Dr. Perlstein received his Medical Degree from the University of Cincinnati and then completed his internship and residency in pediatrics at The New York Hospital, Cornell medical Center in New York City. After serving an additional year as Chief Pediatric Resident, he worked as a private practitioner and then was appointed Director of Ambulatory Pediatrics at St. Barnabas Hospital in the Bronx.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Behavior and education therapy can be an important part of treatment for children with FASDs. Although there are many different types of therapy for children with developmental disabilities, only a few have been scientifically tested specifically for children with FASDs.
Following are behavior and education therapies that have been shown to be effective for some children with FASDs:
Friendship training
Many children with FASDs have a hard time making friends, keeping friends, and socializing with others. Friendship training teaches children with FASDs how to interact with friends, how to enter a group of children already playing, how to arrange and handle in-home play dates, and how to avoid and work out conflicts. A research study found that this type of training could significantly improve children's social skills and reduce problem behaviors.
Specialized math tutoring
A research study found that special teaching methods and tools can help improve math knowledge and skills in children with FASDs.
Executive functioning training
This type of training teaches behavioral awareness and self-control and improves executive functioning skills, such as memory, cause and effect, reasoning, planning, and problem solving.
Parent-child interaction therapy
This type of therapy aims to improve parent-child relationships, create a positive discipline program, and reduce behavior problems in children with FASDs. Parents learn new skills from a coach. A research study found significant decrease in parent distress and child behavior problems.
Parenting and behavior management training
The behavior and learning problems that affect children with FASDs can lead to high levels of stress for the children's parents. This training can improve caregiver comfort, meet family needs, and reduce child problem behaviors.
SOURCE:
U.S. Centers for Disease Control and Prevention
What is fetal alcohol syndrome?
Although the dangers of alcohol during pregnancy had long been suspected,
fetal alcohol syndrome (FAS) was formally described in 1968 by P. Lemoine and
colleagues from Nantes (France) in 127 children of alcoholicparents. Their
report in a French pediatric journal drew little attention. Focus on FAS only
came after it was independently redescribed in 1973 by K.L. Jones and colleagues
from Seattle (U.S.) in eight children of mothers with chronic alcoholism. Their
report in the British medical journal The Lancet triggered an avalanche of
reports of FAS.
Alcohol is capable of causing birth defects. This capability classifies
it medically as a teratogen. Alcohol is now recognized as the leading
teratogen to which the fetus is likely to be exposed. This applies only to
societies in which alcoholic beverages are consumed. In these populations,
prenatal alcohol exposure is thought to be the most common cause of mental
retardation. In fact, according to research published in Pediatrics, alcohol use among women of childbearing age (18-44 years) "constitutes a leading, preventable cause of birth defects and developmental disabilities in the U.S."
What are fetal alcohol syndrome
symptoms and signs?
Most of the features of FAS are variable. They may or may not be
present in a given child. However, the most common and consistent features
of FAS involve the growth, performance, intelligence, head and face,
skeleton, and heart of the child.
Growth is diminished. Birth weight is lessened. Retardation of
longitudinal growth is evident on the measurements of length in infancy
and of standing height later in childhood. The growth lag is permanent.
Performance is impaired. The FAS infant is irritable. The older FAS
child is hyperactive. Fine motor skills are impaired with weak grasp, poor
hand-eye coordination, and tremors.
Intelligence is diminished. The average IQ is in the 60s. (This level
is considered mild mental retardation and qualifies a child in the U.S. as
educable mentally retarded.)
The head is small (microcephalic). This decrease may not even be
apparent to family and friends. It is evident upon comparison of the
child's head circumference to that of a normal child on a growth chart.
The usual degree of microcephaly in FAS is classified as mild to moderate.
It is primarily due to failure of brain growth. The consequences are
neither mild nor moderate.
The face is characteristic with short eye openings (palpebral fissures),
sunken nasal bridge, short nose, flattening of the cheekbones and midface,
smoothing and elongation of the ridged area (the philtrum) between the
nose and lips, and smooth, thin upper lip.
The skeleton shows characteristic changes; abnormal position and
function of joints, shortening of the metacarpal bones leading to the
fourth and fifth fingers, and shortening of the last bone (the distal phalanx) in
the fingers. There is also a small fifth fingernail and a single transverse
(simian) crease across the palm.
A heart murmur is often heard and then may go away. The basis is usually
a hole between the right and left sides of the heart between the
ventricles (the lower chambers) or less commonly, the atria (the upper
chambers).
A number of other birth defects can occur in children with FAS. These
include such major birth deformities such as hydrocephalus (increased
fluid pressure on the brain that may require shunting to relieve the
pressure), cleft lip (sometimes with a cleft palate), coarctation
(narrowing) of the aorta, and meningomyelocele (spina bifida).
