What form of congenital retardation is she most likely to have?

Question

A foster mother brings a 4-year-old child to see you for an evaluation. She has had custody of the girl for 2 weeks. She knows that the child was born in your state and that her maternal grandmother had custody for 6 months. She received good medical care during that time, but after her biologic mother obtained custody the child was abused and has had no further medical care. She says the child has had many behavioral problems and seems to be very behind on her developmental tasks. When you examine the child you notice short palpebral fissures, a wide nasal philtrum, and thin lips. Her cardiac, pulmonary, musculoskeletal, and abdominal examinations are normal. Her Denver Developmental Screening Test shows most of her milestones have occurred only through the 24th month.

A) Fetal alcohol syndrome
B) Congenital hypothyroidism
C) Down syndrome

Answer 1

A) Fetal alcohol syndrome

The facial appearance in fetal alcohol syndrome shows short palpebral fissures, a wide and flattened philtrum, and thin lips. These children often have mild retardation even with good care, but with abuse they may have more profound retardation. This condition may occur with only modest alcohol consumption.