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

EAP: See employee assistance program.
EAR: See early automated responses.
Early and Periodic Screening, Diagnosis, and Treatment (EPSDT): A federal program to fund routine medical and developmental services for Medicaid-eligible persons under 21 years of age.
early automated responses (EAR): A grouping of infantile reflex patterns that includes EAR-I (primitive reflexes) and EAR-II (postural responses).
Early Childhood Special Education Act of 1986: See Education of the Handicapped Act Amendments of 1986 (PL 99-457).
Early Detection Inventory (EDI): A screening test for children between 3½ and 7½ years of age in the areas of motor, social, behavioral, and academic skills.
Early Intervention Amendments to PL 94-142: See Education of the Handicapped Act Amendments of 1986 (PL- 99-457).
Early Intervention Development Profile (EIDP): A criterion-referenced assessment scale for infants from birth to 30 months; its six scales tap perceptual and fine-motor, cognitive, language, social and emotional, adaptive, and gross-motor skills. The cognitive scale in this battery is based on Piagetian theory.
Early Language Milestones Scale-Second Edition (ELM Scale-2): A language screening test for children from birth to 3 years of age, as well as older children with developmental delays whose functional level is within this range; it uses a Denver Developmental Screening Test format and divides language into three streams: auditory expressive, auditory receptive, and visual. Administration time is less than 10 minutes.
Early Screening Inventory (ESI): A developmental screening test to identify children 4-6 years of age who will need special education intervention. Items are derived from the Stanford-Binet Intelligence Scale, Denver Developmental Screening Test, Illinois Test of Psycholinguistic Abilities, and the Purdue Perceptual Motor Survey. The instrument also includes a parent questionnaire.
Early Screening Profiles (ESP): A comprehensive screening instrument for children ages 2-0 to 6-11 years. The ESP yields screening indexes or standard scores in cognitive/language, motor, or self-help/social areas to identify children at risk or gifted children (those who have superior general intellectual ability).
EASIC: See Evaluating Acquired Skills in Communication.
Easter Seal Society: A private fundraising and service organization for children and adults with disabilities. Founded in 1919, this national organization's mission is to help people with disabilities achieve independence. The society strives to do so through the provision of rehabilitative services, technical assistance, disability prevention, advocacy, and public education. The National Easter Seal Society publishes a quarterly newsletter, the Communicator; other publications and informational materials are available upon request.
eccentric power: The ability to resist force as a muscle is lengthened.
ecchymosis: Bruise or contusion. The skin discoloration (red, blue, brown, yellow) in stages of healing that suggest the age of the injury. Ecchymosis can be due to accidents, (child) abuse, bleeding disorders, and other disease processes that cause blood to escape from vessels into surrounding tissue.
echolalia: Parroting; repeating words, phrases, and sentences. Echolalia can be immediate or delayed, with the latter being more pathological. In children without disabilities, this imitative phase is transitory between the ages of 18 and 24 months. In children with mental retardation, language disorders, and autism, the echolalic phase is more prominent, prolonged, and correlated with a mental age closer to 30 months. Echolalia spontaneously observed in clinical situations should give rise to a more detailed assessment of language function. Echolalia after the appropriate developmental stage is a sign of language deviance.
echopraxia: The tendency to mimic the actions of others; a subtype of echolalia noted in Gilles de la Tourette syndrome.
eclampsia: The convulsive stage of toxemia of pregnancy. Eclampsia/toxemia can affect the oxygen delivered to the brain of the baby and contribute to later developmental disorders.
ECMO therapy: See extracorporeal membrane oxygenation therapy.
ECO Scales: Five separate scales used to assess social play, turn taking, preverbal communication, language, and conversation. Administration time is 10-30 minutes, with the results used to address developmental goals and adult-child interaction patterns.
Ecogenetic disorder: A disease caused by the interaction of a genetic predisposition with an environmental factor; for example, emphysema in alpha-1-antitrypsin (a specific enzyme inhibitor) deficiency and smoking.
ectodermal: Refers to parts of the body derived from the outermost layer (ectoderm) of embryonic cells. Human ectodermal derivatives include skin, hair, and nervous system. Their common embryonic origin suggests a rationale for the nonspecific association between minor dysmorphic (atypical) features and mild learning, attention, and behavior disorders, as well as more severe developmental problems.
ectodermal dysplasia: A group of genetic syndromes with involvement of ectodermal derivatives—hair, teeth, and nails. Despite dysmorphic (atypical) facies, neurodevelopmental problems—other than an occasional hearing impairment—are unlikely with the exception of xeroderma pigmentosa (extreme sensitivity of the skin to light).
ectomorph: A thin, asthenic (slender or slight) body type or build; leptosome.
ectopia lentis: Dislocation of the lens of the eye, which can be inherited in isolation or as part of several syndromes, such as Marfan syndrome or homocystinuria.
ectropion: Eversion (turning out) of the eyelid; congenital ectropion is seen in one third of the cases of Down syndrome.
eczema: A skin disorder characterized by erythema (redness), vesiculation (blisters), and flaking or scaling; it sometimes becomes exudative (weeping). Often a sign of atopy (allergy), it is also a component of many syndromes and systemic disorders.
edema: Fluid accumulation with swelling. Common causes of edema include injury and cardiac and renal disorders.
