The world over, people drink in order to socialize, celebrate, and relax, despite the negative health effects of alcohol. Three periods of dynamic brain changes are evidenced to be particularly sensitive to the harmful effects of alcohol: gestation (from conception to birth), later adolescence (15-19 years), and older adulthood (over 65 years). This article is concentrated only on the negative effects of alcohol in children who have been exposed to alcohol before birth, known as foetal alcohol syndrome (FAS). This is a review based on published data in PubMed over the last two decades and is an analysis of more than 150 published papers. Alcohol use during pregnancy can cause miscarriage, stillbirth, and a range of lifelong physical, behavioural, and intellectual disabilities. The effects of ethanol are expressed on a set of molecules involved in neuroinflammation, myelination, neurotransmission, and neuron function. Modern neuroimaging techniques are able to specify some fine structural changes in the affected areas of the brain: volume reductions in the frontal lobe, including the middle frontal gyri in the prefrontal cortex, hippocampal structure, interhemispheric connectivity, abnormalities in glial cells, white matter deficits etc. Corpus callosum myelination is affected, resulting in a lack of the inter-hemispheric connectivity. This is known to facilitate autism, stroke, schizophrenia, as well as dementia, disrupts cognitive performance, and may lead to neurobehavioral deficits. It was pointed out that many symptoms and neuroimaging characteristics are similar in ADHD and FAS, thus the anamnesis for prenatal alcohol and nicotine exposure must be taken very seriously in order to better understand and interpret clinical symptoms.

To be a pediatrician means that one encounters many serious childhood health problems and one finds many ways to help families cope with these problems. Symptoms in children can be discrete, and the responsibility of the pediatrician to distinguish normal development from pathological. We are facing a new era in the developmental assessment of children. A cluster of neurodevelopmental disorders includes ASD (autism spectrum disorder) and ADHD (attention deficit hyperactivity disorder). Parents often do not recognize the problem on time. Generally, their first concern is speech delay, leading to the suspicion of hearing problems. Therefore, it is very important to obtain objective anamnestic information and for the child to undergo a careful physical examination, a neurophysiological assessment, and metabolic and genetic testing. The etiology usually is multifactorial: genetic, epigenetic, and non-genetic factors act in combination through various paths. Most children seem to have typical neurodevelopment during first their year. It was found that approximately one-third of children with ASD lose some skills during the preschool period, usually speech related, but sometimes also non-verbal communication, social or play skills. In conclusion we must say that it is very important to recognize the early signs of ASD and any kind of other developmental delay and to start with early intervention. Clinical pediatricians tend to correlate clinical manifestations and biological underpinnings related to neurodevelopmental disorder, especially ASD. Therefore, better treatment possibilities are needed.

Introduction: When we start our work as medical professionals the most important was improving and understanding physical growth and nutrition. Today we know that as much important as good knowledge in physical examination is adequate assessment of personality and social development which is crucial for appropriate developmental assessment. In this context early identification of developmental delay is not just responsibility but either obligation of all health care professionals, especially pediatricians. Aim of the Study: The aim of this study is to analyze developmental monitoring based on parents informations in our hospital in order to find out which percentage of referred children has to be followed further and has to start with early intervention. Our approach to developmental monitoring is: we start the pediatric assessment by taking very careful history of child. Second step is very careful examination in order to find if the child has same kind of organ dysfunction. In second step crucial is neurological examination especially if we know that children with developmental disabilities have very high rate of seizure disorder, structural MRI abnormalities - especially frontal atrophy… Pediatrician has to be aware that observation of the parent-child interaction also, may be an aid in identifying children with delayed development. Methodology and Sample: The developmental monitoring in 465 children at the age of 12 - 60 months, referred as children with developmental delay according to primary care pediatricians, special educators or family members in the period of 4 years (from January 2016 until the end of 2019) was implemented. The assessment of the evaluated sample is done using CDC developmental milestone checklist (Centers for Disease Control and Prevention) for specific ages -12 and 18 months and 2,3,4 and 5 years. To assess behavioral and emotional problems, physicians need information from family and people who see children in their everyday contexts. Results: The results were presented for each group separately. Conclusion: Research indicates that the first five years of a child’s life are critical to brain development, academic achievement and later life outcomes. The right developmental and behavioral assessment can change the trajectory of a child’s life forever.

For achieving the good health and wellbeing for all children, the main role of pediatrician and other health care professionals is to follow their development. We implemented developmental monitoring for 465 children at the age of 12 - 60 months, in the period of 4 years (2016 - 2019), using standard algorithm in which start is always with child history. It should be comprehensive, and must include a detailed prenatal, perinatal, and postnatal history. Obtained results showed that 16.13% of participants have some serious illness in family history, and the same percentage (16.13%) manifested serious perinatal problems which imposed the support in intensive care unit. Breastfeed are 49,46 % of children. Only 7,53 % are not completely vaccinated. About the parameters for the development, we obtained that 11,83 % were not walking at the time of the assessment, and 65,81 % were not speaking. Toilet control was negative, and in 75,27 % they still were wearing diapers. Allergic manifestations at the time when the assessment was done is present in 8,60%. Finally, serious illness in child past history was positive in 19.35 % of evaluated sample. We concluded that a good history is needed and indispensable in the assessment process, particularly when exogenous causes are identified as the risk for the developmental delay. Obtained positive answers are directory for further investigation as well to correlate risk-consequences relationship.

Introduction: Brain rate is parameter correlated to brain electric and metabolic activity. Aim: The aim of this study was to analyze the results obtained for brain rate parameter as an indicator for general mental arousal in anxious patients and to compare them with results of healthy young people matched in age and gender, as well as with anorectic and hyperactive children. Material and Methods: The diagnosis for all examinees was made according two statistic manuals (DMSIV-R and ICD-10), medical history, neuropsychological assessment, biochemical analysis and QEEG. In this study we examined the spectra power of the brain waves through quantified EEG (QEEG). The obtained results were exported to brain rate software and then calculated for each region separately. The QEEG spectra power data and the brain rate data were analyzed using Statistica software. Results: According to sagittal and lateral topography maximal values of brain rate parameter were obtained in group of healthy individuals and in group of anorectic patients. The lowest results were obtained in group of hyperactive children for all three regions. Conclusions: The general conclusion will be that pathological conditions in childhood, analyzed in this research, can be defined as conditions of hypoarausal and this can be specific sign of brain dysfunction.