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Neuropsychological Profile of an Adopted Patient with Fetal Alcohol Spectrum Disorder


Background: Prenatal exposure to alcohol causes a variety of clinical manifestations known as fetal alcohol spectrum disorder (FASD), with neurodevelopmental effects, among others. Alcoholism is common among mothers of children adopted from Spanish institutions, especially from Eastern Europe. Methods: A 17-year old boy, born in Ukraine and adopted by a Spanish family at the age of two was referred to the Genetics Unit because of psychomotor delay and facial dysmorphia. He is the product of an unknown controlled pregnancy, and had a sister with psychomotor retardation. The presence of dysmorphic features was detected in infancy by the Medical Genetics Unit, as well as psychomotor and pondostatural growth retardation. At the age of 7 he developed inattention and hyperactivity, as well as anxiety and depressive symptoms. The child was evaluated by the Neuropediatrics and Psychiatry Unit. Subsequently, the child was evaluated at school and by the Environmental Pediatric Service. Results: He presented with behavioral problems and poor school performance, limited IQ and verbal reasoning capacity below average, as well as significant curricular gaps in grammatics, mathematics and languages and difficulties in social relationships. He did not show an adequate level of autonomy, all in the context of FASD. The child was diagnosed with FASD. Conclusions: Patients with FASD may have a normal or decreased IQ, from minimum to profound mental retardation. Executive functions are the most frequently afected. In addition, they usually have poor performance in behavioral inhibition and self-control, verbal and nonverbal fluency, organization and planning. Other manifestations include difficulties in the area of mathematics and social communication because of language disorders. Problems in socialization are influenced by understimulation, common in adopted children. Behavioral problems, substance use, sexual behavior and psychotic disorders are also common. Early diagnosis and intervention and psychopedagogical treatment seem to achieve an improvement in the neurodevelopment of these patients.
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