Alcoholism is a disease that includes alcohol craving and continued drinking despite repeated alcohol-related problems, such as losing a job or getting into trouble with the law.
Tremor is the involuntary movements of one or more parts of the body. Causes of tremor include neurological disorders, neurodegenerative diseases, drugs, mercury poisoning, overactive thyroid and liver failure. There are several types of tremor. Treatment depends upon the type of tremor and availability of medications for the condition.
Hydrocephalus is an abnormal buildup of cerebrospinal fluid (CSF) in the ventricles of the brain. The fluid is often under increased pressure and can compress and damage the brain. Symptoms of hydrocephalus vary with age, progression of the disease, and individual tolerance to the condition. Hydrocephalus is most often treated by surgery in which a shunt system is inserted.
A heart murmur is the sound generated when blood flow within the heart is not smooth. Causes of heart murmurs can be functional, congenital, or caused heart valve conditions. Symptoms of a heart murmur may be none, or may include chest pain, shortness of breath, and arm, leg, and ankle swelling. Treatment of a heart murmur depends on the cause.
Learning disabilities can cause an individual to have trouble learning and using skills such as reading, listening, writing, reading, speaking, reasoning, and performing mathematics. There is no cure for learning disabilities. Parents and teachers working together to properly diagnose learning disabilities can properly plan a course of education. For some, medication may be appropriate as complimentary treatment.
Birth defects have many causes and currently, are the leading cause of death for infants in the first year of life. Some of the causes of birth defects include genetic or chromosome problems. Exposure of the mother to rubella or German measles during pregnancy, or using drugs or alcohol during pregnancy. The treatment for birth defects depends upon the condition of the effected child.
Pregnancy planning is important to help prevent exposure of the mother and fetus to potentially harmful medications and substances during the early days, and throughout the pregnancy. Nutritional planning, prevention of birth defects, conditions such as high blood pressure, heart disease, diabetes, and kidney disease need careful monitoring. Gestational diabetes, preeclampsia, and pregnancy induced hypertension are conditions that may arise during pregnancy. Immunizations, inherited disorders, exercise, air travel, intercourse, and birth control are important factors to consider when planning a pregnancy.
Spina bifida is the most common neural tube defect in the United States. There are four types of spina bifida; 1) occulta, 2) closed neural tube defects, 3) meningocele, and 4) myelomeningocele. The cause of spina bifida is not known. Theories include genetic, nutritional, and environmental factors. Lack of folic acid during pregnancy is highly suspected. Symptoms of spina bifida vary from individual to individual. Treatment depends on the type of spina bifida the person suffers.
Good parenting helps foster empathy, honesty, self-reliance, self-control, kindness, cooperation, and cheerfulness, says Steinberg, a distinguished professor of psychology at Temple University in Philadelphia. It also promotes intellectual curiosity, motivation, and desire to achieve. It helps protect children from developing anxiety, depression, eating disorders, antisocial behavior, and alcohol and drug abuse.
Microcephaly is a genetic condition where the circumference of the head is smaller than normal due to underdeveloped brain. Microcephaly is caused by genetic abnormalities, or from abuse of alcohol, drugs, infection (for example, German measles or chickenpox), exposure to toxins, or PKU while the mother is pregnant. Symptoms of microcephaly depend upon the severity of the accompanying syndrome. There is not treatment for microcephaly.
Cleft palate and cleft lip are facial and oral defects that occur early in pregnancy. A cleft lip is a split of the two sides of the upper lip, and a cleft palate is a split in the roof of the mouth. Cleft lip the fourth most common birth defect in the U.S. Repair of a cleft palate or cleft lip may require multiple surgeries.
Children's health is focused on the well-being of children from conception through adolescence. There are many aspects of children's health, including growth and development, illnesses, injuries, behavior, mental illness, family health and community health.
Taking prescription medications or over-the-counter drugs or supplements should be discussed with your doctor. There are some medications that have been found to cause no problems in pregnancy, however, medications such as Accutane for acne, should never be taken during pregnancy.
The human nervous system develops from a small, specialized plate of cells
along the back of an embryo. Early in
development, the edges of this plate begin to curl up toward each other,
creating the neural tube—a narrow sheath that closes to form the brain and spinal cord of the
embryo. As development progresses, the top of the tube becomes the brain and the
remainder becomes the spinal cord. This process is usually complete by the 28th
day of pregnancy. But
if problems occur during this process, the result can be brain disorders called
neural tube defects, including spina bifida.
What is spina bifida?
Spina bifida, which literally means "cleft spine," is characterized by the
incomplete development of the brain, spinal cord, and/or meninges (the
protective covering around the brain and spinal cord). It is the most common
neural tube defect in the United States
- affecting ...
Pregnancy RSS
Healthy Living Tips
This site complies with the