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

OAE: See otoacoustic emission.
obesity: State of being markedly overweight for height. Most obesity is exogenous (related to overeating) and familial. Rarely, obesity is related to a specific syndrome. A baby large at birth may have Beckwith-Wiedemann syndrome or Sotos syndrome, or the child's mother may have diabetes; obesity of later onset occurs in Prader-Willi syndrome and Laurence-Moon-Biedl syndrome. Exogenous obesity secondary to a combination of overeating and inactivity is a common occurrence in adolescents with developmental disabilities as they become acutely sensitive to their being "different."
Obetrol: Trade name for a mixture of salts of dextroamphetamine and amphetamine that had been used in the treatment of attention-deficit/hyperactivity disorder (ADHD) under the trade name Adderal.
object assembly: A Wechsler performance subtest consisting of one sample and four test-item jigsaw puzzles of common objects. The child is asked to assemble the pieces to complete a picture. Items arc presented one at a time in a specified pattern. The items are timed, with bonus points awarded for speed; some points are awarded for partially correct responses. Object assembly is a test of synthesis, involving visual organization and visual-motor coordination and attention. Performance is also related to constructive ability, the speed and ease of motor activity, and long-term visual memory. The child's approach to problem solving and work habits can be observed on this subtest. All children receive all items, beginning with the sample and ending with item number four. Example: a seven-piece jigsaw puzzle of a girl.
object permanence: The realization that objects continue to exist when they can no longer be perceived; for example, when a toy falls and the child can no longer see it, he or she will look to see where it has gone. This developmental milestone emerges late in the first year of life.
objective: Independent of observer bias.
obligatory: Compulsory, necessary, not facultative.
Observation of Communicative Interactions (OCI): An observational measure of 10 categories of caregiver responsivity to an infant's communicative cues. Based on a continuum ranging from basic caregiving to more sophisticated efforts to facilitate language and conceptual development, the observational outcomes can be used to plan and guide intervention efforts.
observational learning: Learning by observing and remembering how others achieved success.
obsessive-compulsive disorder: Obsessive-compulsive neurosis; persistent, unremitting, unrelenting, and irrational thoughts, feelings, or "driven" behaviors (e.g., worries about germ contamination with accompanying excessive hand washing) that are refractory to ordinary coping and change methods. These rare obsessions and compulsions may be viewed as maladaptive coping mechanisms for unconscious conflicts and anxieties. Treatment usually requires a multimodal approach including medication, psychotherapy, and long-term support.
obstipation: Intractable constipation that can occur in Hirschsprung disease associated with Down syndrome.
obstructive sleep apnea: Cessation of breathing during sleep for greater than 8-10 seconds. The usual cause of obstructive sleep apnea in children is hyperplasia (enlargement) of the tonsils and adenoids, but it may accompany or complicate a variety of genetic syndromes and static encephalopathies (brain damage due to lack of oxygen).
obtained score: Raw score.
obtundation: State of decreased consciousness in which the individual can be aroused with some difficulty (and without painful stimuli), but the aroused state cannot be maintained.
obturator nerve: The nerve that supplies sensation to the inner thigh and movement to adduct the thigh (pull it inward).
obturator neurectomy: A surgical procedure in which the obturator nerve is cut. In children with spastic cerebral palsy and scissoring, the adductors (thigh muscles that pull the legs inward) are too strong; this operation relieves the extreme adduction in such cases. It is frequently performed in conjunction with adductor tenotomy.
occipital cortex: The posterior (back) area of the brain responsible for the reception and interpretation of visual stimuli.
occipital lobe: The back part of the brain that contains the visual centers; the part of the cerebrum behind the parietal lobe. The occipital lobe contains the optic radiations that bring messages from the eye; damage to the occipital cortex can produce cortical blindness.
occipitofronial circumference (OFC): Head circumference.
occiput: The back of the head. The occipital cortex of the brain is concerned with vision. A bulging occiput suggests the possibility of Dandy-Walker syndrome.
occult: Hidden; not readily observable; such as occult (internal) bleeding.
occupational therapy (OT): The use of adaptive, work, and play activities to increase independent function, enhance development, and prevent disability; the task or the environment may be adapted to achieve maximum independence and to enhance the quality of life.
