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

DA: See dextroamphetamine.
DAB-2: See Daberon-2 Screening for School Readiness; see also Diagnostic Achievement Battery-2.
Daberon-2 Screening for School Readiness (DAB-2): A standardized measure of school readiness for children 4-6 years of age or children with learning or behavior problems who are functioning at the early elementary school level. The test samples knowledge of body parts, color and number concepts, gross-motor development, categorization, and other developmental abilities. It is individually administered in 20-40 minutes.
dacryostenosis: See lacrimal duct stenosis.
dactylology: Fingerspelling for the purpose of talking; American one-hand manual alphabet with a configuration for each of the 26 letters.
Dallas Preschool Screening Test (DPST): A brief screening test of "primary" learning areas, including speech-language, problem solving, and motor skills. Administration time is 15 minutes.
Dandy-Walker syndrome: A brain malformation resulting in an enlargement of the fourth ventricle that pushes into the cerebellum and prevents the normal formation of the central portion of the cerebellum. This is often associated with hydrocephalus (excess fluid in the brain), as well as other brain and systemic (body) malformations, such as cleft palate, enlarged kidneys with cysts, agenesis (absence of formation) of the corpus callosum (a part of the brain), or an occipital encephalocele (protrusion of the brain out the back of the skull).
dantrolene sodium: Trade name Dantrium; a drug whose peripheral (noncentral) action reduces spasticity in cerebral palsy.
DAS: See Differential Ability Scales.
DASE: See Denver Articulation Screening Exam.
DASG: See Developmental Assessment of Spanish Grammar.
DASI: See Developmental Activities Screening Inventory.
day care: Facilities and programs providing care, stimulation, and socialization to children, older adults, people with developmental disabilities, and other dependents on a nonresidential basis. Care is provided during the day, and the clients return to their homes each evening. Long used with children, the concept was extended to other populations in the 1980s.
day hospital: Facilities and programs for people with mental illness and older adults; these programs provide health, mental health, and social services during the day, but allow individuals to return to their homes at night, thus averting institutionalization.
daydream: A fantasy occurring in a wakeful state, independent of external stimulus, that can serve to gratify wishes not satisfied in real life. Although often dismissed as a waste of time or as escapism, daydreaming is not inherently pathological. In fact, it is frequently associated with creativity, visual production, and problem solving. Daydreaming is common among young people, and is noted particularly when it occurs in school. Daydreaming is antithetical to concentration and performing mental operations, including information integration and calculations. Such activities are routinely encountered in school, making children with attention deficits and other learning difficulties, who often tend to daydream, subject to questions concerning their desire to learn and their level of cooperation and motivation for school. In addition to contributing to school problems, daydreaming may occur as a result of previously experienced school and social failure, since it can be considered an adaptive way of coping with frustration and boredom. Typically associated with children who have attention-deficit/hyperactivity disorder (ADHD), daydreaming is also commonly reported among the gifted (those who have superior general intellectual ability).
dB: See decibel.
DCB: See Devereux Child Behavior Rating Scale.
DCC: See Developmental Communication Curriculum.
DDH: Developmental dysplasia of the hip; see congenital dislocation of the hip (CDH).
DDST: See Denver Developmental Screening Test.
deaf: Having nonfunctional hearing, with or without amplification, for the ordinary purposes of daily living. Deafness is characterized by a pure tone loss greater than 90 decibels over the speech-range frequency of 500, 1,000, and 2,000 hertz. Hearing loss is expressed in a spectrum of degrees ranging from mild to profound. An individual formerly referred to as being deaf is now classified as having a profound hearing loss. Profound hearing loss is preferred because deaf (as well as dumb and deaf mute) implies that mental incapacitation occurs with hearing loss and speech impairment, thus suggesting a disability extending beyond absence of functional hearing.
deaf mute (deaf and dumb): Antiquated term for an individual who can neither hear nor speak, usually one born with (i.e., congenital) severe to profound hearing loss. The term is objectionable because it implies that mental incapacitation accompanies the inability to hear or speak.
deafism: A self-stimulating behavior in a person with a hearing impairment; such behaviors as poking at one's ear may produce auditory feedback.
deafness: Profound degree of hearing loss that prevents understanding of speech through the ear. Deafness is the inability to hear, without reference to the etiology (cause) of the loss. Hearing impairment is the preferred generic term to indicate any degree of hearing loss.
Deaver: A system of physical therapy developed by the physiatrist George D. Deaver for the treatment of cerebral palsy. This approach utilizes extensive bracing and focuses on the achievement of functional activities of daily living (ADL). The Deaver system also places a high value on achieving a typical appearance (e.g., by working to control grimacing).
deceleration: Decrease in fetal heart rate, relative to uterine contractions during delivery. There are three types: early (type I dip), late (type II dip), and variable (type III dip). The duration of the contractions and the degree to which fetal heart rate decreases help the obstetrician to assess fetal hypoxia (oxygen deficiency).
decerebrate posture: The posture assumed when the cortex and cerebrum of the brain are removed or extremely damaged; decerebrate posture is similar to the decorticate posture, except that the upper extremities are extended instead of flexed.
decibel (dB): A quantitative measure of sound intensity or loudness. In audiology, sound intensity is a ratio of the sound being measured to a standard reference sound level. The relative intensity of sounds is expressed on a decibel (dB) scale. Whispering measures about 30 dB, normal conversation is gauged between 50 and 65 dB, and a hairdryer registers 70 dB.
declarative knowledge: A hypothetical construct of the way in which certain information is represented in memory. Within this model, knowledge is 1) represented by declarative propositions, which are the basic units of information, each corresponding roughly to one idea; and 2) knowing that something is the case. The organization of declarative knowledge is similar to the semantic (meaning systems) memory network in which all ideas are ultimately associated with all other ideas. Propositions have varying levels of activity, most being inactive at any specific time and representing a long-term memory store. The few propositions that are active at any one time are old knowledge that is in conscious awareness. This small part of the prepositional network comprises one part of working memory. See memory, procedural knowledge.
decoding: Word calling; the ability to pronounce written letters and words. Decoding is distinguished from comprehension, which implies an understanding of the material read.
decorticate posture: The posture assumed when the cortex of the brain is removed or extensively damaged; it is similar to the tonic labyrinthine supine posture (extension of all four extremities) and includes flexion of the upper extremities, shoulder adduction/retraction, and extension of the lower extremities.
decubiti: Bedsores secondary to pressure and decreased mobility; decubitus ulcers, or pressure sores, can be prevented by proper hygiene and by relieving pressure on bony prominences by frequent repositioning of the individual with limited mobility: specialized beds, mattresses, pads, and cushions can also be used.
deductive reasoning: To draw a specific conclusion from a general rule or to apply a general rule to a specific situation. See top-down processing (conceptually driven).
deep tendon reflex (DTR): When a tendon is tapped with a reflex hammer, a sudden stretch is applied to the attached muscle; this stimulus produces a reflex contraction that can be observed or felt. A number of different DTRs are routinely elicited on neurological examination: the biceps, triceps, and ankle and knee jerks (the last is sometimes referred to as the patellar reflex). The response is graded on a 5-point scale from 0 (pathologically absent) through 2+ (physiological/normal response) to 4+ (pathologically brisk/exaggerated). Asymmetries should be noted.