EDI: See Early Detection Inventory.
EDPA: See Erhardt Developmental Prehension Assessment.
EDTA: See ethylenediaminetetraacetic acid.
educable mentally handicapped (EMH): See mild mental retardation.
educable mentally retarded (EMR): See mild mental retardation. Although people with mild mental retardation is the preferred terminology, the terms educable mentally retarded and educable mentally handicapped (EMH) are still in use, particularly in special education settings with regard to the level of learning support indicated.
Education Amendments of 1974 (PL 93-380): Amendments to the Elementary and Secondary Education Act (ESEA), which included a variety of changes to existing federal education programs and contained two important laws. One of the amendments renamed Title VI of the ESEA to the Education of the Handicapped Act Amendments of 1974. This law required states to establish a timetable for achieving full educational opportunity for all children with disabilities. The act included procedural safeguards to be used in identifying, evaluating, and placing children with disabilities. It mandated that children be integrated into general classes when feasible, and required that testing and evaluation materials be chosen and used on a nondiscriminatory basis. The second major law, the Family Education Rights and Privacy Act (FERPA), also called the Buckley Amendment, gave parents of students under the age of 18, and students 18 years of age and over, the right to examine and comment on the records contained in a student's personal file. FERPA applied to all students, including those in postsecondary education. When a file contains material the parent or eligible student views as inaccurate, misleading, or in violation of his or her rights, provisions are made to challenge and remove the information in question. If school staff and parents disagree about the accuracy or relevance of material, mechanisms for a hearing are stipulated. PL 93-380 began to focus upon and stress the need to fully educate all children with disabilities and to ensure their active participation in this process.
Education for All Handicapped Children Act of 1975 (PL 94-142): A federal law that grew out of and strengthened previous acts including the Education of the Handicapped Act of 1970 (PL 91-230), Title VI of the Education Amendments of 1974 (PL 93-380), and other legislation of similar names. PL 94-142 became fully effective in September of 1978 and was designed to ensure that all children with disabilities have available to them a free, appropriate public education (FAPE); the law provided for impartial and objective decision making, appropriate educational funding, individualized education programming, accountability at all levels of government, and federal financial assistance to state and local school districts. Major provisions of the law included 1) the process for determining that a child has a disability and is in need of special education and related services; 2) developing an individualized education program (IEP) to meet the unique needs of the child with a disability, including provision of "related services" that may be necessary to assist a child in benefiting from special education services; 3) a requirement that students be placed to the maximum extent possible in the least restrictive environment (LRE) that addresses their needs; and 4) creation of safeguards to be used by parents or guardians of children with disabilities. These safeguards allow parents or guardians to examine relevant records on the identification, evaluation, and educational placement of their child; and require that parents or guardians be given prior written notice when an educational agency changes or refuses to change the identification, evaluation, or educational placement of their child. PL 94-142 is the core of federal funding for special education.

In 1990, PL 94-142 was reauthorized and expanded under PL 101-476, the Education of the Handicapped Act Amendments of 1990, and was renamed the Individuals with Disabilities Education Act (IDEA). The law's name reflects a change in terminology; PL 101-476 employs "people-first" language, replacing "handicapped children" with "individuals with disabilities."
Education of the Handicapped Act of 1970 (PL 91-230): A federal law that consolidated previous legislation and established a new Title VI to replace the one enacted in PL 89-750, the Elementary and Secondary Education Amendments of 1966. This new authorization of Title VI, which became known as Part B, established a core grant program for educational agencies at the local level. Part B was the precursor to the Education for All Handicapped Children Act of 1975 (PL 94-142), which significantly expanded the educational rights and opportunities for children and youth with disabilities.
Education of the Handicapped Act Amendments of 1974: See Education Amendments of 1974 (PL93-380).
Education of the Handicapped Act Amendments of 1983 (PL 98-199): Federal legislation that arranged and reauthorized discretionary programs for individuals with disabilities by expanding the means for providing transition services from school to work for students with disabilities; establishing and funding parent training and information centers to help parents guarantee their children's rights under PL 94-142; and providing financial incentives for increasing research and implementation of preschool education and early intervention programs. All of these programs fell under the auspices of the Office of Special Education Programs (OSEP), which had replaced the Bureau of Education for the Handicapped (BEH).
Education of the Handicapped Act Amendments of 1986 (PL 99-457): Federal legislation that lowered the age of eligibility for special education and related services for all children with disabilities to 3 years of age. This initiative was known as Section 619 in Part B, and mandated that, in order to receive federal funding, states had to begin providing services to preschool children by October 1991. All states have since complied. This act also included a Part H, which created a comprehensive early intervention program for infants, toddlers, and their families. This program is directed to the needs of children from birth to 3 years of age who are identified as needing early intervention services and requires tile development and implementation of an individualized family service plan (IFSP) for each participating child and Ins or her family. State definitions of eligibility under this program may vary, but to receive federal funding a state must have an acceptable service delivery system in place by its fifth year of participation in the program.

