Parent Support for Children with Challenges - Definitions

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

babbling: The second stage of infant vocalization following cooing and preceding first words. Consonant and vowel combinations are used repetitively to produce such sequences as "gagaga" and "dadadada." Babbling is a maturational phenomenon that occurs over time (6-7months) even in children who are deaf but is delayed in children with developmental disabilities such as mental retardation and language disorders. Absent or delayed babbling is part of the syndrome of the quiet baby.
Babinski sign: A plantar (foot) reflex in which the toes flex (turn down) when the lateral (outside) of the sole is stimulated. An abnormal (termed positive) Babinski sign is an upgoing (extension) movement of the toes (dorsiflexion). A positive response is not uncommon in the first year of life. A normal (termed negative) Babinski reflex is described as flexion (downgoing) and plantar flexion. The first movement of the hallux (big toe) and the presence of flaring of the toes are important points in equivocal or uncertain Babinski responses. Positive Babinski responses are signs of pyramidal tract involvement in spastic cerebral palsy, and spontaneous (unstimulated) upgoing Babinskis can he observed in extrapyramidal cerebral palsy. Joseph Francois Felix Bahinski (1857-1932) first described this reflex.
Babkin reflex: A newborn reflex pattern in which squeezing the infant's palms produces mouth opening, eye closing, and turning and flexing of the head. This palmomandibular sign weakens in the first month and is absent after 4 months of age.
back pain: In adults, back pain is a frequent complaint and is often related to physical exertion or psychosomatic stress. In children, back pain is almost always associated with significant organic pathology. Rarely does it accompany the psychosomatic triad of headache, abdominal pain, and leg pains often found together in children.
backward: An antiquated and inexact term used to describe mild mental retardation, borderline intelligence, or academic underachievement.
backward reader: An outdated term broadly used to refer to anyone with a significant reading problem. The term was derived from the normal tendency of young children, and the residual tendency of older children with reading difficulties, to reverse letters and words when learning to read. The term was used with great regularity in school psychology as late as 1970 and reportedly still appears infrequently in the literature. If encountered in contemporary special education settings, the user must be asked to define its context. Like its modern counterpart, dyslexia, the term backward reader can easily be misinterpreted.
baclofen: A centrally acting muscle-relaxant drug that is sometimes used in severe cases of cerebral palsy; indications and efficacy remain unclear. One proposed method of improving the efficacy of baclofen is by continuous intrathecal baclofen infusion (CIBI). Baclofen also has been used to treat self-injurious behavior.
BAER: See brain-stem auditory-evoked response.
Baller-Gerold syndrome: A rare genetic syndrome with craniosynostosis (premature fusion of skull sutures), growth deficiency, abnormalities of the forearm and anus, and, in approximately half the cases, mental retardation. Inheritance follows an autosomal recessive pattern.
ballismus: Rotary flailing; irregular, violent, flinging, hurling, large rapid movements at the shoulder or hip. The condition is typically unilateral (hemiballismus) and represents a rare variant of choreiform (involuntary twitching) extrapyramidal cerebral palsy.
Balthazar Scales of Adaptive Behavior (BSAB): A rating scale for adaptive behavior in institutionalized children and adults with mental retardation.
banding: A technique of staining chromosomes that produces characteristic but different patterns of cross-bands. G-banding uses Giemsa staining; Q-banding uses quinacrine fluorescence.
Bankson-Bernthal Test of Phonology (BBTOP): An assessment of articulation and phonological processes among children 3-9 years of age.
Bankson Language Test-Second Edition (BLT-2): A test of language for children from 3 to 7 years of age with results organized into three general categories: semantic (meaning systems) knowledge, morphological/syntactic (language structure) rules, and pragmatics.
Bannatyne classification: A heuristic recategorization of Wechsler subtests in an attempt to assist in the evaluation of children believed to have learning disabilities. The spatial category (picture completion, block design, and object assembly) taps the ability to manipulate objects in space. The conceptual category (comprehension, similarities, and vocabulary) addresses abilities involved in language development. The sequential category (arithmetic, digit span, coding) is the same as the Wechsler freedom from distractibility factor; it measures the ability to remember and utilize auditory and memory stimuli sequences in short-term memory storage. The acquired knowledge category (information, arithmetic, vocabulary) evaluates abilities usually learned at home and school. Bannatyne's categorization is based on examination of the subtest, rather than factor-analytic studies. Designed to aid in test interpretation, the pattern proposed as generally typical of learning disability is spatial-conceptual-sequential. However, no single, unique Wechsler profile for children with learning disabilities has been demonstrated. This is not surprising, because children with learning disabilities are a heterogeneous group. Bannatyne's classifications have not succeeded at either differentiating children with visual-perceptual limitations from those with auditory-perceptual limitations or discriminating children with learning disabilities from groups of children with other disabilities.
barbiturate: A group of addictive drugs that act as central nervous system depressants; they can be used for sedation and seizure control.
Bardet-Biedl syndrome: A genetic syndrome with polydactyly (extra fingers or toes), syndactyly (webbing of the fingers or toes), obesity, retinitis pigmentosa (with night blindness in childhood progressing to complete blindness by age 20 in three fourths of cases), and mild to moderate mental retardation in 85% of cases. Cardiac, renal, and ophthalmological follow-up is indicated. Inheritance follows an autosomal recessive pattern. Recurrence risk is 25%.
