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

Fabry disease: A genetic syndrome characterized by attacks of burning pain in the hands and feet, dark nodular skin lesions, and progressive renal insufficiency. Symptoms are secondary to an enzyme deficiency and can include cerebrovascular (stroke) findings such as seizures, hemiplegia (paralysis of half the body), and mental retardation.
face validity: A test is said to have face validity if a reading of the items appears to reflect the areas that the test purports to measure. Face validity alone is insufficient to judge the value of the test. It is but one aspect of content validity, which can be evaluated by a panel of experts.
FACES: See Family Adaptability and Cohesion Evaluation Scales.
facial index: Ratio of facial height to facial width. A measurement sometimes used in syndrome descriptions.
facial nerve: The seventh cranial nerve; cranial nerve VII is responsible for facial movement and expression and taste at the front of the tongue.
facies: Face, countenance, expression. A facial expression suggestive, diagnostic, or pathognomonic (indicative) of a specific diagnosis or condition. For example, the hippocratic facies with a pinched expression, sunken eyes, hollow cheeks, and a leaden complexion is seen in people about to die. Numerous genetic syndromes have characteristic facies, and many children with minor dysmorphic (atypical) features have a peculiar, if non-diagnostic, facies. A leonine facies characterizes craniometaphysial dysplasia; a pugilistic facies characterizes the otopalatodigital syndrome; a triangular facies characterizes the multiple lentigines syndrome; and a myopathic facies is a relaxed, droopy appearance seen in myasthenia gravis.
facilitated communication
Attempts by a person with a disability to convey thoughts and feelings through means other than spoken language, often assisted by another person who interprets signs or symbols, or through some sort of assistive technology or device. The term facilitated communication is most often used today in reference to people with autism and is considered a controversial system.
facilitator: A person (e.g., social worker, psychologist, counselor) who enables change by assisting with communication, linking or strengthening existing systems, initiating new systems, channeling or developing resources, and acting as or arranging for an expert consultant. Among other activities, facilitators convene linkage meetings, encourage expression of feelings and opinions, gather and disseminate information, brainstorm, provide support, and advocate and lobby.
factitious disorder: The reporting of or presence of symptoms of an actual mental or physical disorder that, on investigation, are found to be purposely created by the patient. See also Münchausen syndrome by proxy and malingering.
factor analysis: A mathematical procedure for analyzing the intercorrelations of a group of variables that have been administered to a large number of individuals. The procedure is based on the assumption that intercorrelation can be accounted for by some underlying set of unobservable facts that are fewer in number than the variables themselves. The output of factor analysis is a factor matrix indicating the extent to which each test is correlated with, or "loads on," one or more factors. Factor loadings are correlations between factors and tests. Loadings indicate the weight of each factor in determining performance on each test. The naming of the factor depends upon the content of the tests that have loaded on the factor. For example, a factor analysis of the standardization group of the Wechsler Intelligence Scale for Children-Revised (WISC-R) resulted in the factors labeled verbal comprehension, perceptual organization, and freedom from distractibility, often referred to as the Kaufman factors.
faculty psychology: A discredited doctrine that the mind is composed of various powers (faculties) that produce mental activities such that the intellect knows, the will desires, and so forth. Such a verbal approach may, however, be rooted in language—in how mental activities are discussed—and is therefore to a certain degree inescapable, accounting for the continual reappearance of faculty psychology in a variety of guises. Sometimes referred to as a modern equivalent of phrenology—the pseudoscience that claimed to interpret personality traits by palpating bumps on the surface of the head.
fading: The process of slowly removing prompts until the desired response can be completed without any prompts. For example, in preparing a child to move from a structured to a less-structured classroom setting, the structure (study carrel, behavior charts, tokens) is gradually removed so that the old setting becomes more like the new one.
Fagan Test of Infant Intelligence (FTII): A screening device used to evaluate cognitive function in 6- to 12-month-old infants. Computerized technology is used to measure visual attention to novel stimuli. This nonmotor test would appear to be especially useful in assessing intelligence in infants with severe motor impairments.
failure to thrive (FTT): A presenting symptom (not a diagnosis) in which a child under 2 years of age (and usually under 1 year of age) exhibits some degree of growth failure in the absence of an obvious cause. The degree of growth failure necessary to raise concern of an underlying illness has never been clearly defined. In the past it was common to distinguish organic FTT (in which a physical disease was causing the growth failure) from non-organic FTT (in which the poor growth was a result of a feeding problem or disorder of parenting). It is now recognized that many cases of FTT are not subject to this dichotomy.