PL 99-457 reiterated the requirements and stipulations found in the education of the Handicapped Act of 1970 (PL 91-230), its amendments, and the Education for All Handicapped Children Act of 1975 (PL 94-142), including the rights of children and youth with disabilities— regardless of severity—to a free, appropriate public education and to an individualized education program (IEP) or IFSP developed and implemented to enumerate the special education, early intervention, and related services a child, youth, and/or family is to receive. Parents' rights were also delineated, including the rights to participate in all aspects of the identification, evaluation, and placement processes; to give consent for initial evaluation and placement; and to dispute any aspect of the process with specified due process procedures. This law also reauthorized discretionary programming and expanded school-to-work transition programs.

In 1991, the act was reauthorized as PL 102-119, the Individuals with Disabilities Education Act Amendments.
Education of the Handicapped Act Amendments of 1990 (PL 101-476): Also called the Individuals with Disabilities Education Act (IDEA) of 1990. A federal law that amended and expanded PL 94-142, the Education for All Handicapped Children Act of 1975. The law renamed and combined the original act and its amendments. The term "handicapped children" was replaced by "individuals with disabilities," and the general definition of those with disabilities was expanded to include people with autism and traumatic brain injury (TRI) as separate categories. Other major changes included the addition of programs to promote research and the use of technology; transition programs beginning after high school; a program to serve children with emotional disorders; greater emphasis on addressing the needs of culturally and ethnically diverse children with disabilities; and waiving a state's traditional immunity from private litigation.
educational sign systems: Manual equivalents of spoken English. Seeing Essential English (SEE₁) and Signing Exact English (SEE₂) are two pedagogical sign systems frequently used with populations of non-vocal people with disabilities. Unlike American Sign Language, which deviates from oral language, educational sign systems consist of manual translations of spoken English, maintaining its syntax (grammar), structure, and morphology (word structure). These systems can also be part of a total communication system.
Edwards syndrome: See trisomy 18 syndrome.
EEC syndrome: A genetic syndrome standing for ectrodactyly (cleft hands and/or feet), ectodermal dysplasia (a skin disorder), and clefting (cleft lip/cleft palate); it is frequently accompanied by urinary tract abnormalities and conductive (involving the middle and outer ear) hearing loss. Inheritance is probably autosomal dominant with variable expressivity.
EEG: See electroencephalogram.
EFA: See Epilepsy Foundation of America.
EFT: See Embedded Figures Test.
Eggers procedure: An orthopedic surgery operation for knee flexion deformity in cerebral palsy; used only in modified fashion.
egocentrism: A young child's inability to understand another's point of view. In Piaget's theory of early development, this describes a cognitive limitation without the pejorative connotation the same behavior would imply in an adult.
EIDP: See Early Intervention Development Profile.
18p—: Deletion of the short arm of chromosome 18; a chromosomal disorder with mental retardation (with language abilities being relatively more severely impaired), growth deficiency, and a peculiar facies (including jug-handle ears).
18q—: Deletion of the long arm of chromosome 18; a chromosomal disorder with mental retardation, hearing impairment, growth deficiency, mid-facial hypoplasia (underdevelopment), a prominent antihelix (part of the external ear), occasional behavioral abnormalities, and eye defects.
eikonometer: See aniseikonia.
ELBW: Acronym for infants of extremely low birth weight (i.e., below 1,000 grams).
elective: Optional, nonemergency. Most cosmetic surgery is elective. Most elective surgery in children is scheduled so that they miss the least amount of school as possible.
electric hair: Uncombable or fly-away hair, a minor dysmorphic (atypical) feature; multiple cowlicks can give the same appearance.
electroencephalogram (EEG): A brainwave test. A clinical tool used to measure brain electrical activity between different areas of the scalp and a reference point. An EEG should include measurements made in drowsy, sleep, and awake states, and, if possible, with hyperventilation (rapid breathing) and photic (light) stimulation. Combined with the clinical history, an EEG can support the diagnosis of a seizure disorder, help classify the focus (location) and type of seizure disorder, and contribute to the selection of appropriate anticonvulsive therapy. In some instances an EEG can clarify prognosis.
electrolyte: A chemical in the blood that can conduct an electric current. Serum electrolytes refers to a battery of tests to determine the levels of these chemicals in the blood. The resulting patterns provide much information on the individual's status and the body's acute and chronic response to a variety of disease states. The most important electrolytes are sodium (Na), potassium (K), calcium (Ca), magnesium (Mg), chloride (Cl), bicarbonate (HCO₃), and phosphate (PO₄).
electromyography (EMG): A study recording the electrical activity in a muscle. It is used to identify and help classify the type of myopathy (disorder of voluntary muscle), neuromuscular disease, or lower motor neuron (nerve from spinal cord to muscle) present. The pattern of muscle response to the electrical stimulation varies with condition(s).
electroretinography (ERG): A measure of retinal (eye) function documented by changes in electrical potentials when light hits the eye. The pattern of sequence of electrical changes and the amplitude of response can be used to diagnose eye diseases that may cause blindness, such as retinal detachment, which occurs in some premature babies with retinopathy of prematurity (ROP).
Elementary and Secondary Education Act (ESEA) of 1965 (PL 89-10): A federal law designed to strengthen and improve educational quality and opportunity for the nation's elementary and secondary students, particularly for economically underprivileged children. This act paved the way for direct federal support for the education of children with disabilities and was the statutory basis upon which early legislation addressing special education was drafted.
