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

IAR 1: Infantile automated responses 1; see primitive reflex.
IAR II: Infantile automated responses II; see postural response.
iatrogenic: Resulting from therapy; a cure following an appropriate treatment is most likely iatrogenic. Iatrogenic diseases, however, are often the result of unwanted side effects of therapies. Examples include bronchopulmonary dysplasia from the treatment for respiratory distress syndrome and drugs producing hyperactivity or lethargy. A certain degree of iatrogenic disorder may be implicit in a given treatment approach and does not necessarily negate the value of the therapy or the skill of the therapist. Iatrogenic disease represents a good part of the risk component in the risk-benefit ratio associated with any intervention.
IBIDS syndrome: A rare neurocutaneous (of the nervous system and skin) syndrome. The acronym refers to Ichthyosis (very dry skin), Brittle hair (trichothiodystrophy), Infections, Dysplastic (atypical) nails, and Short stature. Cataracts, microcephaly (abnormally small head), hypoplasia (less) of subcutaneous (inner) fatty tissue, hypogonadism (small testicles), and mental retardation are also found. Inheritance is probably autosomal recessive.
ICD: See inner canthal distance.
ICD-9-CM: International Classification of Diseases, Ninth Revision, Clinical Modification; a numerical coding system for medical conditions and procedures that is used for billing, research, and statistical purposes.
ICF/MR; ICFMR/DD: See intermediate care facility for people with mental retardation and developmental disabilities.
ICH: See intracranial hemorrhage.
ichthyosis: Dry scaly skin, much more severe than that seen in atopic dermatitis; it is genetically inherited in a variety of modes. Ichthyosis is an occasional to frequent finding in a number of syndromes, some of which are associated with mental retardation.
ichthyosis-oligophrenia-epilepsy syndrome: A genetic syndrome with ichthyosis (very dry skin), mental retardation, epilepsy, and hypogonadism (small testicles) with a eunuchoid habitus (physical appearance). Inheritance remains unclear.
icing: The use of a very cold stimulus applied to the skin to facilitate neuromuscular functioning.
ICM: See integrated classroom model.
ICS: See Individualized Curriculum Sequencing.
ictal: Pertaining to a seizure. Thus, the aura that may precede a seizure is preictal, and the somnolence (sleepiness) that may follow a seizure is postictal.
icterus: Jaundice (literally, "yellow").
icterus neonatorum: Jaundice of the newborn. Although this can be physiological, hyperbilirubinemia (high levels of bilirubin in the blood) can lead to kernicterus.
IDAM: See infant of drug-addicted mother.
IDEA: See Individuals with Disabilities Education Act; see also Education of the Handicapped Act Amendments of 1990.
ideational fluency: A measure of creativity; the number of new/different ideas that can be generated.
identification: A psychological defense mechanism in which a person forms a mental image of another person whom he or she admires and then tries to think, act, and feel the way that person thinks, acts, and feels. Children with developmental disabilities often identify with someone who is very powerful (such as "The Incredible Hulk") as a way of coping with their own feelings of powerlessness. By asking the child whom his or her favorite person or character is, one can get a sense of the emotional impact of the child's disability on self-image and self-esteem.
identified patient (IP): The member of a family or group for whom help is sought. The identified patient may serve as the entry point for services to other family members.
ideographs/ideograms: Graphic symbols used in a system of writing to represent an idea or concept rather than a particular object. Ideographs are typically used in conjunction with pictographs (symbols that look like what they represent) as a form of aided augmentative communication that is particularly useful with non-verbal individuals. The symbols arc also used in international road signs to eliminate language barriers.
ideomotor apraxia: Difficulty in the conscious imitation of gestures and in the conscious carrying out of motor commands with no difficulty in performing these same routine activities automatically.
idiopathic: Of unknown origin; from a medical standpoint, a large number of developmental disabilities remain idiopathic.
idiot: Obsolete and unacceptable term for a person with mental retardation and an IQ under 25. The original Greek term referred to an uneducated private person or layman who did not involve himself in the political life of the city-state. Its extension to persons who were intellectually deficient on a permanent basis began in the 14th century, but its more exclusively pejorative connotation took several centuries longer to develop.
idiot savant: A person with mental retardation or low normal intelligence who can nevertheless perform remarkable intellectual feats in sharply circumscribed areas, most commonly mathematics, music, chess, memory, calendar, or reading (i.e., hvperlexia). These isolated talents require both neurobiological components (nature) and practice (nurture). They are more likely to be noted in the presence of a coexisting developmental disability, such as autism.
IDM: See infant of a diabetic mother.
IEP: See individualized education program.
IFSP: See individualized family service plan.
IHP: Individualized habilitation plan; see individualized program plan (IPP).
ILBW: See incredibly low birth weight.
iliac index: The sum of the two acetabular angles |the angle at which the hip and the femur meet) and the two iliac angles (the natural angle of the ileum hone) divided by 2; this number is smaller in infants with Down syndrome.
ilium: The largest of the three hones of the pelvis; the hips.
