A B C D E F G H I J K L M N O P Q R S T U V W XYZ

AAC
See achievement ability comparison.
AAC
See Augmentative and alternative communication: see also augmentative communication.
AACPDM
See American Academy for Cerebral Palsy and Developmental Medi­cine.
AAMFT
See American Association of Marital and Family Therapy.
AAMR
See American Association on Mental Retardation.
AAMR Adaptive Behavior Scales-School, Second Edition (ABS-S:2)
A behavior rating scale that evaluates the adaptive potential of children with behavior disorders; ABS-S:2 evaluates coping skills in nine behavioral domains and examines social maladaptations in seven domains to help differentiate and diagnose children manifesting adaptive behavior problems, those requiring special educational assistance, and those who can manage in a general classroom.
AAP
See American Academy of Pediatrics.
AAPEP
See Adolescent and Adult Psycho-educational Profile.
Aarskog-Scott syndrome
A rare genetic syndrome in males that combines ocular hypertelorism (widely spaced eyes), a widow's peak, brachydactyly (short fingers), shawl scrotum [scrotum forms a fold around the dorsum, or top, of the penis), cryptorchidism (undescended testes), and later growth retardation. Most of these children have normal intelligence, but mild mental retardation and learning disabilities occur more often than in the general population. Inheritance is believed to be X-lmked semidominant in males, with partial expression in carrier females. Treatment includes symptomatic treatment of the growth parameters and cryptorchidism, and genetic counseling.
AAUAP
See American Association of University Affiliated Programs for Persons with Developmental Disabilities.
abasia
An inability to walk despite the presence of normal motor strength and coordination. This neurological finding can be observed in typically developing infants from 7 to 8 months of age. Prior to that time, the infant may go through the motions of (supported) walking on a reflex basis; after that time, independent walking begins to emerge. Physiologically, abasia follows astasia (inability to stand due to lack of motor coordination).
ABC inventory
A brief screening test (approximately 15-minute administration time) for children between 3½ and 6½ years of age; it assesses fine motor, academic, and language areas.
abducent nerve
The sixth cranial nerve; cranial nerve VI innervates the muscle that abducts the eye (turns it outward); damage to this nerve causes diplopia (double vision) and strabismus (squint) with a tendency for the eye to deviate nasally.
abducent palsy
Paralysis of the sixth cranial nerve leading to an internal strabismus (esotropia) that occurs with fever, increased pressure within the skull, or brain-stem tumors.
abduction
Sideways movement of an extremity (arm or leg) away from the mid-line of the body.
Abecedarian Project
A model North Carolina preschool and school-age educational program to minimize school failure among rural African-American children of parents with borderline intelligence.
aberrant behavior
Behavior that deviates markedly from what is considered typical.
Aberrant Behavior Checklist
A 58-item behavioral scale to measure the effect of drugs and other therapeutic interventions on individuals with moderate to profound mental retardation. Its five subscales are irritability, lethargy/withdrawal, stereotypic behavior, hyperactivity/noncompliance, and inappropriate speech.
abetalipoproteinemia
Bassen-Kornzweig disease; a genetic disorder that combines intestinal malabsorption, progressive ataxia (unsteady gait), mental retardation, acanthocytes (burr-shaped red blood cells) in the blood, and retinitis pigmentosa (night blindness and progressively restricted visual field). High doses of vitamin E stop the progression of the neurological syndrome. Inheritance is autosomal recessive.
ability
A quality that enables an individ­ual to perform an act, solve a problem, or make an adjustment. Ability refers to potential performance or whether an individual can act in a specified manner or demonstrate certain skills or knowledge at a given time. This can originate from inherited traits, previous learning, or a combination of both. Intelligence tests are assumed to be tests of ability.
ablation
Removal; eradication.
able
Competent; sometimes used to refer to gifted children.
above elbow (AE)
An anatomical term used to describe the location of an amputation, either congenital or acquired.
above knee (AK)
An anatomical term used to describe the location of an amputation, either congenital or acquired.
ABR
Auditory brain-stem response; see brain-stem auditory-evoked response.
abruptio placenta
The premature detachment (abruption, tearing away) of the placenta (which, among its other functions, acts as the baby's lungs for its oxygen supply) before the baby is born and can breathe independently. Abruption is accompanied by severe bleeding and represents a significant risk to both the mother and baby. In the normal delivery process, after the baby has been born, the placenta separates spontaneously and a hormonally mediated process prevents severe maternal hemorrhage (bleeding).
absence seizure
Transient loss of con­sciousness lasting up to 30 seconds and a diagnostic electroencephalogram (EEG) pattern of a 3-per-second spike wave. Such seizures are most common after the age of 5 years and often disappear at puberty. Absence seizures are more common in girls. Children with such staring spells rarely have impairment of intellectual function. Daydreaming in children with attention-deficit/hyperactivity disorder (ADHD) may be misinterpreted as absence seizures.
ABS-S:2
See AAMR Adaptive Behavior Scales-School, Second Edition.
Academy of Certified Social Workers (A.C.S.W.)
A recognition of practice competence conferred by the National Association of Social Workers (NASW) to social workers who meet several academic and practice standards. These include a Master of Social Work degree or better, 2 or more ycars of supervised practice, and successful completion of a competency examination. According to the professional standards of the NASW, a social worker cannot practice independently prior to reaching this level of certification. Evidence of this attainment should he readily visible to anyone seeking services.
acataleptic
Antiquated term for an individual with mental retardation.
accent
Relative stress or prominence assigned to a particular syllable of a word or group of words. Tins emphasis is demonstrated through greater intensity (stress accent) or by variation or modulation of pitch or tone (pitch accent). Placement of accent on a word or group of words can be determined by the regional, social, or developmental background of the speaker. Individuals with congenital hearing loss typically have difficulty with standard or expected placement of accent in spoken language and tend to speak in a monotone (with no stress or pitch accent).
accessibility
Modification of buildings, curbs, and other physical structures to allow unrestricted movement and unlimited admittance to people whose mobility may be limited by motor or sensory impairment and who may or may not use a wheelchair. Accessibility of all public and private facilities is now mandated by PL 101-336, the Americans with Disabilities Act of 1990. This might include special ramps and additional elevators for those with motor impairments, and special braille and sound adaptations for those with visual impairments. Accessibility also requires modification of services for persons who speak another language, who have hearing impairment, and who have other cognitive or learning problems.
accident-prone
An unusually high susceptibility to unintentional injury, often assumed to have an emotional basis. Although accident-proneness can be an emotional symptom in children, it more likely reflects the inattention and impulsivity of attention-deficit/hyperactivity disorder (ADHD), the cognitive impairment of mental retardation, or the motor impairment of clumsy child syndrome or developmental dyspraxia.
accommodation
A learning process that applies a general cognitive structure to understanding a particular situation, which then changes the cognitive structure. Accommodation focuses on the adaptation or change in the learning organism.
accommodation
The ability of the eye to change the shape of its lens to produce a clear image. Problems with accommodation can produce fatigue, visual discomfort, eye strain, headaches, and blurred vision. Ophthalmologists do not treat mild accommodative disorders to improve reading; optometrists frequently prescribe lenses and orthoptics (eye exercises) to treat mild accommodative and convergence disorders associated with reading disorders. This therapy is controversial and unproven.
acetabulum
The cup-shaped cavity in the hip hone that holds the head of the femur (thigh bone); abnormalities of the acetabulum contribute to hip pain, instability at the hip joint, dislocation of the hip, and limping.
acetaminophen
Trade name Tylenol; a drug used to reduce fever and pain. Acetaminophen has replaced the use of aspirin for pain because of the latter's suspected contribution to the onset of Reye syndrome; acetaminophen does not, however, have the same anti-inflammatory effect as aspirin.
achievement ability comparison (AAC)
A rating that describes a student's achievement in relation to the achievement of other students with the same measured ability.
achievement battery
A group of tests that measure the amount and degree of attainment of information, knowledge, and skills in specified areas.
achievement test
A test designed to document what a person has learned, usually in specific academic areas such as reading or mathematics. This is in contrast to intelligence tests, which are designed to reflect the individual's intellectual potential (what could he learned). In practice, this distinction is less clear, because intelligence tests reflect past educational achievement (e.g., vocabulary), whereas achievement tests sometimes examine factors (e.g., abstract reasoning, logic) typically associated with intelligence.
Achilles tendon
The heel cord. This tendon is named for Achilles, a hero in Greek mythology whose only weakness was his heel. Shortening or tightening of the Achilles tendon gives rise to toe walking (an equinus [an involuntary foot extension] gait).
achondroplasia
A genetic syndrome that combines short stature with short limbs, bowed legs, and megalocephaly (large head) usually without hydrocephalus (excess fluid in the brain) or accompany­ing developmental disorders. Obstructive apnea (temporary cessation of breathing) and neurological complications secondary to bone or disc compression are major medical concerns. Intelligence in people with achondroplasia is usually normal. Inheritance follows an autosomal dominant pattern with a recurrence risk of 50%. Incidence is estimated at 1/25,000, with 90% of cases representing new mutations. Treatment is generally symptomatic for orthopedic or neurological complications.
ACLC
See Assessment of Children's Language Comprehension.
ACLD
Association for Children and Adults with Learning Disabilities; see Learning Disabilities Association.
acoupedic
An approach to learning speech by children with hearing impairments that relies on hearing alone.
acoustic
Pertaining to sound, the sense of hearing, and the science of sounds.
acoustic impedance
The measurement of sound reflected by the tympanic mem­brane (ear drum) after the introduction of a test tone into the external car canal. The amount of sound reflected depends on the mass, stiffness, and the acoustic resistance of the air surrounding the tympanic membrane. This measurement requires no participation by the individual. Static acoustic impedance (relative flexibility of the ear drum), the point of maximum comparable acoustic reflex (relative contraction of middle-ear muscles), and tympanometry (the resistance to the flow of acoustical energy at the tympanic membrane during various pressure changes) are three aspects of acoustic impedance.
acoustic impedance audiometry
A measurement of the sound reflected by the ear drum, performed by emitting a test tone into the ear and measuring three components of ear function: static acoustic impedance, acoustic reflex, and tympanometry. Static acoustic impedance relates to the compliancy or flexibility of the ear drum. Acoustic reflex measures the con­traction of the muscles in the middle ear. Tympanometry measures the movement of the tympanic membrane during various pressure changes. These three components measure middle-ear functioning in relation to turning sound waves into electrical activity in the cochlea and eighth nerve.
acquired
Postnatal: the absence of significant innate, genetic, or prenatal factors. When describing the etiology of develop­mental disabilities, an acquired condition is contrasted with a congenital one, the implication in the former being that the person was neurodevelopmentally normal until something happened (e.g., a head injury or brain infection). Acquired blindness and acquired deafness, however, are termed adventitious.
acquired immunodeficiency syndrome (AIDS)
A chronic and ultimately fatal disease process resulting from infection with a retrovirus (HIV-1). The most severe manifestation is suppression or deficiency of the cellular immune system. In addition, HIV infects other white blood cells, the brain, the bowel, the skin, and other body organs. Suppression of the im­mune response system predisposes the infected person to opportunistic infections and malignancies. Transmission to children is by body fluid (blood or semen); many cases in children result from in utero contact, with an infected mother transmitting the virus across the placental harrier to her fetus or infant. Current prevalence figures suggest that pediatric AIDS cases represent less than 2% of all AIDS cases. The course is typically prolonged, with neurodevelopmental complications in 90% of affected children. These include a spectrum ranging from mild delays in attaining developmental milestones to frank developmental regressions. Treatment is two-pronged: treatment of the opportunistic infections and malignancies coupled with drugs specifically targeted to delay the progression of the HIV infection. Many of the risk factors for a child being placed in foster care in infancy overlap with risk factors in their mothers, who may also be HIV positive. Thus, HIV testing should be considered for children who were placed in foster care in infancy and who present with developmental problems in early childhood.
acrocephaly
A "tower-shaped" skull secondary to craniosynostosis (premature fusion of skull sutures). Acrocephaly is found in a number of genetic syndromes, including turribrachycephaly (an odd-shaped skull), turricephaly, hypsicephaly, and oxycephaly.
acrodysostosis
A genetic syndrome characterized by prenatal onset growth failure, mental retardation, a strikingly small nose, short hands with stubby fingers, and involvement of other bone structures.
acrolect
Any dialect that closely resembles the accepted standard usage of a language. For example, in Black English, "he be saying" is the equivalent of "he is saying."
acromelic
Affecting the distal segment of a limb (the hand or foot).
acronym
The naming of a syndrome or other condition by a word, each of the letters or syllables of which is the first letter or syllable of one of the components of the syndrome: the acronym serves as a mnemonic (memory) device. Examples include the LEOPARD and TORCH syndromes. Acronyms are also used loosely to refer to the abbreviated names of organizations and tests (e.g., AMA, American Medical Association).
