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

sacral agenesis: A congenital malformation including absence of the sacrum and coccyx (tailbone). If the sacral nerves are involved in the bony abnormality, a neurogenic bladder will result; toilet training and gait disorders are the most commonly associated disabilities. Cognitive functioning is usually normal unless associated with a congenital malformation causing mental retardation. Children with sacral agenesis often have recurrent urinary tract infections leading to hydronephrosis (urine collection due to obstructed flow) and chronic pyelonephritis (kidney inflammation). Sacral agenesis occurs in 1% of infants of mothers with insulin-dependent diabetes. This term is often used synonymously with caudal regression syndrome.
sacrum: Tailbone; triangular bone at the base of the spine deriving from the fusion of the last five vertebrae.
Sacthre-Chotzen syndrome: Acrocephalosyndactyly type III. A genetic syndrome with craniosynostosis (premature fusion of skull sutures) leading to brachycephaly (irregular, flat head shape), maxillary hypoplasia (underdevelopment of jaw), prominent crus (an ear landmark), facial asymmetry, and syndactyly (webbing of the fingers or toes). Mild mental retardation and hearing loss are occasional findings. Early closure of cranial sutures may lead to optic nerve atrophy (wasting). The syndrome is detectable at birth, although mild cases may not he identified until later. Inheritance is autosomal dominant with variable expressivity. Treatment is primarily for correction of cranial-facial abnormalities.
sagittal plane: An anatomical plane that divides the body into a right half and left half.
salaam seizures: See infantile spasms.
salicylate: See aspirin sensitivity.
salmon patch: Small, flat reddish pink, irregularly bordered birthmarks sometimes found on the back of the neck (commonly called "stork bite" or Unna's mark), over the eyes, and on the forehead (commonly called "angel's kiss") of newborns. These marks tend to fade with time as subcutaneous (inner) tissue increases in thickness, and are of no diagnostic significance.
SAMI: See Sequential Assessment of Mathematics Inventories—Standardized Inventory.
sandal gap deformity: An increased space (more than a quarter of an inch) between the first two toes. This is a minor dysmorphic (atypical) feature that may occur with developmental disabilities either as part of a syndrome or nonspecifically.
Sandifer syndrome: The combination of reflux of gastric contents into the mouth accompanied by abnormal head cocking and neck extension/flexion movements, with esophagitis (inflammation of the esophagus) and anemia. Often misinterpreted as disordered parenting or an emotional disorder, the syndrome is secondary to a hiatal hernia and resolves upon surgical correction of the hernia.
Sanfilippo syndrome: Mucopolysaccharidosis III. A genetic syndrome with mild physical features of mucopolysaccharidosis but severe mental retardation and significant behavior management problems. Synophrys (condition in which the eyebrows grow together) is present, there are four enzymatic subtypes ( A, B, C, D); type A is the most common. Inheritance is autosomal recessive. The syndrome is detectable prenatally by enzyme assay of the chorionic villi. No curative treatment is currently available; therefore, affected individuals arc expected to have significantly shortened life spans.
Santmyer swallow: A primitive reflex in which the stimulus of a puff of air blown into an infant's face produces the response of a swallow: this reflex is present in premature infants and disappears by 2 years of age.
SBFE: See Stanford-Binet Intelligence Scale: Fourth Edition.
SCA: See sex chromosome abnormalities.
scaled score: A score on a test resulting from the conversion of the raw score to a number or position on a standard reference scale. For example, the college achievement tests are typically reported on a scale of 200-800; using this scale, a score of 600 is intended to indicate the same level of ability from year to year regardless of the form of the test used or the composition of the candidate group at a particular administration.
SCAN: See Screening Test for Auditory Processing Disorders.
scanning speech: Speech that is slow, with pauses between each syllable.
scanogram: An X ray that includes a ruler on the film so that accurate bone measurements can be made; especially useful for leg length discrepancies.
scapegoat: A family member who is held responsible for all family conflict and who takes the blame for all family distress. Over time, this member is targeted by other family members as the sole cause of all that is wrong with the family. Thus, marital conflicts, sibling rivalry, and even financial problems are described in terms of the scapegoated member's culpability for the problem. Scapegoats evolve when at least two people in a family (usually the parents) cannot openly deal with their own issues. Often the weakest member of the family is selected as the scapegoat. Therefore, a child with developmental disabilities is a likely target for becoming the family scapegoat.
scaphocephaly: A narrow skull (low cephalic index) often with a ridge along the prematurely closed sagittal suture (i.e., craniosynostosis); linked with dolichocephaly (prominent forehead), this is a common, but transient, skull shape in premature infants.
scapula: Shoulder blade.
scarf sign: A technique to evaluate tone in the newborn; the baby's hand and arm are drawn across the front of the neck as if they were a scarf. In a full-term baby with normal tone, the elbow will not pass the chin and the hand will not pass the shoulder; in a premature or hypotonic (decreased muscle tone) infant, these landmarks will be passed.
Schaltenbrandt reaction: Landau 2; a postural reaction usually included in the description of the Landau reaction. It is the phase in which head flexion produces a loss of all the extensor tone that comprises the Landau 1.