Illinois Test of Psycholinguistic Abilities (ITPA): A norm-referenced test to delineate strengths and weaknesses in language abilities of children 2 1/3 to 10 1/4 years of age. The 12 subtests include assessments of three language communication processes—receptive (decoding), organizing (association), and expressive (encoding)—with each of these having an auditory and visual-motor subtest; as well as 4 subtests of closure (ability to fill in missing parts in incomplete verbal or visual presentations or to integrate discrete units into wholes); and 2 subtests of sequential memory (auditory and visual). The instrument yields a psycholinguistic age (PLA) in addition to the subscore profile.
illiterate E: Vision screening test for preschool children 3 years of age and older; administration is similar to the Snellen Test, except that only one letter, E, is used; the E is placed in different positions and the child is asked to indicate with his fingers or by rotating an E card (or a model E) which way the legs of the E on a given line of the chart are pointing. The test provides an accurate measure of visual acuity in a child who does not know the alphabet.
imbecile: Obsolete and unacceptable term for a person with mental retardation and an IQ between 25 and 50; derived from the Latin imbecillus, "weak."
imipramine: Trade name Tofranil; a tricyclic antidepressant that is also used to treat childhood bedwetting by lessening the depth of sleep. It is also a second-line drug in the treatment of attention-deficit/hyperactivity disorder (ADHD), but may receive stronger consideration when the ADHD is accompanied by depressive symptoms.
imitation: Matching the behavior of a model; various types of imitation emerge at different developmental ages: newborns can imitate facial gestures; vowel and consonant sequences can be imitated during the first year of life; echolalia (repetition of what is heard) occurs transiently at around 18 months; toileting is imitated at 3 years; and the imitation of hand gestures has been graded for school-age children.
imitation synkinesis: Mirror movements.
immittance audiometry: Impedance audiometry; an objective measure of the functioning of the peripheral (noncentral) auditory mechanism.
immunization: Preventive medical procedures (usually a vaccination or inoculation) to reduce susceptibility to certain diseases (e.g., smallpox, measles, polio). Such procedures are used prior to exposure to these diseases. Immunizations usually reduce susceptibility by inducing a mild form of the disease against which the body defends itself. Subsequent exposure to these diseases calls upon the already-developed defenses so that the disease itself is averted. Many of these diseases cause severe developmental disabilities if immunizations are not used. Rarely, the immunization itself is sufficient to cause severe disabilities. Such an outcome, however, is considered a minimal risk as opposed to unchecked epidemics in an unimmunized population.
impairment: Any temporary or permanent loss or abnormality of psychological, physiological, or anatomical structure or function. Impairment represents exteriorization of a pathological state and, in principle, reflects disturbance at the level of the organ. Examples of an impairment include a birthmark, a brain lesion, and an incomplete or malformed limb.
impartial due process hearing: A procedure described in PL 101-476, the Individuals with Disabilities Education Act of 1990, for settling disputes between parents of a child with disabilities and the school system. The hearing is similar to a legal trial in that it includes rules of evidence and other legal procedures, with the decision based on the evidence presented. The decision of the hearing officer is binding. If parents or the school system disagree, an appeal may be made for a state-level review of the hearing, or the appeal may go to state or federal court. Either the parents or the school system can request a due process hearing.
impedance audiometry: See immittance audiometry.
imperforate anus: A congenital malformation in which the bowel ends before exiting through the anus; it is associated with a high incidence of urologic, spinal, and other anomalies, often as part of a specific syndrome (e.g., Down syndrome).
implied consent: An assumption of consent or agreement to action based on failure to protest or resist such action. Many young women with developmental disabilities have been surgically sterilized under the guise of implied consent either by the young woman or her parents or guardian. Such abuse of implied consent has led to a legal mandate of informed consent. See informed consent.
imprinting: A type of animal learning in which a specific environmental stimulus releases a genetically preprogrammed behavior pattern only when the matching of stimulus-response occurs during a critical and sensitive period of development; the resultant behavior is especially resistant to extinction. The phenomenon was first described by Konrad Lorenz in newly hatched greylag goslings. Whether any analogous learning occurs in human beings is debatable.
imprinting, genomic: A genetic process whereby a person has two normal chromosomes in a given pair, but both are derived from the same parent. The absence of the chromosome from the other parent causes the failure of an on-off switch in accessing specific genetic information in the chromosome pair. Examples of this genetic accident include Prader-Willi syndrome, secondary to a maternal chromosome 15 disomy, and Angelman syndrome, secondary to a paternal chromosome 15 disomy.
impulsivity: A cognitive style characterized by quick responses and acting without thinking. In children with attention-deficit/hyperactivity disorder (ADHD), impulsivity occurs due to neurological dysfunction. It is important to understand the neurological basis of the impulsivity (and to appropriately manage it), rather than to attribute it to a personality or motivational deficit in the child. When properly diagnosed and understood, impulsivity can be managed with minimal resulting trauma to cither the child or parents.
IMS: See infant monitoring system.
inborn error of metabolism: A specific enzyme deficiency that is genetic in origin and caused by a deletion or change in a gene. The enzyme may be absent or present in an inactive form and causes a block in normal metabolism. Varying degrees of dysfunction result, most commonly in the central nervous system and liver.
inbreeding: See consanguinity.
incentive: See reinforcer.
incest: Sexual intercourse between blood relatives, especially father/daughter and brother/sister relationships. Children with developmental disabilities are frequently targeted as incest victims. Children of incestuous relationships may present with apparent developmental disabilities due to the trauma of the incest. When evaluating children with developmental problems, it is important to maintain an index of suspicion for incest or child sexual abuse.
incidence: A rate indicating the number of new cases of a disorder occurring in a given population over a specified time period (usually a calendar year). An increasing incidence of a disorder may reflect a genuine total increase (e.g., acquired immunodeficiency syndrome [AIDS], crack babies), a newly recognized condition (e.g., Rett syndrome, fragile X syndrome), or greatly refined diagnostic sensitivity (e.g., attention-deficit/hyperactivity disorder, learning disability). Because of the relative stability and early onset of most developmental disorders, the importance of distinguishing between incidence and prevalence is minimal compared to more acute medical conditions. Because developmental disorders must start in the pediatric age group, their incidence in the adult population should be zero. Furthermore, it is of questionable validity to talk of incidence for a disorder with a prenatal etiology (cause); without accurate data on fetal wastage (spontaneous miscarriage), the prevalence rate at birth is more accurate.
