The Toronto experience: DISCUSSION(8)

The Toronto experience: DISCUSSION(8)

We are using the results from this study to improve our classification system. We have refined our diagnostic checklist to reflect our major significant findings and are developing an index of severity assigning numerical values to the traits. We are also attempting to limit the degree of clinical judgment needed to interpret each case.

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The Toronto experience: DISCUSSION(7)

For children who remain in the care of a substance-abusing caregiver, there is the potential for environmental factors to adversely affect cognitive and socioemotional development, by exacerbating the pre-existing effects of prenatal exposure or by creating different problems altogether. Future studies may attempt to decipher which neu-rodevelopmental effects are associated more with the alcohol toxicity in utero and which are associated with having an alcoholic parent at some point during childhood. This might be accomplished by comparing sample populations of children who have been taken into care from birth (and placed into relatively stable homes) with children who have remained in the care of their biological parent(s). buy asthma inhaler

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The Toronto experience: DISCUSSION(6)

The Toronto experience: DISCUSSION(6)

Very recently, researchers at the Hospital For Sick Children have developed a method to test meconium, as well as neonatal and maternal hair samples, for information about type and duration of prenatal substance exposure. This advance offers great potential for overcoming the aforementioned problem about confirmation of exposure history among ARND sample populations. However, because children with ARND do not present with the obvious physical signs of prenatal alcohol exposure that are apparent in the full-blown syndrome, physicians may be less inclined to identify the need to use this test with neonates with suspected or known prenatal alcohol exposure. This raises an important issue with respect to awareness: comprehensive training of medical practitioners, especially obstetricians and pediatricians, in the area of prenatal exposure and its devastating consequences may be the first step in increasing the likelihood that a substance abuse problem will be recognized and responded to early on, either before or during pregnancy, or shortly thereafter.

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The Toronto experience: DISCUSSION(5)

Research on the effects of prenatal exposure to alcohol has been limited by a number of factors. In many of the attempts to define the characteristics associated with ARND, the focus has been on identifying weaknesses even though the children are well known to have a number of personal strengths. Few studies, including the current one, have been able to include specific measures of both dose and timing of alcohol exposure during pregnancy. The main measure for the majority of studies consists simply of knowledge that children were born to mothers who abused alcohol heavily. Buy Asthma Inhalers Online

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The Toronto experience: DISCUSSION(4)

The Toronto experience: DISCUSSION(4)

This study has extended the scope of knowledge by providing further confirmation that significant deficits persist in the absence of physical features associated with prenatal alcohol exposure, by providing further evidence of specific, well-standardized and accessible measures that appear to be particularly sensitive to the effects of prenatal alcohol exposure, and by presenting a statistically replicable and clinically useful method for identifying ARND. It is not clear, however, whether our inclusion of areas of strength, or assets, within the diagnostic process has facilitated the process because the groups did not differ significantly in number or type of asset. Furthermore, there may be other assets that we have not considered, which may prove to be more discriminating between an ARND and a non-ARND population. buy ortho tri-cyclen online

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The Toronto experience: DISCUSSION(3)

In the present study, both groups of children had clinically elevated scores on measures of attention, as was also noted by Nanson and Hiscock , who compared FAS/fetal alcohol effects subjects with an ADHD sample. The absence of significant differences between the ARND and comparison groups in this domain is important in light of the difference between our two groups in their rates of ADHD. ADHD was more likely to have been diagnosed in the children in the ARND group than in children in the comparison group. One might interpret this difference as a confounding factor in the study. And yet, the increased likelihood of ADHD per se being diagnosed among the ARND group cannot, it seems, account for the differences seen across other areas of functioning given that both groups presented with clinically elevated scores on indexes of attention problems. Children in the ARND group did not have significantly more severe attention problems than children in the comparison group (as indicated by the lack of statistical differences on relevant measures). buy asthma inhalers

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The Toronto experience: DISCUSSION(2)

The Toronto experience: DISCUSSION(2)

These results are generally consistent with previous research that has found major cognitive problems among people exposed to alcohol in utero, even in the absence of marked physical dysmorphology . However, our challenge was to establish the defining characteristics of ARND, which can be used in diagnosis. Although our approach revealed a set of consistent deficits, the ARND group did not differ from the non-ARND group in their specific assets. buy ortho tri-cyclen

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