Barlow maneuver: A test of hip stability used to screen for congenital hip dislocation in infants; medial to lateral (outside) pressure is applied to the proximal femur (thigh bone). Testing for hip dislocation is a routine component of the pediatric examination in early infancy.
barrier-free: Describing a building, facility, or area that is accessible to people with impaired mobility. Barrier-free access provides ramps or elevators to supplement steps or stairs. Doorways are wide enough to accommodate wheelchairs, and bathrooms are equipped to accommodate people with impaired mobility. The term is also used to refer to removing barriers that limit access of people with other disabilities by, for example, printing all signs in braille for people with visual impairment.
basal: The point below which test items are assumed to be correct. To shorten test administration time, particularly when the test covers a wide age range, administration procedures often indicate an item to begin with, based on age or grade. Basals are described specifically for each test and are often a set number of consecutive items answered correctly. If, for example, the basal is four consecutive correct answers and the subject misses one of the first four items administered, easier items are administered until the criteria arc met. In scoring, items below the basal, regardless of whether they are correct, are scored as correct. A variation of this rule is sometimes referred to as a "double basal," in which two basals are obtained with errors between them. The Peabody Picture Vocabulary Test-Revised requires that the higher basal be used; other tests may not address this phenomenon. Because scoring procedures differ by tests, instruction manuals should be consulted.
basal ganglia: A group of nuclei (control centers) in the brain whose major function is to regulate voluntary motor activity through the extrapyramidal motor system. These nuclei include the striatum (caudate nucleus and putamen), globus pallidus, and substantia nigra. They are very susceptible to damage by hyperbilirubinemia (high levels of bilirubin in the blood), which can occur in neonatal jaundice (yellowing of the skin) (e.g., in Rh incompatibility [erythroblastosis fetalis]). Immediate pathological effects might include opisthotonos (an arching of the back) with kernicterus; long-term effects are reflected in choreoathetoid cerebral palsy.
Basal readers series: A series of books containing a collection of stories in which vocabulary is controlled. The books are typically used with groups of children and represent different reading levels. The series also includes teachers' manuals, workbooks, placement and achievement tests, and various audiovisual and duplicating materials.
base pair: See deoxyribonucleic acid (DNA).
baseline: A record of the frequency, duration, or intensity with which a behavior occurs over a period of time before an attempt to change the behavior is initiated. For example, the number of times a student talks out in class is recorded over a period of 3 days. This represents baseline data. Continuing to monitor the behavior while a specific method of behavior management is in place or charting it again over a 3-day period at a later date and comparing it to the baseline data will indicate the effectiveness of the intervention. This method may also be used to assess the effectiveness of an academic intervention. For example, the number of words read correctly per minute may be charted. Baseline behaviors can include physiological measures such as heart rate.
baseline exaggeration: A phenomenon in which acute psychiatric symptoms are an exaggeration of preexisting behavior problems in people with mental retardation.
Basic Achievement Skills Individual Screener (BASIS): An individually administered test designed to assess students' basic skills in mathematics, reading, spelling, and writing. The skills are assessed from first- through eighth-grade levels. Administration time is approximately 1 hour. Both norm-referenced (standard scores, percentile ranks, stanines, grade equivalents, age equivalents, and normal curve equivalents) and criterion-referenced (Grade Referenced Placement Score) scores are provided for mathematics, reading, and spelling. Writing samples are scored holistically and are rated as average, below average, or above average. People with disabilities were included in the standardization sample, although several modifications are recommended with these populations.
Basic School Skills Inventory-Diagnostic (BSSI-D): Both a norm- and criterion-referenced test for children ages 4-0 to 7-5. The BSSI-D uses 110 items to measure the following six areas of school performance: 1) daily living skills, 2) spoken language, 3) reading readiness, 4) writing readiness, 5) math readiness, and 6) classroom behavior.
basic skill: A fundamental ability. The mastery of basic skills is necessary to progress to higher levels of achievement. Basic skills are considered to be the activities necessary for functioning on a daily basis. Academically, basic skills include speaking, spelling, reading, writing, and arithmetic. The basic skills of individuals with learning disabilities are often not uniformly developed or are attained through one predominant processing style or channel, making the achievement of more-advanced academic abilities, such as integration of information or problem solving, even more difficult to achieve. In addition, for children with learning and other developmental disabilities, basic skills training may also emphasize social skills, studv habits, attention training, and other specific tasks that assist in the development of independence and self-esteem.
basic trust: In Eric Erikson's version of psychoanalysis, the major achievement of the first year of life; repeated interactions with a caregiver (typically the mother) teach the infant a positive orientation toward the world. The major importance of this theoretical construct lies in the long-term impact of a failure in its development: children who are severely neglected in infancy remain at risk in later life of exhibiting significant sociopathy. Extrapolation of this association to the milder end of the spectrum of parenting disorders is less well documented.
basilect: Dialect that varies considerably from standard English; common in cultural groups that are not frequently exposed or readily inclined to adopt standard English (e.g., English spoken in ethnic communities).
BASIS: See Basic Achievement Skills Individual Screener.
Bassen-Kornzweig disease: See abetalipoproteinemia.
Battelle Developmental Inventory (BDI): A comprehensive, standardized, 341-item assessment for children from birth to 8 years of age in the domains of personal-social, adaptability, motor, communication, and cognition. Administration time is 1-2 hours. A Spanish version is available.
Battelle Developmental Inventory Screening Test (BDIST): A 96-item developmental screening test for children from birth to 8 years of age that yields a total test score and seven subtest scores in the following domains: personal-social, adaptive, gross motor, fine motor, receptive language, expressive language, and cognitive. Derived from the BDI (Battelle Developmental Inventory), the test allows the use of alternative screening cutoffs. Administration time is approximately a half hour.
battered child syndrome: Also known as Caffey syndrome, Caffey-Kempe syndrome; refers to a specific pattern of lesions to the bones found on X-ray examination that indicates a child is being criminally beaten by his or her caregivers. These radiographic findings may be accompanied by bruises, burns, black eyes, cuts, and abrasions leading to suspicion of the etiology (cause).
battery: Specific groups of diagnostic tests used in evaluating an individual for a variety of conditions and in a number of situations. Psychological, educational, neurological, and developmental evaluations include test batteries. Individual tests in a battery focus on different but related skills or on particular aspects of a given skill, providing the examiner with a significant amount of data. Those data, in combination with history information, behavioral observation, and clinical judgment, are used to formulate a diagnosis and, subsequently, to suggest directions for intervention.
Bayes theorem/Bayesian analysis: A probabilistic approach to assessing the effectiveness of a screening test or diagnostic procedure; the approach attempts to allow for the prevalence of the condition being tested for in the population. If the joint probability is prevalence multiplied by sensitivity, then the final, or posterior, probability is the joint probability divided by the sum of the joint probability and the product of the false positive rate multiplied by [1 minus the prevalence rate]. For example, if a disorder has a 3% prevalence rate and a screening test has a sensitivity (true positive rate) of 95% and a false negative (underreferral rate) of 10%, then the posterior probability that the disorder is present when the screening test is positive is only 37%.