fall away: A test for tone in which an infant is suspended upside down and alternately each leg is released. The speed of fall of each lower extremity is compared; the leg that falls faster is considered to have relatively decreased tone.
family: A group of individuals related by blood, adoption, or marriage; in systems theory, a special group of individuals related to each other through reciprocal affections and loyalties. Admission to a family occurs through birth, marriage, or adoption, and members exit only by death. A family differs from other social groups in three important ways. A family has 1) a shared and relatively predictable cycle of life experiences, 2) permanency of membership, and 3) the paramount importance of the affectional ties of attachment, loyalty, and positive regard. Thus, even in the absence of biological or legal ties, people may consider themselves and be considered a family based on their mutual support, involvement, and affection for each other.
Family Adaptability and Cohesion Evaluation Scales (FACES): A 40-item self-report questionnaire used to indicate a family member's perception of his or her family's cohesion and adaptability. Each family member completes the instrument twice, once indicating current perceptions of the family (real) and once indicating how he or she would like the family to be (ideal). To the extent that the real and ideal differ, satisfaction can be estimated. The instrument has a sound theoretical base and has been well normed across diverse populations. FACES III is a shortened 20-item screening revision that limits the amount of information gathered, and thus the instrument's validity, but is quicker to administer. It is a screening tool for clinical settings.
Family Educational Rights and Privacy Act of 1974: See Education Amendments of 1974 (PL 93-380). This law incorporated student school records within the right to privacy.
Family Inventory of Life Events (FILE): A 71-item self-report instrument designed to assess both normative and nonnormative life situations and changes experienced by a family within the preceding year, as well as certain family experiences prior to the past year. The inventory is concerned with the number and duration of stressful events that tax a family's resources and that may be sources of dysfunction or distress. Such information is helpful in determining a family's coping abilities and in recognizing the life events that may hamper or facilitate the family's capacity to care for a child with developmental disabilities.
family life cycle: The sequence of developmental and transitional changes in family structure and relationships from the time families are joined through the marriage of young adults until the death of the marital partners, when the process continues with their children. Families of children with mental retardation or other severe disabilities experience a series of crises as the child reaches various developmental stages. Many surveyed parents describe life with a child with mental retardation as a series of ups and progressively greater downs. The unmet needs of parents and the degree of family stress seem to form a U-shaped curve. Demands and stresses are high among parents of preschoolers. These stresses drop off when children enter school programs, and they rise again beyond their original levels when the children become older; entry into both adolescence and young adulthood appears to be particularly stressful. It is important to realize that parents never fully resolve the complexity of feelings about their child's mental retardation or other form of developmental disability. The entire family and its subsequent life events and experiences are tempered by the presence of a child with a disability.
family of origin: A family or kinship group related by blood or genetic ties.
family planning: Voluntary and deliberate decisions regarding reproduction prior to conception. The number of children, the timing of children's births, the origin of children (biological or adoptive), and any methods of preconception birth control are dimensions of family planning. Although usually discussed within the context of a couple, many single adults are opting for families independent of their plans for coupling. Thus, technological reproductive methods may also become part of such adults' family planning strategies.
family therapist: A therapist who works with the whole family as the unit of treatment or intervention.
family therapy: Therapy in which the family is the unit of treatment or intervention. During the course of therapy, many or all members may be seen. Sessions may involve one or two members or the whole family. Sessions may focus on individual members or relationship pairs within the family; however, the focus is a change in interaction patterns at the family level.
Fanconi pancytopenia syndrome: A genetic disorder with growth deficiency, a peculiar facies, microcephaly (abnormally small head), mild mental retardation (in one fourth of cases), thumb/radial hypoplasia (atypical tissue development), hyperpigmentation, and a diffuse blood disorder. Inheritance is autosomal recessive.
FAS: See fetal alcohol syndrome.
fasciculation: Visible involuntary twitching of muscles. When accompanied by muscle wasting, it may indicate a spinal cord or neuromuscular disorder.
Fay, Temple: See patterning.
febrile seizure: A seizure occurring simultaneously with a fever in the absence of other central nervous system disease. In most children, the seizure is precipitated by the presence of a high fever. In children with febrile seizures, 96.9% do not have other kinds of seizures or cognitive impairments. Acute treatment includes lowering the fever and treating its cause. Chronic treatment with anticonvulsants is only considered in children with complicated febrile seizures, since the medication does not lessen the chance of recurrence, and side effects related to behavior and intelligence are common.
feeble-minded: Obsolete and unacceptable term describing individuals with mental retardation and an IQ between 50 and 70; sometimes generically used for all IQs below 70. The term absolute feeble-mindedness has been used to refer to mental retardation with an organic basis; relative feeble-mindedness has been used to refer to mental retardation due to environmental or unknown causes.