OCI: See Observation of Communicative Interactions.
oculoauriculovertebral dysplasia: See Goldenhar syndrome.
oculogyric crisis: A fixed upward gaze that can occur as a side effect of certain antipsychotic drugs.
oculomotor nerve: The third cranial nerve. Cranial nerve III is responsible for pupillary constriction, eyelid elevation, and vertical and medial (nasal) gaze.
oculus dexter (O.D.): The right eye.
oculus sinister: (O.S.) The left eye.
O.D.: See oculus dexter.
ODD: See oppositional defiant disorder.
odor: Smell. Odors can suggest specific metabolic diagnoses: maple syrup (maple syrup urine disease [MSUD]); musty, mousey, horsey (phenylketonuria [PKU]); yeast or dried celery (oasthouse urine disease, methionine malabsorption, or Smith-Strang disease); sweaty feet (isovalericacidemia). Strong body odors in children are, most often, a reflection of hygiene and quality of care.
OFC: See occipitofrontal circumference.
OFD-I syndrome: See oral-facial-digital syndrome.
off-task: Interfering with criterion behavior.
Office of Special Education and Rehabilitative Services (OSERS): One of 13 federal offices within the U.S. Department of Education charged with overseeing education in the United Stares. OSERS directs, coordinates, and recommends policy for special education programs and services to address the needs of individuals with disabilities. It supports programs to assist children with special needs, provides for the rehabilitation of youth and adults with disabilities, and supports research that addresses quality of life issues for individuals with disabilities. OSERS comprises the Office of Special Education Programs (OSEP), the Rehabilitation Services Administration (RSA), and the National Institute on Disability and Rehabilitation Research (NIDRR). The OSEP administers and oversees all programs related to the free appropriate public education (FAPE) of all children, youth, and adults with disabilities. The RSA funds vocational rehabilitation agencies and programs—with priority given to programs for individuals with severe disabilities— and also provides information about benefits available to individuals with disabilities through the Client Assistance Program. The NIDRR supports a coordinated national and international program of rehabilitation research through a network of training and research centers. The American Printing House for the Blind, the National Technical Institute of the Deaf, and Gallaudet University are administered through the Office of the Assistant Secretary for Special Education and Rehabilitative Services.
OKN: See optokineric nystagmus.
OKN drum: See optokineric nystagmus.
olfactory: Relating to the sense of smell.
olfactory nerve: The first cranial nerve; cranial nerve I is responsible for the sense of smell.
oligohydramnios: Decreased volume of amniotic fluid during a pregnancy. Oligohydramnios is a risk factor associated with abnormalities of the urinary tract, postmaturity (birth after a prolonged pregnancy), and intrauterine growth retardation.
oligophrenia: An antiquated 20th-century term for mental retardation (from the Greek oligos ["small"] and phren ["mind"]). The term's brief life span was most prominent in references to phenylpyruvic oligophrenia, or phenylketonuria.
OLSAT: See Otis-Lennon School Ability Test.
omega personality: A neurobehavioral syndrome that includes complex problems of memory, reasoning, and judgment, with verbal skills that surpass verbal understanding. Children and adults with this pattern are described as fearless, uncooperative, lazy, amoral, antisocial, and isolated. The omega personality appears to represent a combination of subtle language-processing disorders with attention-deficit/hyperactivity disorder (ADHD) that is especially resistant to routine interventions. Omega personality has been proposed as a specific outcome of fetal alcohol syndrome.
on-task: Consistent with criterion behavior.
One-Word Picture Vocabulary Tests: Receptive One-Word Picture Vocabulary Test (ROWPVT) for ages 2-0 to 11-11; Receptive One-Word Picture Vocabulary Test-Upper Extension (ROWPVT-UE) for ages 12-0 to 15-11; Expressive One-Word Picture Vocabulary Test-Revised (EOWPVT-R) for ages 2-0 to 11-11; and Expressive One-Word Picture Vocabulary Test-Upper Extension (EOW-PVT-UE) for ages 12-0 to 15-11. These tests provide measures of receptive and expressive vocabulary for children ages 2-15 years. The receptive tests require the examinee to select the picture that matches the word spoken by the examiner thus assessing receptive vocabulary. The expressive tests require the examinee to name the picture presented by the examiner. All four tests allow raw scores to be converted to percentile ranks, standard scores, and age equivalents.
onychotillomania: Picking at or pulling out one's nails; a behavior that may be pathognomonic (indicative) for Smith-Magenis syndrome.