defect theory: See difference approach.
defectology: A Russian term for the scientific study of mental retardation.
defense mechanism: A psychoanalytic term for various psychic operations used by the ego to avoid awareness of unpleasant and anxiety-provoking stimuli. The ego selectively uses defense mechanisms to ward off conflict originating in the id, the superego, or dangers in external reality. Common defense mechanisms include denial, rationalization, repression, and projection. Defense mechanisms can represent quite healthy responses to stress.
deformation: Abnormal form, shape, or position of a part of the body caused by mechanical forces; prenatal deformations include abnormal foot positions related to oligohydramnios (too little amniotic fluid) or fetal central nervous system defects; plagiocephaly is a postnatal skull (cranial) deformation.
degenerative disorders: See heredodegenerative diseases.
deglutition: Swallowing.
dehiscence: The splitting apart or opening of a closed (surgical) wound.
deinstitutionalization: The relocation of persons with developmental disabilities and psychiatric problems from institutional settings to community placements; one component of normalization. The movement toward deinstitutionalization and normalization of people with mental retardation or developmental disabilities occurred during much of the late 1970s and early 1980s.
de Lange syndrome: See Cornelia de Lange syndrome.
deletion: The absence of a single base pair or a small part of a segment of base pairs along a chromosome. The deletion interferes with the proper coding of an enzyme or protein and causes the product to be inactive. Many genetic disorders that previously had no identifiable chromosomal abnormalities are caused by deletions. For example, Prader-Willi syndrome is associated with a deletion on chromosome 15. The deletion is part of the structure of the chromosome and, therefore, is passed on with the chromosome. The presence or absence of the disorder is dependent on whether the trait is recessive or dominant and, sometimes, from which parent it originates. A deletion on chromosome 15 that is inherited from the father will produce Prader-Willi syndrome. That same deletion inherited from the mother produces Angelman syndrome.
dementia: A marked deterioration of mental processes that is organic in origin. Dementia is characterized by faulty judgment, impaired memory content and processes, concreteness and rigidity of thinking, and, ultimately, personality changes. Although some dementias are treatable, such as those due to malnutrition or adverse drug reactions, most indicate an underlying degenerative process that is irremediable. These processes typically occur in adults. When such processes are noted in children, they are usually referred to as degenerative processes or developmental regressions.
de Morsier syndrome: See septo-optic dysplasia.
denial: A defense mechanism that allows for rejection of elements of reality that would be intolerable if allowed to remain in the conscious realm. Denial is also the negation of experiences of reality through refusal to accept them. Denial can serve a positive function in families with children who have disabilities. As an initial response, denial provides an opportunity for family life to proceed as usual. At the time of diagnosis, a degree of denial (particularly if the disability is severe) allows parents to maintain a positive view of their child. Denial is often a response to misinformation or a lack of information regarding what a disability is or what may he realistically expected from the child. Providing information, support, and guidance often helps a family to acknowledge and adjust to their child's disability. The energy spent denying a problem can then be used to advocate for the child and to experience the other feelings that accompany living with a child with a disability. In extreme cases, denial is the family's consistent and unwavering response to the diagnosis; despite information and assistance, they contend that there is "nothing wrong" with their child and may engage in doctor shopping. The latter often leads to multiple contacts with different professionals and seriously hampers the development of the child's and the family's functioning.
Dennyson-Fulford procedure: An orthopedic surgery operation that is a modification of the Grice subtalar arthrodesis (surgical immobilization below the ankle) used to treat valgus deformity of the foot.
Denver Articulation Screening Exam (DASE): A brief screening test to assess speech (pronunciation) in children 2½-6 years of age by the production of 30 sounds contained in 22 separate words that the child is asked to repeat. The number of correctly produced sounds is charted on an age graph on the reverse side of the test form, and scores below the 15th percentile for age are referred for more detailed evaluation by a speech-language pathologist.
Denver Developmental Screening Test (DDST): A screening test for developmental delay in children from birth to 6 years of age that divides test items into the Gesell streams of development (i.e., gross-motor, fine-motor, language, and personal social skills) and classifies children's performances as "normal," "questionable," or "abnormal." The test depends heavily on the caregiver's report. A recent revision (Denver II, 1990) is attempting to improve the test's validity in children from birth to 3 years of age. The DDST remains the most widely used developmental screening test for preschool children; much of the criticism directed at it reflects limitations in the screening endeavor. The Denver Developmental Screening Test-Revised (DDST-R) differs from the original (itself a revision) only in format and minor details of scoring. Some clinics use the Revised Prescreening Developmental Questionnaire (R-PDQ) as a first-stage screening and the DDST as a second-stage screening.
Denver Eye Screening Test (DEST): A protocol for the assessment of eye functioning in children birth to 6 years of age. It includes a vision test (three types for different age groups: fixation test, picture card test, and E test) and three tests for nonstraight eyes (parent questionnaire, cover test, and pupillary light reflex test).
DENVER II: The 1990 revision of the Denver Developmental Screening Test (DDST) with 125 items; the increase in items (from 105) was mainly in the area of language.
deoxyribonucleic acid (DNA): The basic biochemical unit of genes; the chemical system of nucleotide base pairs connected by sugar-phosphate moieties (parts of divisible items) present in a double helix form in the genes; DNA codes all the proteins and enzymes found in the body. Some inherited disorders (e.g., sickle cell anemia) result from the substitution of one different base pair for the correct one; other disorders are caused by a deletion or addition of one or more base pairs.
Depakene: See valproic acid.
Department of Health and Human Services (DHHS): The federal agency that houses the Social Security Administration, the Office of Human Development, the Health Care Financing Administration, the Family Services Administration, the Developmental Disabilities Administration, and the Public Health Service. The Department of Health and Human Services was formed in 1979 when the Department of Education was separated from the Department of Health, Education & Welfare (HEW) to become an independent agency.
departmentalization: The teaching of different subjects by different specialized teachers; this may be in the same classroom (teachers rotate, pupils remain) or different classrooms (teachers remain, pupils rotate). The onset of departmentalization frequently exacerbates the difficulties experienced by children with learning disabilities, as well as by those with attention-deficit/hyperactivity disorder (ADHD), who have poor organizational skills.
dependency: Behavior characterized by an overreliance (warranted or unwarranted) on another person or system. The reliance can be emotional, physical, or financial. The dependent person fails to utilize his or her own skills and abilities, passively leaning on another person or system to care for his or her needs. The threat of removal or of withdrawal of support is experienced as a psychological threat of loss to the dependent person, who views him- or herself as personally incapable of meeting these needs.
