Learning Disorders and Intellectual Disability – Flashcards
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Development delays are:
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Cognitive, social, motor, behavioral, attentional, psychological, verbal, visual-spatial
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Developmental delays cause:
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Impairment in personal, social, academic, or occupational performance
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Evaluation should do what?
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1. define developmental deficits 2. determine reason if possible 3. plan for a treatment program
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Define intellectual disability
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Impairment in development of cognitive (IQ<70) and adaptive functioning (ADL) -onset in childhood
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T/F 89% of intellectual disability are of mild severity
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True
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prenatal causes of intellectual disability
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genetic syndromes, brain malformations, maternal disease, environmental (alcohol, drugs, toxins)
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perinatal causes of intellectual disability
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labor and delivery-related events leading to neonatal encephalopathy
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postnatal causes of intellectual disability
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hypoxic ischemic injury, traumatic brain injury, infections, demyelinating disorders, seizure disorders, severe and chronic social deprivation, toxic metabolic syndromes (lead, mercury)
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Physical characteristics of Down Syndrome
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High cheekbones, flat nasal bridge, large protruding tongue, microcephaly, small round ears, hypotonic muscles, hyperflexibility
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What is the mean of IQ for Down Syndrome
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Broad IQ range: mean 47-50
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Fragile X
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-Small section of genetic code repeated on X chromosome -Severe to mild ID -Delay in crawling, walking, or twisting; hand clapping or hand biting; hyperactive or impulsive behavior; speech and language delay; tendency to avoid eye contact -Physical signs may include flat feet, flexible joints and low muscle tone, large body size, large forehead or ears with prominent jaw, long face, soft skin
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Trisomy 18
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-Third copy of genetic material from chromosome 18 -Symptoms include clenched hands, crossed legs (preferred position), feet with rounded bottom (rocker-bottom feet), low birth weight, low-set ears, small head, small jaw, underdeveloped fingernails, undescended testicle, unusual shaped chest, kidney problems, congenital heart disease
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Prader- Wili syndrome
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-intense craving for foods -disease that involves obesity, decreased muscle tone, decreased mental capacity, and sex glands that produce little or no hormone --genetic cause of intellectual disability
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Wilsons Disease
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-disorder in which there is too much copper in the body's tissues. -the excess copper damages the liver and nervous system -genetic cause of intellectual disability
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Most common preventable cause of intellectual disability
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Fetal Alcohol Syndrome
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What are the three signs of Fetal Alcohol Syndrome
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-CNS deficits (low IQ), ADHD sx -Faces with broad set eye, narrow eye slits, flat cheek, short nose, thin upper lip/nose, flat philtrum -growth retardation
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Intellectual disability: watch for during pregnancy
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-loss of fetal growth -abnormal weight gain by mother -particularly minimal fetal movement -maternal drug or alcohol use, -illness during pregnancy (rubella, syphilis, HIV especially)
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Intellectual disability: watch for at birth
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-Low birth weight -birth complications, -abnormalities at birth (floppy, unresponsive)
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Intellectual disability: watch for during infancy
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head size, head growth too small or too large, delay in developmental milestones, abnormal muscle tone, abnormal reflexes, abnormal postures, abnormal movements
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Define learning disorder
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a child has a selective delay in only one area (such as math or reading), -it is not ID
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Treatment for intellectual disability
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-refer for specialized training and education -aggression and impulse control (anticonvulsants, lithium) -anxious, obsessive or self-injurious behaviors
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What drugs can be used to treat anxious, obsessive or self-injurious behaviors in intellectual disorder
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-clomipramine -SSRI -buspirone -naltrexone
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Naltrexone
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treatment for repeated harmful behavior
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What is down syndrome caused by
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extra chromocome on the 21st pair
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Describe learning disorders
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-poor development in a specific area to the point of impairment in achievement/ performance -normal or above average IQ -can come with comorbidity (psych disorders) -5-15% of school-aged children -school drop-out rate- 40% -areas include reading, math, writing
