Paley Blair, O'Connor Mary J
Department of Psychiatry and Biobehavioral Sciences, Semel Institute of Neuroscience and Human Behavior, David Geffen School of Medicine at UCLA, Los Angeles, California 90024, USA.
Dev Disabil Res Rev. 2009;15(3):258-67. doi: 10.1002/ddrr.67.
Exposure to alcohol in utero is considered to be the leading cause of developmental disabilities of known etiology. The most severe consequence of such exposure, fetal alcohol syndrome (FAS), is characterized by a distinct constellation of characteristic facial anomalies, growth retardation, and central nervous system (CNS) dysfunction. Some individuals with prenatal alcohol exposure (PAE) do not meet the full criteria for FAS, but instead are diagnosed with partial FAS, alcohol related neurodevelopmental disorder (ARND), or alcohol related birth defects (ARBD). The entire continuum of effects from PAE is increasingly being referred to under the umbrella term of fetal alcohol spectrum disorders (FASDs). An extensive body of research has documented major cognitive, behavioral, adaptive, social, and emotional impairments among individuals with FASDs. Although FAS was identified in the U.S. over 35 years ago, the development, evaluation, and dissemination of evidence-based interventions for individuals with FASDs have lagged behind significantly. Encouragingly, however, in recent years there has been a marked increase in efforts to design and test interventions to remediate the impairments associated with prenatal alcohol exposure. This article will review treatment needs and considerations for individuals with FASDs and their families, current empirically tested treatment approaches, case management issues, and suggestions for future directions in research on the treatment of FASDs.
子宫内酒精暴露被认为是已知病因导致发育障碍的主要原因。这种暴露最严重的后果是胎儿酒精综合征(FAS),其特征是一系列独特的面部特征异常、生长发育迟缓以及中枢神经系统(CNS)功能障碍。一些有产前酒精暴露(PAE)的个体不符合FAS的全部标准,而是被诊断为部分FAS、酒精相关神经发育障碍(ARND)或酒精相关出生缺陷(ARBD)。PAE产生的一系列影响越来越多地被统称为胎儿酒精谱系障碍(FASDs)。大量研究记录了FASDs个体存在的主要认知、行为、适应、社交和情感障碍。尽管35多年前美国就已发现FAS,但针对FASDs个体的循证干预措施的开发、评估和推广却明显滞后。然而,令人鼓舞的是,近年来设计和测试干预措施以纠正与产前酒精暴露相关障碍的努力显著增加。本文将回顾FASDs个体及其家庭的治疗需求和注意事项、当前经过实证检验的治疗方法、病例管理问题以及FASDs治疗研究未来方向的建议。