Depo-Provera: See progestin.
depression: Mood of sadness, despair, and discouragement. Overt manifestations are highly variable and can be culturally specific. Depression may be a symptom of a number of mental and physical disorders, a syndrome of associated symptoms secondary to an underlying disorder, or a specific psychiatric disorder. Slowed thinking, a decrease in pleasure, feelings of guilt and hopelessness, decreased physical activity, and disruption of eating and sleeping arc common disruptive characteristics. Depression is classified by severity, recurrence, and association with mania. In children, depression may he demonstrated through refusal to go to school, antisocial behavior, excessive reaction to separation from parental figures, anxiety, and somatic complaints. Children are more difficult to diagnose with depression, because symptoms are more variable, diagnostic criteria are nor universally agreed upon, and comorbidity with more apparent or overt difficulties (attention-deficit/hyperactivity disorder [ADHD], conduct disorder) may mask the presence of depression.
deprivation: A state of chronic unmet or incompletely met physical, social, or emotional needs. See maternal deprivation.
depth perception: The ability of the visual system to interpret shape and position of a three-dimensional world while only being provided with two-dimensional sensory input. The use of shadow, size, interference patterns, and other learned visual cues allows the presence of depth perception even in the absence of binocular (two eyes) stereoscopic vision.
derived score: Any score obtained by a statistical treatment or other manipulation of raw score or raw data.
dermal sinus: A midline skin pit along the spine, which may connect with an underlying sinus and represent a risk for infection. A dermal sinus may reflect an underlying spinal abnormality.
dermatitis: Rash.
dermatoglyphics: Fingerprints and palm prints; surface skin marking patterns on the fingers and toes, palms and soles that allow unique identification of each individual; dermatoglyphic anomalies (malformations, deformations, disruptions, or dysplasias) can be components of specific syndromes.
dermatome: The area of the skin enervated (supplied) by a single dorsal nerve root for sensation and motor response.
derotative righting: A postural response in which 1) voluntary or passive turning of the head is followed by a segmental or corkscrew (un)rolling of the rest of the body; or 2) voluntary or passive rotation of the pelvis segmentally rolls the trunk, shoulders, neck, and head. This movement pattern is a prerequisite to voluntary rolling over.
de Sanctis-Cacchione syndrome: A genetic syndrome with xeroderma pigmentosa (extreme sensitivity of the skin to light), mental retardation, gonadal hypoplasia (defective reproductive tissue development), microcephaly (abnormally small head), and neurological complications. Inheritance is autosomal recessive.
desensitization: A treatment technique employed to help clients overcome inordinate and disabling learned tears, such as fear of flying and fear of heights, or exaggerated physiological responses such as a hypersensitive gag reflex. A series of successive and closer approximations to the triggering stimulus is paired with relaxation techniques and biofeedback, thus allowing the client to effectively manage or completely eliminate the fear. Desensitization procedures are also used to decrease exaggerated physiological responses that interfere with appropriate functioning (e.g., oral motor desensitization).
desipramine: A tricyclic antidepressant; one of the drugs used to treat attention-deficit/hyperactivity disorder (ADHD).
DEST: See Denver Eye Screening Test.
Detroit Tests of Learning Aptitude-Revised (DTLA-3): A criterion-referenced test of specific mental abilities, composed of 11 subtests: word opposites, sentence imitation, oral directions, word sequences, story construction, design reproduction, object sequences, symbolic relations, conceptual matching, word fragments, and letter sequences. The subtests are grouped into tour domains: linguistic, including verbal and nonverbal composites; cognitive, including structural and conceptual composites; attentional, including attention-enhanced and attention-reduced composites; and motoric, including motor-enhanced and motor-reduced composites. A general intelligence quotient (GIQ) is derived from the standard scores of all the subtests. The DTLA-3 is designed for children 6-17 years of age and takes 50 minutes to 2 hours to administer. It is used to diagnose learning disabilities and mental retardation. There is a 100-item (six-subtest) Detroit Tests of Learning Aptitude-Primary 2 (DTLA-P2) for children 3-9 years of age, as well as a Detroit Tests of Learning Aptitude-Adult (DTLA-A) for people 16-79 years of age.
Developmental Activities Screening Inventory (DASI): A cognitive screening measure for children 6 months to 5 years of age; it can be adapted for use with preschool children who have visual impairments, hearing impairments, and multiple disabilities.
developmental approach: The theory that persons with mild mental retardation (cultural-familial retardation, retardation due to psychosocial disadvantage) without evidence of organic brain damage behave and learn exactly in the same manner as mental-age-matched controls without mental retardation, except for the impact of personality variables, such as wariness and outerdirectedness. The developmental approach has been referred to as a motivational or social learning theory of mental retardation.
Developmental Assessment of Spanish Grammar (DASG): An adaptation of a developmental sentence-scoring technique for Spanish-speaking children.
Developmental Communication Curriculum (DCC): A language curriculum for children who are developmental ages birth-5 years. The DCC includes the Developmental Communication Inventory (DCI) to assess prelinguistic, symbolic, symbolic relationships, and complex symbolic relationships in play contexts.
developmental coordination disorder: See dyspraxia.
developmental-difference controversy: See developmental approach, difference approach, two group approach.
Developmental Disabilities and Bill of Rights Act Amendments of 1987 (PL 100-146): Legislation that amended PL 88-164, the Mental Retardation Facilities and Community Mental Health Centers Construction Act of 1963, and contained a Bill of Rights section for people with developmental disabilities. PL 100-146 expanded the definition of developmental disabilities to include individuals with mental retardation, autism, cerebral palsy, and seizure disorders. It also authorized funding for a wide variety of programs and services affecting individuals with developmental disabilities, to enable them to "achieve their maximum potential through increased independence, productivity, and integration into the community."
Developmental Disabilities Assistance and Bill of Rights Act of 1975 (PL 94-103): A federal law that extended the definition of developmental disabilities to include autism and selected types of dyslexia; it also set up a task force on the definition of developmental disabilities that, in 1977, further broadened the definition by using a generic or functional approach that cut across specific categories or diagnoses. This act also mandated each state and territory to establish a protection and advocacy (P&A) system as a condition of receiving federal funding under this law. Advocacy agencies are authorized to pursue legal, administrative, and other remedies to protect the rights of individuals with developmental disabilities. Each state's governor designates a program to serve as the P&A system and must ensure that it is independent of any service provider. The Administration on Developmental Disabilities, within the Department of Health and Human Services, is responsible for administering a P&A program for people with developmental disabilities at the federal level.
Developmental Disabilities Assistance and Bill of Rights Act of 1990 (PL 101-496): Legislation that amended PL 88-164 and PL 100-146 to add the goals of interdependence, community acceptance, and inclusion for all people with developmental disabilities. It also authorized grants to support the planning, coordination, and delivery of increasingly specialized services to all people with developmental disabilities, and expanded several existing programs, including the protection and advocacy (P&A) system and university affiliated programs (UAPs).