OPD-1 syndrome: See otopalatodigital syndrome.
operant behavior: A term from behaviorist learning theory that refers to behaviors that "operate" on or produce an effect on the environment. Walking, talking, hitting, and reading are examples of operants. Operants are different from respondent or reflexive behaviors.
operant conditioning: A form of learning first hypothesized by psychologist B.F. Skinner (1904-1990). Operant behavior is shaped (modified or changed) and maintained by its consequences. A consequent stimulus event (CSE) always follows an operant and may serve to strengthen, weaken, or maintain the current status of the operant. The condition or conditions upon which a CSE occurs are called the contingency. CSEs that strengthen the operants they follow are called reinforcers; these may be either positive or negative. The weakening of an operant by withholding a known reinforcer is referred to as extinction. CSEs that serve to weaken behaviors are called punishers or aversive stimulus events (ASE). Operant conditioning is reciprocal (successfully modifying another's behavior results in the successful CSE being used again). Reinforcers and punishers may be primary (unlearned or unconditioned) or secondary (learned or conditioned). Satiation occurs when a reinforcer loses its reinforcing properties over time. Deprivation refers to a state of need in which the reinforcer becomes more powerful—the opposite of what happens in satiation.
operational definition: The specific procedures or steps for putting a specific concept into effect. For example, the definition of learning disability has been operationalized (made equal to the meeting of itemized objective criteria) in various ways in different states.
ophthalmologist: Oculist; eye specialist; a physician who specializes in the diagnosis and treatment of eye disease and performs delicate eye surgery.
ophthalmoscope: A medical instrument with lenses and a source of light that is used to look into the eye to visualize the retina (light-sensitive inner back wall).
opisthotonos: A posture of the body with markedly increased muscle tone and trunk arching such that the spine is markedly extended and the individual rests on his or her head and heels. This posture can be seen in tetanus but occurs intermittently in severe cerebral palsy. These tonic spasms may be misinterpreted as seizures. When they are prominent in choreoathetosis, the term tension athetosis may be used. Opisthotonos may be considered the most extreme form of decerebrate posture (stiff and extended extremities and retracted head) or tonic labyrinthine position (extension of all four extremities).
Opitz syndrome: Opitz-Frias syndrome; a genetic syndrome with hypertelorism (widely spaced eyes), hypospadias (genital abnormality in males), severe swallowing problems, and mental retardation in two thirds of cases. Inheritance is autosomal dominant.
Oppenheim sign: Stimulation down the medial tibia (lower leg) produces dorsal (upward) extension of the big toe; a variant of the Babinski sign as an indication of pyramidal tract involvement.
oppositional defiant disorder (ODD): Pattern of negativistic, hostile, and defiant behavior more pronounced than usually seen in children of similar mental age. ODD includes such symptoms as anger, argumentativeness, resentment, swearing, deliberate rule breaking, and annoying others. It needs to be distinguished from the attention-deficit/hyperactivity disorder (ADHD) that it frequently accompanies; ODD can evolve into a conduct disorder.
optic atrophy: A paling of the optic disc (nerve ending) as seen on fundoscopic examination of the retina at the back of the eye. A pale optic disc can be associated with damage secondary to vascular compromise because of trauma, blood clotting problems, or vascular (blood vessel) disorders. Other causes are inflammation of the nerve, demyelinating diseases in which the lipid cover of the nerve cell is destroyed, congenital malformations, diseases of the retina, brain or eye tumors, and glaucoma (increased pressure in the eye, often hereditary). Clinical symptoms can include loss of visual acuity or a visual field defect. Treatment is of the causative agent, and prognosis for vision is related to the extent of injury as well as the causative agent.
optic disc: The circular tip of the optic nerve (cranial nerve II) that can be seen on the retina (light-sensitive inner back wall) of the eye through the pupil. Abnormalities of the optic disc can be hereditary, secondary to toxins (poisons) or infection, or vascular (blood vessels). Often the evaluation of the eye and optic disc can reveal the etiology (cause) of some genetic and ocular abnormalities.