A.C.S.W.
See Academy of Certified Social Workers.
ACTH
See adrenocorticotropic hormone.
acting out
A behavioral, rather than a verbal, expression of feelings, unconscious drives, or impulses. The behavioral acting out of feelings is usually expressed in annoying, disruptive, or antisocial ways. A child exhibiting acting-out behavior is difficult to manage, has trouble adhering to structural limits, and resists timely redirection. Acting-out behaviors are similar to conduct disorders but are typically not so severe in nature nor so fixed in the personality; however, when diagnosing conduct disorders, acting-out behavior is one in a list of criterion symptoms. Although acting-out behaviors occur frequently and are of significant duration, they do not include daily misbehaviors of little consequence. When a behavior is considered to be an indicator of acting out, it is most often operationally defined, observed, and recorded in formal settings such as the classroom, residence, or hospital. Some of the behaviors typically considered as acting out include fighting, stealing, crying, pouting, hyperactivity, temper tantrums, and verbal threats. Children often act out their feelings (termed extenuating), although some may demonstrate emotional conflict in a more introspective or internalizing manner, thus presenting as depressed, lethargic, self-injurious, and withdrawn.
activities of daily living (ADL)
Self-help activities such as bathing, toileting, eating, cooking, mobility, simple health care procedures, and housekeeping. ADL are a major goal of habilitation and rehabilitation.
actometer
A mechanical device to measure children's activity levels; examples include pedometers (instruments that record the number of steps taken) and accelerometers (devices that measure change in velocity). All such instruments are of qucstionable reliability and validity.
acuity
The degree of clarity. The sharpness, clearness, and distinctness of stimuli with respect to the reception of sensory data. Visual acuity is measured against a standard of 20/20 (measuring the accuracy with which people with impairments can visually discriminate objects/shapes/letters at 20 feet against that demonstrated by a person without impairments at 20 feet). (In the metric system 6/6 is the standard.) A visual acuity of 20/40 indicates that the individual with an impairment discriminates at 20 feet what the individual without impairments can discriminate at 40 feet. Visual acuities better than 20/40 are not typically disabling, whereas those worse than 20/40 suggest a problem with far vision. Auditory acuity refers to the sensitivity of the ear to sound.
acuity
The degree of urgency or significance. An illness is acute when it comes on suddenly and unexpectedly; if the illness persists for a long time (usually defined as greater than 3 months or hospitalization exceeding 30 days), it is chronic.
acute
Sharp or sudden; of short duration (the opposite of chronic).
acute dystonic reaction
Uncontrolled muscle activity with stiffness or twisting of extremities and other body parts (including facial grimacing, torticollis (stiff neck), oculogyric crisis, opisthotonos [an arching of the back]). This side effect of antipsychotic drugs can occur with the onset of treatment.
acute infantile spinal muscular atrophy (AISMA)
A type of Werdnig-Hoffmann disease.
ADA
See Americans with Disabilities Act of 1990 (PL 101-336).
adaptation
An equilibration between assimilation and accommodation. In Piagetian theory, a heavily biological process.
adapted physical education
A component of the educational curriculum in which physical, recreational, and other therapists work with children who exhibit delays in motor development and perceptual motor skills in the absence of a motor diagnosis; the program of games, sports, and other activities typically comes under the heading of recreation or play.
Adapted Sequence Inventory of Communication Development for Adolescents and Adults with Severe Handicaps (A-SICD)
An extension of the Sequences Inventory of Communication Development—Revised (SICD-R) to adolescents and adults, including those with severe hearing, loss, legal blindness, epilepsy, spastic quadriplegia, and nonambulation.
adaptive behavior
1. Ability to function in nonacademic skill areas such as self-help, social abilities, and mobility. 2. Activities the individual uses to cope with the natural and social demands of the environment, including feeding, dressing, toileting, and higher-level social interaction skills. Significant limitations in adaptive behavior are necessary components of mental retardation diagnoses.
adaptive education
A general term referring to modifications in instructional methods, materials, or expectations to address students' individual differences.
adaptive equipment
A wide array of devices that provide proper positioning to facilitate motor performance and independence: adaptive equipment includes seating inserts and positioning devices, such as sidelying and prone standers.
Adaptive Learning Environment Model (ALEM)
A mainstream program for integrating students with mild disabilities into the general classroom on a full-time basis. The goals of this model are to modify conditions in the general classroom to accommodate the instructional and special service needs of a range of individuals and to promote students' social and personal development by having them plan and manage their own classroom learning behaviors. The AITM includes 12 program dimensions, 9 related to providing adaptive instruction and 3 related to supportive implementation of adaptive instruction in the classroom. General classroom teachers, working individually and in teams, are the primary instructors for general and special education students. The services of special education range from consultation with general educators to direct instruction for special education students in the general classroom.
ADD
See Administration on Developmental Disabilities.
ADD
Attention deficit disorder; seeattention-deficit/hyperactivity disorder.
addiction
A term widely used by the lay public to indicate a habit of compulsive drug use and drug-seeking behavior that is associated with physical and/or psychological dependence. The term addiction has been replaced in medical literature and professional practice by the more restrictive terms substance tolerance, substance dependence, and substance abuse.
additivity principle
If two events are mutually exclusive, then the probability of finding one of the events is the sum of their individual probabilities.
adduction
Sideways movement of an extremity (arm or leg) toward the midline of the body.
adductor tenotomy
An orthopedic surgery procedure in which the tendons of several of the hip adductor muscles are cut; this procedure is used to treat severe adduction (scissoring), hip dislocation/dysplasia, and related problems in spastic cerebral palsy. It is frequently performed in conjunction with obturator neurectomy in people with severe cases.
adenoid facies
A clinical presentation with the mouth hanging open, mouth breathing, and a generally dull and apathetic expression: there is usually a history of snoring. This is frequently secondary to hypertrophied (enlarged) adenoids and may accompany recurrent tonsillitis and otitis (inflammation in the ear). Hearing loss is possible, and a more detailed inquiry about allergy symptoms should be made.
adenoidectomy
The surgical removal of the adenoids; often performed simultaneously with tonsillectomy and ear tube (pressure equalizing [PE] or ventilation) placement.
adenoids
Hypertrophied (enlarged) pharyngeal tonsils that often give rise to snoring and mouth breathing and contribute to recurrent ear infections with intermittent hearing impairment.
adenoma sebaceum
A skin lesion found in tuberous sclerosis.
adenovirus
A DNA (deoxyribonucleic acid) virus that can be associated with respiratory infections and diarrhea.
ADHD
See attention-deficit/hyperactivity disorder.
adjudication
A court decision rendered as a result of a hearing or trial. Many adults with developmental disabilities are adjudicated for the purpose of determining the need for a guardian.
adjustment disorder
A maladaptive reaction to an identifiable stressful event. The hallmarks of this response include onset within 3 months of the stressor, duration of less than 6 months, and an impairment in school, social, or interpersonal functioning not due to a previously diag­nosed psychiatric disorder. Adjustment disorders may take one of two forms: 1) marked deterioration of normal functioning or 2) excessive and continued overreaction to the stressor.
ADL
See activities of daily living.
Administration on Developmental Disabilities (ADD)
The federal agency mandated to carry out and monitor programs for persons with developmental disabilities. This administrative office was authorized under PL 101-457 and is housed in the U.S. Department of Health and Human Services.
adolescence
Transition period between latency (late childhood) and young adulthood. It is characterized by physical changes such as the adolescent growth spurt, puberty, and, in girls, thelarche and menarche. Complex psychosocial changes also occur. The development of abstract logical thinking (Piaget's formal operational thinking) during this period comprises both deduction and induction.
Adolescent and Adult Psychoeducational Profile (AAPEP)
A criterion-referenced task performance test that is a sequel to the Psychoeducational Profile (PEP) and assesses learning styles and strengths of adolescents and adults with autism and other communication disorders. Test results constitute a profile that is translated into individualized goals and objectives to serve as a foundation for instructional planning and community placement. The time required to administer the test varies. The test is not intended for group use.
Adolescent Language Screening Test (ALST)
A screening test of speech and language for 11- to 17-year-old students. Includes seven subtests: pragmatics, receptive vocabulary, concepts, expressive vocabulary, sentence formulation, morphology, and phonology.
adrenergic
Mediated by adrenalin, as in the sympathetic nervous system.
adrenocorticotropic hormone (ACTH)
A compound secreted by the pituitary gland that stimulates the adrenal gland's cortex (outer part) to make cortisol (a steroid hormone). Excess amounts of cortisol can be found in pituitary tumors called adenomas. The side effects of large amounts of cortisol include truncal obesity, striae (stretch marks), stomach ulcers, osteoporosis (thinning of the bones), and an increased susceptibility to infection. ACTH is used therapeutically in infantile spasms. It is given in the muscle (IM) and used until the spasms and hypsarhythmia (a continuous pattern of high-voltage slow waves and spikes) disappear. The dose is then decreased until the minimal amount for seizure control is reached, at which point it may be discontinued. Although ACTH does not alter the generally poor outcome in infantile spasms, it can improve both the seizures and the electroencephalogram (EEG) pattern.
adrenoleukodystrophy
A syndrome that combines a disorder of brain white matter with atrophy (wasting) of the adrenal glands. It is one of several hereditary degenerative disorders—under the general term sudanophilic cerebral sclerosis—that are characterized by progressive intellectual and visual deterioration, spasticity (increased muscle tone), and seizures. Adrenoleukodystrophy, one of the best described disorders, includes an insufficiency of the adrenal cortex, which makes cortisol (a steroid hormone). The clinical course is variable, with onset generally between 5 and 8 years of age. The progression begins with disturbances in walking and mild intellectual deterioration, followed by seizures, screaming attacks, spasticity, and araxia (unsteady gait). This progressive neurodegenerative disease is genetic in origin and is inherited as an X-linked recessive trait.
adult day care
A continuum of service including sheltered work, day hospital, socialization groups, or custodial services provided to adults who are unable to care for themselves. Often these adults have developmental disabilities from birth, but they may also be older adults who are no longer able to care for themselves when left alone, but who do not need a full-time caregiving placement such as a nursing home.
adult foster care
Placement in the home of a nonrelated family for adults who are unable to care for themselves because of disabilities or health problems and whose biological families are unable to provide the care they need.
adult protective services
The provision of or monitoring of social, medical, legal, residential, or custodial services to adults who are unable to provide such services for themselves. These adults may have developmental disabilities or aging or disease processes that have rendered them incapable of caring for themselves. In the event there is no guardian or significant other, or in cases of a guardian or significant other being abusive to the adult with a disability, a public or private agency may provide adult protective and service coordination services.
adventitious
Acquired; blindness and deafness are divided by origin into two types: congenital (existing at or dating from birth) and adventitious (acquired).
adverse reaction
Harmful side effect.