incision: Surgical cut.
inclusion: See inclusive education.
inclusive education: An educational model in which students with disabilities receive their education in a general educational setting with collaboration between general and special education teachers. Implementation may be through the total reorganization and redefinition of general and special education roles, or as one option in a continuum of available services.
incompetent: Unable to manage one's affairs, make good decisions, or meet one's responsibilities. People with physical and/ or cognitive disabilities that prevent informed decision making may need a guardian to oversee their affairs m one or more areas of their lives (e.g.. financial, medical). A legal judgment of incompetency must be rendered and a guardian assigned. The judgment of incompetency does not pertain to the person's moral worth; rather, it is a legal means of protecting the person's own best interests. Usually assignment is to a close relative, such as a parent or sibling. See also guardianship, conservator.
incontinence: Developmentally inappropriate absence or loss of bladder control (i.e.. urinary incontinence) or bowel control (i.e., fecal incontinence).
incontinentia pigmenti syndrome: Bloch-Sulzberger syndrome; a genetic disorder with depigmented skin lesions, dental abnormalities, alopecia (hair loss), mental retardation, and seizures.
incredibly low birth weight (ILBW): Describing infants who weigh less than 800 grams at birth.
independent living: The ability to be self-governing and self-sustaining. For people with developmental disabilities, independent living is often accomplished within a supportive service network that provides protection while maximizing independence for that person. Although this may mean something as simple as home health and adaptive equipment for negotiating the environment, services may also include many life skills supports for people with greater cognitive impairments. These include supports such as transportation, homemakers, budget monitoring, and sheltered or supported work. See also support group, group home.
Inderal: See propranolol.
index case: See propositus.
index finger exploration: A fine-motor milestone that involves poking and feeling objeets with the second, or pointer, ringer; this tactile (touch) exploration emerges at 10 months and is equivalent to the pincer grasp.
indication: A clinical condition or diagnosis for which a given drug is effective. A labeled indication is one that the U.S. Food and Drug Administration allows to he advertised because research data are judged sufficient to support such a claim; an unlabeled indication is one in which the data remain insufficient. Many clinically effective drug therapies remain unlabeled, especially for conditions in the pediatric age group.
indication: Suggestion, sign. As reasons for acting, indications can have various degrees of strength. See contraindication.
Individualized Curriculum Sequencing (ICS): An instructional model that focuses on skill clusters that cut across content domains in educational programming for children with multiple or severe disabilities.
individualized education program (IEP): A written statement for the education of a child with disabilities that is developed and implemented according to criteria originally presented in PL 94-142, the Education for All Handicapped Children Act of 1975, and now delineated in PL 101-476, the Individuals with Disabilities Education Act of 1990. The education program, based upon the child's individual needs, is to be developed at an IEP meeting, whose members should include a representative of the local school system, the child's teacher, one or both of the child's parents, a professional who participated in or is knowledgeable about the evaluation, the child (when appropriate), and anyone else the parent would like to have involved. The content of the IEP should include 1) a statement of the child's present level of performance; 2) a statement of long-term goals and short-term objectives; 3) a description of services including placement, related services, and the extent to which the child will participate in general programs; 4) a statement regarding the initiation and duration of services: and 5) appropriate objective criteria and evaluation procedures for determining whether goals and objectives are met. The IEP must be reviewed at least once a year. The child's program cannot be changed without another IEP meeting to which parents must be invited.
individualized family service plan (IFSP): A statement of child and family needs, outcomes to be achieved, and a plan of services necessary to meet these needs, including frequency, intensity, location, method of delivery, and payment arrangements. Family-centered services view the family, rather than only the child with developmental disabilities, as the unit of intervention, incorporating concepts that encourage family decision making and empower families to take advantage of the service model. Thus, an IFSP recognizes all family needs and all family members as equally important in devising and implementing an intervention plan. Such an approach was codified in Part H of PL 99-457, the Education of the Handicapped Act Amendments of 1986 (which was reauthorized in 1991 as PL 102-119, the Individuals with Disabilities Education Act Amendments), which required an IFSP that 1) meets the developmental needs of children with special needs, and 2) meets the needs of the family in terms of enhancing the child's development, including communication, social, emotional, adaptive, or developmental needs.
individualized habilitation plan (IHP): See individualized program plan.
individualized program plan (IPP): A document containing a statement of present level of functioning for an individual with a disability, as well as a listing of goals, objectives, and services with stated completion dates, performance criteria, evaluation procedures, and the plan for service delivery to meet these needs and goals. The IPP is analogous to an IEP (see individualized education program). An IPP is also referred to as an individualized habilitation plan.
individualized service plan (ISP): A document containing a statement concerning the total habilitation needs of the person with developmental disabilities, including education, employment, social, emotional, and placement, combined with a plan for meeting these needs and naming a responsible service coordinator to oversee the plan's enactment.
individualized transition plan (ITP): A written plan specifying the skills to be acquired by a student and the vocational transition services to be received prior to and following completion of formal schooling. The plan should be comprehensive in scope and longitudinal in nature. It should focus on the specific needs of the individual and should identify who is responsible for initiating and following through on each specified activity. The plan should first be developed at least 4 years prior to an individual's graduation and then modified at least once a year until the individual has successfully adjusted to a postschool vocational placement. The informed participation of parents and guardians, as well as interagency cooperation, are critical components of the vocational transition process.