Bayley Scales of Infant Development-Second Edition (BSID-II): A measure of cognitive and motor development for children from 1 to 42 months of age. Originally developed by Nancy Bayley, the following two standard scores are obtained: 1) a mental development index from the mental scale, and 2) a psycho-motor developmental index from the motor scale. The mental scale assesses shape discrimination, sustained attention, imitation, comprehension, problem solving, memory, vocalization, and naming objects. The motor scale assesses fine- and gross-motor abilities, including grasping, sitting, and walking. There is also a Behavior Rating Scale, which systematically rates 11 areas of social and affective behavior. Behaviors related to cognitive tasks (i.e., attention span, reactivity, and goal directedness) have been found to relate to mental scores, whereas social extraversion behaviors (i.e., cooperativeness, emotional tone, and social orientation to the examiner) have been found to have little predictive validity. Standard scores on the Bayley have a mean of 100 and a standard deviation of 16. The average length of testing is 45 minutes. Proper administration of the scales requires considerable practice and experience. As of 1996, the scale was regarded as the best available measure of infant development, owing to its psychometric properties.
Bayley II: See Bayley Scales of Infant Development-Second Edition.
BBCS: See Bracken Basic Concept Scale.
BBTOP: See Bankson-Bernthal Test of Phonology.
BDI: See Battelle Developmental Inventory; see also Beck Depression Inventory.
BDIST: See Battelle Developmental Inventory Screening Test.
BE: Below elbow.
BEAM: See brain electrical activity mapping.
Beck Depression Inventory (BDI): A self-administered questionnaire with 21 items rated on a four-point scale to screen for and assess the intensity of depression in persons 17-80 years of age. A version for children is also available.
Becker muscular dystrophy: See muscular dystrophy.
Beckwith-Wiedemann syndrome (Beckwith syndrome): A dysmorphic syndrome of unknown etiology (cause) characterized by exomphalos (umbilical abnormality), macroglossia (large tongue), and gigantism (macosomia [large body size] often present from birth). Mental retardation is an occasional finding. There is a characteristic facies with a birthmark on the forehead and a linear groove in the lobule of the ear. Hypoglycemia (low blood sugar level) and Wilms' tumor (a malignancy of the kidney) are among the potential complications; thus, regular medical follow-up for these conditions is warranted. Inheritance pattern is unclear.
bed-wetting: See enuresis.
Beery and Buktenica Developmental Test of Visual-Motor Integration: A visual perceptual motor test for children 2-16 years of age.
Beery Developmental Test of Visual-Motor Integration (DTVMI): See Developmental Test of Visual-Motor Integration.
BEH: See Bureau of Education for the Handicapped.
behavior disorder: A practical term referring to observable behavior that deviates from the norm. In special education, the term is often used synonymously with the terms emotionally disturbed and emotionally handicapped. PL 94-142, the Education for All Handicapped Children Act of 1975, uses the term "seriously emotionally disturbed" when providing criteria for eligibility for services. (PL 94-142 was reauthorized in 1990 as PL 101-476, the Individuals with Disabilities Education Act [IDEA]). This latter term does not include children with social maladjustments unless it is determined that they also have serious emotional disturbances. States, however, use a variety of terms, including behaviorally disordered, in their legal language when defining criteria for services. The interchangeable use of these terms is confusing, if not contradictory. A serious emotional disturbance encompasses a range of childhood psychopathology, including schizophrenia, whereas a behavior disorder implies behavior that is unacceptable to an environmental norm. The vagueness of behavior disorder as a categorical descriptor makes it difficult to define appropriate intervention strategies. In addition, describing and attempting to modify specific behaviors without questioning etiology (cause) may overlook learning or language disorders as causative factors. Behavior disorder connotes a diagnosis that is based on the presence of one or more deviant or problem behaviors.
Behavior Evaluation Scale (BES): A checklist of six developmental areas and one problem area to help plan educational interventions for children with autism.
Behavior Evaluation Scale-2 (BES-2): A behavior assessment for children in grades kindergarten through 12. The BES-2 measures five dimensions corresponding to the five characteristics of behavior disorders/emotional disturbance in PL 94-142, the Education for All Handicapped Children Act of 1975 (since reauthorized as PL 101-476, the Individuals with Disabilities Education Act [IDEA] of 1990): learning problems, interpersonal difficulties, inappropriate behavior, unhappiness/depression, and physical symptoms/fears. Examiner qualifications are minimal. A seven-point scale is used to rate 76 items according to the frequency with which indicated behaviors are observed. Standard scores with a mean of 10 and a standard deviation of 3 are derived for each subscale, and a behavior quotient with a mean of 100 and a standard deviation of 15 is derived from the sum of the subscale standard scores. Percentiles may he obtained for each of the five subscales and the total scale. The BES-2 is not to he confused with Kozloff's Behavior Evaluation Scale, which is an entirely different instrument.
behavior management: An approach to child rearing/parent training that moves the focus of behavior intervention from a reactive stimulus-response approach to a proactive preventive management approach. Such an approach eliminates environmental support for inappropriate or negative behaviors and provides environmental support for positive behaviors. For children with neurological problems, ordinary parenting techniques that communicate a "Don't do that again" message in response to an inappropriate behavior are usually ineffective. In a structured behavior management approach, misbehaviors are anticipated, and preventive measures are instituted. Thus, children who are neurologically driven (i.e., children with attention-deficit/hyperactivity disorder [ADHD]) can avoid the experience of constant reprimands while enjoying positive reinforcement for good behaviors.
behavior modeling: A training intervention popularized by social learning theory. A practitioner demonstrates (models) the appropriate behavior or uses a visual representation. Behavior modeling is a useful instructional procedure that requires its users to follow specific, but not difficult, procedures to produce maximum results.
behavior modification: A set of techniques based on the systematic application of learning theory. Common to all models of learning theory is the notion that positive reinforcement will increase a behavior and that negative reinforcement or punishment will decrease a behavior. From these fundamental tenets, a number of psychotherapeutic techniques and parent-training models have been developed to help parents handle the tasks of child rearing more systematically. Although these tools are useful for parents of neurologically normal children, they often fail to modify the organically driven behavior of a child with neurological problems (e.g., a child with attention-deficit/hyperactivity disorder [ADHD] or Prader-Willi syndrome). These children may cognitively associate a behavior with an expected consequence, but the neurological substrate of their behavior remains unmanaged. An injudicious application of these techniques and their subsequent failure can lead to secondary emotional and family problems.
