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

radial rake: A stage in the evolution of voluntary grasp in which the hand approaches the object from the radial (thumb and forefinger) side: prominent from 6 to 9 months of age.
radius: The thicker of the two bones of the forearm (see also ulna); dislocation of the radial head (near the elbow) is a common childhood injury that results from the child being pulled by the forearm (also known as nursemaid elbow.)
railroad track ear: A finding in fetal alcohol syndrome in which the pattern displayed by the inner markings of the ear resembles the parallel lines of railroad tracks.
rake: A stage in the development of reaching and grasping in which the infant scoops an object with the entire hand; in the ulnar rake, which is prominent around 6 months of age, the hand approaches the object with its pinky side; in the radial rake, which becomes prominent after 6 months of age, the hand approaches the object with its thumb and forefinger side.
range of motion (ROM): A component of the neuromuscular examination that measures the extent (angle in degrees) of movement at a joint; ROM also refers to active and passive exercise designed to maintain or increase the amount of movement at a joint. ROM exercises may prevent or treat contractures in a variety of neuromuscular disorders.
ranitidine: Trade name Zantac: a drug that can be used in the treatment of gastroesophageal reflux. This is an H₂-receptor antagonist that suppresses gastric acid production.
rapid eye movement (REM): A phase of sleep that coincides with dreaming.
rapport: The relationship established between individuals that allows them to work together in a therapeutic fashion. Ideally, a professional gathering information attempts to create a warm and comfortable atmosphere to facilitate free information exchange and positive regard. With respect to psychological and developmental testing, rapport is an integral part of the testing process; it is required to enhance the likelihood of achieving a valid estimate of the testee's abilities. Establishing and maintaining rapport becomes especially difficult when the therapist or tester has unrealistic expectations of the testee's abilities or is ignorant of the impact of an organic diagnosis on performance. Examples of problem areas include the level of cognitive deficiency, the confusion of attention-deficit/hyperactivity disorder (ADHD) symptomatology with willful maliciousness, and the misdiagnosis of hyperactivity for a language disorder.
RAS: See reticular activating system.
Rasch analysis: A statistical technique to group items in clusters according to level of difficulty.
ratio: A numerical value obtained by dividing one number into another to indicate their relative proportion. Some intelligence and developmental quotients are ratios of mental age (MA) or developmental age to chronological age (CA).
ratio IQ: An intelligence score derived by dividing an individual's mental age (MA) by his or her chronological age (CA) and multiplying the quotient by 100 to eliminate the decimal. Thus, ratio IQ = MA/CA X 100. Because the standard deviation of the ratio IQ distribution does not remain constant with age, IQs for different ages are not comparable; the same IQ at different ages has different meanings. By transforming the raw score (a number representing actual test performance) to a standard score with a given mean and standard deviation (deviation IQ), this problem is eliminated. For this reason, the use of the deviation IQ has replaced the use of the ratio IQ in most instances.
Raven Progressive Matrices: A test of nonverbal intelligence for people 6 years of age to adult; there are three versions of the test: Standard Progressive Matrices (ages 6 and older), Colored Progressive Matrices (5-11 years of age), and Advanced Progressive Matrices (ages 11 and older). Each version presents a series of progressively more complex, incomplete designs that the subject must complete by choosing from a number of fragments presented. The results are scored as percentiles. The test is completely nonverbal and allows children with language-based learning disabilities to demonstrate their abstract reasoning ability more effectively than in other tests. Although Raven scores correlate well with performance IQ in children younger than 10 years of age, for older children, the correlation becomes stronger with verbal IQ scores, owing to the increasingly sequential character of the more advanced patterns.
raw score: The record of test performance expressed in original test units; the actual number of items "passed," correct answers given, or tasks successfully completed.
razzing: The raspberry, or "Bronx cheer"; a spluttering sound produced by blowing through vibrating lips. An expressive language milestone of infancy that typically emerges around 5 months of age.
RCBF: See regional cerebral blood flow.
RDLS-R: See Reynell Developmental Language Scales-Revised.
RDS: See respiratory distress syndrome of newborn.
reactive attachment disorder of infancy: A behavioral syndrome with an onset before 8 months of age in which poor maternal bonding leads to a lack of social responsiveness, apathy, growth failure (failure to thrive), depressive affect, and developmental delay in an infant.
readiness: A condition or state in which it is possible for a person to engage in a given learning activity.
readiness skills: In education, those skills that are prerequisite to success in a formal classroom setting. Traditionally they include oral language (speaking in complete sentences, using words adequately to describe), listening (remembering what is heard), perceptual-motor development (development of large and small muscles, knowledge of body parts and direction, balance), visual-perceptual development (eye-hand coordination, knowledge of size, shape, spatial concepts), reading readiness (letter recognition, sound-symbol association), social-emotional development (understanding self and others, interaction with peers, accepting responsibilities), and number readiness (counting, number values, concepts such as more and less).
reading epilepsy: A convulsive disorder in adolescents with reading disorders in which reading precipitates complex partial seizures; this condition is extremely rare and seems to result from or correlate with, but not cause, the reading disorder.
rebound: In medical terminology, a dramatic increase in the severity of symptoms of a disorder being treated when medication is withdrawn.
rebus: A graphic puzzle representing a word, phrase, or sentence. Letters, numbers, and pictures of objects with names that sound similar to the words or syllables they represent arc used. A rebus is a form of aided augmentative communication used as an alternative method for teaching reading.