Feingold diet/hypothesis: The unproven claim that trace amounts of salicylates, preservatives, and food dyes and coloring can produce behavioral symptoms, attention deficits, hyperactivity, and learning disabilities in children, and that many such neurobehavioral problems can be treated or prevented by a diet that strictly avoids the offending small-molecule additives. Although Benjamin Feingold (1900-1982), who developed this dietary theory, was an allergist, he did not hypothesize an allergic mechanism. The Feingold Association promotes this dietary approach.
femoral anteversion: An orthopedic deformity in which the thighbones turn inward so that the knees and feet both turn in; common in spastic cerebral palsy.
femur: Thighbone.
FEP: See free erythrocyte protoporphyrin.
feral child: A child allegedly raised by animals, such as a wolf-child. There are no documented cases of such an occurrence. Unproven legends and anecdotes about such children have acquired mythical status in modern thinking, but should not be adduced as evidence in any discussion of the impact of early nurturance or deprivation on later development.
Fernald Word Learning Technique (VAKT): A multisensory approach to reading that incorporates visual, auditory, kinesthetic, and tactile (VAKT) components. Words selected by the student are written by the instructor in cursive writing. The child says the word while tracing it with his or her finger in contact with the paper until the child can write the word without looking at the model. When the child has internalized that he or she can write and recognize words, the child is encouraged to write a story. The story is typed immediately, and the child reads it in typed form while it is fresh in his or her mind. Once the story is complete and a new word has been used in a meaningful way, the word is filed alphabetically in the child's word list. After a period of time, tracing is done mentally, and file words are typed. After the child is able to learn the typed version of new words, the reading approach becomes similar to others. The Fernald procedure also calls for "positive reconditioning" for children who have experienced school failure. Positive reconditioning specifically avoids 1) calling attention to emotionally loaded situations (reminding the child of the supposed importance of academic success), 2) using methods that previous experience suggests are likely to be ineffective, 3) permitting conditions that may cause embarrassment, and 4) directing attention to what the child cannot do. Grace Maxwell Fernald (1879-1950) was the psychologist who pioneered this approach.
fertility rate: The number of live births in a given population during a specific time-period. Fertility rates are one indicator of the health status of a given population.
fetal alcohol syndrome (FAS): Smith syndrome; a syndrome resulting from the teratogenic (causing malformations in the developing fetus) effects of maternal alcohol ingestion. Findings include prenatal onset of growth deficiency with microcephaly (abnormally small head) and short stature, cognitive impairments, and a characteristic facies with short palpebral fissures (eye slits) and a smooth philtrum (indentation in upper lip below nose). When present, mental retardation tends to be mild, but the entire spectrum of cognitive and neurobehavioral disabilities is represented by the frequent occurrence of attention-deficit/hyperactivity disorder (ADHD), articulation problems (related to mid-face hypoplasia [flattening] and cleft lip and palate deformities), language disorders, and specific learning disabilities. Cardiac and skeletal abnormalities are common. Incidence figures suggest that 1 in 300 babies show some effect (fetal alcohol effect, FAE) of maternal ingestion of alcohol, and more than 1 in 1,000 babies exhibit the full-blown syndrome. Greater than 10% of mild mental retardation may be secondary to ethanol toxicity to early neuronal migration and nerve cell development, making alcohol the most common severe teratogen (toxic agent) to which the fetus is exposed. The severity of the dysmorphic (atypical) features tends to correlate with the severity of the cognitive dysfunction.
fetal antiepileptic drug syndrome: A constellation of congenital abnormalities associated with maternal use of an antiepileptic (anticonvulsant) drug, such as phenytoin, during pregnancy. See, for example, fetal Dilantin (phenytoin) syndrome.
fetal cytomegalovirus (CMV) syndrome: Congenital cytomegalic inclusion disease; a syndrome of growth retardation, mental retardation, microcephaly (abnormally small head), brain (periventricular) calcifications (less than 10% of cases), hearing loss (50% of cases) and chorioretinitis (inflammation of the choroid and the retina [light-sensitive inner back wall]) that can follow on maternal (and fetal) infection by this herpes group virus. "Blueberry muffin spots" may he noted secondary to a blood disorder. Congenital CMV infection is common, but most cases are asymptomatic. Postnatal CMV infection may be involved in progressive sensorineural (involving the inner ear or the auditory nerve) hearing loss. The interpretation of serologic (serum) and culture tests is not conclusive.