Scheie syndrome: Mucopolysaccharidosis (MPS) I-S (MPS I-S); "mild Hurler (MPS IH)." A genetic syndrome with cloudy corneas that can lead to blindness, mild growth impairment, and joint contractures, hut normal intelligence; frequently, psychotic episodes are present. The disorder is detectable at 10 weeks' gestation by enzymatic assay of chorionic villi. There is no curative treatment yet available, although surgery for joint contractures may be indicated. Formerly termed MPS type V.
schema: Theoretical abstract knowledge structures that organize familiar experiences and provide a framework for making inferences. A schema is a hierarchically organized description of classes of concepts and their interrelations. At the top of the hierarchy is a general schema that incorporates all aspects of the concept class, including both an abstraction and a conceptual frame of reference for all events within this area. For example, in a schema for going to a restaurant, the highest and most abstract level is a stereotype that encompasses everything known about restaurants. Embedded in this highest level are more specific schemata. The restaurant schema, for instance, may organize information about gourmet restaurants, cafes, and fast-food chains. As one moves down the hierarchy, the number of embedded schemata increases at each level, each becoming narrower in scope. At the lowest level are specific perceptual events such as yesterday's lunch at the hot dog stand. Because a schema includes the relations among its component parts, elements are understood in context. Thus, the idea of escargot, for example, would be sufficient to rule out the possibility of a fast-food chain. According to this theory, thinking, reasoning, and problem solving do not occur in a fixed sequence from top to bottom or bottom to top in the hierarchy. Rather, top-down and bottom-up processes are interactive; when there are gaps at one level, information can frequently he supplied from another. In a narrower Piagetian sense, schema are the sensorimoror equivalents of concepts.
Schema Theory Reading Model: A construct that envisions the process of reading as requiring the simultaneous coordination of schema at all levels. Bottom-up processes (visual features) may lead to higher-level schemata (letters) and then to even higher-level schemata (words), and the process continues upward. At the same time, higher-level schemata are evoked by information from the print. These higher-level schemata structure readers' expectations and enable them to rill in gaps in specific information in a top-down manner. Reading, like other forms of thinking, docs not occur in a fixed sequence. The interaction of top-down and bottom-up processes enables children who have difficulty with decoding to use higher-level knowledge to compensate and make guesses about unknown words on the basis of their prior knowledge and context clues.
Scheuthauer-Marie syndrome: See cleidocranial dysostosis.
Schilder Arm Extension Test: The child stands at attention, eyes closed, feet together with arms stretched out in front for 20 seconds. Spooning, choreiform (involuntary twitching) movements, swaying, or drifting of the arms is noted. The head may be passively turned to one side of the trunk to further assess balance.
Schimmelpenning-Feuerstein-Mims syndrome: The association of mid-facial linear nevus sebaceus of Jadassohn with epilepsy and mental retardation. Diagnosis is made at birth. Inheritance patterns are unclear, but evidence suggests an autosomal dominant pattern. Treatment is cosmetic for the nevus, with pharmacological management for the seizures.
Schinzel-Giedion syndrome: A genetic syndrome with growth deficiency, profound mental retardation, seizures (hypsarhythmia [a continuous disorganized pattern of high-voltage slow waves and spikes]), spasticity (increased muscle tone), a peculiar facies, vision and hearing impairments, and kidney disorders. Inheritance is thought to be autosomal recessive. Death usually occurs in the first 2 years of life.
schizencephaly: An anomaly in cortical architecture (the rind [or outer crust] of the brain) characterized by clefts in the brain tissue that run from the surface of the brain to the ventricle. The tissue around the clefts is hypoplastic (underdeveloped) and arranged in a symmetrical fashion. Schizencephaly may be mistaken for porencephaly, which is damage to the brain with cavity formation replacing brain tissue. Unlike the clefts in schizencephaly, a porencephalic cyst may or may not abut the ventricular system. Depending on the location of the clefts, children with schizencephaly may show a variety of neurological abnormalities including cerebral palsy, mental retardation, hypotonia (decreased muscle tone), spasticity (increased muscle tone), hemiparesis (one-sided paralysis), tetraparesis (paralysis of all four extremities [arms or legs]), microcephaly (abnormally small head), or seizures. Schizencephaly does not produce hydrocephalus (excess fluid in the brain).
school phobia: Fear of school. The child who exhibits school phobia is usually not afraid of school, but rather of what might happen at home while the child is away at school. (For example, a parent might leave and not come back or a depressed parent might commit suicide.) The child wants to stay home to prevent these occurrences, although the basis of the fear is not always conscious. There is no specific term to describe the anxiety and fear related to school that occurs in a child who is being bullied or is failing academically. Biological psychiatry successfully treats these cases with antidepressants.
scissoring: A posture of the legs in which the legs tend to assume a crossed position with extension at the knees. This is typically a sign of increased tone in the lower extremities or tight adductor muscles. It is common in spastic cerebral palsy, especially diplegia (paralysis on both sides of the body). An increasing tendency to scissor will make an ambulatory child trip more frequently over his or her own feet and contribute to hip instability. An adductor tenotomy (with or without an obturator neurectomy) is an orthopedic surgical procedure that will help correct the scissoring. Also called Forster sign.
sclera: The white of the eye. The sclera will become yellow in the presence of jaundice (yellowing of the skin), remain white with carotenemia (yellowing of the skin due to excess carotene, rather than bilirubin, in the blood), and develop a bluish tinge in a variety of systemic diseases.
scoliosis: An abnormal lateral (side to side) curvature of the spine (vertebral column). Curves may be C-shaped or S-shaped. The etiology (cause) of scoliosis may be idiopathic (with strong genetic or familial influences), congenital (defective formation of the vertebrae, possibly associated with other anomalies (malformation, deformation, disruption, or dysplasia) or a recognizable genetic syndrome), or neuromuscular disorders. Scoliosis on a neuromuscular basis worsens even after growth is complete; this puts these people at increasing risk for respiratory infection and cardiopulmonary compromise.
scooting: Locomotion in sitting; a rare pattern of locomotion that may reflect motor disability, mental retardation, severe psychopathology, or some combination of these.
scotopic sensitivity syndrome: A group of visual distortions relating to light sensitivity, resolution, attention, and perseverance grouped together on the basis of two arbitrary principles: 1) being distinct from visual-perceptual processing and peripheral/central visual field problems, and 2) being susceptible to remediation by the use of tinted lenses or filters. The syndrome remains a hypothetical entity, unproven and highly controversial; ophthalmology does not accept it even as a theoretical possibility. See also Irlen lenses.