Receptive-Expressive Emergent Language Scale-Second Edition (REEL-2): A test of perceived language development for children from birth to 3 years of age using the child's mother as an informant; the REEL-2 has an interview format that groups the questions to produce separate receptive and expressive language ages. Chronological age is compared to a receptive language age and an expressive language age. In some cases, a depressed expressive language age may help to provide differential diagnostic information regarding environmental influences on language acquisition. Such results can be used as a guide when counseling parents regarding speech and language stimulation in the home. The REEL-2 shares limitations common to all caregiver report scales; however, in most clinical settings, an interview format remains the only reasonable approach.
Receptive One-Word Picture Vocabulary Test (ROWPVT): See One-Word Picture Vocabulary Tests.
Receptive One-Word Picture Vocabulary Test-Upper Extension (ROWPVT-UE): See One-Word Picture Vocabulary Tests.
Recipe for Reading: A multisensory reading method with a strong phonetic component. The content and sequence of each lesson are as follows: 1) teacher flashes phonic sound cards for previously learned letters and student gives sound; 2) teacher gives sounds and student names and writes letters; 3) if a child is ready, teacher teaches new sound; child learns sound and traces and copies letter; 4) teacher dictates words using new letter; student repeats word, spells it orally, and says each letter while writing it; 5) teacher presents the previous words on flashcards and student reads the words he or she has spelled; 6) if time permits, teacher dictates one or more sentences, student repeats sentences, tries to remember them, and spells words out loud as they are written; 7) teacher presents sentences on flash-cards and student reads; 8) student reads book at appropriate level; 9) lesson ends with game using skills in which student is proficient.
reciprocal questioning: A program in which students learn to lead story discussions, first by seeing appropriate question-answering strategies modeled by the teacher, then by having the role of questioner gradually transferred to the student.
recognition memory: The realization that some stimuli have been previously encountered. Multiple-choice testing may allow for the use of primarily recognition skills. See memory.
record (residential intake record): An intake protocol for developmental disabilities residential agencies. Detailed checklists are provided for a variety of domains, including personal history; family history; intellectual and adaptive behavior; educational, vocational, and medical needs; dual diagnosis; and support services.
rectum: The last 6 inches of the large intestine.
red herring: A misleading clue. The term is used often in medicine to describe a sign or symptom that can he associated with a particular disease unrelated to the diagnosis.
red reflex: A physical finding produced by shining a bright light at the eye and looking for its reflection from the retina (light-sensitive inner back wall), which is red. This red reflex is blocked if there is an abnormality in the cornea (e.g., cloudy cornea found in mucopolysaccharidoses), the lens (e.g., cataract or lens opacity), or the retina itself (e.g., tumor such as retinoblastoma). The red reflex is the cause of red eyes seen in some photographic pictures taken with flash cameras.
REEL-2: See Receptive-Expressive Emergent Language Scales-Second Edition.
reflex hypoxic crisis: See breathholding spell.
reflex seizure: Seizures precipitated by a number of specific sensory stimuli. These include music, sound, light, reading, and somatosensory stimuli such as tapping or teeth-brushing.
reflex standing: The ability of a child with severely hypertonic cerebral palsy to stiffen all extensor muscles so as to support weight when balance is maintained from outside. Such children are usually unable to sit, and thus reflex standing should not be interpreted as a prelude to walking; it is a pathological rigidity that will actually inhibit mature voluntary movement patterns.
reflexes (deep tendon): Normal reflexes that indicate the motor system is functional. Reflexes are graded according to response, as follows: 4+—hyperactive and brisk, often indicative of disease and associated with clonus (rhythmic oscillations between flexion and extension); 3+— brisker than average, but not always associated with disease; 2+—normal; 1+— slightly decreased; and 0—no response. Each reflex is associated with one or more spinal nerve roots. The following reflexes are paired with their spinal nerve roots: biceps, C5C6; triceps, C7C8; brachioradialia, C5C6; abdominal, upper, T8, T9, T10; abdominal, lower, T10, T1l, T12; cremasteric L1, L2; knee, L2, L3, L4; ankle, S1, S2; Babinski, L4, L5, S1, S2.
reflux: See gastroesophageal reflux (GER).
refractory: Unresponsive to treatment. Often used to describe seizures that cannot be controlled with standard anticonvulsants.