fetal Dilantin (phenytoin) syndrome: Fetal hydantoin effect; a pattern of fetal malformation caused by maternal use of Dilantin (an antiseizure medication) during the first trimester of pregnancy. This pattern includes poor growth, mild cognitive impairments, unusual facies, and digit and nail hvpoplasia (failure of fingers and nails to develop completely). The facial features include hypertelorism (widely spaced eyes); a broad, flat nasal bridge; short nose; bow-shaped lip; and often a cleft lip and palate. Eve problems including coloboma (absence of part of the eye or retina [light-sensitive inner back wall]), strabismus (squint), ptosis (drooping), or slanting of the eves may be seen. The digits (fingers and toes) are often small at the tip with small nails. Approximately 10% of exposed fetuses exhibit the syndrome, and one third demonstrate isolated effects. Fetal susceptibility to hydantoin exposure appears to be genetic. Clefting and congenital heart disease are increased in children of mothers with epilepsy independent of anticonvulsant exposure. Although only hydantoins (Dilantin) have been studied, there is some concern that combinations of hydantoins and barbiturates increase the risk to the fetus of developing this syndrome.
fetal face syndrome: Robinow-Silverman syndrome; a syndrome with short forearms, hemivertebrae (absence of half of vertebrae), hypoplasic (with atypical tissue development) genitalia, and a facies that resembles that of an 8-week-old fetus. Intelligence is usually normal, but language disorders have been noted.
fetal hydantoin effect: See fetal Dilantin (phenytoin) syndrome.
fetal phenytoin syndrome: See fetal Dilantin syndrome.
fetal rubella syndrome: Congenital rubella; Gregg syndrome; rubella embryopathy. A syndrome of deafness, cataracts, and cardiac and central nervous system abnormalities. German measles (rubella) transmitted from the mother to the fetus in the first or second trimester of pregnancy produces these abnormalities in the baby; maternal vaccination with attenuated (diluted) rubella represents primary prevention. Gamma globulin can be administered as secondary prevention when a nonimmune pregnant woman is exposed. Mental retardation occurs in about one third of patients; learning disabilities, language disorders, autism, impulsivity, and behavior disorders are also common. The last major rubella epidemic in the United States was in 1964-1965.
fetal Tridione syndrome: See fetal trimethadione syndrome.
fetal trimethadione syndrome: Fetal Tridione syndrome; a pattern of malformations described in children of mothers who used trimethadione (Tridione), an anticonvulsant medication used to treat absence seizures that do not respond to other agents. The syndrome includes growth failure, mental retardation, abnormal facial features, heart disease, and abnormal genitalia. The facial features consist of brachycephaly (irregular, flat head shape), small mid-face, upturned nose, Λ-shaped eyebrows, and a prominent forehead. Eyes may show strabismus (squint) or ptosis (drooping), and the external ear is generally malformed. The heart disease is tetralogy of Fallot and the genitalia are ambiguous (girls have a large clitoris or boys have a small penis with an abnormally placed urethral opening). The frequency of severity of defects associated with the use of this drug during pregnancy is significant.
fetal wastage: A maternal history of losing previous pregnancies; the cause for high fetal wastage (such as genetic risk or congenital malformations) tends to persist and may be taken as a risk factor for a pregnancy that goes to term.
fetoscope: See auscultation.
fetus: The product of conception (embryo) from the eighth week of gestation to the moment of birth.
Feuerstein, Reuven: An Israeli psychologist who developed the theory of cognitive modifiability. Factors influencing Feuerstein's views include his early experiences in a concentration camp, studying under Jean Piaget and Andre Rey at the University of Geneva, and working with Youth Aliyah, an agency responsible for the integration of Jewish children from many cultures into a technologically advanced society. Feuerstein views intelligence as not being static but changeable, and has formulated specific "mediated learning experiences" that are reportedly successful in teaching slow-learning adolescents to perform substantially higher, level cognitive tasks. He has created an assessment instrument known as the Learning Potential Assessment Device (LPAD), as well as a teaching method called Instrumental Enrichment (IE). The theory of cognitive modifiability is controversial with regard to the degree in which genetic mental retardation can be altered.
fever: A body temperature above 98.6°F (37°C). Fever is not an illness or a diagnosis, but a sign. For diseases of similar severity, children tend to run relatively higher fevers than do adults. High fever in susceptible young children may precipitate febrile convulsions. Some of the highest fevers in childhood are associated with roseola (measles), otitis media (middle-ear infections), and urinary tract infections.
fever of unknown origin (FUO): Prolonged episode of fever without a readily apparent explanation. In infants and young children, this symptom often leads to a sepsis (infection) workup.