Behavior Observation Scale for Autism (BOS): A 67-item direct observation scale used to diagnose autism.
Behavior Rating Instrument for Autistic and Atypical Children (BRIAAC): A behavior rating scale that generates the following eight subscales: relationship to an adult, communication, drive for mastery, vocalization and expressive speech, sound and speech reception, social responsiveness, body movement, and psychobiological development. The resulting profile is used for diagnosis, prognosis, and programming.
Behavior Rating Profile (BRP): A 124-item questionnaire that includes student rating scales, teacher rating scales, parent rating scales, and a sociogram. The instrument attempts to assess children's behavior in a variety of settings and from different points of view.
behavioral genetics: A field of study concerned with the effects of genes on the expression of behavior. Although nature versus nurture issues continue to be a central controversy in the study of human behavior, recently a convergence of factors has permitted a quantitative measurement of the genetic aspects of the nature versus nurture interdependence in producing states of behavioral health or unhealth. These factors include the following: 1) an availability of adequate family pedigrees in countries that have standardized national health records, 2) standardized diagnostic criteria, 3) molecular genetic technology, and 4) computer modeling. The prototype for such studies is the research on the genetic determinants of alcoholism. Behavioral geneticists have focused on developmental difficulties such as Tourette syndrome, attention-deficit/hyperactivity disorder [ADHD], language deviance, and dyslexia and have described a number of chromosomal and environmental interactions.
behavioral observation audiometry: A hearing assessment procedure used primarily with infants and young children. The child is behaviorally conditioned to perform a certain task in response to sound in order to obtain hearing thresholds. In testing infants, reflex responses are elicited and utilized; the following three types are typically employed: 1) the hear-turn technique, 2) the high-amplitude sucking technique, and 3) the starter technique. The infant's response is used to determine speech-sound discrimination. Play conditioning for 3- to 4-year-olds pairs a fun activity (e.g., building peg-board figures, dropping coins in a bank) with preservation of sound produced by a pure tone audiometer.
behaviorism: Within the discipline of psychology, a theory of behavior that views learning as the central focus of human psychology. Learning is defined as the acquisition of specific responses (R) to specific stimuli (S). This theoretical formulation traditionally viewed any discussion of brain mediation of the S-R chain through cognition, consciousness, or instinct as irrelevant and unscientific, because it was unobservable and therefore nonobjectifiable. Recent theoretical reformulations, however, have readmitted the role of the brain's mediation, using the person him- or herself as a scientific observer. Within the same fundamental framework, the concepts of cognitive behaviorism have developed. These concepts and the resulting methods of therapeutic intervention have now begun to interact with other language and cognitive processing theories, such as information, hemispheric lateralization, and neurolinguistic theories. Although no single theoretical framework has emerged, the interactions are providing a base for developing interventions for children with mental retardation, language impairments, and developmental disabilities.
Behr disease: An inherited spastic paraplegia with optic atrophy (wasting); a rare hereditary degenerative disease characterized by ataxia (unsteady gait), mental retardation, optic atrophy, nystagmus (involuntary eye movements), and peripheral neuropathy that begins in infancy. Inheritance follows an autosomal recessive pattern.
Bell palsy: Paralysis (usually temporary) of the facial (seventh cranial) nerve leading to sagging of the face on the involved side with an ironing out of the usual facial lines.
Benadryl: See diphenhydramine.
Bender Face Hand Test: An examination procedure to test for extinction (failure to perceive). Stimulus: The individual is lightly touched on one or both checks and/or hands and on the ipsilateral (on the same side)/contralateral (opposite) cheek and/or hand. Response: With eyes closed, the individual is asked to identify the body parts touched. The most common failure involves the extinction of the distal stimulus (hand) when the ipsilateral hand and cheek are touched.
Bender Visual Motor Gestalt Test (Bender Gestalt): A measure of visual-motor ability adapted in 1938 by Lauretta Bender from drawings used by Max Wertheimer in his studies of this gestalt concepts involved in visual perception. The Bender Gestalt is a nonverbal test with a range of applications to all age groups and to populations with diverse cultural and experiential backgrounds. The subject is asked to copy on a blank piece of paper nine figures of varying complexity that are presented one at a time. The subject is subsequently asked to reproduce the figures from memory, adding a visual retention component to the test. A significant relationship exists between intelligence and the accuracy of Bender-Gestalt reproductions. The child supplies clues to his or her learning approach, to the ease with which psychomotor skills are acquired, and to how well he or she organizes written work on a page. The Bender-Gestalt drawings help to provide important information about developmental lags, neurological impairment, mental retardation, and emotional disorders. The test takes approximately 5 minutes to administer. The Koppitz Developmental Bender Scoring System is typically used to evaluate the test. The following four categories identify errors on the developmental scoring scale: 1) distortion of shape, 2) rotation, 3) integration difficulties, and 4) perseveration. Percentile norms are available for children ages 5-0 through 11-11. There is also a score based upon 12 emotional indicators, but little is known about their validity.
benign childhood epilepsy: See benign rolandic epilepsy.
benign rolandic epilepsy: Also called mid-temporal epilepsy, sylvian epilepsy, and benign childhood epilepsy with centrotemporal spikes (sharp, pointed deviations). A seizure disorder with infrequent seizures beginning between ages 5 and 10 years. Typically, the seizure is preceded by a sensory aura in the mouth (tongue, cheek, or gums), followed by salivation, speech arrest, and tonic (increased muscle tone) or tonic-clonic (relaxation of muscle tone) movements of the face. Consciousness is preserved in more than half the cases. Seizures occur frequently during sleep. The electroencephalogram (EEG) shows mid-temporal spikes. Prognosis for this type of seizure disorder is excellent, as most children respond to anticonvulsants and are generally seizure-free after middle childhood by the onset of puberty.