Refsum syndrome: Hereditary Motor and Sensory Neuropathy Type IV (HMSN-IV), heredopathia atactica polyneuritiformis, phytanic acid storage disease. A rare genetic syndrome with retinitis pigmentosa (night blindness and progressively restricted visual fields), cerebellar ataxia (unsteady gait), and progressive sensorineural (involving the inner ear or the auditory nerve) hearing impairment (50%). Inheritance follows an autosomal recessive pattern with a recurrence risk of 25%. The syndrome is currently detected by manifest clinical symptoms usually within the first 20 years of life. Dietary restriction of phytanic acid precursors may slow the progression of symptoms.
regard: Look at, pay attention to; see also hand regard.
regional cerebral blood flow (RCBF): A neuroanatomical research procedure used to localize brain abnormalities in developmental disorders such as dyslexia and attention deficits.
registered occupational therapist (OTR): A professional with a baccalaureate degree in occupational therapy and an additional 6 months of fieldwork who has passed the American Occupational Therapy Association's (AOTA) certifying examination. See also occupational therapy.
Reglan: See metoclopramide.
regression: The loss of previously acquired developmental milestones that occurs with a degenerative disease of the central nervous system or sometimes with serious emotional disorders. Such a loss of skills can be associated with a decline in measured IQ.
regression toward the mean: A statistical phenomenon in which people who achieve very high or very low scores on a given test are more likely to score closer to the mean on a retest. In population genetics, traits controlled by multiple genes may also exhibit this same phenomenon; in each succeeding generation it becomes less likely that this exact same combination of multiple genes will come together to produce extreme variations from the mean expression of that trait.
regular education initiative (REI): A movement to restructure education that would require general and special education programs to work more closely together. Proponents maintain that dual systems of education, separate professional organizations, separate personnel preparation programs, and separate funding patterns inhibit integration of students with disabilities and reduce the effectiveness of education. Some have advocated the merger of special and general education; others, although questioning the "second system" approach, do not advocate the elimination of separate special education services. Opponents tear that many of the gains made in the education of students with disabilities would be lost. Advocates of children with behavior disorders or severe emotional disturbances arc among the groups most vocal in their concern that this would result in reduction of services for a group they view as already underserved.
rehabilitation: See habilitation.
Rehabilitation Act of 1973 (PL 93-112): A federal law with a civil rights component that prohibited denial of participation in federally funded programs or activities to individuals with disabilities who were otherwise qualified. The intent of this law was to implement a national policy of integrating people with disabilities into society by providing and expanding employment opportunities in public and private sectors. Major components of the law included 1) Title IV, which defined an individual with a "handicapping condition" as anyone who had a physical or mental impairment that substantially limited participation in one or more major life activities, who had a record of such impairment, or who was regarded as such at the time; and 2) Title V, which established civil rights protection. Section 503 provides for affirmative action with federal contractors, and Section 504 outlines the civil rights aspects. This law permits parents to file complaints with the U.S. Department of Education's Office of Civil Rights if a qualified handicapped student is being denied access to an appropriate education. Students with disabilities not listed in PL 94-142 (the Education for All Handicapped Children Act of 1975), such as attention-deficit/hyperactivity disorder, have been found to be eligible for services under Section 504.
Rehabilitation Act Amendments of 1983 (PL 98-221): Federal legislation that authorized several demonstration projects related to transition services from school to work for youths with disabilities.
Rehabilitation Act Amendments of 1986 (PL 99-506): A federal law that reauthorized PL 93-112, the Rehabilitation Act of 1973, and established discretionary programs for supportive employment services for individuals with disabilities. Supportive employment services include job coaching for people with severe disabilities (including learning disabilities) that affect employability.
Rehabilitation Act Amendments of 1992 (PL 102-569): A federal law that revised and extended the programs of the Rehabilitation Act of 1973 (PL 93-112). These amendments incorporate the philosophy of the Americans with Disabilities Act of 1990 (PL 101-336), including provisions to ensure that the individual's issues and concerns are considered during the process of developing the individualized written rehabilitation plan (IWRP) and throughout its implementation. The law also clarifies what services constitute components of vocational rehabilitation, including personal assistance, transition, and supported employment. Individuals with severe and profound disabilities are eligible for vocational rehabilitation, and intensive services are to be provided based on a maximum amount possible, as well as on the person's particular strengths, resources, interests, and concerns.
Rehabilitation, Comprehensive Services, and Developmental Disabilities Amendments of 1978 (PL 95-602): A federal law that enacted a "functional," rather than categorical, definition of developmental disability. This new definition required substantial functional limitations in at least three of the following major life activities: self-care, receptive and expressive language, learning, mobility, self-direction, capacity for independent living, and economic self-sufficiency. This law also shifted the emphasis from planning to priority in use of state grants.