AE
See above elbow.
AE scores
See age-equivalent scores.
aerophagia
Air swallowing that can lead to abdominal distension and discomfort; in many infants aerophagia reflects a mild feeding disorder, hut children with developmental disabilities may engage in aerophagia as a self-stimulatory behavior; aerophagia may predispose these children to aspiration.
AFB
See American Foundation for the Blind.
affect
A term that until recently referred to both subjectively experienced inner feeling states and their external manifestations. Recent usage separates these two phenomena into 1) mood, to signify inner feeling states; and 2) affect, to refer to the external manifestation of feeling states. Thus, what were affective disorders have become mood disorders. Although mood and affect are both considered psychological phenomena, each has physiological components that are usually expressed through somatic manifestations such as blushing, crying, excessive heart rate, sweating, or shaking. Changes in facial expression, voice tone, activity level, pos­ture, and gait may occur as well. Disorders of affect and mood occur when the intensity, duration, appropriateness, or ability to cope with one's own inner feeling state becomes impaired. Until children learn to express their feelings verbally, they frequently do so through their behavior. An interpersonal process in which the care-giver interprets the child's behavior as a feeling state and offers the appropriate label to the child allows the child to associate this label with the inner feeling state. Children with developmental disabilities frequently have difficulty acquiring this skill and even as adults may continue to act out their feelings. Thus, caregivers must learn to read external manifestations of affect in order to sensitively interact with persons with developmental disabilities.
affective disorder
See mood disorder.
affordance
The complementarity of the organism and the environment that is part of an ecological approach to developmental psychology.
AFO
Ankle-foot orthosis; see orthosis.
AFP
See alpha-fetoprotein.
aftercare
Continued treatment and support services to formerly hospitalized or institutionalized persons after transition into the community.
AGA
See appropriate for gestational age.
age-equivalent (AE) scores
Ratings derived by determining the average score obtained on a test taken by children of various ages. For example, if the average score for 8-year-old children on a test is 15 correct out of 25, any child obtaining a score of 15 receives an age-equivalent score of 8. These scores should be inter­preted with care. The differences between scores may not represent equal units at all ages. Furthermore, at upper levels, they have little meaning for school subjects not taught at that age.
age ratio
The chronological age of a child at one testing divided by the child's chronological age at a later testing date. This ratio can be used as a crude measure of a test's predictive power, which depends on the age at which the test is given and the length of time between administrations. The younger the child, the poorer the predictive power of the test. The longer the interval between tests, the poorer the prediction from one testing to the next. Thus, prediction would most likely be better from ages 7 to 8 (7/8) than from ages 5 to 6 (5/6).
agenesis
Not born: failure of a structure to develop; a specific etiology for the absence of the structure as opposed to later removal or destruction. This may occur because of genetic factors or because of a vascular accident during fetal develop­ment.
Aggregate Neurobehavioral Student Health and Educational Review (ANSER)
A series of questionnaires for parents, teachers, and students to assess all aspects of a child's behavior. The ANSER system is not a standardized test; rather, it is a method of systematically collecting information from parent(s), school personnel, and the child.
aggression
A poorly defined set of human behaviors interpreted from physical or verbal behavior directed at others. Intention differentiates true aggression from pseudo-aggression; the impulsive actions (both verbal and physical) of the child with attention-deficit/hyperactivity disorder can easily be mistaken for aggression and can instigate physical fights. Aggression can he part of the behavior disorder and conduct disorder outcomes of inadequately treated attention-deficit/hyperactivity disorder and learning disabilities.
agitation
Extreme motor restlessness and increased activity level associated with anxiety and tension; a sign of mental distress.
agnosia
Not knowing, with particular reference to sensory stimuli such as visual agnosia, auditory agnosia, color agnosia, and finger agnosia.
agonist
A muscle that while contracting to move a body part is opposed by another muscle, which is termed the antagonist. Every muscle in the body is both an agonist and an antagonist to its opposite number that is needed to reverse its movement.
agrammatism
An inability to produce words in their correct sequence; a marked difficulty with grammar and syntax; speech that is nonfluent, oddly inflected or not inflected at all, slow, and hesitant, with initial words stressed and frequent omission of important connectives. The individual is able to produce words but is unable to arrange them into coherent and coordinated phrases. Agrammatism can be a component of Broca's or syntactical aphasia when a previously established ability to create and adhere to grammatical structure is lost.
agraphia
An acquired condition (usually as a result of brain damage such as follows a stroke in adults) of impaired or absent ability to write or draw (graphomotor skill); the typically milder congenital form seen in children is usually referred to as dysgraphia and may be part of a learning disability syndrome.
Alcardi syndrome
The combination of generalized seizures, severe mental retardation, agenesis (absence of formation) of the corpus callosum (growth failure of part of the brain that is one of the major connections between the two hemispheres), and retinal and vertebral defects. Although not genetically caused, the first trimester intrauterine insult that produces this syndrome occurs only in girls. The clinical seizure type and the EEG pattern suggest that this syndrome may be a variant or subtype of infantile spasms. It must be distinguished clinically from members of the TORCH group of infections, which it may resemble.
Aid to the Permanently and Totally Disabled (APTD)
A 1950 amendment to the Social Security Act, providing financial assistance to those with permanent physical or mental disabilities. This amendment and its provisions were incorporated into the Supplemental Security Income (SSI) program in 1972.
AIDS
See acquired immunodeficiency syndrome.
AISMA
See acute infantile spinal muscular atrophy.
AK
See above knee.
akathisia
1. A disorder with objective motor restlessness accompanied by subjective anxiety; not usually described in children but considered in the differential diagnosis of hyperactivity in adults. 2. One of the motor complications of antipsychotic drugs often used to treat severe maladaptive behavior in people with developmental disorders.
akinesia
A state of diminished or absent motor activity.
akinetic seizure
A type of seizure with head-nodding spells and loss of movement without atonia (loss of tone). Akinetic seizure refers inconsistently to the seizure type associated with Lennox-Gastaut syndrome. These seizures are also known as astatic or atonic seizures.
Albers-Schonberg disease
Marble bone disease; a generic disease with increased density of all bones or mild osteopetrosis, facial palsy, visual impairment, and conductive (involving the middle and outer ear) hearing loss. The severe variant is lethal by adolescence. Inheritance follows an autosomal recessive pattern.
Albert Einstein Scales of Sensorimotor Development
An early attempt at a formal application of Piagetian principles to infant assessment in the following areas: 1) spatial relationships (a 21-item measure of successive stages in the capacity to adapt to the objective properties of physical space as defined by Piaget), 2) object permanence (an 18-item measure of Piagetian object permanence for children ages 5-24 months), and 3) prehension (a 15-item measure of Piagetian developmental advances involving the grasping of objects and their apprehension by the senses for infants ages 2-8 months). There are no "failures" because performance is determined to be at one stage or another; items within a stage represent alternate and often equivalent opportunities to obtain the same developmental level. Scores are based on the pattern of response to stimuli rather than actual achievement of the task. Mean ages for entry and completion of each stage are provided. Named for the College of Medicine in New York City at which the scales were developed.
albinism
The genetic absence of pigment of the skin, hair, and eyes, or eyes only. Visual impairment, nystagmus (involun­tary eye movements). and photosensitivity are common.
alcohol (ETOH)
A chemical compound composed of varying parts of carbon, hydrogen, and water. The number of parts of each of these chemical elements determines the type of alcohol. Drinking (ethyl) alcohol consists of C2H5OH. All alcohols are, in varying degrees, toxic (poisonous) to humans. Alcohol challenges the body to see how quickly it can he broken down into its nontoxic elements of carbon, hydrogen, and oxygen. The slower the body's ability to break it down (in the presence, for example, of liver damage), the more toxic the effect of the alcohol. Alcohol is also teratogenic (causing malformations in the developing fetus): a child with fetal alcohol syndrome (FAS) may have multiple organ system defects that can include blindness, deafness, and severe mental retardation.
alcoholic family
A characteristic set of family dynamics first identified in families in which one spouse was an alcohol abuser. Similar dynamic patterns have since been identified in families with other types of substance abuse. The dynamic interaction between the "dependent" spouse and the "codependent" spouse in maintaining the substance abuse has been reported, along with the characteristic roles assumed by each child according to his or her birth order in the family. The long-term emotional consequences to the children and the characteristic behaviors they exhibit as they move into their own adult intimate relationships are described. Typical behavioral and emotional interventions are prescribed.
alcoholism
The excessive use of alcoholic beverages motivated by either a psychological or a physiological dependence on the chemical effect and mood impact produced by such beverages. Diagnostic criteria assume this underlying dependence and include 1) quantity of usage; 2) failed efforts to stop usage; 3) impaired life functioning in social areas such as family, occupation, and legal difficulties; 4) inability to stop usage despite knowledge of having a persistent problem in one of these life areas due to excess use; 5) increased and driven efforts to obtain alcohol; and 6) increased tolerance for alcohol leading to greater intake before achieving the desired effect.
ALEM
See Adaptive Learning Environment Model.
alexia
An acquired condition, usually as a result of brain damage (such as follows strokes in adults), of impaired or absent ability to read; the typically milder congenital form seen in children is usually referred to as dyslexia.
algorithm
A rule to solve a certain class of problems, especially a formula that automatically generates a solution; loosely, a rule of thumb.
Alice in Wonderland syndrome
A symptom complex characterized by metamorphopsia (hyper- and hyposchematia [visual distortions of size, shape, and spatial relations]). This symptom can occur with migraine, seizure disorders, drug-induced hallucinations, and infectious mononucleosis.
alimentation
Feeding.
ALL
See Analysis of the Language of Learning.
Allen Kindergarten Picture Cards
A preschool vision screening test for chil­dren as young as 2½ years of age; the child identifies pictures of common items at a distance of 20 feet. The test is used until children arc ready to convert to a letter-based screening chart.
allergen
Any substance—food, chemical, drug, or inhalant (pollen, mold, dust)— that, upon repeat exposure, can produce allergic symptoms in a person.
allergic tension fatigue syndrome
Also known as "cerebral allergy." The dual symptoms of tension and fatigue are seen in persons with classically denned allergic disorders. The hypothesis that unsuspected (subclinical or otherwise asymptomatic) food allergies can produce central nervous system irritability and fatigability and thus mimic or cause attention-deficit/hyperactivity disorder (ADHD) and learning disabilities remains unproven.
allergy
"Altered reactivity." The produc­tion of symptoms in a person by substances (allergens) that do not produce symptoms in most other persons. The presence of a family history of atopy (allergy) can help in the interpretation of main nonspecific signs of allergy in children: nasal speech, adenoidal facies, allergic salute (rubbing the nose upward with the heel of the palm), fatigue, nasal polyps, allergic (transverse nasal) crease, allergic shiners (dark circles under the eyes), and a variety of skin conditions (e.g., hives, eczema). Despite extremely high prevalence rates for allergy, the role of allergies in developmental disabilities is often exaggerated. Poor medical management of allergic disease exacerbates but does not cause developmental problems. The contribution of poorly defined subclinical allergies (e.g., to food or yeast via such entities as the allergic tension fatigue syndrome) to the etiology of developmental disabilities remains unproven and controversial.
allied health professional
A person with special training who works under the supervision of a health professional in the provision of direct patient care; a member of the same discipline may function as an allied health professional in a medical setting and as an independent professional in another setting.
alopecia
Hair loss; frequently patchy in children (alopecia areata). This condition is secondary to a variety of conditions in­cluding trauma, drugs, endocrine disorders, and ringworm.