Benton Right-Left Discrimination Test: A 20-item test in which children who arc 6 years of age are expected to identify the right and left sides of their bodies, children who are 7 years old are expected to touch right-sided or left-sided body parts with the ipsilateral (on the same side) hand, and children who are 9 years of age perform the same motion with the contralateral (opposite) hand. Eleven-year-old children are expected to identify the examiner's right and left, and children who are 12 years of age are expected to identify the examiner's right and left with the children's right or left hands.
Benton Visual Retention Test-Fifth Edition: A test of visual-motor coordination and visual memory with direct copying and delayed memory administrations. The number of correct reproductions and the error score can be compared to age norms for children as young as 6 years, with expected scores being given for different IQ levels. The results obtained with this instrument do not discriminate among the impact of visual attention, visual memory, and visual-perceptual motor skill areas.
benzodiazepine: A class of antianxiety drugs including diazepam, lorazepam, clonazepam, clorazepate, nitrazepam, and acetazolamide. Diazepam and lorazepam are also used in the treatment of status epilepticus. Clonazepam is useful in minor motor seizures, mixed seizure disorders (e.g., Lennox-Gastaut, infantile spasms), and atypical absence seizures. Clorazepate is used as an adjunct to other anticonvulsants in the treatment of refractory partial and generalized seizures. Nitrazepam is effective in minor motor seizures and infantile spasms, but is not used in the United States because of its liver toxicity. Acetazolamide has clinical use in many kinds of seizures including absence, menstruation-related generalized, and complex partial seizures. It is especially useful in refractory seizures. In general, side effects of the benzodiazepines include sedation, ataxia (unsteady gait), and respiratory depression. They must be administered 2—4 times a day and can lose their antianxiety effectiveness over time.
BES: See Behavior Evaluation Scale.
BES-2: See Behavior Evaluation Scale-2.
bethanechol: A cholinergic agonist that stimulates the parasympathetic nervous system (trade name, Urecholine). It is used in the treatment of gastroesophageal reflux.
bezoar: A stomach mass that is composed of ingested nonfood items and that may cause symptoms of gastrointestinal obstruction and, rarely, perforation. (A trichobezoar is a hair ball.)
BIDS syndrome: IBIDS syndrome without ichthyosis (very dry skin).
bilateral: Pertaining to both sides of the body.
bilateral integration dysfunction: See vestibular-bilateral disorder.
bilingual: Fluency of verbal communication processes in two or more languages. A key issue in education concerns the impact of bilinguality on the educational process. The younger the person, the easier it appears to be to learn multiple languages; however, it has been suggested that the educational process in other content areas becomes confused when more than one language has been acquired.
Bilingual Syntax Measure I and II (BSM): A criterion-referenced measure of oral syntactic (language) structures. Available in both English and Spanish versions.
Binder syndrome: See maxillonasal dysplasia.
binocularity: The use of both eyes to focus on an object and allow the brain to form a clear three-dimensional picture of the object.
biofeedback: A term used to denote both the process and the outcome of the application of operant conditioning methods, such that a person acquires the ability to shift autonomic nervous system-based physiological functions (both visceral and central) to the control of higher cortical processes. For example, the autonomic vasoconstriction (narrowing of blood vessels) substrate of migraine headache processes is brought into conscious volitional control so that when vasoconstriction begins, the affected person begins the biofeedback processes to redilate the vessels. These training processes include bringing these autonomic questions into awareness by electronic monitors that "feed back" to the subject information on such body processes as skin temperature, heart rate, and skin sweat response. The person learns to change the rate or degree of these body processes as reflected in the electronic indicators by conscious monitoring and body feedback. Biofeedback has been used in people with developmental disabilities in such areas as facilitating continence in the presence of spinal cord lesions such as those that occur in myelomeningocele (protuberance of both the spinal cord and its lining).
biosocial: Pertaining to both biological and social phenomena, especially the interrelationship between the two and usually with an emphasis on the social.
biotinidase deficiency: Also known as multiple carboxylase deficiency. A hereditary metabolic condition in which the clinical signs and symptoms arc extremely variable but can include myoclonic seizures, developmental delay, ataxia (unsteady gait), sensorineural hearing loss, hypotonia (decreased muscle tone), dermatitis, alopecia (hair loss), and optic atrophy (wasting). The incidence of this syndrome is approximately 1 in 75,000. Inheritance follows an autosomal recessive pattern.
biparietal diameter: A measurement of the width of the fetal skull made by ultrasound; this length is used to estimate gestational age.
bipolar illness: A psychiatric disorder characterized by extremes of happiness and sadness of mood and excessive behaviors that reflect the mood. Previously termed manic-depressive disorder, the name change to bipolar illness more accurately reflects the extremes of mood and behavior experienced by those with the disease. In the depressive phase, the affected person may reach a complete vegetative depression and see life as a black hole from which there is no escape and for which there is no hope. While in this "pole" of the disorder, the person may stop eating, stay in bed, and may attempt suicide. As the depression remits, the person often swings to the alternate "pole" where happiness and enthusiasm give way to unrealistic euphoria, untempered enthusiasm and optimism, and behavioral excesses. Thus, in this polar end of the illness, the affected person may not sleep for days or weeks, may talk for hours (or days) on end, may go on spending sprees of hundreds of thousands of dollars, and may engage in excesses of sexual appetite (both in quantity and number of partners). Persons with bipolar illness have a failure of the emotional modulating system combined with both thought processes and behavior components that reflect the unrealistic polar extremes of the disorder. Thought to be genetic in origin, the disease exhibits familial expression. Furthermore, many developmental and learning disorders, such as autism and reading problems, appear in excess in families with bipolar illness.
bird-headed dwarfism: See Seckel syndrome.
birth defect: A congenital disability. The use of the term birth defect is now discouraged because it implies that the person is damaged and may have contributed to the condition by the process of being born.
Birth to Three Developmental Scales: A developmental profile for children from birth to 3 years of age that uses observation, direction following, motor and verbal imitation, object and picture naming, and pointing.
bite reflex: An oral reflex in which tactile (touch) stimulation in the oral area (gums, teeth, or tongue) produces a rhythmic opening and closing of the mouth; a primitive reflex apparent between birth and 6 months of age, after which it is replaced by rotary chewing.
bivalve cast: A cast in two pieces connected at their margins like a bivalve or clam shell; such a cast allows ready access to the casted body part.