Rehabilitation Services Administration (RSA): One of the three program areas of the federal Office of Special Education and Rehabilitative Services (OSERS). The Rehabilitative Services Administration allocates grants to state vocational rehabilitation agencies to help people with mental and physical disabilities obtain job training, employment, medical and psychological assistance, and other individualized services. Priority attention is given to individuals with severe disabilities. The RSA also funds training programs for rehabilitation professionals, and programs that enrich and enhance the lives of individuals with disabilities within their communities. The RSA operates the Client Assistance Program, which informs people with disabilities about the benefits available under the Rehabilitation Act of 1973, as amended, and assists them to receive those for which they are eligible. The two other program areas of OSERS are the Office of Special Education Programs (OSEP) and the National Institute on Disability and Rehabilitation Research (NIDRR). The OSEP administers programs relating to the free appropriate public education of children, youth, and adults with disabilities, whereas NIDRR develops and implements a coordinated program of national and international rehabilitation research. See also Office of Special Education and Rehabilitative Services (OSERS).
REI: See regular education initiative.
reinforcer: Anything that occurs after a behavior and causes an increase in the frequency of that behavior. Primary reinforcers are physiologically or biologically pleasurable stimuli; secondary reinforcers become pleasurable from being paired with primary reinforcers. Food is an example of a primary reinforcer; socialization and attention are examples of secondary reinforcers.
Reiss Scales for Dual Diagnosis in Children: A 60-item problem rating scale for use in people 4-21 years of age with mental retardation; the instrument yields 10 sub-scale scores for anger, anxiety disorder, attention deficit, autism, conduct disorder, depression, poor self-image, psychosis, somatization, and withdrawn behavior. Other significant behaviors are also measured.
Reitan-Indiana Neuropsychological Test Battery for Children: A neuropsychological battery for children 5-8 years of age. The battery was developed as a downward extension from the adult version, with many of the adult tests simply shortened or eliminated for this version. Administration requires extensive training both for administration and interpretation. Reliability and validity are below that of the adult tests.
related services: As originally defined in PL 94-142, the Education for All Handicapped Children Act of 1975, related services are "transportation, and such developmental, corrective, and other supportive services ... as may be required to assist a handicapped child to benefit from special education." Among services specifically included are speech pathology and audiology, psychological services, medical services (for diagnostic and evaluation purposes only), physical therapy, occupational therapy, recreation, and counseling. The reference to "other supportive services ... as may be required" has caused the precise definition of related services to remain a subject of debate.
relaxation: Psychotherapeutic approaches to reduce muscle tone in young children with cerebral palsy. These approaches may include slow rocking, rhythmic rotation, and gentle shaking.
REM: See rapid eye movement.
remedial (compensatory) education: Specialized or additional instruction in deficient academic areas when the deficiencies are assumed to be a result of environmental factors. The expectation is that the student will master the general curriculum through regular channels. Contrast with adaptive education.
remission: The lessening or cessation of disease symptoms.
renal: Relating to the kidneys.
Renpenning syndrome: X-linked mental retardation, otherwise undifferentiated. The clinical manifestations are variable; the most common findings include small head, small testes, and short stature. Although the mental retardation is detectable at an early age, unless a family pedigree of known risk is available, specific diagnosis of Renpenning-type mental retardation may be delayed until adolescence.
residential intake record: See record.
Residential Services Indicator (RSI): A standardized protocol to collect a variety of data to be used in selecting residential and support services for people with developmental disabilities.
residential treatment: A treatment modality in which the child lives away from home in a facility where he or she receives education, psychotherapy, nurturance, structure, safety, and extracurricular and peer interaction opportunities. The need for this intensive, coordinated treatment can be related to significant family pathology (origin) in addition to the child's problems, which not only renders the family unable to cooperate in necessary treatment but also often causes them to undermine the efficacy of existing treatment resources. There is no specific developmental or psychiatric diagnosis in which this level of treatment is indicated per se; it is, rather, the cumulative effect of several factors that lead to the recommendation and utilization of such a milieu.
resonance: The tonal quality imparted to voice sounds by the resonance-chamber action of mouth and pharynx (throat) configurations, and, in some cases, also of the nostrils. The eventual outflow of sound waves that are recognized as the human voice is the result of filtering of that sound by the resonance system. The source of the voice is the larnyx (wind-pipe); impairment of vocal resonance can be any condition in which there is an abnormal acoustical signal clue to inappropriate modification of the laryngeal tone. Clinically, hypernasality (excessive nasal resonance) and nasal emission (escape of air through the nose during the production of pressure consonants) are the most frequently seen vocal resonance problems. Hyponasality (insufficient nasal resonance) is also a disorder of resonance. Hypertrophic (thin) tonsils and adenoids, nasal deformities, cleft lip/palate, congenital palatopharyngeal incompetencey (CPI), and craniofacial malformation syndromes can result in disturbances of normal vocal resonance. There are therapeutic, behavioral, and surgical approaches to improve or correct disorders of resonance.
resource services: One set of services in a continuum of educational placement alternatives. Assistance is provided to the student for some portion of the school day in a resource room; the rest of the day is spent in the general classroom. The resource services provided are listed in terms of goals and objectives in the student's individualized education program (IEP). The ways in which these goals are met varies among schools and teachers. The resource room teacher may act as a consultant to the general education teacher in planning for an individual child or certain children. The success of this interaction varies across situations and personnel.