optic nerve: The second cranial nerve. Cranial nerve II is responsible for vision and is the only nerve in the body that can be seen on direct physical examination (i.e., ophthalmoscopy) via the optic disc on the retina. Damage to the optic disc can result in blindness in that eye.
optician: A lens grinder; a professional who fills eye prescriptions; opticians are not qualified to perform eye examinations or prescribe corrective lenses.
optokinetic nystagmus: (OKN) Opticokinetic nystagmus. Nystagmus (involuntary eye movements) induced by tracking a kinetic (movement) stimulus. Because the tracking does not need to be voluntary, the response can be used to test vision in infants by rotating a striped OKN drum or passing a tape or tie with broad stripes in front of the infant's eyes. The presence of OKN documents the presence of some degree of visual acuity, but quantification is difficult.
optometric training: An intervention for reading disorders based on the observation that children who experience difficulties reading frequently display abnormal saccades (small eye movements) made when tracking print across a page. The coincidence of visual-motor and visual-perceptual disturbances in children with reading problems reinforces this theory, as does the phenomenon of reversals. The training is supervised by an optometrist and consists of the daily practice of visual pursuit and tracking exercises. The intervention is not effective, and the theory confuses an effect of the reading disorder (poor visual tracking) with the cause of the reading disorder.
optometrist: A professional who measures visual acuity and prescribes corrective lenses (glasses); the optometrist is not a physician, is not qualified to diagnose or treat eye diseases, and does not perform eye surgery.
OPV: See oral poliovirus vaccine.
oral-facial-digital syndrome (OFD-I): Léage-Psaume syndrome. A genetic syndrome with multiple frenula (webs) in the mouth; clefts in the tongue, lips, and palate; hypoplasia (undergrowth) of the nasal cartilages; and a variety of digital (finger and toe) abnormalities. Mild mental retardation occurs in about half the cases. Inheritance is autosomal dominant; OFD-I is lethal in males. See also Mohr syndrome.
Oral-Motor/Feeding Rating Scale: An observational tool for assessing oral-motor and feeding functioning in eight areas: breast feeding, bottle feeding, spoon feeding, cup drinking, biting (soft cookie), biting (hard cookie), chewing, and straw-drinking. The scale is applicable to people of all ages, and the assessment results can be used for planning interventions.
oral-motor function: All aspects of motor and sensory function of the structures in the oral cavity and pharynx (throat) related to swallowing until food enters the esophagus.
oral poliovirus vaccine (OPV): One of the primary routine immunizations given to children. It is trivalent (effective against all three poliovirus types).
oralism: Method of educating people who are deaf (i.e.. those who have profound hearing loss) that focuses on verbal communication to the exclusion of manual or unaided augmentative communication.
orchiopexy: Surgical treatment of cryptorchidism (undescended testes).
Ordinal Scales of Infant Psychological Development: Uzgiris-Hunt Ordinal Scales of Psychological Development. A group of Piagetian scales used to describe cognitive functioning in infants up to 1 year of age. The scales include descriptions of visual pursuit, object permanence, circular reactions, vocal and gestural imitation, and object relations.
organ of Corti: The sensory part of the inner car that converts sound pressure waves into nerve impulses that are then transmitted to the brain by cranial nerve VIII (the auditory nerve).
organic acids: Chemicals found in blood and urine that in increased amounts may indicate an enzyme deficiency. Disorders termed organic acidurias are characterized by episodes of vomiting, lethargy, and ketosis (an increase in certain kinds of chemicals, namely ketones). These conditions can be present with striking odors of urine, such as isovalericacidemia, in which an odor resembling that of sweaty socks occurs. Treatment can include a low-protein diet, sometimes supplemented with carnitine. Cognitive functioning can be normal in some disorders (e.g., isovalericacidemia) and poor with profound mental retardation the rule in others (e.g., methylmalonic acidemia).
organic impairments: A disability with a physical (organic) etiology (cause) as contrasted to a nonphysical (emotional or social) etiology.