Alpern-Boll
See Developmental Profile II.
ALPHA (Assessment Link between Phonology and Articulation) Test of Phonology
A l5-minute test designed to relate articulation assessment results to phonological analysis.
alphabet
The letters or symbols of a given language arranged sequentially in the order determined by custom.
alpha-fetoprotein (AFP)
A normal protein found in the serum (liquid part of blood) that is present in large amounts in a developing fetus. Measurements of maternal blood levels of AFP are used as a screening test for potential problems with the developing fetus. An elevated AFP is found with anencephaly (no brain or absent top of skull) and open neural tube defects (spina bifida). The open defect leaks AFP into the amniotic fluid, which then passes it into the maternal bloodstream, thus elevating the maternal AFP level. Levels that are two or more times normal detect 79% of open neural tube defects. Amniotic fluid AFP levels are more accurate, detecting 98% of these defects. The neural tube defect can be confirmed by ultrasound. Low levels of AFP are thought to be associated with trisomy 21 (Down syndrome) in the fetus.
Alport syndrome
A genetic syndrome with progressive bilateral sensorineural (involving the inner ear or the auditory nerve) hearing loss (starting by about age 10) and progressive chronic nephritis (kidney disease starting by age 6). Of those affected, 10% also have ocular/visual abnormalities. Although the syndrome is autosomal dominant, males are more severely affected than females; an X-linked pattern has been described in some families.
ALST
See Adolescent Language Screening Test.
Alström syndrome
A genetic syndrome with progressive central and peripheral impairment of vision, retinitis pigmentosa (night blindness and progressively restricted visual field), progressive sen­sorineural deafness, early transient truncal obesity, and juvenile onset diabetes mellitus. The syndrome is extremely rare, with all known cases being of Swedish extraction. Inheritance is autosomal recessive.
alternative communication
Any procedure or device that substitutes a nonspeech mode of communication for spoken language. Such alternative communication may be aided (e.g., communication board) or unaided (e.g., sign language).
alternative medicine
Nontraditional or unproven approaches to the treatment of disease; treatment modalities outside the mainstream of medical practice; other descriptive synonyms include unorthodox, irrational, controversial, sectarian, questionable, and fringe therapies. The use of mystical or metaphysical in this context should be discouraged, since these terms have valid references in other contexts. New age and holistic treatments, as well as most diet and many allergy therapies for developmental disabilities, fall into this category. See also optometric training.
Alzheimer disease
A late-onset, degenerative disease of brain tissue that results in amnesia (impaired memory), apraxia (inability to perform purposeful movements), agnosia (inability to recognize objects or familiar people so that many people with Alzheimer disease fail to recognize their spouses), aphasia (loss of language skills), impaired thinking and judgment, disorientation, marked personality and behavioral deterioration, and loss of adaptive abilities. The disease affects an estimated 11% of the general population under age 65 and 47% of those over age 85; etiology remains unclear. Among people with developmental disabilities, people with Down syndrome have incidence rates of Alzheimer disease greater than that of the general population (33%-40% of people with Down syndrome over age 50 are affected), and the disease manifests itself at a much younger age. The disorder is named after German neuropathologist Alois Alzheimer (1864-1915).
amaurosis
Blindness; specifically, blindness due to disease of the optic nerve, with the rest of the eye remaining intact; a component of a number of hereditary neurodegenerative diseases.
ambidextrous
Equally skilled with both hands; not yet exhibiting handedness or hand preference. Ambidexterity can be familial or can reflect global or specific cognitive delay or dysfunction.
amblyopia
Decreased vision or visual acuity in one eye. There are two major causes of amblyopia: 1) obstructive amblyopia, and 2) amblyopia ex anopsia. Obstructive amblyopia is the loss of vision resulting from blockage of the retinal path so that images cannot reach the retina (e.g., cataracts, ptosis [drooping so that the eyelid cannot be raised), corneal opacity [clouding]). Amblyopia ex anopsia is caused by either a refractive error (correctable by glasses) or strabismus (a crossed eye secondary to a weak eye muscle that can be surgically treated). In amblyopia without intervention, the image from the weaker eye is suppressed by the brain, and that eye gradually loses its vision; thus, monocular vision results. If diagnosed and treated early, many of the causes of amblyopia can he treated or managed in such a way that vision is preserved. Treatment can involve patching, glasses, or surgery.
ambulation
Walking (a gross motor skill). A delay in ambulation is often upsetting and worrisome to parents out of proportion to its developmental significance. The parental preconscious equation of an erect mobility at 1 year of age with being fully human appears to be stronger than the association of connected speech at 2 years of age with normal intelligence. Most children walk independently between 12 and 13 months of age. Caucasian children tend to walk later than African American children. The range for normal walking is 7-24 months. In persons with motor disorders, ambulation is classified according to the degree of assistive support (braces, canes, and wheelchairs) needed and the distance that can be covered; such categories include community walker, household walker, physiological walker, and nonwalker. Delayed walking is most often noted first in spastic diplegia (paralysis of both sides of the body); other types of cerebral palsy are suspected from earlier delays in rolling over and sitting.
amenorrhea
Absence of menstrual periods; this can occur because of pregnancy, endocrine dysfunction, general debilitation associated with poor diet or health, or as part of a genetic syndrome.
amentia
An obsolete term for mental retardation.
American Academy for Cerebral Palsy and Developmental Medicine (AACPDM)
A professional medical organization of physicians and other professionals in the fields of cerebral palsy, mental retardation, and learning and language disorders. Members include orthopedic surgeons, developmental pediatricians, neurologists, physiatrists, and professionals from associated disciplines, Founded in 1947, the AACPDM annually sponsors a national meeting, as well as several regional courses; it publishes a newsletter; and, along with the British Paediatric Neurology Association, its official journal is Developmental Medicine and Child Neurology.
American Academy of Pediatrics (AAP)
A professional organization of physicians with board-certified specialty training in the diseases of childhood. Founded in 1891, the first meeting of the new AAP section on children with disabilities was in 1991.
American Association of Marital and Family Therapy (AAMFT)
A professional organization for certifying and regulating the practice of marital and family therapists. Membership is achieved through demonstrated competence and acceptance of the code of ethics.
American Association of Speech-Language Pathology and Audiology
See American Speech-Language-Hearing Association (ASHA).
American Association of University Affiliated Programs for Persons with Develop­mental Disabilities (AAUAP)
A network of federally funded programs that fosters graduate training in 10 core disciplines serving people with developmental disabilities. Formerly, UAPs were termed UAFs, for University Affiliated Facilities.
American Association on Mental Retardation (AAMR)
An interdisciplinary association of professionals, parents, consumers, and others interested in mental retardation. Originally the American Association for the Study of the Feeble-minded (1876-1940); followed by the American Association on Mental Deficiency (AAMD, 1940-1988). The AAMR publishes the American Journal on Mental Retardation (AJMR), Mental Retardation (MR), and AAMR News and Notes. The AAMR is active in advocacy and conducts both national and state-level professional meetings.
American Foundation for the Blind (AFB)
An independent nonprofit organization founded in 1921 to function as the national association of local services for people who are blind and have visual impairments. Helen Keller (1880-1968) was closely connected with the AFB from its inception until her death. The AFB has national consultants in many areas, including education, employment, and rehabilitation; it provides direct consumer resources and services and conducts research. Several regional offices serve as liaisons to public and private agencies and institutions serving people with visual impairments in the United States.
American Manual Alphabet
Specific positioning of the hands and fingers to symbolize the various letters of the alphabet. When communicating with individuals who have profound hearing loss, the manual alphabet supplements the use of sign language by spelling out words.
American Occupational Therapy Foundation (AOTF)
The philanthropic sister organization of the American Occupational Therapy Association (AOTA). Founded in 1965, the foundation raises funds and distributes resources across three program areas: scholarships, publication, and research associated with the profession and practice of occupational therapy. Scholarships are offered to provide study in the field. The AOTF publishes the American Journal of Occupational Therapy and offers an interlibrary loan program. Professional research is supported through grant and fellowship awards.
American Orthopsychiatric Association (AOA)
A multidisciplinary organization of mental health professionals founded in 1924 to support knowledge development and professional practice and to advocate for appropriate public policy in areas of mental health and human development. The organization is unique in that it was one of the first to seek multiprofessional and interprofessional cooperation in all areas of human development and mental health. It publishes two quarterly journals, the American Journal of Orthopsychiatry and Readings.
American Physical Therapy Association (APTA)
A professional organization for physical therapists, the APTA accredits academic programs in physical therapy, assists in designing certification examinations, and offers continuing education courses. The association publishes a newsletter and a journal and distributes a variety of pamphlets on injury prevention and chronic conditions. It also provides a referral service for individuals needing physical therapy.
American Psychiatric Association (APA)
An organization founded in 1844 under the name, the Association of Medical Superintendents of American Institutions for the Insane; the current name was adopted in 1921. The APA's objectives include improving the treatment and rehabilitation of people with mental illness, mental retardation, and emotional disturbances. The organization promotes professional research and education, provides infor­mation to the public, and fosters cooperation among professionals concerned with mental health. Its membership includes psychiatrists, other physicians, mental health professionals, lawyers, and members of various other professions. The APA's official journal is the American Journal of Psychiatry. In addition, the APA publishes Hospital and Community Psychiatry, Psychiatric News, and the Psychiatric Residents' Newsletter. Work­shops, continuing education, and library services are available to members.
American Psychological Association (APA)
A professional organization with the following goals: to promote psychology as a science, as a profession, and as a means of promoting human welfare; to set standards for education and training; to disseminate knowledge through professional and lay publications; to ensure the quality of professional and ethical practice; to conduct public and professional advocacy; and to hold an annual convention. The APA publishes The American Psychologist and the APA Monitor as well as more focused professional literature. The 47 different divisions in the APA reflect the diverse nature of psychological practice.
American Sign Language (ASL, sign, Ameslan)
A formal method of communication used by people with hearing impairments, in which manual sign symbols function as words. Each sign consists of four basic parameters: hand shape, location or place of articulation, movement in a particular direction, and palm orientation occurring with various hand shapes. Recognized as a "natural language," American Sign Language has its own structure, semantics (the meaning of words), and syntax (grammar). Manual aspects of ASL include sign formation and placement, whereas nonmanual aspects include facial expression, movements, postures, and other nonmanual signs that enhance and emphasize the meaning of signs.
American Speech-Language-Hearing Association (ASHA)
Formerly the American Speech and Hearing Association. ASHA is the national professional, scientific, and credentialing organization for speech-language pathologists and audiologists. Its mission is for all people with speech, language, and hearing disorders to have access to quality services to help them communicate more effectively. Its activities include setting academic standards and accrediting educational training programs; public and professional advocacy; certifying professional competence; providing continuing education; dissemination of knowledge; and ensuring quality clinical and ethical practice. ASHA publishes Asha, the Journal of Speech and Hearing Research, the Journal of Speech-Language Pathology: A Journal of Clinical Practice, and other specialty practice journals. As of January 1, 1997, ASHA's full name will be the American Associa­tion of Speech-Language Pathology and Audiology.