Developmental Disabilities Services and Facilities Construction Act of 1970 (PL 91-517): A federal law that expanded PL 88-164, the Mental Retardation Facilities and Community Mental Health Centers Construction Act of 1963, to include services for people with cerebral palsy and seizure disorders. This law introduced the concept of "developmental disability" and replaced "clinical training" with "interdisciplinary training." PL 91-517 also created a program of state formula grants to establish councils to plan government activities related to service delivery.
developmental disability: A condition in which a static encephalopathy (brain damage due to lack of oxygen) or brain injury leads to a serious impairment or limitation of one or more functions controlled by the brain. The "injury" may be structurally programmed into the developing brain. All developmental disabilities bear a "family resemblance" because of their common grounding in brain pathology (origin). The onset of a developmental disability must be during the developmental period—variously defined as birth to 12 or birth to 22 years of age. Federal legislation defines developmental disability as "a severe, chronic disability of a person 5 years of age or older, which is attributable to a mental or physical impairment or combination of mental and physical impairments; is manifested before the person attains age 22; is likely to continue indefinitely; results in substantial functional limitations in three or more areas of major life activity: 1) self-care, 2) receptive and expressive language, 3) learning, 4) mobility, 5) self-direction, 6) capacity for independent living, and 7) economic self-sufficiency; and reflects the person's need for a combination and sequence of special, interdisciplinary, or generic care, treatment, or other services that are of lifelong or extended duration and are individually planned and coordinated." The federal definition also states that developmental disability can also be applied to infants and young children from birth to age 5, "who have substantial developmental delay or specific congenital or acquired conditions with a high probability of resulting in developmental disabilities if services are not provided." Individual states may expand and modify the definition to more fully meet the needs of their citizens.
developmental dysplasia of the hip (DDH): Luxatio coxae congenita; previously referred to as congenital dislocation of the hip. A congenital abnormality of the hip that renders it unstable with regard to keeping the femur (thigh bone) in the joint. Present at birth, the defect leads to limitation of hip abduction, asymmetry of thigh folds, leg shortening, and persistent adduction of the involved side. It is more common in females and after breech delivery. The Ortolani and Barlow tests are used to routinely screen for DDH; later, it will show up as a limp and a positive Trendelenburg sign. CDH is often an isolated anomaly (malformation, deformation, disruption, or dysplasia), but it may occur as part of a more generalized syndrome.
developmental hesitation: Benign and typical stumblings, repetitions, and prolongations in the speech of a child learning to talk.
Developmental Indicators for Assessment of Learning-Revised (DIAL-R): A preschool and prekindergarten developmental screening test for children 2-6 years of age. Its three subtests measure gross- and fine-motor skills, expressive and receptive language, and cognitive-academic skills. Administration time is approximately 30 minutes. The acronym DIAL-R also refers to the rotating discs with which visual stimuli for certain test item groups are presented.
developmental output failure: A group of learning disabilities in which the specific nature of the problem does not cause school failure or underachievement until the demand for specific outputs increases, especially the marked increase in written work in fourth grade.
Developmental Profile II: A 186-item questionnaire that yields developmental ages in five areas (physical, self-help, social, academic, and communication), as well as an IQ equivalence score for children from birth to 9½ years.
Developmental Screening Inventory (DSI): A screening test for developmental disabilities in children 1-18 months of age. The test is a clinical selection of items from the Gesell Developmental Schedules, for use by relatively sophisticated examiners; it is more a clinical procedure than a standardized test. The revised form (the RDSI) has been extended to an age range of 36 months and has a first-stage prescreening questionnaire, the Revised Parent Developmental Questionnaire (RPDQ) (not to be confused with the Revised Prescreening Developmental Questionnaire, R-PDQ).
Developmental Test of Visual-Motor Integration (DTVMI): Beery. A measure used to assess perceptual-motor ability in children 4-13 years of age. The child is asked to copy up to 24 geometric figures selected from other developmental tests including the Bender-Gestalt, Cattell, Gesell, and Stanford-Binet. The figures are arranged in order of increasing difficulty, beginning with a simple figure like a circle or square and becoming progressively more complex. Each design is scored on a pass/fail basis, and testing may be discontinued after three consecutive failures. A large number of scoring judgments are subjective, leading to substantial disagreement regarding scoring. The DTVMI was originally normed in 1974 and was renormed by Buktenika in 1981. Raw scores are converted into standard scores with a mean of 10 and a standard deviation of 3. Many of the interpretive rationales described for the Bender-Gestalt are also applicable to the DTVMI. Administration time is 15 minutes.
Developmental Test of Visual Perception (DTVP): Frostig. A battery of five visual-perceptual-motor subtests used to identify the underlying disorder in learning disabilities and to formulate a specific visual-perceptual-motor training program to remediate learning disabilities in children 3-8 years of age. Its component subtests include measures of visual-motor coordination (drawing a straight line between successively closer parallel lines), figure-ground discrimination (differentiation between foreground and background), form constancy, spatial relationships, and position in space. The associated therapy (Frostig Program) improves performance on the test battery, but this has not been shown to spill over into the area of learning.
Devereux Child Behavior Rating Scale (DCB): A checklist of about 100 behaviors that yields a number of interpretable factors. The behaviors are scored on a 5-point Likert-type scale. The DCB is meant to be used by caregivers in institutional settings to refine descriptions of symptom behaviors in children 8-12 years of age. Administration time is 15 minutes. The instrument has good reliability but only face validity.
deviation IQ: Normalized standard score with a mean of 100 and a standard deviation of 15 or 16, depending on the measure employed. The deviation IQ expresses the deviation of the ratio IQ from the mean ratio IQ at each age level. It is not an absolute measure of performance, but, rather, the relative position of a particular measure of intelligence on a normal, or gaussian, curve. Each individual IQ score is given meaning by relating it to the distribution of all relevant IQs and to where in that distribution the given IQ is located. The deviation IQ has replaced the ratio IQ because it controls for the variability of IQ distribution across the age range.
dexamethasone suppression test (DST): The administration of the steroid dexamethasone typically suppresses plasma cortisol levels; many people with major depression do not respond to dexamethasone, but continue to produce excess cortisol. This test can be helpful in diagnosing depression in people with mental retardation and atypical presentations of depression.
Dexedrine: Trade name for dextroamphetamine sulfate.
dextroamphetamine (DA): Trade name Dexedrine; a short-acting stimulant medication that is occasionally still used in the treatment of attention deficit disorders and hyperactivity in children and adults. It is manufactured in multiples of 5 milligrams (5, 10, and 15) and is available in a sustained-action formula. Because of its addictive potential, dextroamphetamine is treated as a controlled substance; however, addiction is not a problem in subjects with attention problems. Side effects include stomachache, headache, anorexia (loss of appetite), poor growth, and sleep problems. Side effects can usually be managed by titrating the dosage.
DHHS: See Department of Health and Human Services.
diadochokinesis: Rapid alternating movements (RAM); the normal power of alternately bringing a limb into alternate positions, as of flexion and extension or of pronation and supination. This facet of motor coordination can be tested in individuals by requesting that they pat their knees with the rapidly alternating palmar and dorsal surfaces of their hands. Performance of the dominant hand is usually slightly superior to that of the nondominant hand. Difficulty in performing this test is referred to as dysdiadochokinesis.
Diagnosis: Diagnosis is both a process and an outcome. It is the process of compiling and categorizing signs and symptoms (medical, emotional, or social) exhibited by an individual and formulating a solution based on that compilation. Diagnosis also involves eliminating other possible categorizations and causes in order to identity a specific pathological condition. The term diagnosis has tended to be restricted to the process engaged in by medical doctors. Social workers, psychologists, nurses, and educators more frequently use the term assessment.
