
                Asociación Española de Neuropsiquiatría (Madrid, Madrid, Spain )
                0211-5735
                2340-2733
                June 2023
                : 43
                : 143
                : 89-115
                Affiliations
                [1] Madrid Madrid orgnameUniversidad Rey Juan Carlos orgdiv1Facultad de Ciencias de la Salud orgdiv2Área de Psicobiología Spain
                [2] Madrid orgnameUniversitaria de la Universidad Rey Juan Carlos orgdiv1Fundación Clínica orgdiv2Servicio de Neurorrehabilitación España
                [3] Madrid orgnameHospital Universitario 12 de Octubre orgdiv1Unidad de Salud Mental Infanto-juvenil España
                Article
                S0211-57352023000100006 S0211-5735(23)04314300006
                10.4321/s0211-57352023000100006
                68f0750b-bb0c-408a-8035-9cb6d55d3876

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 13 June 2022
                : 24 January 2023
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 80, Pages: 27
                Product

                SciELO Spain

                Categories
                Artículos

                disfunción cognitiva,trastorno del espectro alcohólico fetal,neurorrehabi- litación,neuropsicología,terapia ocupacional,cognitive dysfunction,fetal alcohol spectrum disorder,neurorehabilitation,neuropsychology,occupational therapy

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