Americans with Disabilities Act (ADA) of 1990 (PL 101-336)
A joint antidiscrimination and affirmative action federal legislative mandate enacted to 1) protect people with disabilities against further discrimination, while 2) jointly expanding social role valorization and inclusion for such people in all aspects of society. Disability is broadly defined as a physical or mental impairment that substantially limits one or more major life activities. Titles I-V of the act systematically address employment, public and private services, public and private architectural accom­modations, transportation, and telecommunications. A multistage implementa­tion strategy provides time lines for compliance. This law is considered the most significant legislation for people with developmental disabilities since the 1975 enactment of PL 94-142, the Education for All Handicapped Children Act.
Ameslan
See American Sign Language.
amitriptyline
Trade name Elavil; a tricyclic antidepressant.
Ammons Quick Test
See Quick Test (QT).
amnesia
Loss of memory; amnesia after a head injury can be retrograde (before the injury) or anterograde (after the injury).
amniocentesis
A procedure that introduces a needle into a pregnant uterus to withdraw amniotic fluid. The fluid contains fetal cells that are used for prenatal diagnosis of chromosomal abnormalities. It is also used to measure the amount of alpha-fetoprotein (AFP; a protein), which may be increased in myelomeningocele (protuberance of both the spinal cord and its lining) or decreased in Down syndrome.
amphetamine
A central nervous system stimulant drug; street names include "speed" and "upper." Because of their abuse potential (including addiction), drugs in this group have been placed in the Class II (non-narcotic) schedule by the U.S. Drug Enforcement Administration and can be prescribed only by a licensed physician under federal and state regulations. In the past, amphetamines were used for weight reduction because of their marked appetite suppression effect.
amplification
The process of increasing the magnitude of an impulse or signal. For example, an amplifier that increases the strength of electrical impulses is a component of hearing aids.
anaclitic depression
A behavioral syndrome of weepiness, apprehension, withdrawal. refusal to eat, sleep disturbances, and eventually stupor, all secondary to a lack of nurturance or mothering in an infant late in the first year of life. Originally thought to be an infantile depression, it is now interpreted as the behavioral correlate of the more severe degrees of failure to thrive or reactive attachment disorder of infancy. When the primary caregiver is suddenly lost, the infant turns inward and becomes extremely passive. See also hospitalism, institutionalism.
anal wink
Stimulation of the rectum produces anal contraction. This reflex may be absent when either sensory or motor pathways to the anal area are interrupted, as occurs in spina bifida or myelomeningocele (protuberance of both the spinal cord and its lining).
Analysis of the Language of Learning (ALL)
A standardized test of metalinguistic knowledge of words, syllables, and sentences, and understanding of directions. ALL is appropriate for 5- to 9-year-old children, even when nonreaders.
anamnesis
Patient history.
anarithmetria
A problem in carrying out arithmetical operations; also known as anarithmia.
anarithmia
See anarithmetria.
anemia
"Low blood." Reflected in decreases in red blood cell number, size (MCV), or hemoglobin content (MCH). Tiredness is one of the primary findings in mild anemia.
anencephaly
A birth defect in neural tube closure during the first 28 days of embryogenesis, leading to an absent forebrain, an incompletely developed skull, and a variety of facial abnormalities. It is incompatible with survival. The recurrence risk is 4%. Alpha-fetoprotein, sonography, and X rays allow prenatal detection.
angel dust
See phencyclidine.
Angelman syndrome
"Happy puppet" syndrome. A syndrome of severe mental retardation with paroxysmal laughter, an ataxic "puppetlike" gait, and a characteristic facies (large mouth, protruding jaw, and midface hypoplasia [atypical tissue development]). Angelman results from a deletion on the proximal arm of the maternal contribution to the chromosome 15 pair. Transmission and incidence patterns are as yet undetermined.
anhedonia
A state of being unable to experience pleasure.
animism
The belief that all things in nature, both animate and inanimate, are alive.
Aniridia-Wilms tumor association
A rare chromosomal disorder that can include mental retardation, a peculiar facies, aniridia (absent irises), and Wilms' tumor (a malignancy of the kidney). This association is frequently caused by a deletion of part of the short arm of chromosome 11.
aniseikonia
An optometric disorder in which the visual images from the two eyes arrive at the brain with different sizes or shapes. This rare condition is diagnosed with an instrument called an eikonometer and is treated with eiseikonic lenses. The theory that aniseikonia contributes to reading disorders is controversial.
anisometropia
An optometric disorder in which the visual acuity in one eye is significantly different from the visual acuity in the other eye.
ankle-foot orthosis (AFO)
See orthosis.
ankylo
A prefix relating to abnormal fusion, usually of a joint.
ankyloglossia
See tongue-tie.
aniage
An initial or elementary structure that embryologically develops into a more complex structure; used analogously for any primordium (early stage).
anomalad
See sequence anomalad.
anomia
An acquired condition (usually on the basis of brain damage such as follows a stroke in adults) of impaired or absent ability to name objects or find the correct words; the typically milder congenital form seen in children is usually referred to as dysnomia and may be part of a learning or language disorder pattern.
anorexia
Loss of appetite; a common side effect of certain drugs (amphetamines), a symptom of psychiatric disorders (e.g., depression, eating disorders), and a non­specific sign of acute or chronic illness.
A not B error
Searching for a hidden object where it was last found, rather than in its demonstrated new hiding place; this perseveration is normal in infants 8-12 months of age.
anoxia
A lack of oxygen delivered to tissue; prolonged anoxia leads to cell death. Anoxia is relatively more dangerous to brain tissue because the surviving brain cells cannot replace lost neurons.
ANSER
See Aggregate Ncurobehavioral Student Health and Educational Review.
antagonist
A muscle that opposes or resists the action of another muscle (the agonist).
anteroposterior view
(AP) An X ray taken so that the beam goes from front to back.
anteversion
Turning or tipping forward.
anthropometry
The science and study of comparative measurement of the human body.
antianxiety drug
Minor tranquilizer.
anticipation
A characteristic of certain genetic disorders in which the age of onset is earlier with each generation.
anticipatory guidance
Parent education about child development that is included as part of the well-child visit to the primary health care provider. Parents are taught how to recognize, respond to, and facilitate age-appropriate behaviors; discipline and developmental stimulation are major concerns. Medical problems that are stage related (e.g., bow legs in the toddler) and variations in development in the presence of chronic disease are also covered.
anticonvulsant
Any of a broad class of drugs used to reduce the frequency or severity of seizures (convulsions). The drug chosen is based on the type of seizures. Dosage is based on a milligram per kilogram of body weight until therapeutic blood levels are reached. The most common side effects of anticonvulsant medications include blood and liver problems, rashes, and drowsiness. Many of these drugs have subtle effects on attention and cognition, and several are known to be teratogenic (causing malformations). Seizure medication must be taken every day and continued for a time period adequate to treat the type of seizure. The goal is to control seizures without inducing debilitating side effects. The major anticonvulsants include phenobarbital, primidone, phenytoins, ethosuximide, valproic acid, benzodiazepines, trimethadione, and paramethadione.
anticonvulsant embryopathy
See fetal Dilantin (phenytoin) syndrome.
antidepressant
See heterocyclic antidepressants.
antiepileptic
See anticonvulsant.
antihistamine
A broad group of drugs used to treat allergic symptoms by blocking the effects of histamine (a chemical that produces allergic symptoms such as pruritus [itching] and urticaria [hives]). The most commonly used antihistamine is Benadryl (diphenhydramine hydrochloride). A common side effect of most drugs in this class is drowsiness; however, children with attention disorders may become more hyperactive when given such drugs.
antimongoloid slant
A term for down-slanting (going from the nose laterally) palpebral fissures. This feature is a component of the facies in a variety of genetic syndromes and, potentially, an isolated finding of no clinical significance. The name derives by contrast with the mongoloid slant in Down syndrome. The anti-mongoloid slant may be more common in syndromes with mid-facial hypoplasia (atypical tissue development).
antisocial personality (ASP) disorder
A chronic pattern of irresponsible behavior with poor social relationships and non­conformity with accepted social standards; the person must be at least 18 years of age with a diagnosis of conduct disorder prior to age 15. Failure to parent, pay bills, hold a job, and plan ahead, as well as criminal antisocial actions, are common features, along with substance abuse, spouse and child abuse, and sexual promiscuity. Antisocial personality disorder is more common in males with a family history of similar disorders. It represents a possible outcome of poorly treated attention-deficit/hyper activity disorder (ADHD) and conduct disorder. Many qualitative features, such as a tendency to seek immediate gratification, an inability to discern consequences, and a failure to learn from mistakes, suggest an underlying immaturity such as that found in ADHD.
anxiety
An internal state of fear in response to external or a perceived danger. Anxiety may be distinguished from fear, however, in that fear is a response to a real and present external threat or danger, whereas anxiety often exists in anticipation of a danger with an unknown and unspecifiable source. An exception to this distinction occurs when anxiety attaches to a real danger, precipitates an emotional overreaction, and reduces the person's capacity to respond realistically to life events. Anxiety may be mild (in the form of apprehension) or severe and functionally debilitating (in the form of panic attacks or phobias). It may occur in discrete periods of sudden onset or may become constant and unfocused (termed free-floating). Anxiety is an unpleasant emotional state accompanied by physiological arousal and the cognitive elements of apprehension, guilt, and a sense of impending disaster.
anxiety disorder
A generic term for a group of disorders characterized by 1) an internal state of extreme, disabling anxiety; and 2) an avoidance behavior pattern. Some anxiety disorders are episodic in nature, such as the panic disorders, while others are more chronic, such as a generalized anxiety disorder. The person is affected by both the internal state itself, a subsequent recursive fear of experiencing this internal state in response to certain external stimuli, and a progressive limiting of life experiences due to the need to avoid those stimuli that provoke the anxiety.
anxiolytic
A medication for modifying the intensity or impact of mental tension and anxiety without interfering with normal mental activity.
AOA
See American Orthopsychiatric Association.
AOTF
See American Occupational Therapy Foundation.
AP
See anteroposterior view.
APA
See American Psychiatric Association.
APA
See American Psychological Association.
Apert syndrome
Acrocephalosyndactyly type I; a genetic syndrome characterized by craniosynostosis (premature fusion of skull sutures) and turribrachycephaly (an odd-shaped skull) and syndactyly (webbing of the fingers or toes). Conductive hearing loss and speech problems secondary to oropalatal structural defects are common. Because all people with Apert syndrome have cognitive impairments (regardless of early craniectomy), it is important to distinguish mental retardation from hearing impairments, speech and language disorders, and other learning disabilities. The true prevalence of mental retardation in Apert syndrome is unknown; incidence is estimated at 1 in 160,000, with the majority of cases representing fresh mutations, although an autosomal dominant pattern has also been demonstrated. When the latter is true, the recurrence risk is 50%. The disorder is named after French pediatrician Eugene Apert (1868-1940).
Apgar Family Version
A five-item self-report questionnaire to elicit a family member's perception of the current state of his or her family's functioning. Patterned after the pediatric Apgar, the family Apgar acronym denotes Adaptation, Partnership, Growth, Affection, and Resolve, the elements of functioning tapped by the instrument. The reliability and validity of this instrument are adequate for use as a screening instrument for troubled families. An average Apgar score, however, should not rule out family-level difficulties.