SCPNT: See Southern California Postrotary Nystagmus Test.
SCREEN: See Screening Children for Related Early Educational Needs.
screening: The presumptive identification of unrecognized disease or defects by the application of tests, examinations, or other procedures that can he applied rapidly, inexpensively, and often by personnel with a lower level of training than that required to make a definitive diagnosis. A first step in diagnosis, screening is a form of secondary prevention. Screening requires diagnosis prior to the initiation of therapy or other intervention. Screening is applied only to asymptomatic (without symptoms) populations. Thus, when a parent has concern about a child's development, the child is not asymptomatic and should not be screened but assessed. If a screening test or procedure is used for this assessment, it is not being used as a screening test.
Screening Children for Related Early Educational Needs (SCREEN): An educational screening test for current or potential school problems in children 3-7 years of age. The four subtests take approximately one-half hour to administer.
Screening Kit of Language Development (SKOLD): A screening assessment of preschool language development for 2- to 5-year-old children in six areas: vocabulary, comprehension, story completion, individual and paired sentence repetition without pictures, and comprehension of commands. Administration time is 15 minutes. The test is norm referenced both for children who speak black English and for those who speak standard English.
screening test: An instrument that distinguishes apparently well people who probably do not have a specific disease or condition from those who probably do have the condition. The validity of a screening test is measured by its sensitivity, specificity, false positive, and false negative rates. Bayesian analysis suggests that the prevalence of the disorder screened for in the population under consideration has a significant impact on a screening test's validity. An example of a medical screening test is the tuberculin skin test for tuberculosis. The difficulties of achieving definitive developmental diagnoses in infants and young children are multiplied in developmental screening. The dividing line between diagnostic and screening tests is not fixed; a test used as a screening instrument in one context may be diagnostic in another context.
Screening Test for Auditory Processing Disorders (SCAN): A test of auditory processing in children ages 3-11 years. The SCAN yields three subscores: filtered words, auditory figure-ground, and competing words. The SCAN is administered with a portable stereo-cassette player.
Screening Tests for Young Children and Retardates (STYCAR): Block letters, miniature toys, and graded balls arc used to screen vision; noisemakers, toys, and pictures are used to screen hearing in children as young as 6 months of age. These clinical procedures were developed by Mary Sheridan, an English pediatrician, as especially appropriate for usage with children who have physical and cognitive limitations. These vision and hearing rests are part of a more comprehensive approach to screening referred to as the STYCAR sequences, which describe children's developmental progress from birth to 5 years.
SD: See standard deviation.
SDCT for Children and Adults: See Slosson Drawing Coordination Test for Children and Adults.
SDRT: See Stanford Diagnostic Reading Test, Third Edition.
Seckel syndrome: Bird-headed dwarfism. A genetic syndrome with short stature, microcephaly (abnormally small head), mental retardation, and a "bird" facies (e.g., protuberant beaked nose, thin face, sloping forehead, and prominent eyes). Inheritance is autosomal recessive. Detectable at birth, the syndrome has been picked up prenatally by serial ultrasound. There is currently no available treatment.
second signaling system: One of two phylogenetic lines used by Ivan Pavlov (1849-1936) to describe brain function: 1) the first signaling system, which is the animal part of the brain that uses direct sensory perceptions; and 2) the second signaling system, which is the human division that uses intellect with an emphasis on language. These levels are somewhat analogous to Sigmund Freud's (1856-1939) primary and secondary process thinking.
secondary gain: The advantages experienced through being ill, such as being pampered and cared for, and getting out of school or other work responsibilities.
secondary process: A psychoanalytic term that refers to logical, controlled thinking with minimal affective components; conscious intellectualization. Secondary process thinking is also characterized by delay or postponement, unlike the immediate discharge or gratification seen in primary process thinking. The second signaling system identifies language as the principal component of rational control; see also second signaling system.
SED: See seriously emotionally disturbed.
sedative: A calming agent; a drug that allays nervous excitement.
SEE₁: See Seeing Essential English.
SEE₂: See Signing Exact English.
Seeing Essential English (SEE₁): A manual sign language modification of American Sign Language (ASL) to resemble English; signs stand for English prefixes, roots, suffixes, and verb tenses. English syntax (grammar) is emphasized; words are represented by the American sign word plus affixes (suffixes or prefixes) as needed.
segmental rolling: The mature phase of derotative righting in which the infant rolls over with one body segment preceding another or in a "corkscrew" fashion.
Seguin Formboard: A puzzle that requires the correct placement of 10 distinct geometric shapes in the matching hole in the test surface. One of a variety of different formboards designed for training and later used for testing purposes, the Seguin Formboard has been used frequently to assess the presence of higher-level visuomotor problem-solving skills in young children with autism. Many such children between 3 and 6 years of age exhibit superior timed performances on this specific type of puzzle; this usually represents a splinter skill common in autism. The Seguin Formboard can also be administered with the subject blindfolded as a measure of tactile (touch) form recognition, memory for shapes, and spatial location. Sometimes referred to as the Seguin-Goddard Formboard.
seizure: A convulsion or epileptic attack. Epilepsy is a form of recurrent chronic seizures. A seizure is characterized by a paroxysmal burst of electrical activity in the brain that is clinically manifested by unconsciousness or impaired consciousness usually with rhythmic movements of the extremities (arms or legs) and/or other atypical behaviors. The etiology (cause) of seizures may be identified as idiopathic (unknown). Seizures of known organic etiology are more likely to be associated with abnormalities and specific genetic conditions. Seizures are classified as partial, generalized, and unclassified based on the seizure type. Combinations of seizure types that commonly occur together arc termed epileptic syndromes. Diagnosis and treatment typically require a clinical history of the event and a corresponding abnormal electroencephalogram (EEG). Treatment with anticonvulsant medication is based on age and seizure type.