Elementary and Secondary Education Act Amendments of 1965 (PL 89-313): Federal legislation that authorized the first federal grant program specifically targeted for children and youth with disabilities. Grants were awarded to state agencies to educate students with disabilities in state-supported or state-operated schools and facilities.
Elementary and Secondary Education Act Amendments of 1966 (PL 89-750): This law amended Title VI of PL 89-10 by authorizing the first federal grant program for the education of children with disabilities at the local school level, rather than providing assistance solely to state-operated programs. PL 89-750 established the Bureau of Education for the Handicapped (BEH) (now known as the Office of Special Education Programs [OSEP]) to implement, monitor, and evaluate federally funded special education programs. The law also created the National Advisory Council, now called the Council on Disability.
Elementary and Secondary Education Act Amendments of 1968 (PL 90-247): The final piece of federal legislation in the 1960s to address special education. This law established a set of what became known as "discretionary" programs designed to supplement existing special education services. Among supportive services were funding for regional resource centers, services for children with sensory impairments, special education research, and the groundwork for continuing education and informational resources.
Elementary and Secondary Education Act Amendments of 1978 (PL 95-561): Part A of Title IX of this federal law is known as the Gifted and Talented Children's Act. The statute and its regulations defined gifted and talented children and described the special education services to which they were entitled by virtue of their demonstrated or potential abilities in the arenas of academic, creative, leadership, or visual and performing arts achievement.
elephant man disease: See neurofibromatosis. Neurofibromatosis was formerly and derogatorily referred to as elephant man disease because of the famous case of Joseph Merrick (1862-1890), whose deformity led him to a circus career where he was hilled as "The Elephant Man." His condition was described by Sir Frederick Treves (1853-1923) in 1885. Merrick was later made the subject of an award-winning play and movie, which reinforced the often striking discrepancy between severe physical deformity and intelligence.
elfin facies: A facial appearance associated with a number of syndromes, such as leprechaunism and Williams syndrome.
ELIP: See Environmental Language Intervention Program.
Ellis-Van Creveld syndrome: See chondroectodermal dysplasia.
ELM Scale-2: See Early Language Milestones Scale—Second Edition.
emaciation: Lean muscle mass wasting and fat depletion, with starvation.
Embedded Figures Test (EFT): A measure of cognitive style that requires the subject to find simple geometric figures in complex, colored designs. Several versions of the EFT exist, including preschool (PEFT), children's (CEFT), and group (GEFT) tests. Field dependence and disembedding have been related to problem-solving style and a number of other variables.
embryo: The product of conception from fertilization to birth; in the later stages of development the embryo is referred to as a fetus. Sometimes the term embryo is restricted to development prior to the fetal stage, rather than to the entire period of gestation. The major organ systems arc formed during this early stage; disturbances in the developmental process at this time contribute to fetal wastage (spontaneous miscarriage) or major organ system malformations.
embryogenesis: The process in a fetus where cells multiply and specialize to form a particular organ or organ system, such as the brain and central nervous system (CNS). This process is a complex progression from induction (where cells divide) to migration and organization into specialized layers. The critical period of fetal (before birth) development is during embryogenesis, when the cells are particularly vulnerable to damage by a teratogen (toxic agent), thus disrupting the normal pattern of events. This leads to CNS malformations that cause a large number of fetal, neonatal, and infant deaths. It is estimated that 3% of neonates have a significant CNS or other systemic malformation. Genetic abnormalities, maternal infection, drugs, and illness account for 40% of malformations. However, the cause in the remaining 60% is unknown.
EMG: See electromyography.
EMH: Educable mentally handicapped; see mild mental retardation.
emotion: A set of subjective feelings often accompanied by physiological changes that can impel one toward action. Examples of emotions include fear, love, surprise, and hate. See also affect.
empathy: Insightful awareness. The objective or intellectual recognition of the nature and significance of another's emotions and behaviors or of their experience of a specific situation. Empathy allows a helping professional to view events from a client's or patient's perspective. Empathy differs from sympathy, which stems from having a similar personal, cognitive, or affective experience (i.e., "I know how you feel").
employee assistance program (EAP): Employer-based services to employees to help with life stresses and problems that negatively affect job performance through such things as accidents, absenteeism, attitude difficulties, emotional problems, or substance abuse. Employee assistance services may include drug treatment, family services (e.g., helping with nursing home or group home placement), and marital or family therapy. The philosophy is one of treatment to enhance job performance rather than punishment for poor performance.