BK: Below knee.
BLAT: See Blind Learning Aptitude Test.
blended family: A nuclear family formed by the joining of two previously unrelated families. For example, a woman and her two biological children may join (usually by marriage) with a man and his two biological children to form a blended family with four children. Blending requires not only the working out of the adults' relationship, both as intimate partners and as parents, but also the working out of relationships between previously unrelated children to each other and to previously unrelated adults who are now, de facto, authority figures. Often this process is further complicated when one or more of the children maintains a principal residence with the other parent and is part of the blended family on an irregular basis.
blepharophimosis, camptodactyly, short stature, mental retardation, and inner hearing impairment syndrome: A dysmorphic syndrome with peculiar facies including short palpebral fissures (eye slits), camprodactyly (permanent flexion of the fingers or toes), short stature, severe mental retardation, and hearing loss.
Blind Learning Aptitude Test (BLAT): A 61-item verbal-touch test of tactile (touch) discrimination for children who are blind and ages 6-16 years. The examiner guides the child's hands over pages of patterned dots and lines and the child is asked to describe what is felt. Learning aptitude is assessed through recognition of differences and similarities, identification of progressions and missing elements, and the ability to complete a figure. Administration time is approximately 45 minutes. The BLAT appears to be most useful for children between the ages of 6 and 12. Standard scores are provided (with a mean of 100 and a standard deviation of 15). In conjunction with the use of verbal measures, the BLAT is a supplementary test for evaluating the nonverbal cognitive abilities of children who are blind.
blindism: A self-stimulatory behavior typically exhibited in people who are blind, such as eye gouging or eye rubbing noted in preschool children who are blind (see digito-ocular sign of Franceschetti). Other such socially inappropriate behaviors include rocking, hand movements, smelling, and autistic stereotypies (constantly repeated meaningless gestures or movements).
blindness: A person is termed blind when there is corrected visual acuity worse than 20/200 in the better eye. It has been recommended that the definition of the term blind be restricted to the absence of light perception and that "visual impairment" and "low vision" be extended to describe persons with vision worse than 20/200 but who retain light perception.
Blissymbolics: A graphic symbol system created by Charles Bliss in 1942. In this system, symbols are combined in a logical manner to depict aspects of human experience. Blissymbolics use photographs (symbols that look like what they represent), ideographs (symbols representing ideas), and symbols depicting characteristics of the word (i.e., plural or action) to construct compound symbols, providing for a large vocabulary. Blissymbolics arc particularly useful to those who are unable to use traditional written language but who can learn and employ a large vocabulary. The system is an aided augmentative communication approach for nonvocal individuals with physical disabilities; it has also been used successfully with individuals with mental retardation or hearing impairments and adults with aphasia (loss of language skills).
Blitz-Nick-Salaamkrampfe syndrome: See West syndrome.
Boch-Sulzberger syndrome: See incontinentia pigmenti syndrome.
blood-brain barrier: The relative impermeability of the adult brain to certain metabolites and especially to sudden fluctuations in the levels of these metabolites that occur in the bloodstream: the brains of premature and very young infants are more susceptible to such changes.
Bloom syndrome: A genetic syndrome with a short stature, facial erythema (inflammation) with a butterfly distribution (exaggerated by sunlight), midface hypoplasia (flattening), and occasionally mild mental retardation. There is a high incidence of immune defects and of cancer. Inheritance follows an autosomal recessive pattern. Risks for this disorder are increased among Ashkenazic Jewish populations, of whom 1 in 100 is thought to be a carrier of the gene for Bloom syndrome.
Blount disease: Genu varum (bow legs), from an abnormality of the tibia (calf bone).
BLT-2: See Bankson Language Test-Second Edition.
blue sclera: A bluish tinge to the whites of the eyes that occurs in premature infants and persons with glaucoma (increased pressure in the eye, often hereditary); it is also noted in the following systemic disorders: osteogenesis imperfecta (fragile bone disease), Marfan syndrome, Hallermann-Streiff syndrome, Crouzon syndrome, Turner syndrome, and a syndrome of hyperextensibility of the joints with hearing impairment.
Brazelton NBAS: See Brazelton Neonatal Behavioral Assessment Scale.
BNT: See Boston Naming Test.
Bobath: See neurodevelopmental therapy.
bobble-head doll syndrome: A peculiar head-bobbing behavior (2-4 times/second) associated with a third ventricle cyst (hydrocephalus [excess fluid in the brain]); it may be the presenting sign for this latter condition. To be distinguished from spasmus mutans.
Boder Test of Reading-Spelling Patterns: A criterion-referenced diagnostic test to identity the following three subtypes of reading disability originally described by Elena Boder: 1) a dysphonetic pattern (inability to sound out and blend component letters and syllables of a word), 2) a dyseidetic pattern (limitations in visual memory and visual discrimination), and 3) a mixed pattern (incorporating both types of errors). Results are reported in terms of reading level, reading age, mental age, and reading quotient (based on sight-word vocabulary), spelling test score, and reading-spelling pattern (normal, nonspecific reading disability, dysphonetic, dyseidetic, mixed dysphonetic/dyseidetic, and undetermined). The Boder was designed for screening and clinical use and is not standardized.
Boehm Test of Basic Concepts-Revised (Boehm-R) (BTBC-R): A group test for children in kindergarten through grade two to assess conceptual mastery for early school success and pinpoint areas in need of remediation. There is also an individually administered preschool version for children 3-5 years of age.
bolus: A globular mass; it can refer to food ready to be swallowed or drugs to be injected intravenously in a single dose or administered over a short time period.
bone age: Also known as anatomical age. Skeletal growth age as determined by the X-ray appearance of the bones compared with standards for different ages; the most commonly used standards are those of Greulich and Pyle for the hand. In children with short stature, chronological age, bone age, height age, and mid-parental height can be used to predict final adult height.
BOR syndrome: See Melnick-Fraser syndrome.
borderline intellectual functioning: The presence of an 1Q between 70 and 85 in the absence of functional or adaptive impairment. Sometimes equated with the slow learner educational category. Earlier classifications referred to this IQ range as borderline mental retardation; there is no association of either with borderline personality disorder.
