Abstract
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.
Highlights
Since its licensing in 1982, isotretinoin, the main com pound in Roaccutane®, has successfully been used for the treat ment of cystic acne that occurs predominantly in women between the age of 15 to 44 years (Honein, Paulozzi & Erickson, 2001)
The complex o f symptoms in infants prenatally exposed to isotretinoin is known as Foetal Retinoid syn drome (FRS) or retinoic acid embryopathy and these infants may display an array of morphological, sensory and developmental disorders (Adams, 1990; Moerikejet al., 2002)
The results were obtained by means of clinical observations, guided by the Genetic Screen ing Checklist (Rritzinger & Louw, 1998) and a report from the clinical/geneticist who diagnosed the participant with FRS
Summary
Since its licensing in 1982, isotretinoin, the main com pound in Roaccutane®, has successfully been used for the treat ment of cystic acne that occurs predominantly in women between the age of 15 to 44 years (Honein, Paulozzi & Erickson, 2001). Isotretinoin is classified as a Category X drug, i.e. contra indicated during pregnancy (Kassis, Sunderij & Abdul-Karim, 1985) and its use is rigorously controlled. According to Kuznar (2001) preg nancies during the use of isotretinoin may occur as a result of false-negative pregnancy tests or lack of information about con traceptive methods. Christiansson (personal communication, 1997) added that isotretinoin, an expensive drug, was known to be used by women to induce the abortion o f an unwanted pregnancy. The misuse of the drug for these purposes may have stopped since the legalization o f abortions in South Africa in 1996
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