FFD: See freedom from distractibility.
FG syndrome: A genetic syndrome with mental retardation, hypotonia (decreased muscle tone), seizures, hyperactivity, outgoing personality, short stature, peculiar facies with prominent forehead, and imperforate (not open) anus. Inheritance is X-linked recessive.
fibula: Calf bone; the smaller of the two leg bones.
field theory: The application of gestalt psychology to the study of mental retardation.
fifth disease: Erythema infectiosum.
figure-ground discrimination: Recognition of the difference between foreground and background in the context of any given set of visual or auditory stimuli. Individuals with visual figure-ground discrimination may confuse printed words with the paper upon which they are printed, or may give undue significance to ancillary sections of the page rather than attending to the most prominent shape or figure. Those with auditory figure-ground problems have difficulty discerning the teacher's voice from other noises in the classroom. Figure-ground limitations refer to difficulty distinguishing a particular sight or sound from a larger group of shapes or sounds that constitute the background.
FILE: See Family Inventory of Life Events.
fine-finger movements: A test of fine-motor integration in which the thumb is repetitively tapped against the index finger or is successively tapped against each of the other four fingers in series. The task can he administered as a timed test of motor coordination, or the results can be interpreted as signs of minor neurological dysfunction according to the degree of clumsiness and the presence of spillover to the opposite side (mirror movements). Asymmetrical performance may be a significant indicator of asymmetrical central nervous system dysfunction.
fine-motor skills: Activities that require the coordination of the small muscles of the body, especially those of the hand. Eye-hand coordination in infancy; problem solving with toys and puzzles in early childhood; and graphomotor/drawing and dressing skills in middle childhood are used to assess fine-motor skills.
finger-to-nose test: The tip of the forefinger (index finger or pointer) is rapidly moved from the tip of the nose to either the examiner's fingertip or to an extended reach position. Dyssynergia (incoordination) or terminal tremor are often interpreted as indicating cerebellar disease; however, they may also occur with dysfunction of the cerebral cortex. Asymmetric performance should be noted.
fingerspelling: Dactylology, dactyl speech. A form of unaided augmentative communication with finger movements that uses the conventional language system and its vocabulary, spelling, and grammar; the American Manual Alphabet is a finger-spelling system. Fingerspelling is generally used as an adjunct to sign language, where signs represent words or word parts, not letters. Fingerspelling allows for the rendering of proper names, specialized terms for which no signs exist, and slang.
first-arch syndrome: Any of a large group of syndromes that involve derivatives of the first brachial arch (an embryologic structure); these include Treacher-Collins syndrome, mandibulofacial dyostosis, Pierre Robin syndrome, cleft lip and palate, and deafness associated with ear deformities.
first-degree relative: Parent, child, sibling; an individual who has half of his or her genes in common with the index case (also includes identical twins with all genes in common).
first-order change: In general-systems theories and family therapy based on these system theories, first-order change is behavior change with no real systemwide change. First-order change is viewed as superficial by many theorists; however, it is often a necessary precursor to more fundamental system change (termed second-order change).
Fisher-Logemann Test of Articulation Competence: A test of pronunciation that includes picture and sentence tasks for examining all English phonemes according to syllabic function in preschoolers to adult.
fisting: Hand position with fingers flexed in a clenched palm. This is the normal posture for the first 3 months of life, after which the hand begins to be open or unfisted most of the time. Persistence of fisting past this time is often a sign of hypertonicity (increased muscle tone) or spasticity.
fit: See seizure.
5p—: See cri-du-chat syndrome.
fixed: Describes an orthopedic deformity (or abnormal positioning of extremities) that cannot be passively corrected.
flaccid: Floppy, hypotonic (decreased) muscle tone due to neuromuscular dysfunction.
