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The present study aimed at examining postnatal repairability of sodium valproate-induced skeletal alterations in rats. Sodium valproate (400 mg/kg) or the vehicle (distilled water) was orally administrated to pregnant Sprague-Dawley rats from gestation days 9 to 11. Fetuses and pups were obtained on gestation day 21 and postnatal day 11, respectively, and their skeletons were stained with Alizarin red S and Alcian blue and examined. Sodium valproate-induced costal and vertebral alterations in the fetuses included discontinued rib cartilage, fused rib, full or short supernumerary rib, bipart ossification of thoracic centrum, supernumerary lumbar vertebrae, and lumbarization. In pups, however, discontinued rib cartilage was not observed, and the incidence of a short supernumerary rib was significantly lower than that in the fetuses, suggesting that these alterations are postnatally repairable., (© 2017 Japanese Teratology Society.)

Background: Fetal Alcohol Spectrum Disorders (FASD) affect a significant number of children in this country. This article addresses diagnostic issues related to fetal alcohol syndrome (FAS) and other alcohol-related disabilities, discusses associated features and behaviors of FASD, and introduces interventions to support children with FASD in school settings., Methods: A comprehensive review of FAS and FASD literature as it relates to school functioning was conducted., Results: Prenatal alcohol exposure can result in a broad range of negative developmental consequences, including deficits in cognitive and academic functioning, psychological disorders, behavioral problems, and difficulties with independent living. Children with prenatal alcohol exposure are at risk for a spectrum of difficulties at school., Conclusions: This topic is of considerable relevance to all professionals in a school setting, including teachers, administrators, school psychologists, special education providers, special service providers, and school nurses who interact with children who may be prenatally exposed to alcohol. Successful interventions will need to balance the use of environmental modifications, immediate and meaningful positive and negative consequences for behaviors, and opportunities to teach children skills to monitor and modify their behavior.

The aim of the article is to describe the communication development of a child with Fetal Retinoid syndrome (FRS) from six months to seven years of age. Little is known about this rare acquired syndrome and its long-term implications, especially on a child's communication development. A descriptive, ex post facto research design was used to study the participant's communication development from 1996 when the family enrolled in an early communication intervention programme. Annual serial assessments of the participant and her family were conducted and the data were stored in a research database after each assessment. The results are described according to a 4-level assessment framework and indicated consistent, but moderate to minor delays in the participant's communication development with a mild hearing loss in the right ear, associated with ear anomalies. Although prenatal exposure to isotretinoin may have serious effects on the unborn fetus and even cause death, the participant did not display all the symptoms of FRS described in the literature. The favorable family circumstances, early commencement of intervention, and supporting early educational environments were protecting factors that could have contributed positively to the participant's communication development. The importance of knowledge accumulation about rare syndromes such as FRS in Communication Pathology and Audiology is discussed and guidelines for early identification, assessment and treatment applicable to the case are proposed as an intervention option.

The wide range of the congenital skeletal limb deficiencies caused difficulties with their classification. We present the most fundamentally and the most common classifications of the congenital skeletal defects.

In 1994 Alcohol Health & Research World (now titled Alcohol Research & Health) last devoted a full issue to the topic of fetal alcohol syndrome (FAS) and other alcohol-related birth defects (ARBD). This introductory article provides readers with information on how the field has advanced since then. In addition to tracing the development of the terminology used in the field, it describes the difficulties involved in determining the true prevalence of FAS and ARBD; the mechanisms that may play a role in alcohol-derived fetal injuries; approaches to preventing drinking during pregnancy; and strategies for assisting people who have been born with FAS and ARBD.

Although the number of women who have been exposed to diethylstilboestrol (DES) in the womb is relatively small (about 10,000 in the UK) professionals should be aware of the possible associated problems. The situation is very different in other countries. For example, in the Netherlands DES was in use until 1975 and up to that time more than 300,000 people were exposed. Throughout Europe and the USA the drug was in widespread use, giving thousands of women and their children unnecessary problems. The situation is very serious and has been compared to the scandal of Thalidomide exposure. In both cases the drug was used before proper toxicity tests had been carried out and its use continued long after the side-effects to the unborn child had become apparent. Therefore, it is important for professionals to make themselves aware of the problems associated with DES.

The purpose of this review is to familiarize physical therapists with the diagnostic, clinical, and behavioral characteristics associated with fetal alcohol syndrome (FAS) and other alcohol-related birth defects. Through review of FAS research studies of both humans and animals, the prevalence, pharmacokinetics, and clinical features of this syndrome are described. Deficits in the areas of cognitive, behavioral, and motor development are also described. Particular attention is given to neuromotor differences and orthopedic abnormalities associated with FAS that may require consultation or intervention from physical therapists.