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DSM diagnostic criteria of specific learning disorder
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-difficulties learning/ using academic skills -affected academic skills substantially and quantifiable below those expected for the individual's age and cause significant interference with functioning -began during school-age years -not better accounted for by ID, other disorders
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Impairment in math
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-deficiencies in arithmetic skills -problems decoding math symbols, learning addition, substraction, multiplication -apparent 1st grade -recognized 2nd-3rd grade
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early signs of impairment in math
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-failure to: -name -count -understand numbers in simple everyday activities
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Impairment in written expression
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-deficiency writing skills -errors in spelling, grammar, punctuation -difficulting composing sentences/ paragraphs -apparent by age 7 -mild not recognized by age 10
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impairment in reading
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-dyxlexia -most common learning disorder -more common in boys -apparent by 7 -difficulty recognizing words and comprehending written text -reading speed, accuracy, comprehension falls, IQ and education
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Children with dyslexia
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-read slowly, with great difficulty -may distort, omit or substitue words when reading aloud -trouble decoding letter combinations -trouble translating letters to sounds -may misperceive letters as upside-down or reversed -more prone to depression, low self-esteen and ADHD
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T/F Dont give professional advice about learning disorder
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True -they are complex -REFER! neuropsychologist, educational psychologist
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Etiology of learning disorders
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-cause unknown -abnormal brain structure/ function -no one single neurological cause or area of brain -difficulty bringing together info from several areas of the brain -GENETIC + ENVIRONMENT
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What are known risk factors for learning disorders
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-prematurity -very low birth weight -prenatal exposure to nicotine
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What are often the first signs of disability: whether it be learning, hearing, intellectual disability, autism or other conditions
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Speech and language development -REFER!
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Define language disorder
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-difficulties in acquisition and use of language, both receptive and expressive
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Speech sound disorder
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problem with speech- pronunciation problems, omissions of sounds, substitutions of sounds -not a problem with communicating/ understanding
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Childhood onset fluency disorder
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AKA stuttering -sounds are made accurately, but fluency and time patterning are disrupted
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Social (Pragmatic) Communication disorder
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-persistenc difficulities in the social use of verbal and nonverbal communication as manifesated as: -difficits in using communication for social purposes -impairment in ability to change communication to match contex or needs of listener -difficulties following rules or conversation and storytelling -difficulty understanding what is not explicitly stated and or ambiguous meaning of language -deficits results in IMPAIRMENTS in communicatoin or functioning -onset during early developmental period
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Signs during first year of life: needs speech therapist
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Little vocalizing and babbling Poor contact with adults Suspicion of impaired hearing Orientation, suckling, swallowing Reflexes are poorly developed; Difficulties in eating Short frenulum of the tongue
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Signs during1-2: needs speech therapist
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No words or attempted words or other attempts at expressing ONESELF Suspicion of poor speech comprehension or does not obey commands Poor alertness Difficult to make contact with the child Speech is scant or not clear after the second birthday
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Signs during 3-4 years old: needs speech therapist
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Speech is defective or not clear Major grammatical errors Poor vocabulary, difficulty in finding words Little speech, no or only a few sentences Inadequate answers, "own language" Stammering continues or starts after the physiological stammering age Does not stop to listen Difficulties in following short instructions
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Signs during 5-6 years old: needs speech therapist
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Pronunciation errors Non-fluent speech Language or speech is scant or poorly developed in relation to age Overall speech is not clear
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non clear speach in kids 5-6
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may be due to problems with motor and/or phonological fluency or comprehension of spoken language
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non clear speach in kids 7-15
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the abovementioned problems if they have not been investigated before
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Developmental coordination disorder