Börjeson-Forssman-Lehmann syndrome: An X-linked genetic syndrome characterized by severe to profound mental retardation, hypotonia (decreased muscle tone), hypogonadism (small testicles) and microcephaly (abnormally small head) with a coarse facies and large cars. Inheritance follows a recessive pattern.
BOS: See Behavior Observation Scale for Autism.
Boston Naming Test (BNT): An aphasia test with 60 stimulus picture cards for use with subjects above 5 years of age.
BOTMP: See Bruininks-Oseretsky Test of Motor Proficiency.
Botox: See botulinus A toxin.
bottom shuffling: See scooting.
bottom-up processing (stimulus-driven): A term found in cognitive psychological theory referring to processing directly affected by stimulus input. In bottom-up processing, perception is based on a detailed analysis of stimulus information. Perception is largely bottom-up when viewing (or listening) conditions are clear, but may increasingly involve top-down processing as conditions deteriorate. For example, a word that is clearly written (and recognized by the reader) can be processed on its own merits (bottom-up). However, if it is not clear to the reader, context clues and expectations based upon previous expreience must be utilized (see top-down processing). In most circumstances, perception involves the interaction of bottom-up and top-down processing.
botulinus A toxin (Botox): The neurotoxin that produces botulism (food poisoning). This neurotoxin can be used in the treatment of neuromuscular disorders such as rigidity and spasticity.
boundaries: Emotional and interactional barriers that protect and enhance the integrity of individuals, relationships, and families. Boundaries are unwritten rules that function as invisible lines defining both closeness and distance in a relationship, authority structures in the family, and the relationship of the family to the outside world. Boundaries can be too rigid to allow growth, or they can be too loose to protect the family. When too rigid or too loose, family therapy may be necessary to redefine, loosen, or strengthen boundaries.
Bourneville-Pringle syndrome: See tuberous sclerosis syndrome.
bow legs: Genu varum; mild bowing of the legs is physiological (normal) in late infancy. In this mild form, gross motor development is not affected; hence, significant motor delay should prompt a search for other causal factors. See genu varum.
bowing reflex: See damper reflex.
BPD: See bronchopulmonary dysplasia.
brachial: Relating to the arm.
brachycephaly: A disproportionately short head (high cephalic index).
brachydactyly: Short fingers; can be an autosomal dominant trait with or without other developmental or syndromic associations. Short fifth fingers that do not reach the distal interphalangeal crease of the fourth finger are a minor dysmorphic feature that may reflect the presence of a neurodevelopmental disorder.
Bracken Basic Concept Scale (BBCS): An educational diagnostic instrument that measures 258 basic concepts in 11 subtest categories for children 2-6-8 years of age in order to assess school readiness as reflected in receptive language. Administration is individual or group. Responses may be verbal (stating the number that corresponds to the answer) or nonverbal (pointing to the correct option). Standard scores (mean of 100, standard deviation of 15) by age, percentile bands, normal curve equivalents, stanine scores (a scoring system with scores expressed as whole numbers from 1 to 9 with a mean of 5 and a standard deviation of 2), and mental age scores are provided. Two short screening tests are used to identity children who would benefit from the full scale.
brain: The part of the central nervous system contained in the skull or cranium. It performs a multitude of tasks, from control of basic functions (e.g., breathing) to higher cortical functions (e.g., intellect and learning). The brain is divided into the following four major parts: 1) brain stem, 2) diencephalon, 3) cerebrum, and 4) cerebellum. The brain is also divided into halves, called hemispheres, that are connected by the corpus callosum. For protection, the brain is surrounded by a layer of tissue called the meninges, and is further protected by a fluid, the cerebral spinal fluid (CSF), that flows through the brain in a system of conduits called ventricles. Blockage of these ventricles can cause hydrocephalus (excess fluid in the brain).
brain electrical activity mapping (BEAM): A complex computer technology that uses electroencephalographic (EEG) readings to map the electrical activity of the brain. BEAM is a potentially useful research tool in the evaluation of children with learning disabilities.
brain-stem auditory-evoked potentials (BAEP, BAER, ABR): A test using auditory stimuli (sound) to measure the passage of the message along the auditory nerve (cranial nerve VIII) to the brain stem and associated areas of the brain. This gives information about the intactness of the system but not about the perception of the sound. Damage to hearing resulting in an abnormal BAEP can he caused by meningitis (inflammation of the spinal cord and brain membranes), hyperbilirubinemia (high levels of bilirubin in the blood), perinatal asphyxia (lack of oxygen), or central nervous system disorders like leukodystrophy. It can be used to assess hearing in children who are too young to cooperate for a behavioral hearing test.
brain-stem auditory-evoked response (BAER): Also known as ABR (auditory brain-stem response) or BSER (brain-stem evoked response). A test of the intactness of the auditory nerve (cranial nerve VIII) and its tract in the brain stem. The test gives information only about brain-stem structures and therefore reveals nothing about cortical defects in auditory perception. It is performed by introducing a set of clicks to one ear and tracing the resulting electrical activity from the eighth cranial nerve sequentially to the following structures in the brain stem: cochlear nucleus, superior olivary nucleus, the nucleus of the lateral lemniscus, and the inferior colliculus. Abnormal BAERs are found with brain-stem damage resulting from meningitis (inflammation of the spinal cord and brain membranes) or encephalitis (brain inflammation), neonatal jaundice (yellowing of the skin), or perinatal asphyxia (lack of oxygen). Hereditary degenerative diseases like Friedreich ataxia can show subclinical abnormalities of the eighth nerve. Abnormal BAERs can also be the result of middle-ear disease that impedes the activation of the eighth cranial nerve.
branchial arch: An anatomical anlage (predisposition) that evolved from gills in fish into structures of the ear and neck in humans. Abnormalities in fetal branchial arch development give rise to branchial cysts deep within the neck and to conditions such as the Treacher Collins and Goldenhar syndromes.
branchio-oto-renal syndrome: See Melnick-Fraser syndrome.
Braverman-Chevigny Auditory Projective Test: An adaptation of the Thematic Apperception Test (TAT) for persons with visual impairments; the stimulus is a conversation with garbled language.