respiratory distress syndrome (RDS) of newborn: A condition of newborn infants that includes dyspnea (difficult breathing) and cyanosis (blue color). It is most common in premature infants and infants of diabetic mothers (IDM). RDS can present with hyaline membrane disease (HMD) or idiopathic (unknown) respiratory distress syndrome (IRDS). Long-term effects can include chronic lung disease (bronchopulmonary dysplasia— BPD) and adverse neurological and developmental outcomes related to poor cerebral blood flow and bleeding into the head that occur during the acute management of RDS.
respondent behaviors: A term from behavioral learning theory that refers to reflexive behaviors controlled by the autonomic nervous system and involuntary muscles. The eye-blink reflex, knee-jerk reflex, and salivation are examples. Respondent behaviors are elicited or caused by a prior stimulus. Pavlov's classical conditioning experiments are examples of eliciting respondent behaviors.
response cost: See cost contingency.
response cost procedure: A behavior modification technique that involves the withdrawal of a reward/reinforcer when an undesirable behavior occurs; it is often employed in the treatment of maladaptive behaviors in people with mental retardation.
retention: Holding back; requiring a child to repeat a grade in school. Although retention is one of the most commonly employed interventions, research has documented that in the long run it is ineffective. Its major impact appears to be that of delaying the preparation of a diagnostic workup that could more effectively describe the reasons for this child's failure and how to address it.
reticular activating system (RAS): An area of the brain stem involved in the control of attention, wakefulness, and sleep.
retina: The light-sensitive inner layer of the eyeball; it can be examined by looking through the pupil with an ophthalmoscope; it is the only part of the central nervous system available for routine direct visualization.
retinitis pigmentosa: A disease of the eye producing nyctalopia (night blindness) and progressive visual loss; it can he associated with a variety of conditions: lipidoses (e.g., Gaucher disease), spinocerebellar degenerations (e.g., as in Friedrich ataxia), hearing loss (e.g., Usher syndrome), mucopolysaccharidoses, myotonic dystrophy, Lawrence-Mood-Biedl syndrome, and syndromes with renal (kidney) disease or external ophthalmoplegia (ocular muscle paralysis).
retinopathy of prematurity (ROP): Also known as Terry disease; an eye disease that is a major cause of blindness. It occurs predominantly in premature infants and is more severe with decreasing birth weight. The cause remains unknown, but high levels of oxygen have an exacerbating effect. Both the active (proliferation) and cicatricial (scarring) stages are scored 1-4, with the higher numbers reflecting more severe involvement.
retrograde amnesia: A specific impairment of memory for events experienced immediately before a closed brain injury; the period of time included in the amnesia varies with the severity of the head injury as reflected in the duration of unconsciousness.
retrolental fibroplasia (RLF): See retinopathy of prematurity.
Rett syndrome: A degenerative condition that occurs in girls who develop typically early in life and then between 6 and 18 months of age undergo a rapid regression in motor, cognitive, and social skills that subsequently stabilizes at a level that leaves the individual with mental retardation. After the regression stabilizes, affected individuals exhibit autistic features and hand stereotypies: wringing, clapping, tapping, washing, and mouthing. Seizures and scoliosis (spinal curvature) are common medical complications requiring care. Treatment is symptomatic and supportive; prognosis is poor. Deceleration of head growth is prominent. Etiology (cause) remains unknown.
return to clinic (RTC): An acronym for return to clinic, typically followed by a time interval; thus, "RTC 3 months" indicates that the individual's next appointment should be in 3 months.
reversals: Letters or numbers written backward (e.g., b/d, p/q, was/saw); often erroneously considered a pathognomonic (indicative) sign of dyslexia. Younger children frequently reverse the direction of letters and numbers; some degree of reversals persists in the early elementary grades and should not be considered pathological until 8 years of age or third grade. Marked use of reversals (and mirror writing) can be considered suspicious for learning disabilities in earlier grades when accompanied by other findings suggestive of academic difficulties. Rotations or inversions of letters or numbers across an axis other than the vertical should probably be considered more serious than the common right-left reversals.
reversals frequency test: A three-part instrument that measures the frequency of letter and number reversals in three situations: execution (writing), recognition (reading), and matching (same/different comparison). This test, devised by Richard Gardner, purports to differentiate children with minimal brain dysfunction from typical children when used as a screening instrument.
reverse genetics: A laboratory procedure using gene mapping (identifying the location of a gene on a chromosome) to make copies of a gene found in a particular disease where the biochemical problem is not known. The goal is to identify the protein that is made from the gene and perhaps learn more about the process of that particular disease. Although identifying the abnormal protein, such as locating the gene that makes an abnormal dystrophin in Duchenne muscular dystrophy, helps explain what goes wrong in muscular dystrophy, it does not imply that a cure is readily possible.
reversed tailor: A sitting posture associated with hypotonia (decreased muscle tone) or hip instability: sometimes referred to as mermaid sitting, after the statue of the Little Mermaid in Copenhagen.
reversible hyposomatotropinism: See psychosocial deprivation syndrome.
reversible obstructive airway disease (ROAD): See asthma.