"flaky": Informal, nonspecific term describing a mild to moderate state of psychological disorganization that may be demonstrated through trouble organizing thoughts, remembering plans, formulating intentions, and carrying out everyday affairs. The term is often used to refer to individuals who probably have undiagnosed learning and attention disabilities or to characterize an aspect of task performance (e.g., "flaky" sentence structure or word association). With respect to developmental assessment, "flaky" is a partial clinical impression or initial indicator that becomes refined, quantified, and objectively defined by standardized tests and neurodevelopmental examination.
flat affect: Lack of expressed emotion or a fixed emotional state with no range of variability or emotion. Thus, a person appears to have no reaction to obvious humor, or to hearing good news or bad news. Flat affect should be investigated, since it may be symptomatic of depression. Children with learning disabilities who are developing secondary emotional disorders often present with a flat affect.
Flesch index: An index of the reading difficulty of a passage: it is calculated from empirically derived regression formulas that use counts of words per sentence, syllables per 100 words, and frequency of personal words to generate reading ease and human interest scores and to calculate grade levels.
flexion: Bending of a joint.
flexor: Any muscle that bends a joint. Flexor tone refers to the degree to which the predominant muscle tone produces a flexor habitus (appearance).
flexor withdrawal reflex: A procedure to induce active foot dorsiflexion (upgoing movement of the toes); in a sitting position, the patient is asked to flex the hip (lift the thigh) against resistance; a positive response is automatic dorsiflexion of the foot at the ankle.
flight of ideas: A continuous change of subject and thought content with little apparent connection among the topics and little external stimulation for the change. This may be one manifestation of attention-deficit/hyperactivity disorder (ADHD).
FLK: See funny-looking kid.
floppy infant: Hypotonia (decreased muscle tone) with motor delay in the first 1-2 years of life. This may be an early presentation for a variety of cognitive or neuromotor disorders. Rarely, the floppy infant is diagnosed as having a congenital myopathy (disorder of voluntary muscle) or neuromuscular disorder via nerve conduction studies and electromyography. More commonly, hypotonia evolves into spastic cerebral palsy by late in the first year of life or extrapyramidal cerebral palsy by late in the second year of life. In the absence of any of these outcomes, the floppy infant most commonly has benign cerebral hypotonia, a motor condition that will be outgrown. The more severe and prolonged the hypotonia, the greater the likelihood of more-pervasive cognitive and motor dysfunction. See also Prader-Willi syndrome.
flora: Vegetation; can refer to bacteria normally residing on or in the body.
fluency disorder: Any condition resulting in an interruption in the flow of oral language; this includes, but is not restricted to, stuttering and cluttering.
fluid intelligence: A term for the Horn-Cattell theory of intellectual processing. Fluid intelligence is the ability to infer relationships and correlations; it is best measured by novel tests, particularly when adaptation and flexibility are involved. Tasks intended to measure fluid intelligence should not depend on previously acquired knowledge or earlier-learned problem-solving procedures; rather, they should require the discovery of the essential correlations of a task for the first time and the drawing of inferences that could not have been worked out previously. The Woodcock-Johnson Psycho-Educational Battery Revised (WJ-R) Tests of Cognitive Ability are based upon the Horn-Cattell theory. The Kaufman Assessment Battery for Children (K-ABC) also provides, to some extent, a framework for assessing crystallized and fluid abilities.
fluoxetine: Trade name Prozac; an anti-depressant drug.
FO: See foot orthoses.
folic acid: A B-complex vitamin implicated in neural tube defects; when a pregnant woman has a low folic acid level, the fetus may be more inclined to develop spina bifida (open neural tube defects).
fontanel: A "soft-spot" on a baby's head; there are two palpable fontaneles at birth (anterior [front] and posterior [back]), but usually only the anterior one is followed clinically. Each fontanel represents a membranous interval at the angles of the cranial hones in the infant. The anterior fontanel closes between 8 and 15 months of life; the posterior one by 4 months. Premature closure of the fontanel may result from craniosynostosis (premature fusion of skull sutures); this should be of special concern when associated with decreasing head growth or microcephaly (abnormally small head). An enlarging anterior fontanel may reflect hydrocephalus (excess fluid in the brain) or vitamin-A toxicity, especially with an enlarging head circumference. A persistent anterior fontanel may occur in a variety of genetic, metabolic, and bone disorders. In young infants, the anterior fontanel may pulsate with the heartbeat; dramatic visual pulsations may be seen in increased intracranial pressure and a variety of heart conditions.
foot orthoses (FO): Orthopedic corrections including arch supports, shoe inserts, and corrective or orthopedic shoes.
foot-switch system: A component of gait analysis that allows recording of the foot-to-floor contact patterns for each leg.