selective posterior rhizotomy: A neurosurgical ablative procedure to eliminate spasticity (increased muscle tone) in spastic cerebral palsy by destroying the reflex arc at the level of the dorsal root of the spinal cord. The operation is characterized as selective because only nerve rootlets that demonstrate an exaggerated electromyographic response on stimulation are cut. This operation is relatively new and is still controversial.
self-concept: An evaluation an individual makes and strives to maintain with regard to him- or herself. Self-concept includes the thoughts, attitudes, characteristics, feelings, and behaviors a person considers vital to who he or she is. Self-concept is a fundamental issue for everyone, but it is especially important for people with disabilities. There are two issues that must be considered: 1) How the person views him- or herself (i.e., how the person integrates his or her particular disability and the "disabled" concept into the total self-concept); and 2) how the person feels that his or her disability is regarded by others on personal, social, and cultural levels.
self-esteem: An individual's perception and valuation of him- or herself when compared with a particular reference group. Having a "disability," requiring "special education," and experiencing "failure" in "typical" situations can negatively affect a child's self-esteem. Self-esteem can be enhanced by the experience of success in any of a range of areas. Realistic awareness of specific strengths and limitations, positive relationships, and the use of an appropriate reference group to whom the individual can fairly and accurately compare him- or herself can promote positive self-esteem.
self-help group: See support group.
self-injurious behavior (SIB): Self-inflicted repetitious and chronic behaviors that can cause physical harm and tissue damage to the person performing these behaviors. The behaviors, which appear dysfunctional and devoid of desirable consequences, can include face slapping, head hanging, biting, pinching, scratching, gouging of the self, rumination, pica, and coprophagia (eating feces). The behaviors are stereotyped, self-stimulatory, and most common in individuals with severe mental retardation. They occur more frequently in specific syndromes (e.g., Lesch-Nyhan), but they are also common in the absence of meaningful ways for an individual to communicate. Behavior modification, drugs, and protective devices (e.g., helmets) are the mainstays of therapy. Significant acquired brain injury is rare, but permanent eye damage can occur.
self-monitoring: Recording one's own behavior in order to effect change. The process of self-monitoring first involves recognition of the need to regulate or change a specific behavior (e.g., negative comments, time off task, talking out). The behavior to be changed must be measured against a standard, often defined by determining a baseline (data collected on a behavior before any intervention occurs). This phase may require another person to collect the data. The individual then keeps a record of the occurrence of the targeted behavior. Self-monitoring may be combined with self or external reinforcement; however, in some cases, the act of record keeping alone has been effective. Studies regarding the long-term effects of this change have been inconclusive.
self-stimulatory behavior: Persistent, highly repetitive, invariant motor actions, mannerisms, or sequences that have no recognizable purpose and are not injurious to the individual. They include such stereotypies as hand flapping and rocking; if they become harmful to the subject, they are reclassified as self-injurious behavior.
semantic memory: Conceptualized by memory theorists as the memory component containing the most knowledge of the world (word definitions, names of presidents, etc.). The most obvious fact about this memory component is that it is highly organized, as shown by the ability to quickly recall one relevant bit of information from the millions stored. The form of this organization is not clear, hut a network model with concepts and categories playing key roles seems likely. For example, terriers and spaniels are both members of the dog category, which is a member of the mammal category. Information may he initially encoded in episodic memory ("The dog 1 saw yesterday at the beach was a spaniel") before becoming part of the semantic network. The organizational structure of semantic memory is similar to that described in the construct of declarative information.
semantics: The study of the history and meaning of words. Knowledge of semantics involves understanding the way in which meaning is associated with words as well as how meaning is conveyed through sentences. Knowledge of vocabulary refers to a part of semantics that relates to the ability to understand and use the meaning of the independent word. For example, to use the word ball in a coherent sentence requires particular semantic knowledge. The ball threw the boy" is syntactically correct hut semantically impossible. Semantics also extends to broader contexts. For example, the meaning of "The fan is loud" is conveyed by previous reference to a spectator at a ball game or to a mechanical device. Some aspects of semantics have been associated with simultaneous processing.
semiotics: The signs and gestures that accompany verbal language. The signs and gestures may clarity or disqualify the verbal communication.
sensation: The most fundamental level of receptive behavior. Sensation refers solely to the activation of sensory-neural structures. Impairments at this level include deafness, blindness, and other peripheral (noncentral) nervous system impairments. Sensation contrasts with perception, which is the interpretation or processing of sensory information. Mild disorders in sensation can often be compensated for by the perception operations of the brain.
sensitive period: A period of time in the organism's development when conditions arc optimal for the emergence of a specific function. Missing this temporal window of opportunity does not preclude the later evolution of this function, but renders it more difficult. It would seem almost impossible to distinguish whether the difficulty in later achieving a missed milestone is due to having passed the sensitive period or whether it reflects, instead, the continued or long-term impact of those very factors (organismic or environmental) that caused the milestone to he missed in the first place. The sensitive period is to be contrasted with critical period.
sensitivity: An epidemiological term denoting a true positive rate. Sensitivity is a statistic that describes the ability of a screening test to successfully identify those tested who actually have the condition for which they arc being screened. Sensitivity is the ratio of true positive (positive test result, condition present) to all positive test results (whether the condition is present or true positives plus false positives). The closer this ratio is to 1.0, the better the screening test.
sensorimotor: Relating to the use of sensory information (including visual, auditory, tactile [touch], olfactory [smell], proprioceptive, and kinesthetic) to produce an adapted (purposeful, goal-directed) motor response.
sensorimotor: The earliest Piagerian stage of cognitive development; six substages during the first 2 years of life demonstrate increasing structuring of motor responses to immediately perceived objects.