Individuals with Disabilities Education Act (IDEA) of 1990 (PL 101-476): See the Education of the Handicapped Act Amendments of 1990.
inductive reasoning: See bottom up processing.
infancy: From the Latin infans, "unable to speak": the period from birth to 1 year. In the antiquated seven ages of man schema, infancy included the first 7 years of life; this usage survives in the United Kingdom, where schoolteachers refer to children between 5 and 7 years of age as "infants."
infant milestones: Specific skills that are achieved at ages for which norms have been derived in the first several years of life.
infant monitoring system: (IMS) A Gesell-based developmental screening test for children that utilizes parent report forms at 4-month intervals from 4 to 30 months of age and again at 36 months of age, and includes five subtests: communication, gross-motor, fine-motor, adaptive, and personal-social skill areas.
infant of a diabetic mother (IDM): Maternal diabetes is associated with infantile macrosomia (large birth weight and body size) and increased mortality and morbidity secondary to fetal distress, respiratory distress, central nervous system irritability, plethora (elevated hematocrit), and congenital malformations (e.g., cardiac and musculoskeletal abnormalities including caudal regression syndrome). Meticulous control of maternal diabetes reduces the infant mortality and morbidity.
infant of drug-addicted mother (IDAM): Narcotic and non-narcotic drug use during pregnancy tends to produce a premature and/or small-for-gestational-age infant with a withdrawal syndrome (irritability, fever, breathing difficulties, and gastrointestinal disturbances) in the newborn period. Depending on the drugs and their contaminants, there may be an increased risk for congenital malformations. Long-term effects on development are not well defined and may be related in part to a chaotic, neglectful, and abusive prenatal, as well as postnatal, environment. Transient behavioral disturbances are commonly part of a neonatal withdrawal syndrome; long-term problems include hyperactivity, learning disabilities, and behavior disorders.
infant of substance-abusing mother (ISAM): Chronic substance abuse during pregnancy contributes to poor growth of the fetus and a low birth weight or small-for gestational-age newborn. This, in turn, is associated with an increased risk for developmental disabilities. There is concern that exposure in utero to mind-altering substances may have some as yet undetermined long-term influence on the chemical neurotransmitter pathways of the brain and thus affect later mood and behavioral reactivity.
infantile autism: See autism.
infantile automated responses I (IAR I): See primitive reflex.
infantile automated responses II (IAR II): See postural response.
infantile spasms: Brief symmetrical contractions of the muscles of the neck, trunk, and extremities (arms or legs) resulting in a jackknifing of the body at the waist or only a head bob, depending on the muscles involved. Also known as salaam seizures or infantile myoclonic seizures, they usually begin between 6 and 8 months of age and rarely after 12 months. The seizures generally occur many times a day and often in clusters. They are frequently accompanied by eye movements (e.g., eye deviation [inward or outward], nystagmus [involuntary eye movements]), and a postspasm cry. The spasms are rarely related to sudden noises or tactile (touchy stimulation and are not precipitated by photic (light) stimulation or feeding. A variety of electroencephalogram (EEG) findings can be associated with infantile spasms, although the most common finding is hypsarhythmia (a continuous disorganized pattern of high-voltage slow waves [rounded curve deviations] and spikes [sharp pointed deviations]). Infantile spasms may he associated with cerebral dysgenesis (e.g., lissencephaly [smooth, rather than convoluted, brain surface]), genetic disorders (e.g., tuberous sclerosis), intrauterine infection, head injury, inborn errors of metabolism (e.g., nonketotic hyperglycinemia), central nervous system (CNS) infections, and intracranial hemorrhage (bleeding). They also may be cryptogenic (with no known etiologic factors). About 85%-90% of infants with infantile spasms have some degree of developmental delay and mental retardation. In general, the outcome is more favorable in children who have no underlying neurological or metabolic abnormality. The triad of infantile spasms, retardation, and hypsarhythmia is called West syndrome.
infantilization: Treating a person as much younger than his or her age or abilities would dictate. Children with developmental disabilities are often infantilized by family members who, with good intentions, may overprotect and underencourage the child. If allowed to continue unchecked, infantilization can become a second, and even more debilitating, disability.
infection: Invasion of the body by microorganisms (viruses, bacteria, fungi) that cause disease.
inferior: Below, anatomically.
inflammation: A local reaction of the body to insult, injury, or infection that includes redness, heat or warmth, swelling, and pain (the classical rubor, calor, tumor, and dolor).
Information: A Wechsler verbal subtest designed to measure the subject's fund of factual information. Included are questions concerning dates, names of objects, geographical and historical facts, and other information. Children are required to know specific facts, not to find relationships or draw inferences from the information. Sequencing and organizing skills, as well as time orientation, are evaluated. The results may also reflect a child's ability to store and retrieve information from long-term memory. The score obtained on the Information subtest partially depends upon a child's experiences and exposure to stimulating situations at home and school. The subtest is discontinued after five consecutive failures. Factitious example: "What does the heart do?"