Revised Prescreening Developmental Questionnaire (R-PDQ): A brief parent/care-giver survey to decide on the need to administer the full Denver Developmental Screening Test to children 3 months to 6 years of age; 10 questions are asked at selected ages. Despite extensive development, both the prescreening instrument and the Denver Developmental Screening Test lack adequate sensitivity and specificity.
Revised Problem Behavior Checklist (RPBC): A 1987 revision of the original Behavior Problem Checklist (BPC; Quay and Peterson), for children from kindergarten through grade 12. Items are organized into four major subscales: conduct disorder (22 items), socialized aggression (17 items), attention problem—immaturity (16 items), and anxiety—withdrawal (11 items). Two minor subscales are also included: psychotic behavior (6 items) and motor tension—excess (5 items). Using a 3-point rating scale, respondents (parents, teachers, or other professionals associated with the child to be rated) score the degree to which each item characterizes the child's behavior. Items from the subscales are scattered throughout the test. Templates are provided for adding circled numbers (1, 2, and 3) to yield a raw score for each subtest. Twelve rated items are not scored. Raw scores for each subscale are then converted to normalized T scores with a mean of 50 and a standard deviation of 10. The tables have some potentially confusing features, and the user is advised to read the headings carefully. The authors suggest that local norms be developed.
revisualization: A memory task in which the person must recall the configuration (shape of a letter or word) in the absence of visual clues; phonetic spelling errors are common in children with revisualization deficits.
Reye syndrome: An acute, life-threatening, postinfectious (following flu or chickenpox) encephalopathy (brain damage due to lack of oxygen) with hepatitis. Salicylate (aspirin) has been implicated in the etiology (cause); this risk has markedly reduced the usage of aspirin in children. Mortality is 30%. Morbidity can include the entire spectrum of neurodevelopmental disorders of varying severity.
Reynell Developmental Language Scales-Revised (RDLS-R): A test that provides separate measures of expressive language and verbal comprehension for children 1-17 years of age. The RDLS was normed and is most commonly used in the United Kingdom.
Reynell-Zinkin Developmental Scale for Visually Impaired Young Children: An assessment instrument for infants and preschoolers with visual impairments who are from birth to 5 years of age, with separate age norms for children who are totally blind, partially sighted, and sighted.
Rh factor: A genetically determined blood antigen, the presence or absence of which is important in the compatibility of blood for transfusion purposes. Repeated maternal-fetal Rh incompatibility with the mother not having the factor (Rh-) and the baby having the factor (Rh+) can lead to the mother producing antibodies against the baby's red blood cells with increasingly severe responses with each successive incompatible pregnancy. Treatment with RhoGAM prevents this sequence.
rhinitis: An inflamed or runny nose.
rhinorrhea: Runny nose.
rhizomelic: Referring to the proximal segment of a limb (e.g., the upper arm or thigh).
rhizotomy: Cutting a nerve root; see also selective posterior rhizotomy.
Rhode Island Test of Language Structure (RITLS): A test of language structure designed for use with children with hearing impairments ages 3-20 years; it can also be used with children ages 3—6 years who have mental retardation or learning disabilities or who are bilingual.
rib hump: An elevation of one side of the thorax (chest) when an individual bends forward 90 degrees at the hips in the presence of scoliosis (spinal curvature). A rib hump indicates rotation of the thoracic vertebrae to the convex side of a scoliosis.
Richards-Rundel syndrome: A genetic syndrome with progressive severe mental retardation, nystagmus (involuntary eve movements), ataxia (unsteady gait), muscle wasting, absent secondary sexual characteristics, and sensorineural (involving the inner ear or the auditory nerve) deafness. Inheritance follows an autosomal recessive pattern.
rickets: Stunting of growth and hone deformities secondary to a failure of normal calcification of bone; this condition can be nutritional or based on a variety of metabolic disorders.
RIDES: See Rockford Infant Developmental Evaluation Scales.
Rieger syndrome: A genetic syndrome or anomaly (malformation, deformation, disruption, or dysplasia) with abnormalities of the anterior (front) part of the eye (i.e., iris), glaucoma (increased pressure in the eye, often hereditary), hypodontia (decreased number of teeth), and mental retardation. Inheritance follows an autosomal dominant pattern. The syndrome is detected in the neonatal period or later, depending on the presence of structural eye defects. Treatment is restorative for the hypodontia, with ongoing ophthalmological care for the eye complications.
righting reaction: One of a subgroup of postural reactions (EAR-II) concerned with maintaining the position of the head in space.
rigidity: A physiological type of extrapyramidal cerebral palsy with consistently increased tone ("lead pipe" or "cogwheel" variety), such that there is resistance to passively moving an extremity (arm or leg) throughout the entire range of motion. In many ways, this stiffness or inflexibility is similar to the most severe forms of spastic quadriplegia (paralysis of all four extremities) and is usually associated with severe to profound mental retardation.
rigidity: A lack of flexibility or sluggishness in the thought processes of people with mental retardation (as interpreted by the Lewin-Kounin model).
