Acceso usuarios
Yuri E. Vega Rodríguez
, Elena Garayzábal, Esther Moraleda Sepúlveda
En población infantil que presenta Trastornos del Espectro Alcohólico Fetal (TEAF) se observan manifestaciones clínicas que interfieren en el desarrollo del lenguaje y la comunicación y que, por tanto, afectan su inclusión social. Por ello, se hace necesario que desde el ámbito fonoaudiológico como educativo se conozcan las características que presenta esta población. El objetivo de este estudio fue conocer la evidencia científica actual y disponible, específicamente sobre las características lingüísticas y comunicativas en TEAF. Para ello se realizó una revisión de la literatura científica sobre el tema, en artículos publicados desde 2010 a 2020 en las bases de datos Pubmed, Scopus, Ebsco, ScienceDirect, en población menor de edad. Tras la revisión de criterios de inclusión sobre los títulos y resúmenes, se analizó con el programa Atlas Ti 7.5.4. el contenido de 34 publicaciones a través de una codificación abierta de los textos, para la identificación de dimensiones de significado emergente. Se obtuvieron diferentes dimensiones en relación al lenguaje expresivo, características comunicativas y sociales, lenguaje comprensivo y características motoras orales, y se observaron alteraciones en todas ellas. La diversidad de alteraciones lingüísticas y comunicativas que presenta la población con TEAF demanda que reciba de manera temprana intervención fonoaudiológica que le permita el desarrollo de habilidades necesarias para un mejor desempeño educativo e inclusión social.
Alcohol is a teratogen, and exposure to alcohol during pregnancy can damage developing fetus generating three types of key features: (a) alterations in prenatal and postnatal growth; (b) dysmorphic facial features (flattened midface and upper jaw, short palpebral fissures, including long narrow upper lip, flat philtrum); (c) and central nervous system (CNS) dysfunction. These features are commonly known as fetal alcohol spectrum disorders (FASDs). In children with (FASD), there are a spectrum of deficits including cognitive disorders, memory impairment, problems in executive functions, learning disorders, attention deficits, and psychopathology disabilities. All these features clinical features interfere with the development of language and communication and, as a result, affect their social inclusion. Therefore, it is necessary for both speech therapists and specialists in education to be aware of these population features. The purpose of this review is to know the current and available scientific evidence specifically on the linguistic and communicative features in FASD. A review of the scientific literature on the linguistic and communicative features in FASD was carried out, in articles published from 2010 to 2020 in the Pubmed, Scopus, Ebsco, ScienceDirect databases, in the underage population with FASD, with the keywords:
"Fetal Alcohol Spectrum Disorders" and "Communication Disorders". The latter was selected because its subcategories include both speech and language disorders and communication disorders. After reviewing the inclusion criteria on titles and abstracts, the content of 34 publications was analyzed through open coding in ATLAS TI program, to identify dimensions of emerging meaning. Clusters emerged in relation to expressive language, communicative and social features, comprehensive language, and oral motor features. Some of the codes described in these clusters are: difficulties in oral motor skills and speech development, low intelligibility, low auditory discrimination, possible processing disorders, receptive language difficulties, low lexical diversity, difficulties in passive vocabulary, grammatical deficits, deficits in morphological and syntactic development, alterations in elements of the macro and microstructure of the oral narrative, they are active and communicative but have pragmatic deficits, deficits in social skills and in social cognition. Difficulty establishing relationships with peers their own age, so they have better relationships with younger children. As these children get older, the social difficulties are greater. Clusters also emerged related to developmental contexts, adverse childhood, behavioral and cognitive difficulties, co-morbidities and the need for an interdisciplinary approach. Within these groups, the following codes stand out: low intellectual functioning, cognitive deficits, memory difficulties, deficits in executive functions, difficulties in visuospatial skills, learning disorders, deficits in self-regulation, in impulse control, behavioral disorders, and reactive attachment disorder. These children are often in foster and adoptive homes. This population in young and adult age is likely to enter the criminal justice system. An early and multidisciplinary approach is essential, such as psychiatric, pharmacological, physiotherapeutic, psychological, nutritional, ophthalmological, otorhinolaryngological, dental, sensory integration and occupational therapy support, among others. It is observed that the diversity of linguistic and communicative impairments in the population with FASD, together with other intervening factors of comorbidity, increase these impairments, and it justifies that they receive both speech-language therapy in a timely manner to help develop the linguistic and communication skills necessary for better educational performance and social inclusion, as well as multidisciplinary and collaborative care, in the different contexts in which people with FASD participate.
When there is the presence of complex clinical profiles, involving language, cognitive, behavioral, social, attention difficulties, and in effective social communication, among others, a great challenge is presented for professionals who intervene with these school-age children.