organomegaly: Enlargement of an organ; typically used without further specification in reporting negative abdominal examination findings with regard to the size of the liver and spleen. Thus, "no organomegaly" means that neither the liver nor spleen were enlarged. Hepatomegaly (liver enlargement) or splenomegaly (large spleen) can reflect gastrointestinal, cardiac, or hematological (pertaining to blood and blood-forming tissues) disorders. In the area of developmental disorders, hepatosplenomegaly (enlargement of the liver and spleen) may be part of a storage disease.
orientation: Neuropsychological awareness of the environment with respect to place, time, and people; developmentally, the locating and turning toward the source of a stimulus (light or sound).
orienting, auditory: turning toward a sound stimulus; localizing at least the general direction of a sound source, if not its exact location, by use of the sense of hearing unsupported by visual cues. Orienting is a receptive language milestone that has cognitive content; failure to orient does not necessarily reflect a hearing deficiency. Orienting is one of the few language milestones readily open to direct observation in the clinical setting. Orienting to mother's voice (at 4 months) precedes orienting to a hell (5 months and later); orienting accurately to a sound source above the horizontal precedes orienting to a sound source below the horizontal.
ornithine transcarbamylase (OTC) deficiency: A hereditary urea cycle disorder leading to hyperammonemia, mental retardation, failure to thrive, headaches, vomiting, and lethargy in cyclic episodes related to protein intake. Inheritance is X-linked.
oromotor dysfunction: Difficulty in the motor control and coordination or the lips, tongue, cheeks, and pharynx (throat); oromotor dysfunction can contribute to and be associated with early feeding problems (which can lead to failure to thrive), drooling and choking, and later articulation disorders. The relationship between oral motor reflexes, infantile feeding experiences, and mouth sensation (stimulation) is complex. Some of the most severe oromotor dysfunction occurs in infants with cerebral palsy. Also referred to as oromotor apraxia or oral motor apraxia.
orotracheal tube: A tube going from the mouth to the trachea (windpipe) and used both to clear an airway and to passively assist ventilation (breathing) either through a manually pumped bag or a mechanical ventilator.
orthogenetic principle: The theory that development proceeds in a directed manner from a lower state of less differentiation to a higher state of greater differentiation, increasing complexity, and hierarchic organization.
orthomolecular treatment: Therapy based on a hypothesized vitamin deficiency localized to (a small region of) the brain. After having been disproved to have any efficacy in the treatment of schizophrenia in adults, the therapy continues to be offered as a panacea for all types of developmental disorders in children, where it remains unproven. The vitamin regimen (i.e., megavitamin therapy) is quite varied and often also includes diverse trace elements on the basis of a rationale reminiscent of alchemy and homeopathy.
orthopedist: A surgeon who specializes in the treatment of diseases of the bones, joints, and muscles.
orthopsychiatry: An interdisciplinary field that emphasizes the development of mental health (rather than illness) from infancy and supports efforts for the prevention of mental illness. See also American Orthopsychiatric Association.
orthoptics: Eye exercises; optometric training.
orthoroentgenogram: An X ray that includes a ruler next to the index limb to accurately measure bone length.
orthosis: Orthopedic appliance; any device or appliance used to support, align, prevent, or correct orthopedic deformities or otherwise improve motor functioning; orthoses include braces and splints.
orthotics: The science and practice of designing, measuring, fitting, evaluating, and teaching the use of orthoses (corrective appliances); sometimes used as a synonym for "splinting."
Ortolani sign: A maneuver to elicit an audible hip click; when present, such a click is indicative of congenital dislocation of the hip. Testing for hip dislocation is a routine component of the pediatric examination in early infancy.
Orton-Gillingham reading method: A structured multisensory approach to reading, spelling, and penmanship. The psychologist Anna Gillingham based this remedial methodology on the neurologist Samuel T. Orton's (1879-1948) theories about dyslexia. This method is based on the rationale that children must be taught through the constant use of association of 1) how a letter or word looks, 2) how it sounds, and 3) how the speech organs and the hand feel when producing (writing and tracing) the word. The Orton Society continues to focus on dyslexia.
O.S.: See oculus sinister.
os calcis: Calcaneus, heel bone.
oscillation: The absence of a clear trend toward traversing the sequence of Piagetian stages; children with mental retardation may be observed to fluctuate between the various stages.