sensorineural hearing impairment (SNHI): Also termed sensorineural deafness; a hearing impairment in which the abnormality is located along the auditory nerve (cranial nerve VIII) from the inner ear to the brain stem. This can be caused by a congenital abnormality in the nerve, by damage to the nerve (e.g., from certain antibiotics such as gentamicin [brand name, Garamycin]), or by diseases such as Friedreich ataxia. Many syndromes can he associated with a sensorineural hearing loss that may be static or progressive. Frequent monitoring of hearing acuity is necessary in individuals with progressive hearing loss to keep their hearing aids functioning effectively.
sensory function: Neurological screening tests of sensation. These include a pinprick to test for pain sensation, light touch, temperature, position sense, vibration, stereognosis (solid form recognition by touch), graphesthesia (recognition of items written on the skin), and two-point discrimination. Sensation requires that both the central and the peripheral nervous systems he intact. Riley-Day, or familial dysautonomia (hereditary disease of the autonomic nervous system), is a condition in which affected members cannot feel pain. Asymmetric brain lesions may result in the loss of sensation on one side only.
sensory integration: The neurological process that organizes sensation from one's own body and from the environment and enables one to use the body effectively within the environment. The spatial and temporal aspects of inputs from different sensory modalities are interpreted, associated, and unified. The brain selects, enhances, inhibits, compares, and associates sensory information in a flexible, constantly changing pattern.
Sensory Integration and Praxis Tests (SIPT): A battery of 17 performance (nonverbal) tests to assess the relationships among tactile (touch) processing, vestibular-proprioceptive processing, visual perception, visual-motor coordination, practice ability, and bilateral integration and sequencing in children 4-8 years of age with moderate learning, behavior, or developmental irregularities. Administration time is 1.5 hours, with computer scoring to compare patterns in six different cluster groups: deficit in bilateral integration and sequencing, visuo- and somatodyspraxia, dyspraxia on verbal command, generalized sensory integrative dysfunction, low-average sensory integration and praxis, and high-average sensory integration and praxis. This is a 1989 revision of the 1972 Southern California Sensory Integration Tests.
sensory integration theory: A theory of brain behavior relationships that attempts to explain deficits in interpreting sensory information from the body and the environment, and deficits in academic or neuromotor learning in people with learning disabilities or clumsiness. The theory has a specific battery of assessment instruments and a menu of intervention techniques for a wide variety of developmental disorders. The founder of sensory integration theory was A. Jean Ayres (1920-1988).
sensory register: A construct hypothesized by memory theorists to store information from the sensory receptors (rod and cone sensitivity to light, middle-ear bone sensitivity to sound, proprioceptor cells sensitivity to touch, etc.) in the central nervous system. It is usually assumed that there are as many sensory registers as there are sense modalities, each being modality specific. Most stored information fades quickly, with the temporal duration of auditory information (approximately 2 seconds) generally lasting longer than that for visual information (about 0.5 seconds). From the immediate representation of sensory information, a small fraction is kept for continued representation in short-term memory, while the rest is lost from the system. Although the sensory register is the first stage of the hypothetical construct, it is not often tested or considered outside of laboratory settings.
sentence completion technique (Rotter): A projective measure that is an extension of the word association test. The subject is presented with incomplete sentences and is asked to complete them. Examples include: "I worry about ..." or I am happy when ..." The sentences are typically analyzed in terms of the attitudes, concerns, and motivations expressed in the responses. Caution must be exercised when analyzing responses from people with developmental disabilities. The length and quality of responses can be significantly affected by language impairment, processing problems, and attention deficits.
separation anxiety: Childhood anxiety caused by actual or threatened separation from mother; a positive sign of the presence of attachment or bonding. It becomes prominent late in the first year of life around the same time as stranger anxiety, from which it is distinct. Although separation anxiety may recur briefly on the first day of school, it is distinct from the more pathological school phobia.
sepsis workup: A battery of tests (microbiological, hematological [pertaining to the blood and blood-forming tissues], chemical, and others) to identify the presence and nature of an infection (i.e., sepsis); the particular battery of tests varies with the age of the child and the nature of the presenting signs and symptoms. Infections in premature babies and young infants can be nonspecific and so quickly life-threatening that sepsis workups are more frequent in this pediatric age group and are often performed simultaneously with the initiation of antibiotic treatment for a yet-undiagnosed infection. If cultures and other test results are negative after several days, therapy may he discontinued. The child suspected of having an infection is referred to as "septic" or "ill-looking"; this does not require fever but may include lethargy and anorexia (loss of appetite).
septo-optic dysplasia: De Morsier syndrome. A syndrome including abnormal development (i.e., agenesis [absence of formation] of the septum pellucidum (a membrane separating the anterior [front] portions of the lateral [outside] ventricles [fluid-containing spaces] of the brain), optic nerve hypoplasia (underdevelopment resulting in severe visual impairment, and growth hormone deficiency with short stature and sometimes other hypothalamic pituitary endocrine dysfunction. Many people with this syndrome have no associated limitations, but a wide spectrum of neurodevelopmental disabilities can be present. Endocrine follow-up with replacement hormone therapy can he beneficial.
sequela, pl. sequelae: A morbid condition that follows as a consequence of another disease or condition; the original condition is a cause of the sequelae, which are effects. For example, mental retardation, deafness, and cardiac disease are possible sequelae to prenatal rubella.
sequence anomolad: A pattern of multiple anomalies (malformation, deformation, disruption, or dysplasia) derived from a single prior anomaly or mechanical factor. The term sequence implies greater understanding of the impact of the initial event or subsequent formation than a syndrome.
Sequenced Inventory of Communication Development-Revised (SICD-R): A scale of expressive and receptive language milestones for children 4 months to 4 years of age. The instrument, which is part parent interview and part child performance, evaluates receptive items of awareness, discrimination, and understanding and expressive items of imitation, initiating, responsiveness, and verbal output. It is grossly scored in 4-month increments; however, standardization figures are available.