EMR: Educable mentally retarded; see mild mental retardation.
enanthem: A rash on the mucous membrane (e.g., inside the mouth), usually associated with an exanthem (a skin rash) in the presence of systemic (body) disease. The Koplik spots of measles are an example.
encephalofacial angiomatosis: See Sturge-Weber syndrome.
encephalopathy: Brain abnormality; typically subdivided into static and progressive. The effects of static encephalopathies include the entire spectrum and continuum of developmental disabilities.
encopresis: Fecal soiling, fecal incontinence. Lack of or incomplete bowel control can be primary, when the child has never achieved such control, or secondary, when the child previously achieved bowel control but then later lost it. Age-appropriate lack of bowel control should not be referred to as encopresis. Even in older children, if the absence of toilet training is developmentally appropriate, the term encopresis should be avoided because it connotes severe emotional pathology (origin). Secondary encopresis in otherwise normal children is often "overflow diarrhea," leakage around fecal impaction associated with prolonged constipation. Secondary encopresis that is more than occasional or transiently associated with emotional stress should be considered a major psychiatric symptom and potentially reflective of severe psychopathology.
endemic: A disease or disorder that is peculiar to, or occurs at high rates in, a given population or geographic area (e.g., lead poisoning in inner-city children, histoplasmosis infection in the Mississippi Valley, myelomeningocele [protuberance of both the spinal cord and its lining] in the Irish).
endogenous: Disease or illness that comes from within rather than being caused by external sources (e.g., depression resulting from unresolved emotional conflict rather than in response to a specific sad experience).
endomorph: A body type tending to be short, stocky, rounded, well padded; pyknic.
endorphin: An opiate that occurs naturally in the body and is involved in the perception of pleasure and pain; the ability of certain drugs to affect endorphin levels is being explored in the etiology and treatment of self-injurious behavior.
engram: Memory trace; a hypothetical physical modification of the brain that accounts for memory retention. This is a research, rather than a clinical, term.
enmeshment: A term describing a pattern of family relating characterized by strong allegiance and closeness, few or extremely permeable hierarchies and boundaries, and little individual autonomy. Often such a pattern of relating has strong ethnic and cultural origins. When culturally determined, this pattern is less often pathological. When a family is enmeshed to protect itself from psychological pain, that family can become extremely toxic and pathological. Often a family member must become symptomatic in order to prompt the family to secure help and enable the opportunity to grow. Families who have children with developmental disabilities often develop enmeshed patterns as a way of protecting the child and themselves from hurt. This protection can become a stranglehold, with neither the child nor the family able to mature.
enrichment: Providing children with extra social, emotional, and cognitive stimulation, as well as improved nutrition, sanitary conditions, and regular and preventive medical and dental care. Enrichment is often used generically to refer to any supplementary activity, intervention, or opportunity added to a child's daily life experiences. Enrichment activities are routinely part of early childhood special education, including home-based programs, which encourage parental involvement and teach parents ways to enhance their child's development. Enrichment is also used to refer to supplementary educational experiences and programming for gifted children (those who have superior general intellectual ability).
ENT: Ears, nose, and throat; see otolaryngology.
enteral feeding: Tube feeding; examples include nasogastric and gastrostomy tube feedings.
entropion: Inversion (turning in) of the eyelid; it can be associated with mental retardation and a variety of congenital defects.
enuresis: Urinary incontinence after 5 years of age. Nocturnal enuresis is night-time bed-wetting; diurnal enuresis is urinary incontinence when awake during the day. Primary enuresis is defined as uninterrupted lack of bladder control for at least 1 year; secondary enuresis is defined as being preceded by at least 1 year of dryness. Most primary nocturnal enuresis is familial, which can be confirmed by a detailed family history. Regressive secondary enuresis may indicate urinary tract infection or severe emotional stress; it may be a presenting sign of child sexual abuse. Daytime bladder control can be influenced by mental age and the presence of inattentive, impulsive behavior. Primary enuresis is associated with a small bladder and/or a sleep disorder (e.g., a deep sleeper). Primary enuresis is more likely to be a neurodevelopmental phenomenon, whereas secondary enuresis often reflects intrapsychic stress.
Environmental Language Intervention Program (ELIP): An assessment/diagnostic remediation program for prelanguage and early language skills. The Environmental Prelanguage Battery |EPB) assesses readiness behaviors such as play in children who have no oral language skills. The Environmental Language Inventory (LLI) assesses language development (two or more word phrases) in conversation, imitation, and free play.
eosinophilia: An excessively high number of a specific type of eosin (red) staining white blood cells; of the variety of conditions associated with eosinophilia, the most common in children are allergy, parasites (worms), and cancer.
EOWPVT: Expressive One-Word Picture Vocabulary Test; see One-Word Picture Vocabulary Tests.
EPEC: See Evaluation and Prescription for Exceptional Children.
ephedrine: An adrenergic drug that increases bladder muscle tone and can be used in the treatment of neurogenic bladder.
epicanthus/epicanthal fold: A semilunar (crescent-shaped) fold of skin extending downward from the side of the nose (upper) to the lower lid and partially covering the inner canthus. An epicanthal fold is most commonly an isolated autosomal dominant feature; it is also associated with Down syndrome and many other genetic syndromes. It is present in the normal fetus from the third to the sixth month, so its postnatal presence may be considered a sign of developmental immaturity. Up to one third of normal infants under 1 year of age exhibit persistent epicanthus. It is one of a number of minor dysmorphic (mildly atypical) features that, in combination, may have developmental significance. It does not affect vision hut its presence may produce the mistaken impression of strabismus (squint) by concealing the medial sclerae (pseudostrabismus).
epicritic: Pertaining to the mild sensation of pressure, touch, and temperature.
epidemic: A disease or disorder with an occurrence rate that massively exceeds normal rates either in the numbers affected or in the rapidity of occurrence. Current examples include acquired immunodeficiency syndrome (AIDS) and lead intoxication in children.