Diagnostic Achievement Battery-2 (DAB-2): An individually administered academic achievement test that provides a profile of abilities in listening, speaking, reading, writing, and mathematics. Sub-tests include story comprehension, characteristics, synonyms, grammatic completion, alphabet/word knowledge, reading comprehension, capitalization, punctuation, spelling, writing composition, and mathematical reasoning and calculations. Writing composition, spelling, capitalization, punctuation, and math calculation subtests may be given to small groups. Subtest scores convert to standard scores (with a mean of 10 and a standard deviation of 3) and percentile ranks. Composite scores (with a mean of 100 and a standard deviation of 15) in listening, speaking, reading, writing, mathematics, spoken language, written language, and total achievement are generated by combining subtests.
Diagnostic and Statistical Manual of Mental Disorders (DSM): The most commonly used classification system for abnormal behaviors and mental disorders. Published by the American Psychiatric Association, the DSM is the system generally used in the United States for official diagnostic and record-keeping purposes. The first version of the DSM was published in 1952 and reflected a psychobiological perspective that viewed mental disorders as the reaction of the person to psychological, social, and biological factors. Subsequent editions have classifications compatible with the International Classification of Diseases (ICD) and do not specifically imply any particular theoretical framework for understanding nonorganic mental disorders. DSM-IV (1994) contains specific diagnostic criteria, a multiaxial classification system, and an increased emphasis on descriptive determinants of mental and physical disorders. Even though DSM-IV categories are more behaviorally explicit than prior editions, clinical judgment is still required. For example, some of the diagnostic criteria require that a child's symptoms be inappropriate for age. Since the DSM-IV does not provide age norms, base rate, or treatment recommendations for any of its diagnostic conditions, judgment must he used to decide whether a child's behavior is in fact deviant. Inclusion of specific developmental disorders is considered controversial by some because many children with these disorders have no other form of mental disorder. DSM-IV does require that standardized, individually administered educational achievement and intelligence tests be used to diagnose such developmental disorders.
Diagnostic Checklist for Behavior-Disturbed Children (Form E-2): The earliest objective behavior checklist used in the diagnosis of autism; it was first used to document a decrease in autistic symptomatology after 5 years of age.
Diagnostic Interview Schedule (DIS): A structured, standardized interview designed to elicit the information required to make certain DSM diagnoses. Versions of the DIS have been periodically created and contain procedures and probes for use in identifying specific clusters of symptoms not previously included in the schedule. The DIS can he administered by both professional and lay interviewers.
Diagnostic Reading Scales (revised edition): An integrated series of tests designed to provide a standardized evaluation of a student's silent and oral reading levels (from elementary level for poor readers through high school for normal-ability readers) and auditory comprehension. The battery measures the nature and extent of word skills and provides an estimate of the student's instructional level.
diagnostic teaching: An informal method of assessing learning abilities when formal diagnostic methods are ineffective or incomplete. It involves observation and instruction to determine if the student possesses and can utilize the skills being assessed or if remediation and development or compensatory techniques are necessary. "Trial lessons," or "teaching probes," are used to simultaneously test and teach by recording and interpreting the student's reaction to and progress with the material. Diagnostic teaching can be employed by many disciplines involved with persons with developmental disabilities.
DIAL-R: See Developmental Indicators for Assessment of Learning-Revised.
dialect: A distinct form of a language spoken in a specific geographical area, varying uniquely from the official standard of the larger surrounding community in, for example, pronunciation, word usage, and grammar. The dialect is different enough to be regarded as a unique entity, but not sufficiently different to be considered a separate language.
diaschisis theory: The theory that the return of function following brain damage occurs as the nervous system recovers from a period of shock, since the shock had widespread effects on areas of the brain not directly damaged. In this theory a significant amount of brain damage symptomatology is attributed to nonspecific shock as opposed to specific brain lesions.
diastema: A split; a wide space between the upper central incisors ("two front teeth"); associated in folklore with marrying wealth.
diastematomyelia: A developmental malformation in the spinal cord often found with myclomcningocele (protuberance of both the spinal cord and its lining). It consists of a splitting of the spinal cord without duplication. A bony spur is often found between the split pieces of cord.
diathesis: An inherited predisposition or tendency to develop certain diseases or disorders. For example, the members of a certain family may be more likely to become alcoholics. In other families, there may be a predisposition to the development of otoselerosis (chronic progressive deafness) and progressive hearing loss.
diazepam: Trade name Valium; a benzodiazepine that is used as an antianxiety drug, a muscle relaxant (for spasticity), and an anticonvulsant. It can also be administered intravenously to stop prolonged, uncontrollable seizures (status epilepticus).
dichotic listening: A test of speech lateralization in children in which different stimuli are stereophonically presented to both ears (dichotic); the stimulus that is correctly discriminated indicates the relative efficiency of the processing auditory input of the right versus the left cerebral hemispheres, so that a right-ear advantage is consistent with left hemisphere language localization.
diencephalic syndrome: Progressive emaciation in a euphoric, hyperactive, hyper-alert infant with a brain tumor (usually astrocytoma in type) of the hypothalamus or third ventricle. It presents as a disorder of growth, with neurological and neurodevelopmental findings occurring later.
difference approach: Defect theory; the theory that people with moderate to profound mental retardation as well as those with mental retardation with independent evidence of organic brain damage may not behave and learn in the same way as mental-age-matched controls without mental retardation. There are qualitative as well as quantitative (mental age, IQ) differences between people with and without mental disabilities. See also developmental approach, two group approach.
Differential Ability Scales (DAS): A cognitive abilities battery for children and adolescents 2-6 to 17-11 years of age. It is composed of 17 cognitive subtests in verbal and nonverbal areas, as well as diagnostic subtests (basic number skills. spelling, and word reading). Administration time is 1-1½ hours.
Digit Span: A supplementary verbal subtest of the Wechsler Intelligence Scale for Children-III, in which the child listens to a series of numbers and then repeats them. The subtest, in two parts, assesses sequential memory, short-term memory, and attention. The first part of the subtest, called digits forward, contains a series of items varying in length from 3 to 9 numbers. The second part, called digits backward, contains a series of items ranging in length from 2 to 8 numbers. There are two series of numbers for each sequence length; digits forward is administered first, followed by digits backward. Digits forward predominantly involves rote learning, memory, and sequential processing, whereas digits backward requires sequential processing, planning ability, and an ability to retain and manipulate the mental image of the object for a longer time period. Difficulty with digit span may suggest or relate to anxiety, attention deficits, memory, and auditory processing problems. The pattern of errors (omissions, reversals) can provide some clue as to what type of processing problems the child may have.
digit span test: A test in which the subject is required to repeat a series of random numbers immediately after a single presentation; also known as digits forward. The number of digits a child can repeat increases with age, intelligence level, and rote sequential memory skills. Compared to digits backward (see Digit Span), digits forward appears to be a more left-brain function.
digito-ocular sign of Franceschetti: Poking at the eyes; "eye boring" or pressing the fists, knuckles, or fingers into the orbits of the eyes. This behavior is an example of a "blindism," an activity common in preschool-age children who are blind; it can also occur in children with mental retardation who have no eye pathology, and can accompany other self-stimulatory behaviors in institutionalized persons. It is probably only mildly specific for visual impairment (as with ear boxing for hearing impairment), and occupies a position on the nonspecific spectrum of self-stimulatory—self-injurious behaviors.
diglossia: A bifid or forked tongue; a congenital anomaly (malformation, deformation, disruption, or dysplasia) of the tongue.
diglossia: Occurs when a young child can recognize that two varieties of a language are each to be used in different social settings.