Sequential Assessment of Mathematics Inventories-Standardized Inventory (SAMI): An individual test of mathematics achievement for children from kindergarten through eighth grade. The 243 items assess eight curriculum strands: mathematical language, measurement, ordinality, geometric concepts, number and notation, mathematical applications, computation, and word problems.
sequential processing: The manipulation or processing of stimuli one at a time, with each idea linearly and temporally related to the preceding stimulus. Both verbal and nonverbal information may be processed sequentially when the order of the stimuli is necessary for extracting meaning or problem solving. Sequential processing is related to a variety of school-oriented tasks including memorization of number facts, applying step-wise mathematical procedures, phonics, spelling, grammatical relationships and rules, chronology of historical events, and following directions. The Kaufman Assessment Battery for Children (K-ABC) is based on the concept of sequential versus simultaneous information processing.
serial casting: A sequence of casts used to progressively correct a deformity; each successive cast positions the body part closer to the desired norm.
seriously emotionally disturbed (SED): An educational condition including impaired learning, unsatisfactory interpersonal relationships, inappropriate behaviors, depression, and physical symptoms related to school.
serous otitis media: Otitis media with effusion (OME), catarrhal otitis, secretory otitis media, nonsuppurative otitis media, mucoid ear, glue ear. A middle-ear effusion (fluid collection) as evidenced by visual and tympanometric findings and without the signs and symptoms of acute otitis media (e.g., fever, pain).
service coordination: Term previously referred to as case management. PL 101-476, the Individuals with Disabilities Education Act (IDEA) of 1990, renamed this service provided to people with disabilities and their families. See case management.
Serum Multichannel Analysis (SMA): A battery of blood tests performed on one specimen. SMA is followed by a number indicating the number of electrolytes and other blood chemicals being measured.
SES: See socioeconomic status.
setting sun sign: Deviation of the eyes below the horizontal so that the white of the sclera is visible above the cornea. This finding can be a sign of progressive hydrocephalus (excess fluid in the brain).
severe mental retardation (SMR): Mental retardation in which the IQ level is between 20 and 40. Adults with SMR arc typically independent in self-help skills and can live in supervised group home settings in the community.
severe and profound mental retardation (SPMR): A grouping of people with severe mental retardation (IQ level between 20-25 and 35-40) and people with profound mental retardation (IQ level below 20 or 25) for purposes of education and habilitation. One can also see references grouping people without mental retardation but with severe to profound handicaps (SPH) together with people with mental retardation as SPH/SPMR.
sex chromosome: The chromosomes responsible for the determination of sex (XX in females, XY in males).
sex chromosome abnormalities (SCA): A group of chromosomal disorders involving abnormal numbers of X and Y chromosomes (i.e., the sex chromosomes). This group includes both monosomies (e.g.. Turner syndrome [XO]), with only one X chromosome instead of the normal two [XX], and polysomies (e.g., Klinefelter syndrome [XXY]), which have an extra X or Y chromosome. Other variations are multiple X chromosomes (e.g., trisomy X [XXX or XXXY]), tetrasomy X (XXXX or XXXXY), and multiple Y chromosomes (XYY). In general, abnormal numbers of sex chromosomes are associated with milder cognitive and behavioral effects than with other chromosomal abnormalities. Nonetheless, the trend is that individuals with greater numbers of chromosomes have lower cognitive functioning.
sex-influenced: A trait that, although not X-linked in its inheritance, is nonetheless expressed differently (either in the extent or frequency of expression) in males and females.
sex-limited: A trait that is expressed in only one sex, even though the gene may be present in the other sex. Sex-limited genes are not necessarily X-lmked.
S-FRIT: See Slosson Full-Range Intelligence Test.
SGA: See small for gestational age.
shagreen patch: A skin lesion found in tuberous sclerosis: a patch of thickened, raised, green/gray/brown skin in the lumbosacral region (lower back).
shaken baby syndrome: Caffey syndrome, Caffey-Kempe syndrome. A type of child maltreatment with intracranial injury and long bone fractures that represents an important masked presentation of child abuse. When an infant is violently shaken, flailing of the limbs causes metaphyseal lesions (X-ray irregularities at the growing ends of long bones), and shaking of the head causes subdural bleeding and retinal (eye) hemorrhages (bleeding).
shaping: A term from behavioral learning theory referring to the process of gradually changing a person's behavior by reinforcing progressively closer approximations of the desired behavior. For example, a student who is seldom in his seat more than 3 minutes at a time might be reinforced for progressively closer approximations of the target behavior of staying in his or her seat for 20 minutes. First, the student would be reinforced for staying in his or her seat for 3 minutes, then 4, then 5, and so on until the student reaches the target of 20 minutes.
sheltered employment: A protected, monitored work environment for people with developmental disabilities (and other cognitive or physical impairments). Work programs are based on an individual's capacity to produce rather than an external production standard. Thus, one worker may produce 5 units per hour and another 25 units per hour, yet each is producing at his or her maximum capacity.
sheltered workshop: A specialized work setting for people with developmental disabilities. Workshops provide employment based on the person's ability to produce, rather than on a competitive employment model. Levels of performance are measured against a competitive productivity standard. However, a person whose productivity is maximized at 10% of such a standard is rewarded for producing at his or her maximum, and is not penalized for inability to meet normative production standards.
short bowel syndrome: Any malabsorption condition that results from loss or resection of significant lengths of small intestine; symptoms can include diarrhea, poor growth and nutrition, and fatty stools.
short leg brace: A brace extending from just below the knee to the foot.