Forestown boot: A foot orthosis to treat equinus (involuntary foot extension).
formal operations: The final Piagetian stage of cognitive development characterized by achievement of formal logic (induction and deduction) and abstract reasoning; it usually emerges at adolescence (12-15 years of age). People with mental retardation do not reach the formal stage of operations.
Formal Reading Inventory (FRI): A method for assessing silent reading comprehension and oral reading miscues for individuals ages 6-6 to 17-11. The inventory includes four forms, each form has 13 developmentally sequenced passages with five literal, inferential, critical, and affective multiple-choice questions following each story. Silent reading quotients (with a mean of 100 and a standard deviation of 15) and percentiles are provided for all four forms. However, the manual suggests that forms A and C be read silently and that forms B and D he read orally (forms B and D providing a posttest). Quotients are not provided for orally read passages. Oral reading miscues may be noted and characterized as: 1) meaning similarity—the ability to use comprehension strategies; 2) function similarity—the ability to use appropriate grammar forms; 3) graphic/phonemic similarity—the ability to use word-attack strategies; 4) multiple sources—the category used when a miscue fits several of the miscue types; and 5) self-correction—the ability to recognize errors and provide an accurate response without help.
formboard: A flat board of various dimensions with a number of (usually different) geometric shapes cut out and matching shapes (usually slightly thicker than the board) that can be inserted in the board. Formboards were invented by Edouard Seguin (1812-1880) as a visual-perceptual motor training device, and later were incorporated into many intelligence tests for preschool children.
forme fruste: An incomplete or abortive form or manifestation of a condition or disease.
4p— syndrome: Deletion of all or part of the short arm of chromosome 4 syndrome; a chromosomal disorder with profound mental retardation, seizures, growth deficiency, and a peculiar facies.
fragile X syndrome: Martin-Bell syndrome. Marker X syndrome, Escalante syndrome. A genetic syndrome with the familial occurrence of moderate mental retardation, predominantly in males, who also demonstrate a long narrow face with thick features, prognathism (a prominent jaw), blue eyes, and, early in life, macrosomia (large body size), and later in life, macro-orchidism (large testicles). This is an X-linked disorder with a fragile site (FMR—1 gene) on the long arm of the X chromosome (Xq 27). The 30% of female carriers who are affected appear to be more mildly involved, with shyness, anxiety, and panic attacks. The syndrome accounts for approximately 5% of mental retardation in males, but has also been reported with learning disabilities, autism. speech and language disorders, and mathematics and motor disabilities. A carrier female has a 38% risk of producing a son with mental retardation and a 16% chance of producing a daughter with mental retardation.
frame: An orthopedic device for a bed; the frame is either on or around the bed or is itself a specialized bed. The frame allows extrinsic support (such as a pulley system) for positioning.
Franceschetti-Klein syndrome: See Treacher Collins syndrome.
Fraser syndrome: See cryprophthalmus.
free association: A term originally applied to a therapeutic technique most often used by psychoanalytically oriented psychotherapists in which the client is instructed to say whatever thought, feeling, or image comes to mind. Free association has become a component of many psychological and educational tests.
free erythrocyte protoporphyrin (FEP): A component of hemoglobin; when its level is high, lead poisoning or iron deficiency can be suspected. The FEP level is not sufficiently sensitive to be used any longer, given the current lowered limits for lead exposure of the Centers for Disease Control (CDC).
free-floating anxiety: Pervasive and ever-present tensions and insecurities unrelated to specific events, situations, or threats.
freedom from distractibility (FFD): The Wechsler Intelligence Scale for Children (WISC) Kaufman factor score that attempts to measure the ability to concentrate and to remain attentive. The factor score is obtained by totaling the scaled scores of the arithmetic, digit span, and coding subtests. A high FED score suggests good short-term memory, the ability to maintain attention, good encoding ability, and the capacity to self-monitor. A low FED score suggests distractibility, poor rehearsal strategies, anxiety, and difficulty with encoding and shifting mental processes when manipulating symbolic material. The FFD score can be difficult to interpret, and it may not capture all of the skills and complex processes that contribute to attention.
Freeman-Sheldon syndrome: See whistling face syndrome.
frenulum linguae: The lingual frenulum; a fold of tissue from the floor of the mouth to the mid-line of the undersurface of the tongue. A short lingual frenulum is described as tongue-tie, which can affect the elevation of the tongue tip to the palate for production of specific sounds (generally L, T, D), but is rarely clinically significant.
frequency: Measurement of the pitch of a sound. The number of complete cycles a sound wave makes over a period of time, expressed in hertz (Hz). Human beings with average hearing can detect frequencies from approximately 20 to 20,000 Hz.