Riley-Day syndrome: Familial dysautonomia, hereditary sensory and autonomic neuropathy, type III (HSAN III); a genetic syndrome of insensitivity to pain, lack of tearing contributing to corneal ulceration, dysarticulation, poor motor coordination, increased sweating, cutis marmorata (blotching or marbling of the skin), smooth tongue, and normal intelligence. The primary defect is one of the autonomic nervous system, with death often occurring before the age of 20 from respiratory complications. Incidence rates are 1 in 10,000 in Ashkenazic Jews. Inheritance patterns follow an autosomal recessive mode. Although the disease is often suspected at birth, confirmation usually is delayed until the child is older. Antibiotic treatment for recurrent respiratory infections is indicated.
Riley Preschool Developmental Screening Test: A 15-minute screening test that includes six graphomotor tests of visual perceptual and fine-motor skills in children 3-6 years of age. Standardization and validity are limited.
ring chromosome: A structural abnormality in a chromosome, in which both ends of the chromosome are deleted and the broken ("sticky") ends join to form a ring. The clinical picture varies with the amount of genetic material that is missing and the chromosome involved.
ringworm: See tinea.
RIPA: See Ross Information Processing Assessment.
Ritalin: Trade name methylphenidate.
RITLS: See Rhode Island Test of Language Structure.
ritodrine hydrochloride: Trade name Ritodrine; a beta-sympathomimetic drug used to treat preterm labor and prevent premature birth.
RLF: See retrolental fibroplasia, retinopathy of prematurity (ROP).
R/O: See rule out.
ROAD: Reversible obstructive airway disease; see asthma.
Roberts-SC phocomelia syndrome: See tetraphocomelia—cleft palate syndrome.
Robin syndrome: See Pierre Robin sequence/syndrome.
Robinow syndrome: See fetal face syndrome.
rocker bottom foot: See congenital vertical talus.
Rockford Infant Developmental Evaluation Scales (RIDES): A developmental behavior checklist for children from birth to 4 years of age.
roentgenogram: X ray, radiograph; named after Wilhelm Conrad Roentgen (1845-1923), discoverer of the medical usefulness of X rays.
role taking: The ability to put oneself in another's place; to experience his or her perspective; egocentricity describes immaturity or deficiency of role taking.
rolfing: Structural integration; manipulation of body tissue via deep massage. A form of body-centered psychotherapy that has been applied to treatment of cerebral palsy, with no proven efficacy; after Ida Rolf (1897-l979).
roll over: Gross-motor milestone of infancy; typically children roll from prone (front) to supine (back) (P→S) at 4 months of age and from supine to prone (S→P) at 5 months of age. Markedly delayed rolling over is considered a sensitive early indicator of cerebral palsy. Rolling S→P before P→S suggests the possibility of significant hypertonia (increased muscle tone).
rollator: Walker with wheels; an assistive device to aid ambulation.
ROM: See range of motion.
Rood: A system of physical therapy for treatment of cerebral palsy. Developed by Margaret Rood, a physical and occupational therapist, this approach uses exaggerated sensory input in the form of stroking, brushing, icing, heating, pounding, squeezing, and pressure to facilitate an awareness of normal movement patterns.
rooting reflex: A primitive oral motor reflex found in infants from 32 weeks gestation to 6 months of age; a tactile (touch) stimulus to the lips or cheeks causes the infant to respond by turning the head in the direction of the stimulus and reaching the mouth toward the stimulus. Because there are four possible directions (up, down, right, left), the reflex is also referred to as the four cardinal points reflex. The reflex persists longer and actually becomes stronger in breast-fed infants. This reflex is innervated by cranial nerves V, VII, XI, and XII.
ROP: See retinopathy of prematurity.
Rorschach inkblots: A projective technique developed by the Swiss psychiatrist Hermann Rorschach (1884-1922). The test consists of 10 symmetrical inkblot cards, half colored and half black and white, with the various nuances of shading. The test is administered by showing the cards one at a time in a definite order and asking the individual what he or she sees in them. After the person has responded to the inkblots in an unstructured manner (i.e., free association or performance proper period), the examiner asks questions about particular responses (i.e., inquiry period) to clarify ambiguous answers and to elicit latent repressed content. A third period (i.e., testing of limits) may be employed to further clarity any responses that remain confusing. The first step in interpreting the Rorschach record is the numerical tabulation of formal scoring categories and percentages. Records are scored for area or location, determinants, content, and popularity of responses. This composite Rorschach picture is based on the reciprocal relationship between formal structure and dynamic content. The administration and scoring of the Rorschach requires specific training and considerable practice. There are many scoring systems. In assessment batteries, the Rorschach may provide information regarding the individual's reality contact, organizational ability, affect, defenses, areas of conflict, and richness of resources. In addition, comparison of performance on more structured measures with the Rorschach may demonstrate how ambiguity affects the individual. It is important to note that most of the Rorschach data on children were derived from typical children, many of whom were above average with respect to intelligence and socioeconomic level. Rorschach responses of children tend to be brief and unelaborated. Records from children with emotional disturbances can help define problems of thought and affect and also aid in identifying specific conflict areas. When viewed from the developmental perspective of a continuum of various degrees of normality and disturbance, the task is to determine whether a long chart record represents a consolidation or a disruption of psychological and emotional growth.