OSERS: See Office of Special Education and Rehabilitative Services.
ossicles: Small hones; usually refers to the three small bones of the middle ear (incus, malleus, stapes).
ostension: Definition by pointing: "That's a(n)...." A technique to increase young children's vocabulary.
osteomyelitis: Bone infection.
osteotomy: An orthopedic surgery procedure that changes the alignment of a bone, usually by removing a wedge-shaped portion of that bone.
OT: See occupational therapy.
OTC deficiency: See ornithine transcarbamoylase (OTC) deficiency.
Otis-Lennon School Ability Test (OLSAT): A measure of cognitive ability as related to school success for children in kindergarten through grade 12; there are seven levels of the test for the different grades, with clusters of 10-15 items in the five areas of verbal comprehension, verbal reasoning, pictorial reasoning, figural reasoning, and quantitative reasoning.
otitis externa: "Swimmer's ear"; inflammation of the external auditory canal.
otitis media: Middle-ear infection; inflammation of the middle ear. There are three subtypes: serous (with an accumulation of fluid in the middle ear); secretory (with an accumulation of thick fluid—"glue ear"), and suppurative (pus accumulation). Associated ear pain, fever, and hearing loss are variable.
otoacoustic emission (OAE): Experimental hearing screening test for children based on the principle underlying sonar.
otolaryngology: A surgical specialty of the ears, nose, and throat.
otology: The science or study of the ear and its functions. Physicians who specialize in otology are otolaryngologists, or ENT (ear-nose-throat) doctors.
otopalatodigital syndrome (OPD-1 syndrome): A genetic syndrome with moderate conductive (involving the middle and outer ear) hearing loss; cleft palate; irregular digits with short, broad terminations; mild mental deficiency; a variety of skeletal abnormalities, and a characteristic pugilistic facies. Inheritance is X-linked.
ototoxic: Damaging to the eighth cranial nerve; drugs that cause nerve deafness are ototoxic.
OTR: See registered occupational therapist.
outer canthal distance: A measurement of the distance between the two lateral (outside) canthi of the eyes. It is not a very sensitive indicator of dysmorphology because it is variably influenced by the angle of the palpebral fissures (eye slits): Large angles will relatively decrease the significance of variations in this measurement.
outer-directedness: A personality characteristic of people with mental retardation that includes both their imitativeness and their reliance on external (especially adult) cues to guide their behavior.
overcorrection: A mildly aversive behavior modification technique. In restitutional overcorrection, the person being treated is made to restore the environment to a better condition than before the inappropriate behavior (washing all the desks in the classroom as punishment for writing on one). Positive practice overcorrection requires the overpractice of acceptable behaviors incompatible with the behavior to be eliminated or the repeated performance of a behavior until it becomes learned (writing a missed spelling word 100 times).
overdetermined: Having multiple causes, with the implication that one cause would suffice. In psychiatry, an overdetermined symptom would reflect a confluence of defenses, needs, and unconscious drives. In developmental disabilities, a disability is often overdetermined by a combination of genetic, environmental, familial, social, and learning etiologic (causal) factors.
overflow movements: See associated movements.
overprotection: A style of parenting characterized by I) an encouragement of dependency by the child on the parent or family, and 2) an exclusion by the parent of family or outside influences on the child. In an attempt to protect the child from any perceived danger, the parent constantly intrudes on and controls the child's world. The result is a child with lessened opportunities to learn from experience, diminished capacity to cope with new situations, and a mistrust of his or her own capacities. Thus, the child develops socialization difficulties, anxiety, depression, and sometimes retributive aggression. In the long term, the child functions at suboptimal levels of independence. Furthermore, both child and family become trapped in a system in which individual autonomy is compromised. Parents of children with developmental disabilities are especially vulnerable to the trap of overprotection in an effort to protect everyone from hurt and rejection. Overprotection can contribute to developmental, emotional, and family problems.
oxybutynin: Trade name Ditropan: a spasmolytic drug that increases bladder capacity and decreases the urgency to void; used in the treatment of neurogenic bladder.
oxycephaly: Turricephaly. A small "tower" shaped skull produced by craniosynostosis (premature fusion of skull sutures) involving all sutures. There is a high vertical index (height of skull divided by length of skull).