short-term memory: A hypothesized component of memory with the function to receive information from a sensory register. This information corresponds roughly to awareness. It is also called working memory. The term short-term memory emphasizes the duration of information, whereas the term working memory emphasizes the function. Two key characteristics usually associated with short-term memory are the fragility of storage and an extremely limited capacity. Unless it is rehearsed, information passes out of short-term memory in about 10 seconds. A slight distraction will cause the information to be lost sooner. Approximately seven chunks of information can be held in short-term memory at one time. A chunk may be described as the highest-level integration of stimulus material available to an individual. For example, 346 represents one chunk while 3-4-6 represents three. In students with learning problems, it may be difficult to discriminate between deficits in attention and deficits in short-term memory, as either can appear as a lack of ability to accurately retain information for immediate recall. The normally limited capacity also plays a part in reading and mathematics disabilities. If decoding skills or mathematics facts are not learned automatically, they "take up space" in working memory that would otherwise he utilized for comprehension or problem solving. Thus, providing an aid to working memory (e.g., a number chart, number line) can allow some students to utilize their intact conceptual skills. See also memory.
Shprintzen syndrome: A genetic syndrome including cleft palate, congenital heart disease, and a peculiar facies (long face, prominent nose, and micrognathia [small jaw]) leading to the synonym velo-cardio-facial syndrome. Mental retardation is uncommon, but the syndrome exhibits a striking learning disability and personality profile. Inheritance is autosomal dominant with recurrence risk of 50%. Treatment is special education for language and cognitive impairments.
shunt: A surgical anastomosis or artificial passage, See also ventriculoperitoneal (VP) shunt.
SI: See social intelligence.
sialorrhea: Excessive drooling; unintentional loss of saliva and other oral contents from the mouth. Some normal drooling can persist until 18 months of age.
SIB: See self-injurious behavior.
sibling: A brother or sister. One of two or more children with the same mother or father. When a family includes a child with a disability, siblings often feel left out owing to the attention and "special treatment" the child with a disability requires and receives. Research suggests that parents of children with developmental disabilities often place increased demands on their other children. Siblings may be expected to help care for the child with a disability and to subordinate their needs and feelings to those of their sibling. These children may feel guilty over their lack of a disability and pressured to excel and to be "perfect" in order to compensate for their sibling with a disability. Other possible reactions include behavioral acting out and single-handedly "solving" problems. Young siblings of children with disabilities may mistakenly think they are at risk of developing the-same disability. Sibling support groups to address many of these issues are available for selected disorders.
sibling rivalry: Competition among children of the same generation in a family for parental attention, approval, recognition, and affection. The quality of sibling relationships helps to determine the degree to which individuals will have successful interpersonal relationships later in life. A weakness, special need, or disability can complicate and alter this typical developmental process, making the competition one-sided, cruel, unfulfilling, or ineffective, it can create negative feelings (e.g., guilt, shame, anger) that hinder growth. Siblings of children with developmental disabilities have a unique perspective on and experience of themselves as well as their families. This perspective must be identified and addressed to facilitate optimal individual development and family functioning. Groups and organizations for siblings exist for these purposes.
sibship: A group including all of the brothers and sisters (siblings) in a family. This is an important grouping for determining the mechanism of transmission of a genetic disorder. For example, a disorder in a family with normal parents but two affected siblings is probably recessive.
sicca cell therapy: Implantation by injection of fetal sheep brain cells to promote brain growth and improve intelligence; an unproven and hazardous intervention in Down syndrome and mental retardation.
SICD-R: See Sequenced Inventory of Communication Development-Revised.
sickle cell anemia: An autosomal recessive disorder that is common in African American and Mediterranean populations. It is caused by a gene base-pair substitution that produces a type of hemoglobin (oxygen-carrying red blood cells) that does not bind oxygen well. In the disease, the red blood cells assume a sickle shape that can cause a stroke by blocking blood flow through the vessels. Such brain damage can produce loss of function in the form of hemiparesis (one-sided paralysis), aphasia (loss of language skills), or even mental retardation. The sickling can also cause pain (called a sickle crisis) and swelling of the hands or feet. Children with sickle cell anemia are prone to infections.
sidelying: A posture in which a person lies on the right or left side with the legs slightly bent; a variety of cushions or pads are sometimes used to help maintain this posture.
sight word: Recognition of a whole word based on the memory of the whole word. This is in contrast to the phonetic (representing sounds) sequential analysis of a word.
sign: An objective, atypical, physical marker or symptom of a condition or disease; a finding that is objectively measurable or localized (e.g.. fever can be a sign of infection or other disease). Signs are usually detected on the physical examination of the individual, but some signs are found on laboratory or radiological examination.
signed English: Siglish, pidgin sign English. A sign system that shares some of the characteristics of American Sign Language and some of English, effectively reducing the grammar employed from each.
Signing Exact English (SEE₂): A sign language system in which signs represent words instead of word roots, as in SEE₁. Prefixes and suffixes are added when necessary.
sign systems: Manual communication systems used by people with severe and profound hearing loss. A sign system may have its own structure and syntax (grammar), or may use that of another language. Signs can be either phonetic (representing sounds), idiographic (representing ideas, or pictographic (representing objects). Sign systems in use include American Sign Language, manual English, signed English, SEE₁, and SEE₂.
Silver syndrome: See Russell-Silver syndrome.