We evaluated two neonates born within nine weeks of each other who had limb malformations and whose urine toxicology screenings were positive for cocaine metabolites and other drugs. Review of the literature indicates that fetal exposure to cocaine could lead to limb reduction deficits. The purpose of this report is to alert the physiatrist to a possible increase in incidence of limb malformation related to maternal cocaine use during pregnancy. The two cases are detailed, etiology is discussed, and the initial physiatric management is explained.

This paper highlights the need for methodologically sound research on the motor, cognitive and psychosocial development of children with congenital limb deficiencies and the integration of findings in these three areas. Such topics have received little attention in the literature and systematic attempts to apply developmental theory to the assessment, fitting, training and evaluation of these children seldom have been made. A number of important current issues in research and practice are critically reviewed including optimal age for fitting, training procedures, prosthesis usage, cognitive deficits and vulnerability to psychosocial problems. Recommendations for the adoption of a more holistic approach to research and practice with amputee children are presented and the need to develop strategies for systematic evaluation and follow up is emphasized.

An examination programme for assessing the functional capacities of the upper extremities with special regard to manual skills is presented. Experience involving 200 clients are reported on, permitting to assume the programme's usefulness in assessing functional disorders in the hand.

In 1985, 517 of the 2,486 thalidomide-affected Germans were interviewed by mail questionnaire concerning their educational and vocational situation. 250 usable returns were received, and the sample was found to correspond to the overall thalidomide-affected population in terms of age, sex, and residence, with the exception however of above-average social status and educational levels. 49.4% of the interviewees were gainfully employed, 23.7% students; 17.2% however were unemployed, undergoing retraining, or working in a workshop for the disabled. Contrasted to the German population as a whole, our sample included more university graduates and workers in service sector occupations, and fewer in the crafts or in clerical occupations. Women tended more towards social occupations, men more towards technical ones. On account of their disablement, many of our interviewees were inclined to accept white-collar employment, because their desired vocational objectives had been inaccessible to them due to purely technical difficulties or problems related to rejection by others. 80% nonetheless declared themselves content with their situation, only those in a workshop for the disabled were less satisfied on an average. Contentness was found to be linked more with job satisfaction than with the extent of disablement. About one third of our sample lived with their parents, only four in residential accommodation. More than 75% could be considered independent and needing no outside assistance, with the same share holding a driver's licence. In 90%, the majority of private or occupational contacts, or even all of them, were maintained with nondisabled people. More than 80% considered themselves financially and socially equal to their fellow workers.

Thalidomide-induced deformities, affecting some 400 British children, caused various combinations of malformations. Classified by type of defect and whether confined to upper and/or lower limbs, the malformations can be treated on a radional basis. The treatment from infancy to the present time includes the fitting of carbon dioxide gas-powered upper limb prostheses, initially in their simplest form and finally in the most sophisticated form. For a baby with bilateral lower phocomelia, a special "sitting socket" was devised to enable sitting in an upright position. When each child was about 12 to 15 months of age, extension protheses were supplied and the effects on walking when upper limbs are malformed or absent were noted. The methods of achieving personal independence and developing constructive youngests' pastimes are important. One patient was so well rehabilitated that she was able to marry and start a healthy family.

This paper describes the work carried out at the Rehabilitation Engineering Unit, Chailey Heritage Hospital, in applying carbon fibre reinforced plastic CFRP to prosthetics and orthotics. The prosthetic application relates to the construction of the Chailey Harness which was used to mount externally powered, upper limb prostheses to the torso of limb deficient children damaged by the drug Thalidomide. The application to orthotics was limited to Hip-Knee-Ankle-Orthoses (HKAO) as worn by severely handicapped children with spina bifida and led to the development of a shapable CFRP/aluminium alloy hybrid composite bar. The construction of the composite, its properties and the assembly and performance of the first orthoses are described. Some of the practical problems experienced with the use of carbon fibre reinforced plastic are identified.

The habilitation of 34 thalidomide children, begun in 1963 at the Rehabilitation Institute of Montreal, involved the contribution of many medical and paramedical disciplines. These individual contributions are described.Habilitation of congenitally deformed children must be initiated at an early age. The early prescription of a prosthesis is desirable. Their care involves a broad range of services that must be continued over many years. Parents require support before they can accept the misfortune that has befallen them and their deformed child. Despite the necessity of frequent hospitalizations, children should be reared in a home setting. From their experience, the authors conclude that children born with malformations, and their parents, should be thoroughly evaluated and followed up for many years; and recommend that governments should finance programs for the complete habilitation of all children born with congenital malformations. National registries for the compulsory recording of birth deformities should also be established.