Information and Referral (I and R): An agency whose sole service is to assess individuals' problems and refer them to the appropriate service or entitlement. Thus, the parent of a child who is newly diagnosed with Down syndrome might be directed to the Social Security Administration for Supplemental Security Income (SSI), the Down Syndrome Association for more specific information and support, the local school district's early intervention program for education, and the local branch of The Arc (formerly, Association for Retarded Citizens of the United States) for socialization and recreational activities.
information processing: A broad framework in which intelligence is studied as a process rather than as a definition of abilities. This framework includes an examination of the way in which knowledge is organized and located in the memory system and the mental operations necessary to accomplish intellectual tasks. Cognitive psychologists have used computer simulation and mathematical modeling to discover data patterns that suggest strategies of cognitive processing. Neuropsychological models also include structural brain considerations in the analysis of mental functions.
information processing: A theory of human communication processes based on a mechanical model of information processing. Major elements include encoding, decoding, feedback, kinetic loops, and cybernetics. The origins of many family therapy theories can he traced to an information processing theory base.
informative: A term used in the analysis of a genetic condition through use of a pedigree or sophisticated DNA (deoxyribonucleic acid) mapping. An informative family is one that has enough information about a particular disorder to determine its inheritance pattern. For example, a woman who has a son and a brother with muscular dystrophy and sisters and daughters without it carries an X-linked form of muscular dystrophy. This family is informative because the gene can be traced through the family. However, if that same woman had only typical sons and daughters, then it would be uncertain whether she carries the gene, and the family would not be informative.
informed consent: A consent for action based on the assumption of three criteria: 1) adequate information, 2) an ability to understand and process the information, and 3) a lack of coercion in the outcome of the decision-making process. Thus, parents may be asked to sign a statement of informed consent prior to the initiation or termination of a medical procedure on their child. Informed consent becomes a more complex issue when dealing with adults with mental retardation. Current normalization and self-advocacy efforts, as well as empowerment philosophies, offer adults with mental retardation many life-decision opportunities previously denied them. With these opportunities, however, also comes the potential for bad decisions and poor or distasteful outcomes. The question of informed decision making and informed consent becomes inextricably entwined with a person's capacity. See also incompetent, guardianship.
inguinal hernia: A weakening of the abdominal wall, leading to a bulging and protrusion of abdominal contents outward in the area of the groin. Because of the high risk of incarceration or strangulation, inguinal hernias are routinely surgically repaired.
inhibition: A condition in which one function or circumstance prevents the expression of another function or behavior; an act or process by which the typical or expected response is restrained despite the presence of the eliciting stimulus.
inion: Occipital prominence; a landmark on the back of the skull.
initial teaching alphabet (i/t/a): Augmented roman alphabet. A written system for teaching reading phonetically, in which there is a direct symbol for each phoneme. Forty-four characters are used, each representing only one English sound or phoneme; a specific sound is learned for each symbol. Use of the augmented alphabet was originally proposed in the 1960s and 1970s in America and Great Britain to teach beginning reading. It made phoneme-grapheme correspondence more regular and simplified spelling for beginning readers. This alphabet can be used to teach speech and language to individuals with hearing impairments and has been used successfully with children with other disabilities as well. Gifted children (those who have superior intellectual abilities) can also benefit from the i/t/a.
innate: Vague qualifier suggesting a genetic or fixed organic component to a(n) (dis)ability. A cognate of the nature in the nature versus nurture debate.
inner canthal distance (ICD): A measurement of the distance between the two medial (nasal) canthi. The distance is increased with hypertelorism (widely spaced eyes), telecanthus, and epicanthal folds. Increased ICD is a nonspecific mild dysmorphic (atypical) feature that may be associated with developmental disabilities.
insatiable child syndrome: The whining, irritable, and demanding behavior that can accompany attention-deficit/hyperactivity disorder (ADHD) and is interpreted as a biological or learned persistent dissatisfaction.
insensitivity to pain: A neurological finding in dysautonomia (hereditary disease of the autonomic nervous system). What is often interpreted as an insensitivity to pain can be a reflection of the difficulty that people with severe developmental disorders have in effectively communicating their awareness of pain.
insidious: Not easily detectable evolution of symptoms or disease, due in part to a very gradual onset.
insight: In psychology, insight generally refers to the ability to be aware of changes in one's behavior and feeling state—a "psychological mindedness" or self-knowledge that enhances a person's understanding of him- or herself and, to some extent, others. It involves interpreting the significance and purposes of one's behaviors and motives and includes the ability to recognize inappropriateness and irrationality in these behaviors and emotions. An individual's level of insight has implications for the types of treatment approaches that are appropriate and available to that person. In learning theory, insight is a type of knowledge that facilitates the reorganization of the field of experience to create a new idea or discover a solution to a problem. Insight is considered by some to be central to a sub-theory of intellectual giftedness. Three distinct, but interdependent, psychological processes collectively constitute insight: 1) selective encoding—recognizing recurrent information in a given context; 2) selective combination—integrating relevant information in a new and productive way; and 3) selective comparison— recognizing how new information is related to old information. Insight plays a more significant role in the learning processes of the gifted compared to those of the nongifted.
instinctive avoiding reaction: Hyperextension of the fingers in response to forward-upward elevation of the arm.
institutional care: A self-contained facility, usually large in size, that provides temporary custodial supervision, evaluation, training, and treatment for individuals with mental retardation, other developmental disabilities, and certain mental illnesses until appropriate community alternatives are located or become available. In some cases, particularly if the degree of developmental disability is severe to profound or no other form of appropriate placement is available, institutional care can be prolonged and indefinite. Institutional care is also used to generically refer to any residential out-of-home placement that incorporates educational and therapeutic treatment components.
institutionalism: A developmental and behavioral profile of motor and language (especially expressive) delay, increased visual interest in adults, rocking, and bland indiscriminate amiability with absence of stranger anxiety in a quiet, sober, noncuddly infant being reared in a nonfamily setting. Institutionalism can be considered a type of maternal deprivation or prolonged hospitalism and can give rise to anaclitic (dependence) depression and failure to thrive. Later impairments in forming emotional ties, controlling impulses, thinking abstractly, and being able to enjoy life can become prominent.