epidemiology: The study of the distribution, determinants, and deterrents of disease. Epidemiologists study disease at the macro perspective (in large groups of people), whereas clinical medicine pathologists study disease at the micro level (in single individuals). Epidemiologists study groups with a disease and groups without the disease in order to determine the difference between those affected and those spared. For example, to gauge distribution, epidemiologists might study whether the disease is more prevalent in men or women, northerners or southerners. To isolate its determinants, they might try to find out whether it is genetically transmitted or the result of behavioral habits. To identify deterrents, they might ask whether some diets prevent the disease more than others. Many people with developmental disabilities have been epidemiologically investigated.
epigenetic: Relating to the appearance of new genetic phenomena not present at previous stages of development.
epigenetic sequence: The biological and psychological development of the individual in an ordered and sequential series of stages.
Epilepsy Foundation of America (EFA): A nonprofit, voluntary organization dedicated to epilepsy treatment, research, and education. The national foundation and its local chapters provide information regarding epilepsy, its treatment, and related issues including employment, advocacy, and educational programming.
epileptic: Relating to a seizure or seizure disorder.
epileptic syndrome: A seizure disorder characterized by a pattern of findings that recurs together. These can include age of onset, etiology (cause), types of seizures, electroencephalography (EEG) findings, precipitating factors, family history, evaluation, and prognosis. For example, West syndrome consists of infantile spasms (onset and seizure type), hypsarhythmia (a continuous disorganized pattern of high-voltage slow waves [sharp pointed deviations]), and developmental delay.
epiloia: See tuberous sclerosis syndrome.
episodic memory: A component of memory hypothesized by memory theorists to consist of an experiential record of events and occurrences. Episodic memory has an autobiographical flavor and usually contains spatial-temporal information, such as memory for specific episodes (e.g., what one had for dinner the previous night). Repeated exposure to certain kinds of information seems to produce a shift from episodic to semantic (meaning systems) memory. Being told there is a snake called a rattlesnake would presumably be stored initially in episodic memory (e.g., "Uncle Bob told me about a rattlesnake when we were sitting on the porch last night"). Eventually, the idea of rattlesnake would become a part of semantic memory as a type of reptile.
eponym: The naming of a syndrome (or sign or symptom) after the person who first defined, described, or popularized its importance. Use of the possessive to title the syndrome is obsolete (i.e., Down syndrome, not Down's syndrome). The more neutral historical term is the preferred usage before the true etiology (cause) is known. Once, however, the underlying scientific basis is discovered, nomenclature should reflect that knowledge. Thus, Down syndrome would become trisomy 21.
EPSDT: See Early and Periodic Screening, Diagnosis, and Treatment.
equilibration: The tendency of biological organization and mental development to progress toward more complex and more stable levels through a balanced interaction between assimilation and accommodation.
equilibrium: The process of maintaining an upright posture. Equilibrium reactions are a subgroup of postural reactions facilitating the development of voluntary movement late in the first year of life, enabling the infant to compensate for changes in the body's center of gravity and thus achieve successful head control, sitting, and standing.
equinovalgus: Rocker-bottom foot deformity.
equinovarus: See clubfoot.
equinus: The foot position in toe-walking, resembling the posture naturally assumed by a horse's hoof; plantar flexion.
equinus deformity: An orthopedic abnormality in which the heel of the foot is pulled upward and the forefoot downward.
equipotentiality: A hypothetical mechanism of recovery after brain damage that involves the assumption of control by undamaged parts of the same neural system.
Erb palsy: Paralysis of the upper arm due to injury to the upper brachial plexus (nerves to the arm), usually sustained by an infant during childbirth. The arm lies limp at the infant's side with the hand pronated in the "policeman's tip" position. This peripheral nervous system injury (nerves running throughout the body) should not be confused with a central monoplegia; named after Wilhelm Heinrich Erb (1840-1921).
ERG: See electroretinography.
Erhardt Developmental Prehension Assessment (EDPA): A criterion-referenced assessment for hand function development for children from birth to 6 years of age that yields age levels for three areas: involuntary hand-arm movements, voluntary movements, and prewriting skills. Administration time is up to 1 hour.
ERP: See event-related potential.
error of measurement: The standard deviation of the difference between the obtained score and the true score. Such .1 difference is attributed to the unreliability/variability in the test instrument or the examiner. The error of measurement is often expressed in the form of confidence bands. For example, if the mean score on a test is 100, the standard deviation 1.1, and the standard error of measurement 3, then the confidence interval at the 68 percent level for a test score of 100 is 100 ± .5, or 97 to 103. (There is a 68% chance that the subject's true score lies in the range of scores from 97 to 103.) For the 95% level, the range will be defined as the mean ± 1.96 (standard error), or 100 ± 6. (The chances are 95 out of 100 that the subject's true score falls in the range 94 to 106.)
erythema: Redness of the skin; one of the cardinal signs of inflammation; a component of many skin diseases.
erythema infectiosum: Fifth disease (so-called relative to an older system of numbering common exanthems [skin rashes] in children); a viral exanthem in which an otherwise well child has red flushed cheeks. This "slapped cheeks" appearance should not be interpreted as a sign of child abuse.
erythroblastosis fetalis: Hemolytic disease of the newborn; a blood group incompatibility (usually Rh) between mother and baby causes an anemia in the baby; erythroblasts (blood cells that produce red blood cells) then increase in the circulation where they are normally rare; the increased breakdown of red blood cells contributes to jaundice (yellowing of the skin), liver enlargement, and generalized edema (fluid-filled swelling) (hydrops fetalis). With immunological treatment of Rh negative mothers, this condition is usually preventable.
erythrocyte sedimentation rate (ESR): A blood test that nonspecifically indicates inflammation or disease.