DIP joint: See distal interphalangeal joint.
diphenhydramine: Trade name Benadryl; an antihistamine that can be used to treat allergic symptoms. Because of the side effect of drowsiness, it can also be used to treat mild sleep disorders.
diphenylmethanes: A group of minor tranquilizers that includes hydroxyzine hydrochloride (Atarax) and hydroxyzine pamoate (Vistaril), used in the treatment of anxiety.
diplegia: Little disease; literally, "two palsy." A topographical subtype of spastic cerebral palsy in which all four extremities (arms and legs) are involved, but the upper extremities are less involved than the lower extremities. Therefore, sitting is not as delayed as walking. It is a common sequela to prematurity and can exhibit a fairly benign course. Toe walking, scissoring, strabismus (squint), and normal intelligence are common associated findings. Probably the most common single subtype of cerebral palsy.
diplomyelia: A developmental malformation of the spinal cord often found with myelomeningocele (protuberance of both the spinal cord and its lining). It is a complete duplication of the cord over several segments.
diplopia: Double vision; a neuro-ophthalmological finding.
Direct Instruction Systems for Teaching Arithmetic and Reading (DISTAR): A reading method that was developed as an outgrowth of a program established primarily as a compensatory effort to prepare disadvantaged Black children for entrance into traditional middle-class, White-oriented school programs. It is highly structured, fast-paced, and directive. The beginning level starts with sound identification, left-to-right sequencing, and oral sound blending. Children learn to read by sounding out words, then by reading groups or words as complete thoughts. The second level expands the beginning level. Reading III, the third level, is described as a basal reader program for third grade or for a remedial reading program. The first and second levels are designed for use in small groups, but much of level III is designed for use with 30 children at a time. A detailed teachers guide is provided.
directionality: Internal awareness of the right and left sides of the body and the ability to apply this realization to external objects. Individuals with directionality problems frequently reverse letters or numbers (b for d and vice versa) because they cannot consistently perceive or determine that the particular symbol is pointed in a particular direction ( b to the right and d to the left). Difficulty with directionality is sometimes referred to as right/left confusion.
DIS: See Diagnostic Interview Schedule.
disability: Any restriction or lack of ability (resulting from an impairment) to perform an activity in the manner or within the range considered usual for a human being. Disability may be temporary or permanent, reversible or irreversible, and progressive or regressive. Disability may arise as a direct consequence of impairment or as a response by the individual, particularly psychologically, to a physical, sensory, or other impairment. Disability represents the objectification of an impairment and, as such, reflects disturbances at the level of the person. The World Health Organization defines disability as the second level of a continuum: impairment, disability, and handicap based on health experience. Thus, its definition is, "In the context of health experience, a disability is any restriction or lack (resulting from an impairment) of ability to perform an activity in the manner or within the range considered normal for a human being."
disability etiquette: Preferred word usage and behavior when writing about, meeting, socializing with, or assisting people with disabilities. Although some specific terminology is still debated among groups of people with disabilities and their advocates, agreement has been reached regarding some general rules. These include emphasizing abilities, not limitations; avoiding words with negative or judgmental connotations; demonstrating patience; and asking if assistance is needed before giving it. The goal of enlightened language usage and treatment is to more fully integrate people with disabilities into society and to lessen misunderstanding and ignorance among the population without disabilities.
disability, secondary: A disability or adverse circumstance that does not necessarily follow as a direct consequence of a primary disability but for which the primary condition is a risk factor.
discharge planning: An interdisciplinary process for facilitating reintegration into the community after a major illness (accidental, physical, or mental). A discharge plan may include environmental modification (e.g., ramps), adaptive equipment (e.g., a walker), psychological counseling to facilitate adjustment, vocational rehabilitation for work adaptations, visiting nurses for ongoing care, and special transportation arrangements. A discharge plan should be safe and realistic, and should allow the person to resume as normal a life as possible.
discipline: An area of training and practice. Training, certification, and licensure vary greatly among disciplines, and the degree of autonomous independent practice allowed differs among states and clinical settings. For example, medicine is sometimes considered a single discipline; at other times the various medical and surgical specialties and subspecialties are considered separate disciplines.
discipline: From the Latin "discipimo," meaning teaching and learning. In a broader sense, disciplining of children is the inculcation of the mores of a culture by families first and continuing through various educational settings. However, common usage of the word connotes limit setting, with rewards for compliance and punishment for transgressions. Whereas discipline may include many methods for reaching the goal of self-control, punishment may actually be detrimental in its long-term effects.
DISCO: See Dyskinesia Identification System-Coldwater.
discordant: A term used in studies of twins where one twin has the trait being investigated and the other does not. See also concordant.
disease: Literally, "without ease," "uncomfortable"; a failure of an organism to adequately adapt to stress, resulting in a disturbance in structure or function. A disease is a definite entity with a single cause (even if unknown) and recognizable signs and symptoms from which it can be diagnosed.
disengagement: A pattern of family relations characterized by extreme emotional distance and detachment, rigid boundaries, and strong individual autonomy rather than family closeness. Although not necessarily pathological if all members are comfortable with such a style of relating, the pattern can indicate a number of relationship difficulties, including little interaction or exchange of feeling, and lack of a sense of belonging. Families with children who have developmental disabilities often develop a style of relating in which one parent (usually the mother) becomes overly close and involved with the affected child to the exclusion of other family members, who then drift into a pattern of disengagement.
disfluency: See dysfluency.
dislocation: Luxatio; complete and persistent displacement of a bone from its joint; dislocation is accompanied by pain, shortening, and loss of function.
displaced speech: Talking that refers to past or future events and not to the immediate present. In the development of children's language, references to the present represent the earliest stage, followed by references to the past, and finally reference to the future.
distal: Farthest from the center.
distal interphalangeal joint (DIP joint): The joint nearest the tip of the finger or toes.
distal transverse palmar crease: A flexion crease on the palm of the hand; the "heart line" of palmistry. Variations in this crease pattern occur in genetic syndromes and nonspecifically in developmental disabilities.
DISTAR: See Direct Instruction Systems for Teaching Arithmetic and Reading.
Ditropan: See oxybutynin.
dizygotic twins: Fraternal twins; two individuals born at the same time to the same mother, but having different genetic makeups. Dizygotic twins occur when two ova are fertilized at the same time. Such twins are no closer to each other genetically than two siblings born from different pregnancies.
DMD: Duchenne muscular dystrophy; see muscular dystrophy.
DNA: See deoxyribonucleic acid.
Dolch Word List: A list, developed by Edward W. Dolch, of 220 words that constitute more than 65% of all words found in elementary reading materials and 50% of the words found in all reading materials. It includes prepositions, conjunctions, pronouns, adjectives, adverbs, and the most common verbs, hut no nouns. Thus, the list comprises structure words that hold language together, rather than content words; it is often taught as a sight word vocabulary. Many of the words have irregular spellings and cannot be learned by picture clues.
dolichocephaly: A disproportionately long head; a low cephalic (head) index secondary to premature closure of sagittal (median) sutures, producing craniosynostosis (premature fusion of skull sutures) and linked with scaphocephaly (projected head). A common skull shape in premature infants.
doll eyes maneuver: Cantelli sign; eye movements normally follow head movements; when the head is rotated and the eyes do not follow or actually go in the opposite direction, then the "doll eyes" phenomenon is present. This indicates the absence of the eye righting reflex, with probable brain-stem injury.