instruction, modality-based: Presenting material in a manner aimed at utilizing visual, auditory, or tactile (touch) channels (modalities), according to the channel presumed to be stronger in an individual. Multisensory approaches attempt to combine several modalities (see Fernald Word Learning Technique). This is often confused with the psychological process model of educational intervention, in which attempts were made to train auditory and visual-perceptual processes directly in the hope that academic performance would then automatically improve; this approach was not effective. Modality-based instruction does not attempt to train psychological processes but, rather, teaches academic material in a manner designed to circumvent weakness and utilize the learner's strengths. Research has not consistently shown this method to be significantly successful. Critics charge that 1) evidence relating psychological processes to learning failure is correlational rather than causal; 2) tests used to measure psychological processes are inadequate; and 3) processing tests and teaching procedures may be more important in planning for young children rather than adolescents. An alternative approach is that of functional skills training and task analysis, which recommends focusing on academic skills students need to learn rather than on disabilities that impede learning. Each of these theories may be viewed alone as a simplistic approach to a complex problem. The profile of learner strengths and weaknesses must be refined and broadened to capture the relationship of other variables. This more comprehensive theory must also include the interaction of student-centered variables with instructional variables.
instruction, task analysis: An approach to teaching in which complex behaviors are broken down into their component parts and taught in an ordered and logical sequence. This theory holds that assessment should be restricted to determining which subskills have been mastered and which have not, and does not acknowledge any ability limitations within the learner other than lack of mastery of specific necessary subskills through lack of practice or experience. Instruction is based on teaching those subskills rather than on tailoring learning to match the learner's processing strengths and weaknesses (see instruction, modality-based). Steps to this approach include 1) state objectives to be achieved and skills to be learned; 2) analyze the skill in terms of specific tasks; 3) list tasks in a sequential order; 4) determine which tasks are not known by the student; 5) teach through direct instruction; 6) teach one task at a time, moving to the next when the previous task has been learned; and 7) evaluate the effectiveness of instruction by whether the skill has been learned. Critics of the application of this model to academic tasks have raised several questions, including the following: 1) Can a complex learning task be subdivided into specific measurable and observable skills? Does learning the sub-skills transfer to what is understood to be, for example, "reading"? 2) Can skills lie ordered in a hierarchy? Does an adult determination of a logical sequence match the way in which a child learns? 3) What does the establishment of a set of skills say about how that skill should be taught? 4) How does this apply to the concept of learning disability? Both task analysis and modality-based instruction, taken individually, are simplistic models for describing a complex process. A comprehensive theory of learning must include a number of student-centered variables in interaction with instructional variables.
insult: Injury or that which produces injury to an organ.
integrated classroom model (ICM): A service delivery model for educating students with mild disabilities and students without disabilities in the same classroom, administered jointly by general and special education personnel. The classrooms are highly structured, with clear behavioral and academic expectations.
integration: Incorporating individuals with disabilities in the general community through provision of necessary support in educational, vocational, residential, community, and employment settings. In regard to education, integration is the process of educating all children who have needs and interests to which the schools have previously not responded (e.g., students with disabilities, students who are ethnically or culturally different) in a general, rather than segregated, academic setting. See also mainstreaming, inclusive education.
intelligence: A capacity for knowledge about the world. Intelligence as both an attribute in and of itself and a construct for learning is a vast and controversial field of study. There is little agreement on a precise definition. However, intelligence is generally considered to include the ability to perform more abstract processes, such as understanding and integrating concepts, the capacity to learn and acquire knowledge, and the ability to adapt and deal effectively with new situations. Both biological and environmental factors contribute to the individual expression of intelligence.
intelligence quotient (IQ): A quantitative index of an individual's level of mental development derived from performance on a test designed to measure intelligence. When the concept was originally introduced in the early part of the 20th century, ratio IQs (dividing mental age by chronological age and multiplying the result by 100) were computed. Ratio IQs have been replaced by deviation IQs (test achievement relative to the test performance of a comparable group). Intelligence quotients are limited by the type of skills they are designed to measure, and may not provide a comprehensive description of an individual's abilities. However, IQs are still widely used and generally accepted. IQ ranges vary by instrument, but generally have comparable classifications starting from a mean of 100: 130 and above, very superior; 120-129, superior; 110-119, high average; 90-109, average; 80-89, low average; 70-79, borderline; and less than 70, mentally deficient or mental retardation.
intelligence test: Standardized measure used to establish an intelligence level rating, typically an IQ, by measuring an individual's ability to perform a variety of tasks involving information, word meaning, concept formation, and performance on various nonverbal tasks. Intelligence tests are controversial, in part because there is no universally accepted definition of intelligence, making tests to measure it both theoretically and inherently limited and subjectively determined by the test creators' definitions of intelligence. However, intelligence testing is widely practiced and generally accepted when well-standardized and validated tests are used as components of a broadly based assessment process. Valid testing considers cultural and linguistic diversity as well as differences in communication and behavioral factors. The term intelligent testing has been coined to serve as a reminder of the hazards of relying solely "on the numbers" and to emphasize the importance of gathering and using all available information and integrating it with clinical acumen and careful reasoning in assessing an individual.
intelligibility threshold: See speech reception threshold.
intensity: The loudness of sound as measured in decibels (dB). To determine a sound's intensity, the sound is compared to the reference level (.0002 dynes/square centimeter), determined to he the faintest sound pressure most humans can detect. Ten decibels is the intensity of a whisper from several feet away, whereas a commercial jet raking off nearby produces a sound intensity of about 120 dB.