Brazclton Neonatal Behavioral Assessment Scale (NBAS): A tool for the behavioral assessment of newborn infants. The 37 items include a careful description of state, visual and auditory alertness and orientation, tone and posture, cuddliness and consolability, as well as startle and self-quieting. Elicited responses (primitive reflexes) are scored separately.
breathholding spell: A paroxysmal behavior observed in preschool children after severe crying following an identifiable emotional upset; it may end in unconsciousness with a brief clonic (rhythmic contraction and relaxation) asphyxic seizure. Breathholding spells should be treated behaviorally rather than with anticonvulsant medication.
breech: The delivery of a baby feet first rather than head first. In a frank breech presentation, the baby's pelvis comes out first with the legs flexed (turned down) on the body; in footling breech, the feet themselves come out first. The neonatal mortality rate, incidence of prematurity, specific genetic syndromes, major organ malformations, and the later presence of neurological abnormalities are significantly higher in children born by breech presentation. Breech presentation accounts for approximately 3% of all deliveries. The major obstetrical risk in a breech delivery is that the umbilical cord may be compressed during the relatively prolonged delivery of the largest part of the baby, the head.
BRIAAC: See Behavior Rating Instrument for Autistic and Atypical Children.
bridge: A three-block construction that can be imitated by a child at 3 years of age; a fine-motor milestone.
Brill Educational Achievement Test for Secondary Age Deaf Students: An academic screening test for adolescents who are deaf and 13-20 years of age.
Broca's aphasia: Expressive aphasia; motor aphasia; the loss of the ability to speak secondary to damage to a specific area or the left frontal lobe (Brodmann area 44, Broca's area, inferior frontal gyrus, anterior speech cortex). Residual speech is characterized by agrammatism.
Broderick decision: Halderman vs Pennhurst State School and Hospital, et al.; A 1978 court decision rendered by U.S. District Court Judge Raymond Broderick stipulating that keeping individuals with mental retardation in institutions isolated from the rest of society violated their constitutional rights. This ruling was the result of a class-action suit filed in May 1974 by parents of clients at the Pennhurst School for the Mentally Retarded in Pennsylvania. Judge Broderick argued that institutionalization violated these individuals rights under the Fourteenth Amendment to the U.S. Constitution.
Brodmann areas: A system to numerically map the functional areas of the human cortex: sensory reception—1, 2, 3; primary motor—4; sensory association—5, 6, 7; visual reception—17; visual association—18; speech reception (Wernicke)—39; auditory reception—41; auditory association—42: speech motor (Broca)—44.
bronchopulmonary dysplasia (BPD): Severe chronic lung disease secondary to respiratory distress syndrome and the toxic effects of prolonged high oxygen on the immature lung. Developmental problems associated with BPD are twofold: 1) cardiopulmonary insufficiency has a direct, slowing effect on motor development and 2) most infants who develop BPD have survived neonatal courses replete with other events potentially traumatic to the central nervous system. Some infants with BPD develop a movement disorder characterized by chorea and oral motor problems.
BRP: See Behavior Rating Profile.
Bruininks-Oseretsky Test of Motor Proficiency (BOTMP): An instrument to differentially assess fine- and gross-motor skills in children 4½-14½ years of age; the eight subtests take less than 1 hour to administer. The test represents a major standardized tool to evaluate motor skills in the areas of running speed and agility, balance, bilateral coordination, strength, upper-limb coordination, response speed, visual-motor control, and upper-limb speed and dexterity. It is an adaptation of the earlier Lincoln-Oseretsky Tests of Motor Proficiency.
bruit: Noise; an abnormal sound heard on auscultation (listening with a stethoscope); a cranial bruit may be heard in the presence of an intracranial vascular (blood vessel) malformation or tumor, hyperthyroidism, heart disease, or fever. Pathological bruits have the quality of "footsteps in an empty church."
Brunnstrom: A system of physical therapy for the treatment of cerebral palsy. Developed by Signe Brunnstrom to treat hemiplegia (paralysis of half the body), this approach induces primitive (fetal) synergistic movement patterns to help teach purposeful movements.
bruxism: Teeth grinding; can reflect a sleep disorder or nervous habit in children. In children with more severe developmental disabilities, this self-stimulatory behavior can lead to severe dental impairment, with teeth being ground flat. Teeth grinding when awake is often associated with mental retardation.
BSER: Brain-stem evoked response. See brain-stem auditory-evoked response.
BSID-II: See Bayley Scales of Infant Development—Second Edition.
BSM: See Bilingual Syntax Measure I and II.
BSSI-D: See Basic School Skills Inventory Diagnostic.
BTBC-R: See Boehm Test of Basic Concepts-Revised.
bulbar syndrome: See pseudobulbar palsy.
burden: A term used in clinical genetics to describe the total impact of a disorder on an individual, his or her family, and society. In genetic counseling, the impact of the burden of a child with disabilities generally outweighs the probability of recurrence in determining whether to have additional children.
Bureau of Education for the Handicapped (BEH): Former name for the U.S. Department of Education's Office of Special Education and Rehabilitative Services.
Burks Behavior Rating Scale: A 110-item written inventory used to identify patterns of behavior problems in children grades one through nine. A parent or teacher rates descriptive statements regarding the child's observed behavior. Subscales measure a broad spectrum of behavioral tendencies: 1) anxiety, 2) withdrawal, 3) sense of persecution, 4) aggressiveness, 5) attention, 6) impulse control, 7) anger control, 8) reality contact, and 9) social conformity. The rating scale can be completed in 15-20 minutes. Guides for parents and teachers define each sub-scale, suggest possible causes for problem behavior, and offer suggestions for addressing undesirable behaviors from both perspectives. The manual provides instructions for use with particular groups including persons with mild mental retardation, learning disabilities, speech and hearing impairments, and physical disabilities.
Burks Behavior Rating Scales, Preschool and Kindergarten Edition: A downward extension of the Burks Behavior Rating Scale for use with children ages 3—6 years. The Preschool and Kindergarten Edition consists of 105 descriptive statements for a parent or teacher to rate. This scale includes all of the subscales of the Burks Behavior Rating Scale, with the exception of academics.
butyrophenone: A group of major tranquilizers such as haloperidol (Haldol). These drugs are used to treat psychosis.