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-delays in GROSS motor skills --sitting, walking -delays in FINE motor skills --self-feeding, zipping -marked delays in achieving motor milestones -DROP THINGS (clumsy) -poor handwriting -academic preformance normal -self-esteem low
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ADHD
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can also be clumsy
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Sterotypic movement disorder
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Repetitive, seemingly driven, apparently purposeless motor behavior Interferes with functioning Head banging, body rocking, self-biting, etc
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Tic disorders
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-motor -verbal -present for at least 1 year, onset before 18: not because a substance or other medical condition
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Tourette's disorder
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motor and verbal disorders
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persistent motor vs persistent vocal tic disorder
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ONE of the tic (motor vs vocal)
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Autism spectrum disorder
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*presistent deficits in communication and social interaction across multiple contets -deficits in social-emotional reciprocity -deficits in nonverbal communicative behaviors -deficits in developing, maintaining and understanding relationships *restricted, repetitive patterns of behaviors -sterotyped/ repetitive motor movements -insistence on sameness, inflexible adherence to routine -highly restricted (not a lot); but fixated (intense) -hyper or hyporeactivity to sensory input (any of the 5 senses)
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With autism spectrum disorder what do you specify:
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-w/ w/o: accompanying intellectual impairment -w/ w/o: accompanying language impairment -ass with known medical/ genetic condition/ envt -ass with another neurodevelopmental, mental, behavorial disorder -w catatonia
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New study with autism spectrum disorder
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-kids who live close to pesticides!
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T/F Asperger syndrome, childhood disintegrative disorder and Rett syndrome all deleted from DSM-V
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True
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Asperger syndrome now what?
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Autism spectrum disorder or social communication disorder =High functioning disorder on the autism spectrum -Less severe social impairment, but still often demonstrate lack of social reciprocity -Have restricted, repetitive, behaviors as in autism -No delays in cognitive development and language
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Autism spectrum disorder associated with Rett syndrome
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-Normal for several months, then stereotyped movements, poor social interaction, impaired communication - but these symptoms typically improve -Deficits in expressive and receptive language, psychomotor retardation, poorly coordinated gait, deceleration of head growth -Only in girls -Gene abnormality on the X chromosome
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What is the IDEA
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Individuals with disabilities education Act : law ensuring services to children with disabilities throughout the nation. -early intervention -special education
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IDEA Part C
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Infants and toddlers with disabliities (birth-2) -early intervention service
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IDEA part B
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Children and youth (3-21) -special education
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Developmental surveillance (AAP)
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-surveillance during each physician visit -->screenings -@ 9, 18 and 30 months especially
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what are the 5 components of developmental surveillance
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-listen to parents concerns about child's development -document developmental hx -accurate observation of kid -identify risk/ protective factors (neglect, second hand smoke) -maintain an accurate record over time
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Denver
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-assessing normal development -BIRTH - 6 YEARS OLD -identify those who need further assessment -quick administered by trained professionals -reflect the development of a broad range of heterogeneous skills in min about of time
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Bayley infant neurodevelopment screener (BINS)
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-3, 6, 9, 12, 18, 24 months -Screens low, moderate, high risk for neurological impairment or developmental delays -Practitioner administrated, 5-10 minutes -Sensitivity and Specificity - "Excellent"
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Ages and Stages Questionnaire
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-30 questions completed by the PARENT -General developmental delay: communication, gross motor, fine motor, problem-solving, personal/social
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Parents Evaluations of Developmental Status (PEDS)
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-0-8 years -General developmental delay, behavioral problems -PARENT questionnaire, 10 questions
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Modified checklist for Autism in Toddlers (M-CHAT)
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-16-30 months -Screening for AUTISM and developmental delay -Administered to parents
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Bright futures
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-American Academy of Pediatrics -Theory based guidelines for health supervision of infants, children and adolescents -also talks about interventions!
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Pocket Guide
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Describes appropriate procedures for health supervision visits (infancy-21 years) -developmental observation -PE -screening -guidance for parents/ families -immunizations