interalar distance: Width of the nose.
interdisciplinary: Describing a team approach to the diagnosis and treatment of developmental disabilities; in such a team, professionals representing two or more disciplines interact so that the final case formulation reflects the conclusions of a staffing conference at which professional disagreements are discussed and resolved in a manner that respects each individual's contribution.
interjacent child: Antiquated term for a child with minimal brain dysfunction.
intermediate care facility for people with mental retardation and developmental disabilities (ICF/MR): Also known as ICFMR/DD. A facility that serves people with developmental disabilities (not just those with mental retardation) and that assumes a need for some level of medical or custodial care beyond that required in supported living or group home placements, but less than a full-time intensive medical or custodial need. Although numerous such care arrangements still exist, many have given way to the newer model of supported living arrangements. Funding shifts toward the latter model suggest that this is the preferred model for long-term care in people with mental retardation or developmental disabilities.
intermittent photic stimulation: The use of strobe light (flashing lights) during an electroencephalogram (EEC) to stimulate electrical activity. There are three EEC responses to photic stimulation. One is photic drive, a normal response of rhythmic activity over the posterior (back) regions of the head. Depression of this response can he seen with destructive brain lesions, whereas increased amplitude is associated with scarring and an epileptogenic focus. The photomyoclonic response is a nonspecific response consisting of fluttering of the eyelids, movements of the eve, and sometimes jerking of the face. The photoconvulsive (PCR), or photopparoxysmal, response is most commonly found in individuals with seizure disorders. It is characterized by a symmetrical spike and wave or multiple spike and wave complexes in response to an intermittent light stimulus. The EEG pattern change may he associated with an impairment of consciousness and brisk jerks of the upper body. The PCR response may he familial and represent a susceptibility to convulsions. It is also present in the EEGs of some degenerative disorders.
intermittent positive-pressure breathing (IPPB): A type of assisted ventilation used in infants and children with respiratory distress.
internal rotation: Turning a limb toward the mid-line of the body.
internal tibial torsion: An orthopedic deformity in which the lower leg is twisted inward so that the feet turn in but the knees face forward. In children without cerebral palsy, this deformity often resolves spontaneously by 3 years of age if weight bearing is normal/typical at this developmental age.
international phonetic alphabet: A system of symbols for writing the speech sounds of all languages.
international standard manual alphabet: A mode of communication in which block letters are stroked with the fingers of the speaker in a prescribed manner on the palm of the listener; this type of finger-spelling is used predominantly in communicating with individuals who are blind and have profound hearing loss.
interpreters for the deaf: Hearing individuals who listen to a spoken message and communicate it in some way to an individual with a hearing impairment. In interpreting a spoken message, it is permissible to depart from the speaker's exact words to paraphrase and explain what the speaker is saving. In this way, interpreting is different from translating, which is a verbatim presentation of another's words. There are various types of interpreters for the deaf, including sign language interpreters who communicate what has been said through some form of sign language or fingerspelling; oral interpreters who mouth (enunciate clearly and more slowly) the speaker's message, allowing the individual with a hearing impairment to speech read; and reverse interpreters who render sign language or difficult-to-understand speech into clearly spoken English. Specialized interpreters familiar with technical language serve in a variety of settings. Educational interpreters are used to facilitate inclusion of students who are deaf. In addition to educational applications, interpreters are mandated to be available as a component of vocational rehabilitation services, and most states require that interpreters be available whenever the civil rights of people with hearing impairments are involved. Before 1964, interpreters were largely friends or relatives of individuals with hearing impairments. In 1964, the National Registry of Interpreters for the Deaf was established to promote training and recruitment, to establish standard competencies, and to maintain a listing of certified interpreters. Training programs arc available throughout the United States; many colleges offer degree programs in interpreting.
interpupillary distance: The distance between the two eyes, using the center of each pupil as the landmark for the measurement. Abnormal interpupillary distances occur with hypertelorism (widely spaced eyes), hypotelorism (decreased distance between the eyes), and strabismus (squint); normal distances are present in pseudostrabismus (false squint) and pseudohypertelorism (false impression of widely spaced eyes).
intersensory integration: The use of two sensory modalities in accomplishing a task. For example, listening to a series of numbers and writing them requires auditory-motor integration, whereas seeing a list of numbers and saving them requires visual-verbal integration.
interval sample: Data gathered by monitoring and recording behaviors at predetermined times, rather than continuously. A teacher may set aside three 5-minute intervals during a morning and record a student's behavior only during that time.
intervention: Planned strategies and activities that modify a maladaptive behavior or state of being and facilitate growth and change. Intervention is analogous to the medical term treatment. Social workers, psychologists, speech-language therapists, and other helping professionals often prefer the term intervention, in order to connote a broader range of activities to the individuals they assist. Thus intervention may include such activities as advocacy, psychotherapy, speech-language therapy, obtaining entitlements, obtaining adaptive equipment, modifying the environment, facilitating resource development, and networking, among others.
intracerebral: Within the cerebrum of the brain.
intracranial: Within the skull.
intracranial hemorrhage (ICH): Bleeding into the substance of the brain.
intrathecal: Within or into the sheath (theca), usually referring to the sheath surrounding the spinal cord.
intrauterine growth retardation (IUGR): Newborn infant with birth weight low for gestational age. Babies with weight reduction proportional to their other parameters (small head circumference, short body length) are more likely to have underlying genetic, metabolic, toxic, or infectious etiologies (causes) that will adversely influence later development. Disproportionate growth parameters (with head circumference approximating normal percentiles) in newborns allow the possibility of better developmental outcomes, depending on environmental variables.