Doman-Delacato approach: See patterning.
Doman-Delacato Developmental Profile: An instrument used to measure improvement during patterning therapy.
dominance: A tendency to preferentially use one side of the body, usually reflecting a preferred development of one side of the brain for particular functions. Hand dominance is typically established and clearly evident by 2 years of age. Strong hand dominance before 18 months of age is usually suggestive of a motor impairment of the nondominant side. Neuromaturational delay in expression of dominance can occur with children who have learning disabilities or mental retardation.
Donohoe syndrome: See leprechaunism.
dorsum: The back; the posterior or superior surface. Dorsal is the opposite of ventral.
double blind: A method of studying treatment efficacy in which neither the person administering and evaluating the treatment nor the person receiving the treatment is aware of whether an active or inactive treatment (placebo) is being administered.
double hemiplegia: A type of spastic cerebral palsy in which both arms appear to be more severely involved than both legs. Because the functional and practical implications or this do not significantly differ from quadriplegia (paralysis of all four extremities), the condition is probably just as well described as an asymmetrical quadriplegia.
"downers": A slang term for drugs (legal or illegal) that depress the central nervous system. Such drugs include tranquilizers, alcohol, and sleep medications.
Down syndrome (DS): Trisomy 21, trisomy G. A chromosomal disorder with hypotonia (decreased muscle tone), short stature, flat facial profile, epicanthal folds, upslanting palpebral fissures (eye slits), small ears, speckling (Brushfield spots) of the iris (the colored part of the eye that surrounds the pupil), short fingers, single transverse palmar crease (simian crease), cardiac detects, duodenal atresia, atlantoaxial instability, thyroid disorders, conductive hearing loss, and mental retardation. Because people with Down syndrome have an extra chromosome 21, they have a total chromosome count of 47 instead of the usual 46. The multisystem involvement in this disorder requires ongoing follow-up in a multidisciplinary specialty (DS) clinic setting. Incidence is 1 in 660 (1 in 1,500 for mothers under 30 years of age to 1 in 25 for mothers over 45 years of age). The recurrence risk of DS is 1%, although it may be higher in the presence of a parental translocation carrier. Originally described by John Langdon Down (1828-1896) in 1866, Down syndrome was not clearly differentiated from cretinism (hypothyroidism) and other dysmorphology (atypical features) syndromes until 1959, when Jerome Lejeune demonstrated the atypical chromosome count.
DPST: See Dallas Preschool Screening Test.
DPT: Combined diphtheria, pertussis (whooping cough), and tetanus immunizations; diphtheria and tetanus toxoids with pertussis vaccine. The existence of developmental disabilities should not be a contraindication to the routine administration of DPT; adverse events following a first dose and a progressively deteriorating neurological status are the only recognized contraindications.
Draw-a-Man Test: See Goodenough-Harris Drawing Test.
drug: Any nonfood substance that affects living tissue.
drug-free period: See drug holiday.
drug holiday: Discontinuing a drug in order to reevaluate baseline (before intervention) behavior and drug/dose responsiveness. The use of the term holiday unfortunately connotes that the drug was bad or unnecessary in the first place. A drug holiday is an important tool in the management of psychotropic medication.
DS: See Down syndrome.
DSI: See Developmental Screening Inventory.
DSM: See Diagnostic and Statistical Manual of Mental Disorders.
DST: See dexamethasone suppression test.
DTLA-3: See Detroit Test of Learning Aptitude-Revised.
DTP: See DPT.
DTR: See deep-tendon reflex.
DTVMI: See Developmental Test of Visual-Motor Integration.
DTVP: See Developmental Test of Visual Perception.
Dubowitz Neurological Assessment: A brief (10-minute) neurological screening of infants that can he used to monitor the progress of central nervous system insults in infants at high risk.
Dubowitz Scale: Dubowitz score; an instrument to determine gestational age by examining 11 physical characteristics and 10 neurological findings.
Dubowitz syndrome: A genetic syndrome with eczema (skin rash), short stature, a peculiar facies (somewhat similar to that seen in persons with fetal alcohol syndrome), and a range of cognitive functioning from average intelligence to severe mental retardation. Inheritance is autosomal recessive.
Duchenne muscular dystrophy (DMD): See muscular dystrophy.
due process: See impartial due process hearing.
duodenal atresia: A congenital malformation of the first portion of the small intestine with complete blockage; unless surgically corrected, duodenal atresia leads to death from aspiration–if the baby is fed–or from starvation if the baby is not fed. Duodenal atresia is more common among infants with Down syndrome than among other infants.
duodenum: The first part of the small intestine, connecting the pylorus (lower end of the stomach) to the jejunum (middle of the small intestine); it is a major site for digestion and ulcerations.
dwarfism: Outdated term, with a pejorative connotation, referring to extremely short stature on the basis of endocrinological (hormonal) or genetic etiology (cause). In general, although poor growth is frequently associated with severe developmental disorders, most individuals with syndromes typically referred to under the rubric of dwarfism exhibit normal intelligence and no associated developmental disabilities.
Dwyer instrumentation: An anterior (front) cable orthopedic surgery procedure for treatment of scoliosis (spinal curvature).
Dycem: A nonslip material used to cover handles and trays.
Dyggve-Melchior-Clausen syndrome: A genetic syndrome with disproportionately short trunk, dwarfism, microcephaly (abnormally small head), mental retardation, and a variety of bone and joint abnormalities including atlantoaxial instability. Inheritance is autosomal recessive.
Dyke-Davidhoff-Masson syndrome: A nongenetic syndrome including facial asymmetry (with X-ray confirmation of underlying asymmetrical skull [cranial] abnormalities), contralateral hemiplegia (paralysis of one half of the body), mixed seizure disorder, and varying degrees of mental retardation.
dynamic: Describes an orthopedic deformity, with abnormal positioning of extremities (arms or legs), that can he passively corrected; characterizes a flexible or nonfixed deformity.
dysarthria: Generic name for a collection of motor speech problems caused by various impairments of the central or peripheral nervous systems. Faulty speech production, characterized by imprecise consonants and irregular articulation, is typical of the disorder. Respiration, voice, fluency, and prosody (melody of speech) are usually hindered as well. Both volitional and automatic actions, including chewing, swallowing, and other oral-motor movements, may also be deviant. Children with cerebral palsy can show marked delays in achieving articulation comparable to that of their age peers. Most adults acquire dysarthria as the result of cerebral vascular accidents (strokes) or degenerative disease after a lifetime of normal speech. Anarthria, or the inability to articulate at all, is the result of severe neuromuscular involvement.
dysautonomia: See Riley-Day syndrome.
dyscalculia: Mathematics disability; a learning disability in which mathematics is the only or the most severely involved subject area. A mathematics disability that begins in the fourth grade may be secondary to a reading disability. Mathematics errors, such as misreading operational signs (addition for subtraction) or reversing numerical order, may reflect either a mathematics or a reading problem. Difficulty with mathematics often reflects right-brain impairment.
