PECULIARITIES IN THE COURSE AND TREATMENT OF ACUTE BILATERAL ARTERIAL OCCLUSION

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PLASTIC OF THE DEEP FEMORAL ARTERY ON THE OCCASION OF 47 OBSERVATIONS

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Child Welfare Reform in Bulgaria - from Institutional to Family-Based Community Care: Engaging with Families, Children and Colleagues?

The authors present the child welfare policy reform and the process of deinstitutionalization of children's services in Bulgaria. These developments are examined in the context of the country's transition from a post-totalitarian to a liberal democratic state and from collectivistic to individual-centred practices. Therefore, the implementation of social policy promoting and regulating individualised community-based services faces challenges related to attitudes that support group-oriented and institutional-based care. There are three key contextual barriers to the provision of quality services for children with disability: engaging with the individual client, involving parents, and working in multidisciplinary teams. Clinical social work vignettes are presented to illustrate the above challenges

Assessment of Children with Autism Spectrum Disorder and Post-Assessment Meeting with Parents: Some Issues of Planning and Professional Attitude

The authors, child psychiatrists and clinical psychologists, conducting team assessment of children with developmental disabilities (including autism spectrum disorder) for more than two decades, present some important in their view issues and recommendations concerning planning and proceeding of assessment and post-assessment meetings with parents. It is essential to ensure not only an accurate assessment protocol and diagnosis, but also to "attune" to parents in order to facilitate their understanding and more positive use of assessment outcome results. Parents need further support to "survive" psychically the post - assessment period and to provide for adequate interventions for their child

DIABETIC ANGIOPATHY - SURGICAL PROBLEMS AND POSSIBILITIES

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DIAGNOSTIC POSSIBILITIES OF ELECTROROENTGENOGRAPHY IN POSTPHLEBITIC SYNDROME

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Early Assessment of Mental Development in Children with Autism Spectrum Disorder (ASD) and other Neurodevelopmental Disorders - Sharing of Clinical Experience

The authors present a synthesised review of the methods for assessing mental development and autism, with an emphasis on the general tendency to reduce the age of diagnosis. Based on clinical experience, a number of particularities are described in terms of: testing, working with parents, observing and reflecting on the nature and meaning of autistic behaviours. On focus is a toolkit for detailed assessment of mental development that was elaborated within the inter-university cooperation between Sofia Medical University and Universite catholique de Louvain (UCL) - Belgium. Illustrated and discussed are typical profiles of cognitive and socio-communicative functioning of children with ASD and other neurodevelopmental disorders, which help a differential diagnosis to be made by the multidisciplinary clinical team. Further described are the advantages of early assessment of mental development as a basis for future educational and therapeutic programs

Asperger’s Syndrome in a Clinical Sample: Reasons for Referral and Comorbidity

Asperger’s Syndrome (AS) is an autism spectrum disorder without mental retardation and language delay. AS often remains unrecognized until these children fail to adapt to school or kindergarten. The comorbid psychiatric disorders, achieving clinical significance, were considered as another pathway to diagnosis. This study is aimed to elucidate the reasons for referral, the frequency and the kinds of comorbidities in a clinical sample of consecutive cases of children and adolescents with AS. To this objective, clinical records of children and adolescents, who have received a DSM-IV diagnosis of AS after multidisciplinary assessment in a given time period were reviewed. After excluding 3 cases due to insufficient information, 24 cases of children and adolescents with Asperger’s Syndrome (23 boys and one girl) were identified. The mean age at the time of assessment and receiving diagnosis was 9.6 yrs. (age range 4 to 17 years). In twenty-one (87%) of the cases the reason for referral was an episode of disorganized behavior following an attempt to enrollthe child at school or kindergarten, and more rare referral occurred within the significant school transition period. In the remaining 3 cases, the reason for referral was a comorbid condition. Comorbid conditions identified at the moment of assessment include: ADHD documented in 4 cases, tics in 3 cases, obsessive-compulsive behaviors in 4 cases, Stereotypic Movement Disorder or Trichotilomania in 4 of the cases. Within the clinical sample, a priori expected to include relatively severe cases, a higher frequency of comorbidity was found as compared to the rates in the general population. Adjustment reactions and comorbidities occasioned the refer