Escalante syndrome: See fragile X syndrome.
ESI: See Early Screening Inventory.
esophageal atresia: A congenital malformation in which the gullet ends in a blind pouch and does not communicate with the stomach; part of the VATER association and other malformation syndromes.
esophagus: Throat, gullet; the part of the gastrointestinal tract that connects the pharynx (back of the throat) with the stomach.
esophoria: An inturning of one eye after its vision has been covered and uncovered. This is demonstrable by using the crossed-patch test, which alternately covers and uncovers each eye while looking for deviation in the covered eye.
esotropia: Cross-eve; internal or convergent strabismus or squint. The sixth cranial nerve supplies the lateral rectus muscle of the eye; if this is damaged, the unopposed medial rectus muscle pulls the eye inward. Increased intracranial pressure such as occurs in hydrocephalus (excess fluid in the brain) frequently affects this sixth nerve function.
ESP: See Early Screening Profiles.
ESR: See erythrocyte sedimentation rate.
ethnicity: Shared origins, characteristics, values, customs, and traditions. An ethnic group is a distinct group of people who share a common race, language, customs. and other traditions.
ethosuximide: Trade name Zarontin; an anticonvulsant used to treat absence seizures; it is not effective against other kinds of seizures. Ethosuximide is generally given twice a day. Minor side effects include stomachache, rash, headache, and a reversible blood problem. Unusual side effects at high dosages include hiccups or neurotoxicity with lethargy or hallucinations. Therapeutic blood levels are used to monitor treatment.
ethylenediaminetetraacetic acid (EDTA): A drug with salts that is injected intramuscularly to treat lead poisoning.
etiology: Cause; medically, this refers to the underlying pathology. Traditional medical etiologies are characterized as belonging to one of the following groups: genetic, infection, trauma, tumor, and toxin (poison).
eugenics: A social engineering philosophy with scientific pretensions to improve racial hereditary characteristics. Negative eugenics is concerned with the sterilization of "carriers" of "undesirable" genetic traits; positive eugenics promotes matings between carriers of "desirable" genetic traits. The "eugenics scare" of the early 20th century gave rise to the compulsory sterilization of people with mental retardation in the United States, and contributed to the racial theories and holocaust atrocities of the National Socialist Party in Nazi Germany. Any discussion of eugenics must carefully distinguish its narrow scientific base from its broader unproven pseudoscientific assumptions.
euthanasia: Permitting or facilitating dying, usually in a person with a terminal illness or in a persistently vegetative state.
Evaluating Acquired Skills in Communication (EASIC): A criterion-referenced assessment for children with severe impairments who are 3 months to 8 years of age. The EASIC rates the following behaviors: prelanguage, receptive I (noun labels, action verbs, and basic concepts), expressive I (emerging modes of communication), receptive II (more complex language forms), and expressive II (using more complex communication).
Evaluation and Prescription for Exceptional Children (EPEC): An educational planning assessment for preschool children.
evaluation, educational: A diagnostic procedure by which students are assessed with regard to their eligibility and specific needs for special education services. Federal law requires parents' consent for any initial preplacement evaluation. Under federal law (most recently, the Individuals with Disabilities Education Act [IDEA]), all tests and other evaluation materials must be administered in a child's native language, validated for the specific purpose for which they are used, and administered by trained personnel in accordance with proper instructions. No single test shall be used as the sole basis for determining appropriate educational placement. The evaluation is to be made by a multidisciplinary team and is to include areas appropriate to the individual student. Reevaluation is required at least every 3 years and may be done more often, but not more than once per calendar year.
event-related potential (ERP): A wave generated on electrophysiological monitoring of brain response to a specific stimulus. ERPs have been used in research on the efficacy of stimulant medication in the treatment of attention disorders.
eversion: Turning the sole of the foot outward from the mid-line of the body; the foot posture utilized in the indirect Fog test (a gait test that involves walking on the insoles of the feet).
exanthem: A skin eruption that is a symptom of a more general disease such as roseola (measles) or scarlet fever. Viral exanthems before the age of 3 years (especially around 2 years of age in boys) have been correlated with specific learning disabilities.
exanthema subitum: See roseola.
exceptional child: Term used equally to describe a child who is gifted (with superior general intellectual ability) or a child who has a disability.
exclusionary discipline: The practice of removing a student from the routine school environment for a specified period of time; it includes both supervision and expulsion. When children with disabilities achieve a predefined cumulative total time of exclusion, an individualized education program (IEP) review is mandated.
exophoria: A latent outward turning of one eye after its vision has been blocked. This is provoked by the cover-uncover test.
exophthalmos: Pop eyes; abnormal protrusion of the eyeballs; bilateral (both eyes) exophthalmos is usually a sign of hyperthvroidism, whereas unilateral (one eye) exophthalmos often reflects localized orbital or neurological disease (e.g., a tumor).
exotropia: Walleyedness; external or divergent strabismus or squint. The third cranial nerve controls the medial rectus muscle of the eye; impairment of that nerve often produces some degree of strabismus sometimes accompanied by ptosis, or drooping, of the eyelid.
expectant: An approach to diagnosis and therapy that does not involve any test or intervention other than waiting and watching; there is an implication that such waiting is "hopeful." In young infants, the diagnosis of developmental disabilities may sometimes be partially expectant.
expectorant: A cough medicine that promotes the expulsion of bronchial (chest) secretions.
