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Systematic review of interventions for children with Fetal Alcohol Spectrum Disorders.

Peadon E, Rhys-Jones B, Bower C, Elliott EJ - BMC Pediatr (2009)

Bottom Line: Early diagnosis may decrease the risk of adverse life outcomes.However, little is known about effective interventions for children with FASD.Pharmacological interventions, evaluated in two studies (both RCT) showed some benefit from stimulant medications.

View Article: PubMed Central - HTML - PubMed

Affiliation: Discipline of Paediatrics and Child Health, University of Sydney, Australia. elizabp5@chw.edu.au

ABSTRACT

Background: Children with Fetal Alcohol Spectrum Disorders (FASD) may have significant neurobehavioural problems persisting into adulthood. Early diagnosis may decrease the risk of adverse life outcomes. However, little is known about effective interventions for children with FASD. Our aim is to conduct a systematic review of the literature to identify and evaluate the evidence for pharmacological and non-pharmacological interventions for children with FASD.

Methods: We did an electronic search of the Cochrane Library, MEDLINE, EMBASE, PsychINFO, CINAHL and ERIC for clinical studies (Randomized controlled trials (RCT), quasi RCT, controlled trials and pre- and post-intervention studies) which evaluated pharmacological, behavioural, speech therapy, occupational therapy, physiotherapy, psychosocial and educational interventions and early intervention programs. Participants were aged under 18 years with a diagnosis of a FASD. Selection of studies for inclusion and assessment of study quality was undertaken independently by two reviewers. Meta-analysis was not possible due to diversity in the interventions and outcome measures.

Results: Twelve studies met the inclusion criteria. Methodological weaknesses were common, including small sample sizes; inadequate study design and short term follow up. Pharmacological interventions, evaluated in two studies (both RCT) showed some benefit from stimulant medications. Educational and learning strategies (three RCT) were evaluated in seven studies. There was some evidence to suggest that virtual reality training, cognitive control therapy, language and literacy therapy, mathematics intervention and rehearsal training for memory may be beneficial strategies. Three studies evaluating social communication and behavioural strategies (two RCT) suggested that social skills training may improve social skills and behaviour at home and Attention Process Training may improve attention.

Conclusion: There is limited good quality evidence for specific interventions for managing FASD, however seven randomized controlled trials that address specific functional deficits of children with FASD are underway or recently completed.

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Related in: MedlinePlus

Flow chart of the study selection process. *Studies were excluded if they were animal studies; did not include children aged 0 to 18 years with FASD; or did not evaluate an intervention.
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Figure 1: Flow chart of the study selection process. *Studies were excluded if they were animal studies; did not include children aged 0 to 18 years with FASD; or did not evaluate an intervention.

Mentions: We identified 6263 studies using our search strategy (Figure 1). After exclusion of ineligible studies (animal studies, people with FASD aged over eighteen years and studies which did not evaluate an intervention), only twelve studies fulfilled our inclusion criteria. These included six RCT; one quasi-RCT; one controlled trial; and four pre- and post- intervention studies. Of these, two studies evaluated pharmacological interventions (total n participants = 16), seven studies evaluated educational and learning strategies (n = 167), two evaluated social skills and communication (n = 101), and one evaluated a behavioural intervention (n = 20).


Systematic review of interventions for children with Fetal Alcohol Spectrum Disorders.

Peadon E, Rhys-Jones B, Bower C, Elliott EJ - BMC Pediatr (2009)

Flow chart of the study selection process. *Studies were excluded if they were animal studies; did not include children aged 0 to 18 years with FASD; or did not evaluate an intervention.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2698825&req=5

Figure 1: Flow chart of the study selection process. *Studies were excluded if they were animal studies; did not include children aged 0 to 18 years with FASD; or did not evaluate an intervention.
Mentions: We identified 6263 studies using our search strategy (Figure 1). After exclusion of ineligible studies (animal studies, people with FASD aged over eighteen years and studies which did not evaluate an intervention), only twelve studies fulfilled our inclusion criteria. These included six RCT; one quasi-RCT; one controlled trial; and four pre- and post- intervention studies. Of these, two studies evaluated pharmacological interventions (total n participants = 16), seven studies evaluated educational and learning strategies (n = 167), two evaluated social skills and communication (n = 101), and one evaluated a behavioural intervention (n = 20).

Bottom Line: Early diagnosis may decrease the risk of adverse life outcomes.However, little is known about effective interventions for children with FASD.Pharmacological interventions, evaluated in two studies (both RCT) showed some benefit from stimulant medications.

View Article: PubMed Central - HTML - PubMed

Affiliation: Discipline of Paediatrics and Child Health, University of Sydney, Australia. elizabp5@chw.edu.au

ABSTRACT

Background: Children with Fetal Alcohol Spectrum Disorders (FASD) may have significant neurobehavioural problems persisting into adulthood. Early diagnosis may decrease the risk of adverse life outcomes. However, little is known about effective interventions for children with FASD. Our aim is to conduct a systematic review of the literature to identify and evaluate the evidence for pharmacological and non-pharmacological interventions for children with FASD.

Methods: We did an electronic search of the Cochrane Library, MEDLINE, EMBASE, PsychINFO, CINAHL and ERIC for clinical studies (Randomized controlled trials (RCT), quasi RCT, controlled trials and pre- and post-intervention studies) which evaluated pharmacological, behavioural, speech therapy, occupational therapy, physiotherapy, psychosocial and educational interventions and early intervention programs. Participants were aged under 18 years with a diagnosis of a FASD. Selection of studies for inclusion and assessment of study quality was undertaken independently by two reviewers. Meta-analysis was not possible due to diversity in the interventions and outcome measures.

Results: Twelve studies met the inclusion criteria. Methodological weaknesses were common, including small sample sizes; inadequate study design and short term follow up. Pharmacological interventions, evaluated in two studies (both RCT) showed some benefit from stimulant medications. Educational and learning strategies (three RCT) were evaluated in seven studies. There was some evidence to suggest that virtual reality training, cognitive control therapy, language and literacy therapy, mathematics intervention and rehearsal training for memory may be beneficial strategies. Three studies evaluating social communication and behavioural strategies (two RCT) suggested that social skills training may improve social skills and behaviour at home and Attention Process Training may improve attention.

Conclusion: There is limited good quality evidence for specific interventions for managing FASD, however seven randomized controlled trials that address specific functional deficits of children with FASD are underway or recently completed.

Show MeSH
Related in: MedlinePlus