roseola: Exanthem subitum; a viral illness in preschool children in which 3-4 days of very high fever are followed by a transient (i.e., subitum) rose pink rash. It has no developmental sequelae.
Ross Information Processing Assessment (RIPA): A test instrument that assesses cognitive-linguistic impairments following acquired brain injuries in adolescents and adults. It quantitates cognitive impairments, establishes severity ratings, and develops rehabilitation goals and objectives with profiles in 10 areas: immediate memory, recent memory, temporal orientation (recent memory), temporal orientation (remote memory), spatial orientation, orientation to environment, recall of general information, problem solving and abstract reasoning, organization, and auditory processing and retention.
Rosseti Infant-Toddler Language Scale: A criterion-referenced assessment scale for infants and toddlers, birth to 3 years of age, that probes multiple developmental areas: interaction and attachment, gestures, pragmatics, play, language comprehension, and language expression.
rotated ear: See pinna.
rotator cuff of shoulder: A bandlike arrangement of muscle, cartilage, and bone that holds the shoulder joint together.
ROWPVT: Receptive One-Word Picture Vocabulary Test; see One-Word Picture Vocabulary Tests.
ROWPVT-UE: Receptive One-Word Picture Vocabulary Test-Upper Extension; see One-Word Picture Vocabulary Tests.
RPBC: See Revised Problem Behavior Checklist.
R-PDQ: See Revised Prescreening Developmental Questionnaire.
RSA: See Rehabilitation Services Administration.
RSI: See Residential Services Indicator.
RTC: See return to clinic.
rubella (German measles): An acute infectious disease with low-grade fever, exanthem (rash), coryza (nasal inflammation), lymphadenopathy (swelling of the lymph nodes), and arthritis. The importance of prevention through immunization (vaccination) with live virus stems from the teratogenic (causing malformation) effects of the rubella virus (i.e., fetal rubella syndrome). Rubella is also known as "3-day" measles in reference to the typical duration of the rash.
rubella embryopathy: See fetal rubella syndrome.
rubeola: Measles; a highly contagious viral exanthem (rash) with fever, cough, coryza (nasal inflammation), conjunctivitis (eye inflammation), an enanthem (Koplik spots), and photophobia (extreme sensitivity to light). It is also known as "7-day" measles, based on the duration of the rash. Unlike German measles (i.e., rubella), rubeola is not teratogenic (causing malformation). It is, however, a much more severe illness with a 0.1% incidence of encephalitis (brain inflammation) and a 1 in 100,000 risk of subacute sclerosing panencephalitis (SSPE) (a generally fatal hardening in the brain).
Rubinstein-Taybi syndrome: A dysmorphic (atypical appearance) syndrome that includes broad thumbs and toes, a characteristic facies (downslanting palpebral fissures [eyeslits], maxillary hypoplasia [atypical midfacial development], and a beaked nose), and mental retardation. The etiology (cause) is unknown.
rule out (R/O): An abbreviation prefixed to a diagnosis or condition and indicating that tests must he or were done to assess the presence of that diagnosis. "R/O appendicitis" as an admission diagnosis suggests that the physician was concerned over that possible diagnosis. "R/O appendicitis" as a discharge diagnosis suggests that the diagnosis was not confirmed.
rumination: The regurgitation (spitting up after meals) of food or liquid that is either allowed to run out of the mouth or is rechewed and reswallowed. Originally considered a bizarre psychosomatic disorder of infancy, it is more common in people with significant mental retardation; its frequent occurrence in institutional and deprivational settings suggests that it may be a self-stimulatory behavior. Behavior modification techniques represent the most effective intervention approach. The behavior can be fatal due to chronic malnutrition.
Russell-Silver syndrome: A dysmorphic (atypical appearance) syndrome with short stature of prenatal onset, skeletal asymmetry, clinodactyly (deflection of fingers), cafe au lait spots, and a small triangular facies that contributes to a misleading impression of hydrocephalus (excess fluid in the brain) (i.e., pseudohydrocephalus). Cognition is usually normal. Etiology (cause) is unknown.
Ruvalcaba syndrome: A dysmorphic (atypical appearance) syndrome with mental retardation, "jovial" personality, peculiar facies with small mouth, short fingers, and other bone abnormalities. Etiology (cause) and inheritance are unclear.