Apgar score
A technique to assess the status of a newborn baby at 1 and 5 minutes of age by assigning scores of 0 to 2 for each of five descriptors: A—appearance (color); P—pulse (heart rate); G—grimace (response to stimulation); A—activity (muscle tone); R—respiration (breathing effort). Named after Virginia Apgar (1909-74), the Apgar score is an acceptable measure of the acute status of the infant; however, it is a poor predictor of later developmental outcome. The best possible score is 10; however, because most babies have blue extremities (arms or legs) for several hours after birth, a score of 9 is usually the highest obtained.
aphakia
Absence of the lens from the eye.
aphasia
Diminished ability to correctly use and comprehend language. In developmental pediatrics, aphasia is usually limited to a profound lack of language. Children with a less severe disorder are diagnosed with a language disorder. Aphasia may be due to damage to the cor­tex (outer part) of the left hemisphere of the brain.
aphemia
Obsolete and vague term for aphasia.
APIB
See Assessment of Preterm Infant Behavior.
apnea
"No breathing"; respiratory arrest, either transient or prolonged, which can lead to cyanosis (blue color), decreased heart rate, hypotonia (decreased muscle tone), and eventually, brain damage and death. True apnea is defined as a period of at least 15 seconds without breathing. Origin can he obstructive (mechanical) or central (physiological central nervous system response). Apnea is common in pre­mature infants as a result of the develop­mental immaturity of the regulatory mechanisms of the respiratory system. An apnea monitor is a device that sounds an alarm when an infant stops breathing; home apnea monitors are used for some infants at high risk.
apoplexy
An antiquated term for stroke.
appendicular
Relating to an appendage; with regard to the body, reference is to the peripheral arms and legs, rather than to the central head and trunk.
apperception
The perception of stimuli combined with additional mental abilities, including interpretation, classification, and recognition. The process of understanding how newly observed qualities of an object, picture, or situation are related to past experience. Apperception is assessed through projective techniques in psychological testing. See Children's Apperception Test, Thematic Apperception Test (TAT).
APP-R
See Assessment of Phonological Processes-Revised.
appropriate for gestational age (AGA)
A birth weight and length compatible with length of pregnancy.
apraxia
An inability to perform familiar purposeful movements in the absence of motor (paralysis) or sensory loss.
aprosody
Loss or absence of prosody (melody of speech), leading to a mono­tone delivery. Aprosody can be a component of a communication disorder; milder versions are referred to as dysprosody.
APTA
See American Physical Therapy Association.
APTD
See Aid to the Permanently and Totally Disabled.
aptitude
An individual's potential for learning a certain skill or developing, a particular type of knowledge. Aptitude differs from ability in that the latter is generally used in a more restrictive sense to refer to a specific skill or area of knowledge. Ideally, aptitude is measured prior to any specific training. Aptitude may result from environmental influences that provide appropriate attitudes or related knowledge and skills or to a combination of hereditary and environmental factors. Aptitudes are usually measured by specifically devised tests; for example, the Scholastic Aptitude Test (SAT) is designed to measure success in postsecondary education.
aptitude test
A test that attempts to measure specific types of mental competence, often aimed at predicting achievement in certain areas. For example, aptitudes may be described as language (verbal), nonverbal, reasoning, or motoric. In practice, descriptions of these tests often use the terms aptitude, ability, and intelligence interchangeably. For example, the Detroit Test of Learning Aptitude-Revised (DTLA-2) is described as measuring abilities in linguistic, cognitive, attention, and motor domains. The Peabody Picture Vocabulary Test-Revised (PPVT-R) is described as estimating verbal ability. The Test of Nonverbal Intelligence-2 (TONI-2) is described as a language-free measure of intelligence, ap­titude, and reasoning. Subtests of the Woodcock-Johnson Psycho-Educational Battery-Revised (WJ-R) are described as measuring various cognitive abilities. The subtests measuring these abilities are then regrouped to measure scholastic aptitude in order to provide information regarding a subject's expected achievement in reading, mathe­matics, written language, and general knowledge. Aptitude tests do not measure the effects of a standard curriculum or set of experiences; they do include the effects of learning through daily living in combination with innate predispositions.
arachnodactyly
"Spider fingers"; long and slender fingers and toes; can be part of a syndrome such as Marfan syndrome.
arbovirus
A group of RNA (ribonucleic) viruses that includes the rubella virus and that is the most common cause of epidemic encephalitis (brain inflammation).
ARC
AIDS-related complex, the prodrome to acquired immunodeficiency syndrome (AIDS).
ARC-US
See The Arc.
arching
The tendency of a baby to bend the head, neck, and back in a concave curve backward as if withdrawing or pulling away from a frontal stimulus. Arching can be a manifestation of an exaggerated tonic labyrinthine reflex and may then suggest an underlying motor diagnosis. It may also be a behavioral pattern observed in children with autism, pervasive developmental disorder, and other atypical patterns of development.
arginase deficiency
A metabolic disorder of the urea cycle; because the associated hyperammonemia is mild, acute presentation in infancy does not occur. Foe walking (an equinus [involuntary foot extension] gait) and progressive spastic diplegia (paralysis on both sides of the body) may accompany mental retardation and recurrent episodes of vomiting, headache, and irritability. Dietary restriction can prevent the progression of symptoms.
argininosuccinicaciduria
One of the urea cycle defects caused by a block in the enzyme argininosuccinate lyase, the gene for which is found on chromosome 9. The condition is characterized by mental retardation and poor hair formation. It is diagnosed by an elevation in argimnosuccinic acid on amino acid screens. Often protein-loading (giving a protein meal) is required to identify affected people and carriers.
arithmetic
A Wechsler verbal subtest comprising 18 mathematical problems that the child is required to compute mentally and answer orally, thus forbidding the use of paper and pencil. The subtest is timed and requires that the child process verbal information, store components of the problem in auditory memory, manipulate the numbers, and arrive at a solution. The test assesses abstract thinking ability and concentration in addition to auditory memory and arithmetic ability, which makes it difficult to accurately interpret the test in isolation. Success is also influenced by fluctuations of attention and is highly susceptible to anxiety. The subtest is discontinued after three consecutive failures. Adapted sample item: "If I cut a pear in half, how many pieces will I have?"
Arnold-Chiari malformation
A malformation of the brain in which the base (cerebellum, medulla, pons) is elongated and protrudes into the foramen magnum (the opening in the skull where the spinal cord exits). There are four types of malformation numbered I—IV and indicating increasing severity. Hydrocephalus (excess fluid in the brain) is common with a Chiari malformation and generally occurs earlier in life with the more severe types. The most common variant is Type II, which is often found in association with a lumbar or sacral myclomeningocele (protuberance of both the spinal cord and its lining). Type III is more commonly associated with a cervical myelomeningocele. Diagnosis is made by either computed tomography (CT scan) or magnetic resonance imaging (MRI). Treatment generally involves a shunting procedure for the hydrocephalus. Sometimes the pressure within the cervical spinal canal causes neurological dysfunction, and the tops of the cervical vertebrae must be removed in a procedure called a cervical laminectomy.
arousal
State of alertness.
arthritis
Inflammation of a joint; symptoms can include pain, limitation of motion, warmth, redness, and swelling.
arthro
A prefix relating to the joint.
arthrodesis
An orthopedic surgical procedure that immobilizes or fixes a joint by fusion.
arthrogryposis multiplex congenita
A syndrome of multiple congenital joint contractures with a usual pattern of symmetrical involvement of all four limbs. There are no associated neurodevelopmental deficits. This is a pure motor impairment syndrome to be treated by physical therapy, casting, and orthopedic surgery. Etiology and incidence are unknown, although oligohydramnios (too little amniotic fluid) is suspected to contribute to causation. There is no recurrence risk within a family. There is a higher than expected incidence in identical twins; however, only one twin is affected.
Arthur Adaptation of the Leiter International Performance Scale
A nonverbal intelligence test for children between 2 and 12 years of age.
articulation
The way speech sounds are formed. Proper formation requires correct placement, timing, direction, pressure, speed, and integration of the movement of the lips, tongue, palate, and pharynx.
articulation disorder
Developmental articulation disorder, phonological disorder, speech defect; difficulty with pronunciation. This disorder is characterized by consistent failure to use developmentally expected speech sounds.
ash leaf spot
A hypopigmented skin lesion found in tuberous sclerosis.
ASHA
See American Speech-Language-Hearing Association.
Ashworth scale
A grading scale for degree of spasticity (increased muscle tone) with resistance to passive range of motion, scored 1 for no tone, 2 for marked increase in tone but limb easily flexed, 3 for considerable increase in tone such that passive movement is difficult, and 4 for rigidity in flexion and extension.
ASIEP
See Autism Screening Instrument for Educational Planning.
ASL
See American Sign Language.
ASP disorder
See antisocial personality disorder.
Asperger syndrome
A behavioral syndrome with eccentric and obsessive interests, impaired social interactions, average to above-average intelligence, gross-motor clumsiness, and communicative deviance. Children with Asperger syndrome occupy the mild end of the autistic spectrum, with the major differential points being the absence of early language delay, the absence of mental retardation, and the presence of motor clumsiness. Incidence is estimated at 2 per 1,000 with a 7 to 1 male predominance.
asphyxia
Suffocation: lack of oxygenation. When asphyxia is mentioned as a possible cause of developmental disability, it must be of sufficient duration and severity to produce the death of nerve cells. For perinatal asphyxia to be seriously considered as a cause of brain damage, the Apgar score should be 0-3 at 10 minutes, and there should also be severe hypotonia (decreased muscle tone) and seizures.
aspiration
Literally, breathing or inhalation. The medical procedure of aspiration is the removal of a substance from the body by suction. Aspiration pneumonia is a lung infection caused by breathing (aspirating) an irritating substance into the lungs. Aspiration pneumonias are common with tracheoesophageal fistulas and neuromotor disorders with an oromotor or swallowing problem. Meconium aspiration is common with fetal stress and postmature deliveries. Foreign body (e.g., a peanut) aspiration can produce severe lung disease.
aspirin sensitivity
Allergic asthma, nasal polyps, and severe intolerance to aspirin is a widely recognized syndrome in adults. The widespread presence of salicylate (the active ingredient in aspirin, ASA) in foods has contributed to salicylates being included on the list of substances to be avoided in almost all of the dietary regimens claiming to treat disorders of attention and learning, Evidence supporting this latter association remains anecdotal.
Assessing Prelinguistic and Early Linguistic Behaviors in Developmentally Young Children
A set of five early language skills that assesses cognitive antecedents to word meaning, play, communication intention, language comprehension, and language production.
Assessing Semantic Skills through Everyday Themes (ASSET)
A test of receptive and expressive vocabulary for 3- to 9-vear-old children in 10 areas: understanding labels, identifying categories, identifying attributes, identifying functions, understanding definitions, expressing labels, expressing categories, expressing attributes, expressing functions, and expressing definitions.
assessment
Information gathering aimed at 1) evaluating previous performance, 2) describing current behavior, and 3) predicting future behaviors. A comprehensive assessment synthesizes past records, evaluations, interviews with significant people, observations of current behavior, results of standardized tests, and other special procedures. Assessment differs from testing in that testing reflects perfor­mance at a particular time, whereas assessment requires clinical judgment to give meaning, to the overall pattern and interrelationships among the various results.
Assessment of Children's Language Comprehension (ACLC)
A test that uses a picture-pointing task to relate single-word vocabulary to the comprehension of two-, three-, and four-word phrases.
Assessment of Phonological Processes—­Revised (APP-R)
A 20-minute assessment of phonological processes that can he used for intervention planning.