Expressive One-Word Picture Vocabulary Test (EOWPVT): See One-Word Picture Vocabulary Tests.
expressivity: The extent to which a gene manifests its effects. Variable expressivity means that some individuals may show only mild manifestations of the gene, whereas others show severe ones. When discussing the expressivity of a genotype, there are no individuals that do not express some characteristic of the trait. See also penetrance.
extended family: A family unit including parents, children, and other relatives, perhaps representing several generations. In some cultures, close or long-term family friends are part of the extended family. A natural support system, extended family members often share the caregiving responsibilities of a child with disabilities, and, depending on the extent of their involvement, should be included in varying degrees in the child's intervention plan.
extension: Straightening of a joint.
extensor thrust: Sudden extension of the neck, back, hips, and knees so that the body is arched back like a bow; tonic spasm.
external motivation: Engaging in a task in order to meet a goal separate from both the task itself and the feeling of accomplishment engendered by successful completion. Completing a task to please others, to get a good grade, or to receive a reward are examples of external motivation goals. Rewards for learning should be used judiciously because, in some instances, they decrease interest in a task. Once the reward is perceived as the reason for engaging in an activity, an individual may engage in that activity only when the reward is available. Moreover, rewards that are theoretically but not actually available give negative reinforcement and undermine intrinsic motivation (e.g., the A grades that some children can never achieve). Extrinsic rewards are appropriate and effective for tasks that have limited intrinsic appeal; many rote tasks fall into this category. Rewards that are contingent on a specific level of performance, and that provide information regarding level of mastery, are less likely to undermine interest. In a classroom setting, rewards are often necessary as incentives to prod students into engaging in tasks in which they have little initial interest. Once begun, an attempt should be made to shift attention to intrinsic rewards by making the task interesting and challenging but achievable, with the value of the skill being made apparent.
external rotation: Turning a limb away from the mid-line of the body.
externalization: Attributing cause for feelings or behaviors to external sources.
extinction: The process of discontinuing reinforcement to reduce a conditional response to its preconditional level, for example, Penelope cries until her parents bring her an after-bedtime drink of water. Her parents stop bringing her the water and ignore her crying. The crying behavior eventually stops or is extinguished because it is no longer reinforced.
extracorporeal membrane oxygenation therapy (ECMO): A method of delivering oxygen to infants with respiratory compromise that uses a heart-lung bypass system and allows the lungs to rest and heal without the negative pulmonary effects of high oxygen levels and the complications of ventilator therapy.
extrapyramidal cerebral palsy: Any of the clinical physiological subtypes of cerebral palsy that do not reflect predominantly pyramidal tract involvement (spastic cerebral palsy). Ataxic/cerebellar, choreoathetoid, hypotonic or atonic (decreased or no muscle tone), rigid, and tremor are the principal members of this group. In general, for similar degrees of motor involvement, the degree of the motor delay is more severe for extrapyramidal than for spastic cerebral palsy. This appears to be due to the more frequent impairment of equilibrium and balance reactions as well as the more variable tone in extrapyramidal cerebral palsy; extreme variations in tone in this type of palsy also contribute to the decreased incidence and later onset of contractures. Facial grimacing is more common in extrapyramidal cerebral palsy than in spastic cerebral palsy.
extrapyramidal system: Voluntary muscle reactions are a result of cooperation between the cortically controlled pyramidal system and three nonpyramidal systems: the vestibular system, the cerebellar system, and the striatal system. This last system, often referred to as the extrapyramidal system, includes such structures as the caudate nucleus, putamen, globus pallidus, and substantia nigra. Damage to these extrapyramidal centers (basal ganglia) produce movement disorders such as Parkinson disease, Huntington chorea, and choreoathetoid cerebral palsy.
eye color: An inherited characteristic that has been suggested as a biological marker for learning style, with light- (blue) eyed persons being more self-paced and dark- (brown) eyed persons being more socially reactive. Dark-eyed children are thought to exhibit better perceptual motor speed and accuracy and have a lower prevalence of learning disabilities than light-eyed children. Light-eyed children in turn may have a higher incidence of autism and do better on learning skills that involve language, numbers, and pencil and paper tasks.
eye exercises: See optometric training.
eye-hand coordination: Refers to the direction of fine-motor activities of the hand in interaction with the visual system. Activities requiring eye-hand coordination include tracing, drawing, writing, lacing, and use of scissors. Direct training of eye-hand coordination has been attempted to remediate academic failure. Research has not proven this approach to be effective.