intraventricular hemorrhage (IVH): A bleeding into the brain (specifically the subependymal [beneath the innermost layer] area), most common in premature infants because their brain and vascular (blood vessel) structures are more delicate than those of infants born at term. When IVH occurs in a term infant, it can be due to a traumatic delivery or, rarely, to a bleeding disorder. Intraventricular hemorrhages are graded 1-4, with grade 1 being the mildest and involving only the ependymal (innermost) area; grade 2 involving more of the ependymal area than grade 1; grade 3 being hydrocephalus with a grade 2 bleed; and grade 4 bleeding into the brain tissue itself. Complications of IVH include hydrocephalus (excess fluid in the brain), porencephalic cysts, and leukomalacia. The hydrocephalus may be treated with shunts or medication; however, treatment does not ensure typical development. The developmental outcome can include cerebral palsy and mental retardation. The severity of outcome is generally worst in bleeds of grades 3 or 4, although that correlation does not always hold.
intrinsic motivation: Completing a task because of interest and the feeling of personal competence engendered, rather than for an external reward. Theories of intrinsic motivation suggest that some tasks are intrinsically motivating because humans have innate tendencies to develop competencies, to be curious about novel events and activities, and to feel that they are autonomous and engaging in activities by their own volition. An additional assumption is that some children have been socialized to value academic work. Students have been found to be more intrinsically motivated to complete tasks when 1) the tasks are moderately challenging, novel, and relevant to their own lives; 2) the threat of negative external evaluation is not salient; 3) their attention is not focused on extrinsic reasons for completing tasks; and 4) they can take responsibility for their success by having been given some choice in the task.
intubation: The placement of a tube through the nose (nasotracheal tube) or through the mouth (orotracheal intubation) into the trachea (windpipe) to provide artificial ventilation (breathing).
intuition: Judgment by perception rather than by reason.
in utero: In the womb (uterus); that phase of an individual's life cycle preceding birth, the usual duration being 9 months. It is during this time that organogenesis (formation of the baby's organs) occurs, and the developing fetus is therefore susceptible to maternal exposure to harmful substances such as alcohol, drugs, and tobacco. In utero includes the entire prenatal period.
inversion: Turning the sole of the foot toward the mid-line of the body; the foot posture utilized in the direct Fog test.
IP: See identified patient.
IPP: See individualized program plan.
IPPB: See intermittent positive-pressure breathing.
ipsilateral: On the same side. For example, in hemiplegic cerebral palsy, the ipsilateral arm and leg are involved (the right arm and the right leg in a right hemiplegia and the left arm and left leg in a left hemiplegia). However, because brain control of motor function crosses the mid-line (e.g., the right brain controls movement for the left side of the body), brain injury in a hemiplegia is contralateral (on the opposite side), with a right hemiplegia being secondary to a left brain insult.
IQ: See intelligence quotient.
Irlen lenses: Tinted eyeglasses or lens filters used to treat dyslexia. An intervention devised by Helen Irlen, it first achieved popularity in Australia; the tinted nonrefractive lenses purportedly treat an underlying disorder known as scotopic sensitivity syndrome. However, both the treatment and the syndrome remain unproven. An inexpensive variant involves the use of tinted cellophane overlays to be placed on top of material to be read.
iron deficiency anemia: Anemia secondary to inadequate dietary iron becomes common from 9 to 24 months of age. Iron deficiency anemia may contribute to apathy, irritability, short attention span, and lowered cognitive performance. It remains uncertain whether iron deficiency in the absence of anemia may produce similar effects.
ISAM: See infant of substance-abusing mother.
ischemia: Decreased blood secondary to decreased blood flow associated with hypovolemia (decreased blood volume or shock) or vasoconstriction (narrowing of blood vessels).
Ishihara test: A series of 38 plates used to screen for color blindness. Each plate depicts a large number of colored dots in which a number (or other design) is embedded in colored dots that are visible only to a person with intact color vision. The number and types of errors define the presence and type of color blindness (red-green or total). Overreliance on this test contributed to earlier reports of an increased incidence of color blindness in learning disabilities. In fact, many people with learning disabilities have trouble interpreting these cards because of figure-ground perception problems, rather than color vision problems.
isochromosome: An abnormal chromosome with arms of equal length caused by the duplication of one arm and the deletion of the other. Chromosomes normally have a short arm, p, and a long arm, q. For example, instead of a p arm and a q arm, the isochromosome has two p arms. An isochromosome is designated in a chromosome or medical report as an isochromosome number (#), where the number refers to the number of the affected chromosome. This condition may cause anatomical abnormalities as well as developmental disabilities, such as mental retardation.
isodisomy: See heterodisomy.
isometric power: The ability to hold a position against the force of gravity or another resistance.
isotonic power: The ability of a muscle to move through its range of motion with resistance applied throughout.
ISP: See individualized service plan.
i/t/a: See initial teaching alphabet.
item difficulty: The frequency with which any given test item is passed or failed as compared to the other items on the test.
itinerant services: In reference to education, support service personnel (e.g.. speech and language, learning disability) provide instruction to students in the hospital and home, or travel between schools to supplement instruction provided by the classroom teacher. This differs from a resource room model in that a resource room teacher remains in a specific classroom setting to which students come for instruction.
ITP: See individualized transition plan.
ITPA: See Illinois Test of Psycholinguistic Abilities.
IUGR: See intrauterine growth retardation.
IVH: See intraventricular hemorrhage.