Assessment of Preterm Infant Behavior (APIB)
An adaptation of the Brazelton Neonatal Behavioral Assessment Scale for use with newborns under 37 weeks gestational age. The APIB rates behaviors in visual, auditory, tactile, organization, and reflex categories. It is used with medically stable premature infants until they react to the environment in a manner similar to full-term infants.
ASSET
See Assessing Semantic Skills through Everyday Themes.
assimilation
A learning process that applies a general cognitive structure to particular environmental data and modifies the data to suit that internal cognitive structure.
assistive technology device
An item, piece of (re)habilitation equipment, or product system used to increase, maintain, or improve the functional capabilities of individuals with disabilities. Examples of such devices are orthotics, wheelchairs, and adaptive seating. PE 103-218, the Technology-Related Assistance for Individuals with Disabilities Amendments of 1994, encourages and assists states in developing programs of technology-related assistance and extending the availability of assistive technology to individuals with disabilities and their families.
associated deficits
Neurobehavioral findings that do not derive directly from the primary developmental diagnosis but, rather, indicate more diffuse brain involvement and suggest the possibility of other developmental diagnoses. Associated deficits may be more disabling than the primary diagnosis, their impact on functioning is more than additive, and they reflect the underlying continuum of developmental disabilities.
associated movements
Overflow move­ments; extraneous or adventitious move­ments that occur in the performance of a motor act, such as tongue protrusion when writing. Mirror movements arc contralateral (opposite) associated move­ments; synkinesis refers to ipsilateral (on the same side) associated movements. Associated movements decrease with age and increase with many developmental disabilities; they are inversely correlated with intelligence level. Associated movements are included with soft neurological signs or signs of minor neurological dysfunction.
associated reactions
Movements seen on the affected side of a hemiplegia (paralysis of half the body) or hemisyndrome in response to voluntary forceful movements in other parts of the body.
association
Also known as syntropy, a nonrandom occurrence of multiple anomalies (malformation, deformation, disruption, or dysplasia) in more than two individuals. There is a purely statistical relationship between the anomalies. Examples include VATERS, MURCS, and CHARGE, all acronyms denoting typical associations. Understanding of the relationship between anomalies in an association is weaker than in a syndrome, although an association such as VATERS may occur as part of a syndrome, such as trisomy 18.
association area
The primary visual, auditory, sensory, and motor areas of the cerebral cortex (Brodmann areas 1, 2, 3, 4, 17, and 41) are bounded by association areas (e.g., 5, 6, 7, 18, and 42) in which the incoming sensations and outgoing motor actions are interpreted or initiated by the subject. Problems with higher-order thinking (such as occur with learning disabilities) are often localized to the association areas.
Association for Children and Adults with Learning Disabilities (ACLD)
See Learning Disabilities Association of America.
Association for the Gifted
One of 13 divisions of the Council for Exceptional Children (TAG—The Association for the Gifted). Founded in 1958, the division strives to promote an understanding of gifted and talented students and their educational needs, to disseminate current knowledge of the gifted, to ex­pand existing knowledge, and to advocate for policies and legislation on all levels that address the needs of the gifted. The association publishes the Journal for the Education of the Gifted and the TAG-UPDATE, the association's newsletter.
associationism
A theory of learning suggesting that once two stimuli are presented together, one of them will remind the learner of the other. Basic principles of associationism are 1) contiguous stimuli (occurring close together) are more likely to be associated than those occurring far apart; and 2) the more frequently the paired stimuli are repeated, the more strongly they will be associated.
assortative mating
The tendency of individuals with cognitive and emotional disorders to form relationships with each other. Although the majority of pairing occurs between like types—for example, between people with schizophrenic disorders—there are also documented pairings of people with complementary or nonrelated disorders. For example, people with sociopathic tendencies and those described as hysteric often couple. Such mating thus increases the genetic probability that their offspring will be similarly affected. Although not documented within the population with learning disabilities, it is reasonable to assume that a similar process occurs and increases the likelihood or genetic risk of the offspring having learning or other developmental disabilities. Whereas this phenomenon applies to some extent to people with mental retardation, there is usually a cognitive level difference (one member of the couple being more functional than the other) that allows for their adaptive existence as a couple and as a family. In some cases assortative mating is enhanced by prolonged association with a particular social reference group (e.g., mental health facility, group therapy, sheltered workshop). However, research also indicates the existence of this phenomenon independent of prolonged affiliation.
astasia
An inability to stand due to motor incoordination; this neurological finding can manifest itself in episodes of sudden collapse, with loss of support of the weight of the body. Astasia can he observed in typically developing infants at 4-5 months of age; physiologically it precedes abasia.
astatic seizure
See akinetic seizure and atonic seizure.
astereognosis
Congenital or acquired difficulty with stereognosis (solid form recognition by touch).
asthenic body type
A long, slender habitus (appearance).
asthma
A disorder with recurrent episodes of wheezing and shortness of breath (dyspnea) precipitated by allergy, infection, and physical or emotional stress. The incidence is 2%-5% with a prevalence of 2%; there is a male predominance. As a chronic disease in childhood, asthma accounts for a significant percentage of school absence; however, students with asthma tend to be academic overachievers. When associated with allergies, atopic asthma represents one of the more severe allergic disorders of childhood; yet the incidence of learning and behavior disorders in this condition does not appear to be elevated over that of the general population. This gives rise to serious doubt that allergy plays any significant role in the etiology of neurobehavioral syndromes.
asymmetrical tonic neck reflex (ATNR)
A primitive reflex in which turning the baby's head to one side causes the arm and leg on that side to extend while the opposite arm and leg tend to flex, producing a "fencing posture." This is a physiological (normal) response in newborn babies that gradually disappears during the first 6 months of life. However, even late in the first year when the reflex is no longer visible, it can significantly influence tone and other reflex responses, facilitating extension on the face side and flexion on the occiput side. Any examination of the neuromotor system in infancy should therefore be performed with the baby's head in midline. With an obligatory response, the child would be unable to break out of the ATNR pattern so long as the head remained turned to the side; such a response should be considered pathological.
asymptomatic
Without symptoms. Appearing healthy and without disabilities when in reality there is a disease condition present. Some carriers of infections diseases remain asymptomatic while spreading the disease; others become symptomatic. Genetic carriers of autosomal recessive conditions may have no symptoms or only mild symptoms compared to homozygotes. Many diseases of various etiologies have quiet phases or asymptomatic stages. Screening tests often attempt to diagnose asymptomatic disorders. An asymptomatic impairment should not produce disability, but if identified, might engender a disability (see prodrome). Many definitions of health equate health with being asymptomatic. Such a definition is controversial, in that it ignores those conditions just mentioned.
ataxia
Literally, "lack of order"; in developmental disabilities, absence or loss of muscular coordination leading to clumsy and uncertain standing, walking, and reaching. An ataxic (unsteady) gait is wide-based, staggering, almost drunken; the difficulty is exaggerated when walking with the eyes closed. Significant ataxia is usually associated with disorders of the cerebellum.
ataxia telangiectasia
Louis-Bar syndrome; a progressive, ultimately fatal genetic disorder with marked coordination problems (ataxia); dilation of the small vessels (telangiectasia) of the eyes, nose, and ears; frequent infections (secondary to an im­mune system limitation); and, in approximately half of the cases, mental deficiency in the later stages of the disease. Incidence is rare, with inheritance following an autosomal recessive pattern.
ataxic cerebral palsy
One of the physiological subtypes of cerebral palsy in which the prominent motor signs are early hypotonia (decreased muscle tone) and later ataxia (unsteady gait). When ataxia is the prevailing motor symptom and it exhibits constant improvement with age, congenital cerebellar involvement is typical, with some degree of cerebellar hypoplasia or agenesis (absence of formation) usually being demonstrable on neuroradiological investigation. The most frequent associated defecit with cerebellar cerebral palsy is mild cognitive limitation; tremor and articulation disorders are not uncommon. This is one of the rarer subtypes of extrapyramidal cerebral palsy.
atelectasis
A collapse of a segment of the lung; its presence is usually associated with preexisting or underlying lung disease, and its occurrence is usually marked by increased respiratory distress.
athetoid posturing
An abnormal movement pattern of the hand and fingers (and sometimes of the foot and toes) involving splaying of the digits, spooning, and an "almost withdrawal" or "avoidance" posture when attempting to grasp an object (and sometimes spontaneously). Athetoid posturing of the feet contributes to the "spontaneous Babinski" of extrapyramidal cerebral palsy.
athetosis
Literally, "without position"; in motor disabilities, a pattern of movement disorder characterized by involuntary, slow, writhing, and undulating movements of flexion, extension, pronation, and supination—more peripheral than central, sometimes called vermicular or wormlike. When the associated motor delay is serious, the type of extrapyramidal cerebral palsy present is usually described as choreoathetoid. More purely athetoid movements are slower and more sustained than choreiform (involuntary twitching) movements. See also choreoathetosis.
Ativan
See lorazepam.
atlantoaxial instability
An enlargement of the distance between the first two cervical (neck) vertebrae that leaves the individual susceptible to spinal cord compression. neurological involvement (transient or permanent weakness or paralysis), and death. Children with Down syndrome are at increased risk for atlantoaxial instability. Periodic radiologic screening (cervical spine X rays), close neurological monitoring, and caution with regard to contact sports and other activities that might precipitate cord compression are indicated.
ATNR
See asymmetrical tonic neck reflex.
atonic cerebral palsy
See hypotonic cerebral palsy.
atonic seizure
Akinetic or astatic seizures: seizures characterized by sudden loss of posture and tone. In infants who do not stand independently, these seizures are manifested in the "salaam seizures" during which the infant suddenly drops his or her head and neck forward. In older children, the loss of postural tone results in a sudden drop to the ground ("drop attack"). Although there is only a brief loss of consciousness, head injuries commonly occur after such events. Atonic spells are most common in the morning shortly after waking, but can occur frequently during the day. Atonic seizures are part of Lennox-Gastaut syndrome, which has a poor prognosis for seizure control and cognitive development. See also Lennox-Gastaut syndrome.
atopy
Literally, "strangeness." A group of allergic diseases with common features. Atopic diseases include hay fever, allergic asthma, certain cases of eczema, and some cases of urticaria (hives). These have a definite familial or genetic tendency, but not to specific diseases or allergens.
atresia
The congenital absence of or failure to develop a normally present body cavity or canal.
atrophy
Shrinkage; wasting away. A decrease in size of an anatomical structure (body part or organ).
attention
Selective, goal-directed perception. Neuropsychological theories and (neuro)physiological correlates of arousal and attention remain confusing and disappointing. Whatever the operational definition of attention, the length of time a child can attend to a stimulus (attention span) increases with age, interest, and intelligence level.
attention-deficit/hyperactivity disorder (ADHD)
Formerly, attention deficit disorder (ADD) with or without hyperactivity (H). This disorder is a neurobehavioral syndrome characterized by short attention span, distractibility, impulsivity, and hyperactivity. Frequently this disorder (either ADHD or ADD) overlaps with learning disabilities. Diagnosis is by interview, observation, and behavioral questionnaires. The child or adult should, over a prolonged period of time, demonstrate a behavioral pattern that includes the fol­lowing: fidgeting, difficulty remaining seated, distractibility, difficulty waiting turns, blurting out answers, failure to complete assignments, poorly sustained attention, excessive shifting, noisiness, excessive talking ("motor mouth"), intrusiveness, failure to listen, frequently losing things, and physically dangerous behavior. There is some overlap with oppositional defiant disorder. Motor clumsiness and visual perceptual motor disorders are also common in this condition. Current prevalence estimates suggest that 5%-10% of all children exhibit some form of ADHD, with 20% of these exhibiting a severe form. Although familial in occurrence, transmission patterns are not vet fully delineated.