dysdiadochokinesis: A neurological finding in which the individual has difficulty with rapidly alternating pronation and supination of the arms.
dyseidetic: One of the three dyslexic subtypes—the other two being dysphonetic and mixed—identified by Elena Boder. These subtypes are based on specific reading-spelling error patterns. Dyseidetic readers show strength in the auditory analytic function and weakness in the visual gestalt function. They have poor memory for visual configurations of letters and words and read laboriously, sounding out familiar as well as unfamiliar words. Typical misspellings are phonetically accurate. They also write good phonetic (representing sounds) equivalents of words that they could not read. For example, "talk" might be read as "talc" and spelled as "tok." The mixed group exhibits weaknesses in both the visual gestalt and the auditory analytical functions, with resulting disability in developing both sight vocabulary and phonic skills. The Boder Test of Reading-Spelling Patterns is based on these error patterns. See also dysphonetic.
dysfluency: Any type of speech characterized by an interruption in the flow of sounds. Such speech is marked with prolongations, hesitations, repetitions, and other rhythmic disturbances. Dysfluency can refer to the developmental hesitation of a child or the dysprosody (loss of melody of speech) of an individual who stutters.
dysfunction: Abnormality or malfunctioning of a system.
dysfunctional family: A family unable to effectively carry out its tasks or emotional functions. Such families tend to respond to stress situations with rigid, unyielding, patterned behavior, rather than effectively accommodating themselves to the demands of the situation. Frequently, boundaries between individual members are either too loose, too rigid, or too distant for cooperation and support to occur. When stress levels reach unmanageable proportions, frequently one member develops symptomatology that forces the family to initiate treatment.
dysgraphia: Poor pencil and paper (handwriting and drawing) skills for age; the condition is usually congenital in children and may be part of a learning disability syndrome. Dysmorphisms can be an isolated problem reflecting poor motor planning or execution, or a component of a developmental disorder of written language.
dyskinesia: Any impairment of voluntary movement.
Dyskinesia Identification System-Coldwater (DISCO): A 34-item movement rating scale used in the diagnosis of dyskinesia.
dyslexia: Reading disability; a term loosely employed to describe any learning disability in which reading, writing, and spelling are more severely involved than other subject areas. In the strict sense, dyslexia refers to a pure reading disorder with no other subjects involved, and no attentional or other neurological problems. Such pure dyslexia is rare, often familial, and predominantly male. There are no diagnostic markers, such as letter reversals, specific to dyslexia.
dysmaturity: The impact of placental insufficiency on a term or preterm infant includes generalized growth retardation; dry, peeling, cracked skin; meconium staining; and a wide-awake, hyperalert expression. Dysmaturity is sometimes used more generally to refer to any situation in which birth weight is low for gestational age secondary to placental insufficiency; it would then include postmaturity but not all cases of prematurity.
dysmorphology: The science or study (logy) of abnormalities (dis) of shape, form, or structure (morpho); in human beings most disorders of morphogenesis (the development of form and structure) are congenital—either genetic or the result of other prenatal influences. The visual recognition of dysmorphic features is an important component in the identification of genetic and other syndromes (syndromology), sequences, and associations. A cumulative number of mild superficial malformations (minor dysmorphic features) may be of developmental significance even in the absence of an identifiable syndrome.
dysnomia: A weakness or inability to name objects (word finding), not as severe as anomia; a frequent component of a language or learning disability.
dysphagia: Difficulty swallowing; one of the signs of oromotor dysfunction that is common in cerebral palsy and can contribute to feeding disorders and poor growth.
dysphonetic: One of three dyslexic subtypes identified by Elena Boder. These subtypes are based on specific reading-spelling error patterns. Dysphonetic readers show strength in the visual gestalt function and weakness in the auditory analytical function. They typically have a functional, although relatively limited, sight word vocabulary but lack phonic word analysis skills. Their most striking error is semantic substitution (i.e., substituting a word similar in meaning to the original word but unlike it phonetically, such as "sweater" for "jacket"). Their misspellings are phonetically inaccurate and include such errors as extraneous letters, omitted syllables, auditory discrimination errors, syllable reversals, letter-order errors, and other auditory sequencing errors. The other dyslexic patterns are dyseidetic and mixed. The mixed group has weaknesses in both the visual gestalt and auditory analytical functions, with resulting disability in developing both sight vocabulary and phonic skills. The Boder Test of Reading-Spelling Patterns is based on these error patterns.
dysphonia: Disorder of voice quality that includes hoarseness due to chronic laryngitis and, rarely, to papillomata (tumors on the larynx [windpipe]).
dysplasia: Abnormal development in shape and size, especially at the cellular level.
dyspraxia: Partial loss of or failure to develop the ability to perform coordinated movements, not explainable by mental retardation; also known as developmental coordination disorder.
dysraphism: An abnormality of the axial skeleton including the skull (cranial) and spinal column. Dysraphic states include anencephaly (no brain or absent top of skull), myelomeningocele (protuberance of both the spinal cord and its lining), and duplications or split spinal cords (diastematomyelia or diplomyelia). These disorders generally involve neurological dysfunction as well as skeletal abnormalities. The abnormal formations occur early in fetal life and have a genetic component.
dysrhythmia: Stammering due to an incoordination between breathing and speech.
dyssemia: A disorder of socialization characterized by problems with respecting boundaries, interpreting gestural language (including facial expressions), vocal loudness, rhythm, and dress.
dysthymic disorder: A specific depressive disorder characterized by a constant and chronic disturbance of mood involving either depressed or irritable mood (particularly in children and adolescents) for at least a year (2 years for adults). Although there may be brief periods of relief, dysthymic depression is present for most of the day more days than not. In addition, there may be other associated symptoms, including appetite disturbances, sleep disturbances, chronic fatigue, concentration and problem-solving difficulties, low self-esteem, and feelings of helplessness and hopelessness. Young people with developmental disabilities are especially vulnerable to this disorder. Often these youth are subject to constant demands that exceed their capabilities, leading to a constant sense of failure and, ultimately, chrome depression or dysrhymia. Too often, this treatable disorder gets reinforced when it is seen by teachers, parents, and others as "lack of motivation."
dystocia: Abnormal labor; usually refers to maternal dystocia or structural abnormalities of the uterus giving rise to premature or prolonged labor.
dystonia: Abnormality of muscle tone often leading to unusual posturing (dystonic movements). A number of transient dystonia syndromes have been described in premature infants, and dystonia is one of the motor complications of antipsychotic drugs frequently used to treat severe maladaptive behaviors in people with developmental disabilities.
dystonia musculorum deformans: A disorder – frequently genetic – of movement and posture characterized by progressive, intermittent, or continuous muscle spasms including torticollis (stiff neck)
dystonic attack: Opisthotonic attack; an intermittent, exaggerated, involuntary total body extension pattern with the head thrown backward in an arching posture. These episodes occur in children with severe motor abnormalities (e.g., cerebral palsy), almost always when the child is supine or the head has been extended, so that the episodes can be mistaken for seizures. Modifications in handling usually decrease the incidence of such pseudoseizures.