FRI: See Formal Reading Inventory.
Friedreich ataxia: A heredodegenerative disorder characterized by ataxia (unsteady gait), nystagmus (involuntary eye movements), kyphoscoliosis, and pes cavus (a foot deformity). Degeneration occurs in the axons of the nerve cells of the spinal cord long tracts, and occasionally in other parts of the nervous system (cerebellum, brain stem, and vestibular [balance] and auditory systems). Progressive ataxia involves the legs more than the arms. Speech can he affected because of a dyscoordination between breathing and phonating (sound production). Lateral nystagmus (a jerky movement of the eyes) is present, as is optic atrophy. Visual-evoked potentials (VEPs) are abnormal in two thirds of patients, but electroretinograms are normal. Weakness and wasting of the distal muscles are common, as are abnormal sensations such as paresthesias (numbness, tingling, or heightened sensitivity). Intelligence is preserved. Heart problems and diabetes are common. Life expectancy is to the 40s or 50s; individuals with advanced cases are often confined to bed with swallowing difficulties. Inheritance is autosomal recessive.
frog posture: Refers to posture of a pithed, or debrained, frog. A posture that indicates extreme hypotonia (decreased muscle tone) or floppiness: an infant lies flat with arms in a surrender posture, legs flexed, feet everted, and hips abducted (turned outward). Bilateral hip abduction deformity is the "frog leg" posture.
frontal lobe: The anterior portion of the brain just behind the forehead; the area of the cerebrum in front of the central sulcus (fissure of Rolando, one of the major indentations on the brain). It comprises much of the front part on the brain. Loss of the frontal lobes can result in passivity and loss of motivation. The posterior (back) part of the frontal lobe contains the motor cortex, which is involved in voluntary movement.
frontal lobe syndrome: A behavioral profile that follows severe, diffuse bilateral damage to the frontal lobe and includes disturbances in voluntary action, speech initiation, and sustained interest or affect; apathico-akinetico-abulic syndrome.
frontometaphysial dysplasia: A genetic syndrome with prominent supraorbital (just above the eye or brow) ridges, joint limitations, and bone abnormalities; progressive hearing loss, and occasional mental retardation. Inheritance is X-linked.
frontonasal dysplasia: Median cleft face syndrome.
frustration: A feeling of discomfort, disappointment, or insecurity aroused by a blocking of gratification or by the existence of unresolved problems. Children and adults with developmental disabilities often experience frustration in academic, vocational, and social situations, because they are frequently unable to meet the expectations of themselves or others. Frustration can be exacerbated by an inability to express the feeling as such, by exposure to consistently unrealistic or inappropriate expectations, and by a misunderstanding of the nature or extent of the individual's disability. If frustration is unchecked indefinitely, it may evolve into learned helplessness (a belief that external stresses are beyond the individual's ability to cope with all stress, including that which is controllable). Emotional and behavior problems secondary to the disability and associated frustration may develop as well. Several theories contend that frustration arouses, and may result in, aggression.
FTII: See Fagan Test of Infant Intelligence.
FTT: See failure to thrive.
functional: Having an emotional or psychiatric cause.
Functional Independence Measure for Children (WeeFIM): A measure of the severity of disability in children and adults with developmental levels between 6 months and 7 years; performance on each of 18 items in six domains (self-care, sphincter control, mobility, locomotion, communication, and serial cognition) is assigned to one of seven levels on an ordinal scale, with scores ranging from complete independence (level seven) to complete dependence on a helping person (level one).
functional skills training: Direct training in the skills and competencies necessary for everyday living. These skills may include the use of adaptive equipment, counting change, reading single words, balancing a checkbook, and completing a job application.
fundus: The bottom or base of an organ; the part of a hollow organ that is farthest from its opening.
funny-looking kid (FLK): Antiquated medical colloquialism for a child with sufficient minor (or major) dysmorphic (atypical) features to support the need for genetic evaluation and the possible presence of an identifiable syndrome. "Funny" does not infer that the patient is to be laughed at, but, rather, that the presence of the malformations make the examiner feel "funny"—uncomfortable and uncertain for overlooking, or failing to diagnose, a rare syndrome or variant. Such children are now more accurately characterized as dysmorphic.
FUO: See fever of unknown origin.