attribution retraining
Experimental programs based on attribution theory are designed to teach children how to change their performances by changing their perception of the cause of success or failure from an uncontrollable factor, such as ability, to a controllable factor, such as effort. Students are given feedback regarding their effort on tasks, such as "You were trying hard" or "We usually fail because we don't try hard enough." It is important that the tasks undertaken be consistent with the students' abilities.
attribution theory
A social psychology theory that explores the cognitive rules typically used by individuals to explain observed social behavior. People develop a repertoire of causal schemata, defined as a general conception of how certain kinds of causes interact. A major division separates those who blame themselves (internal causation) from those who blame others or their environment (external causation). A person's explanations for feelings, successes, failures, or other outcome's may be enhanced or inhibited by his or her position on the internal versus external causal axis.
audile
Describes a person who learns best by listening (e.g., rather than by looking).
audiogram
A record showing hearing level by sound frequency. A clinical audiogram should show hearing thresholds measured by both air conduction and bone conduction. Better hearing by bone conduction than air conduction indicates an air—bone gap, a sign of conductive hearing loss.
audiologist
An individual who holds a degree and/or a certification in audiology and who is concerned with the identification, assessment, and rehabilitation of hearing impairments.
audiology
The study of hearing and hearing disorders; specifically, the assessment of the nature and degree of hearing loss, hearing conservation, and the rehabilitation of individuals with hearing impair­ments. Clinical audiology considers hearing to be the foundation of learning and utilization of language skills; thus, emphasis is placed on understanding the social uses of hearing and on maximizing the ability of individuals with hearing impairments to cope with the demands of communication.
auditory
Relating to hearing or audition.
auditory brain-stem response (ABR)
See brain-stem auditory-evoked response.
auditory discrimination
The (brain's) ability to tell the difference between very similar sounds. People with problems in auditory discrimination have difficulty distinguishing between words that sound alike or differ in a single phoneme. Such words as "tow" and "toll," and "whim" and "win," may sound identical to them. An impairment in auditory discrimination can interfere with verbal comprehension and the development of functional reading skills. In addition, a serious weakness in auditory discrimination in the classroom setting can be confused with inattention, as the child appears not to have listened closely. See also Wepman Auditory Discrimination Test.
auditory memory
The ability to store and retrieve information presented verbally as sounds or in the form of sound symbols, which may involve auditory sequential memory (remembering details in a particular order). Auditory memory relates to the acquisition and use of both expressive and receptive language vocabulary. Expressive vocabulary may partially depend on an ability to recall and retrieve particular words at the appropriate time, whereas receptive vocabulary may constitute a form of auditory recognition, retention, and association. See also auditory sequential memory.
auditory motor
See perceptual-motor.
auditory nerve
Also known as the acoustic nerve; the eighth cranial nerve. Cranial nerve VIII has two major branches: the cochlear nerve for hearing and the vestibular nerve for balance.
auditory perception
The ability of the brain to interpret information that enters the body through the ears. Auditory perception is not directly related to auditory acuity or sharpness but to the process by which the brain discriminates sounds from each other and identifies meaningful units of sound.
Auditory Projective Test
See Brayerman-Chevigny Auditory Projective Test.
auditory sequential memory
The ability to retain verbally presented information in a particular order. Auditory sequential memory is measured by tests such as digit span and memory for sentences and nonsense syllables. People with auditory sequential memory problems may also have difficulty following a series of instructions. However, such a difficulty may be confused with or may coexist with attentional limitations, which may also be manifested by an inability to respond correctly to an ordered series of verbal directions.
auditory training
The process of teaching a person with a hearing impairment how to make the best use of residual acoustic cues (i.e., how to listen, localize, and dis­criminate). Auditory training is not to be confused with auditory process training, a method of ameliorating learning disabilities prevalent in the 1960s.
augmentative communication
Any procedure or device that facilitates speech or spoken language.
augmentative and alternative communication (AAC)
Temporary or permanent compensation techniques of individuals with severe expressive communication disorders. AAC interventions should utilize an integrated group of components, including the symbols, aids, strategies, and techniques used by individuals to en­hance communication. In this definition, "symbols" refer to the methods used to facilitate communication by representing conventional concepts (e.g., gestures, photographs, manual sign systems, printed words, spoken words). The term "aids" refers to a physical object or device to assist with the communication process (e.g., board, chart, device, computer). "Strategies" arc the specific ways AAC aids and techniques are used to enhance communication (e.g., role playing, classroom learning), and "techniques" refer to the way in which the messages are transmitted (e.g., scanning, encoding, signing, natural gestures). All these interventions come from both augmentative and alternative communication approaches.
augmentative communication system
Aggregate communication process for an individual with verbal communication difficulty.
aura
A sensation that may precede a seizure or migraine headache. This may be caused by vasodilation (increase in diameter) of the blood vessels of the brain in migraines. The auras present in migraine headaches include vomiting; visual disturbance; tingling; or transient hemiplegia (paralysis of half the body), aphasia (loss of language skills), or ataxia (unsteady gait). Auras preceding seizures—generally complex partial seizures—are often olfactory (smell), a gastric "rising" sensation, fear, visual hallucinations, or, rarely, rage reactions. The frequency of auras appears to increase with age; however, this may reflect the ability of a child to describe the phenomenon.
aural rehabilitation
Educational procedures used with individuals with hearing impairments to improve their overall ability to communicate. Rehabilitation includes developing, utilizing, and integrating existing receptive and expressive modalities such as utilizing auditory, tactile, visual, and kinesthetic channels. All the techniques are based on two methodologies: 1) the analytic method, which is a sequential approach that stresses mastery of the parts of the technique for assimilating information into a comprehensive picture; and 2) the synthetic method, which promotes the use of language in spontaneous, simultaneous situations through speech, reading, and writing before the language is presented formally.
auricle
The external ear, or pinna. The term is also an old synonym, little used, for the heart chamber now called the atrium.
auscultation
Listening; a diagnostic procedure to listen to the body's internal sounds; examples include the use of a stethoscope to auscultate heart sounds and breath sounds or a fetoscope to auscultate the unborn baby's heart rate.
autism
Kanner syndrome, autistic disorder, early infantile autism. A neurobiological syndrome characterized by extremely deviant behavior including failure to develop social relationships, language delay and deviance, hyperactivity, tactile defensiveness, stereotypies, insistence on the preservation of sameness, and, in approx­imately 85% of cases, mental retardation. This rare developmental disorder was first described by Leo Kanner (1894-1981) in 1943 and was, for many years, thought to reflect maternal ambivalence toward the child. It is now generally recognized to be a severe organic brain disorder with many different etiologies (causes) such as rubella, neurofibromatosis, and fragile X syndrome. Incidence is estimated at 0.02%. Treatment is generally through the educational system using highly structured, non-stimulating environments, behavior management techniques, and a language-based curriculum. Prognosis for adult functional outcome is related to IQ and the degree of language impairment. Autism has been diagnostically categorized as a pervasive developmental disorder.
Autism Screening Instrument for Educational Planning (ASIEP)
A classroom assessment and educational planning system for persons with autism, severe disabilities, and developmental disabilities who are between 18 months of age and adulthood and who have low language abilities. The ASIEP includes five components: autism behavior checklist (ABC); sample of vocal behavior; interaction assessment (including self-stimulation, crying, laughing, gesturing, manipulation of toys, conversation, and tantrums); educational assessment; and prognosis of learning rate.
autistic features
Behavioral deviance frequently seen in children with autism, deafness, or other developmental disorders with somewhat atypical presentations. These features can include language delay, noncommunicative language, reference to self in third person, pronominal reversal, neologisms (introduction of new words or new senses of words), echolalia (repetition of what is heard), poor eye contact, lack of cuddliness as a baby, nor responding to auditory input, good rote memory, acting as though off in own world, treating people like furniture, laughing for no reason, odd play, no peer interactions, water play, toe walking (an equinus [an involuntary foot extension] gait), rocking, twirling, spinning, perseveration (unable to move to an­other thought or idea), hyperactivity, unusual object attachment, hand regard, hand flapping, stereotypies, and preservation of sameness.
autognosis
Diagnosis through the awareness of the feelings that the individual engenders in the examiner. For example, an interview with a depressed person may leave the physician feeling depressed.
automatic processing
Behavioral sequences that, after prolonged practice, no longer require attention. Some processes arc susceptible to this type of learning, whereas others may be intrinsically incapable of automatization. Although automatic processes are rapid and efficient, once learned they are inflexible and difficult to change. In a learning situation, automatization failure and deficiency refer to the fact that a person must still devote conscious attention to learning tasks that have become automatic for others. For example, having to consciously decode words hinders comprehension, and having to consciously compute math facts decreases the attention available for processing new concepts. In everyday life, whereas the process of learning to drive requires conscious attention, once the process becomes automatic, little thought is given to the specific actions necessary.
automatisms
Semipurposeful movements or activities that occur frequently with complex partial seizures. These are generally stereotypic movements that may he related to the activity in progress before the onset of the seizure or may begin after the onset. Automatisms can be described in five groups based on the characteristics of the activity. These groups include gestural motions (picking at clothing), alimentary motions (chewing or lip smacking), mimicking (facial grimaces), verbal occurrences (yelling, laughing, or repetitive speech), and ambulatory movements (walking or running). In general, automatisms occur after consciousness has been lost and children do not remember them.
automatization
The point at which information processing becomes effortless and more efficient due to practice or increased expertise.
autonomic nervous system
The involuntary nervous system; that division of the nervous system that controls the unconscious functioning of the cardiovascular, respiratory, digestive, and reproductive systems; sometimes referred to as brain-stem, vegetative, or life-sustaining functions. There are two major subdivisions to the autonomic nervous system: 1) the sympathetic (adrenergic), and 2) the parasympathetic (cholinergic) nervous systems.
autosomal dominant
Describes the inheritance pattern for a trait that appears in every generation, is transmitted by an affected person (one parent), but never by an unaffected person. Transmission and occurrence are not affected by sex. Neurofibromatosis is an example of an autosomal dominant trait.
autosomal recessive
Describes the inheritance pattern for a trait that is inherited when a child receives two genes for the trait, one from each parent, both of whom must carry the gene for that trait although they are not necessarily affected by it. Every human probably carries several harmful recessive genes, but these genes are usually present in the general population at a relatively low prevalence. A specific harmful gene may be present in a particular population at a higher rate than that of the general population. For example, although Tay-Sachs disease is present in all populations, it occurs at a greater rate in the Ashkenazi Jewish population. Inbreeding among ethnically, religiously, or geographically isolated populations results in an increase in the number of individuals with rare recessive disorders. See consanguinity.
autosome
Any chromosome other than a sex chromosome. Humans have 22 pairs of autosomal chromosomes and one pair of sex chromosomes.
auxology
The study or science of (human) growth. The term was introduced by Paul Godm (1860-1935) in 1919 and was popularized by J.M. Tanner in the 1970s to refer to the whole subject of physical and physiological growth and development.
aversive stimulus
A stimulus that, applied to a response, decreases the tendency of that response to recur; a noxious stimulus.
axial
Central in the body; along the axis of the head and trunk; axial tone (especially hypotonia [decreased muscle tone]) is often distinguished from appendicular tone.
axilla
The armpit.
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