Silverskiold test: An orthopedic examination to differentiate whether limited dorsiflexion (upgoing movement of the toes) at the ankle is due to gastrocnemius (muscle in the lower leg) contracture or to gastrocnemius and soleus (muscle in the calf) contractures. If foot dorsiflexion is greater with the knee flexed than with the knee extended, the gastrocnemius is the main site of the contracture. In the latter condition, orthopedic surgical treatment of equimus (an involuntary foot extension) deformity of the foot involves a transplantation of the heads of the gastrocnemius muscle; if the equinus deformity persists regardless of the position of the knee, then a tendon lengthening is in order.
simian crease: A single transverse palmar crease instead of the more common pattern of two incomplete palmar creases. This is a minor dysmorphic (atypical) feature that occurs (at least unilaterally) in approximately 50% to 55% of people with Down syndrome, in approximately 0.4% - 10% of people without disabilities, and with variable frequency in a variety of other syndromes and throughout the spectrum of neurodevelopmental disorders.
similar sequence hypothesis: A theory that people with mental retardation and those without mental retardation traverse the same stages of cognitive development but at different rates and with final attainment of different stages.
similar structure hypothesis: A theory that, when matched for mental age, people with mental retardation and those without mental retardation solve problems in the same way (with regard to the underlying formal cognitive structures).
similarities: A Wechsler intelligence scale-verbal subtest consisting of 14-20 pairs of words for which the child must explain how the items in each pair are alike. The subtest measures verbal concept formation that can be an effortful process or can also reflect well-automatized verbal conventions. Categorizing and capturing an abstract concept in a couple of words that form a category require simultaneous processing recall skills and language facility. The subtest is discontinued after three consecutive failures. Example: "How are oil and electricity alike?" Reliability and validity coefficients are contained in the WISC-III manual.
simple partial seizure: A seizure type with unilateral hemispheric involvement resulting in focal or localized symptoms, including motor, sensation, or psychic characteristics. Consciousness is unimpaired during a simple partial seizure. Simple partial seizures may evolve into generalized seizures or complex partial seizures. Partial seizures arise from a specific locus (area) in the brain, and the symptoms manifested are related to that location. For example, abnormal electrical seizure activity in the motor cortex around the arm produces a twitching of that arm. Treatment includes use of one of the following anticonvulsants: carbamazepine (Tegretol), phenobarbital, valproic acid (Depakene), phenytoin (Dilantin), or primidone (Mysoline).
simultaneous processing: The manipulating or processing of many stimuli or aspects of stimuli at the same time in a holistic fashion. Both verbal and nonverbal stimuli may be processed simultaneously when the meaning or solution requires the input to be integrated and synthesized at once, rather than one step at a time. Simultaneous problem-solving skills are related to a variety of academic skills including deriving meaning from pictures and other visual stimuli, number shapes, basic arithmetic concepts, and more complex mathematical principles, shapes of letters, configuration of words, understanding main ideas, diagrams, flowcharts, and creative problem solving. The Kaufman Assessment Battery for Children (K-ABC) is based on the concept of simultaneous versus sequential information processing.
single gene disorder: A disorder produced by a single mutant (changed) gene with a large effect on phenotype (appearance).
single photon emission computed tomography (SPECT): A procedure using gamma-ray emission isotopes to measure regional blood flow in an area of the brain.
single umbilical artery: The umbilical cord typically has two arteries and one vein (three vessels); when there are only two vessels (and one umbilical artery), there is a significant association with a variety of major organ malformations. The presence of three vessels is ascertained when the cord is cut.
sinus: A recess, cavity, or channel; often used synonymously with a collection of skull cavities (paranasal sinuses: frontal, ethmoidal, sphenoidal, and maxillary) that are subject to allergic inflammation and secondary infection (i.e., sinusitis) and contribute to sinus headaches.
SIPT: See Sensory Integration and Praxis Tests.
sit: gross-motor milestone of infancy; there are three distinct phases in the achievement of sitting: 1) tripod sitting with anterior (front) propping at 5 months, 2) sitting unsupported with lateral (outside) propping at 7 months, and 3) mature sitting with posterior (back) propping at 9 months. Failure to achieve sitting by 1 year of age suggests the presence of cerebral palsy or other motor disability; failure to achieve sitting by 2 years of age suggests that the child will never walk independently. Long sitting is sitting with the legs straight out in front. Cross-legged sitting is sitting with the knees flexed and the legs crossed in front. Side sitting is sitting with the legs and thighs flexed to the same side. Between-heel sitting is the reversed tailor position.
SIT-R: See Slosson Intelligence Test-Revised.
sitting in air: A descriptive phrase applied to the posture assumed by a very young infant attempting to elicit a positive support response.
Sjogren Hand Test: A vision screening test for children 3 years and older. A variant of the illiterate E test that uses a hand rather than an E as the directional stimulus. Sec also illiterate E.
Sjogren-Larsson syndrome: A genetic syndrome with ichthyosis (very dry skin), short stature, spasticity (increased muscle tone), and mental retardation. Chonoretinal lesions are noted in approximately 50% of affected individuals. The syndrome is usually detected in the neonatal period, treatment is symptomatic for the skin lesions, with special education modifications for the cognitive limitations. Inheritance follows an autosomal recessive pattern.
Skeels and Dye study: A follow-up study (1939) of 25 infants who had exhibited variable developmental delay in an institutional setting; those children who received mothering from women with mental retardation while living in institutions made dramatic cognitive gains, they qualified for adoption, and they continued to exhibit significantly better outcomes about 30 (1966) years later. These results seem more descriptive of the severely deprivational impact of institutional settings in the 1930s than of the qualifications of adults with mental retardation to parent.
skiascopy: Measurement of the refractive error of an eye by focusing on the retina (light-sensitive inner back wall).
skinfold thickness: Calipers are used to measure the compressed double fold of fat plus skin at normed sites of the body to estimate the size of subcutaneous (inner) fat stores.
Skinner, Burrhus F. (B.F.) (1904-1990): A psychologist who distinguished between two types of behavior—respondent and operant—and clarified how various reinforcement contingencies could control or modify behavior. His theories indicate that speculation on any intervening process between stimulus and response is superfluous. In The Behavior of Organisms (1938), Skinner described the results of years of research using white rats in an operant conditioning chamber, and in Beyond Freedom And Dignity (1971), he applied behaviorist principles to the concepts of freedom, value, and dignity. His novel, Walden Two (1948), is a Utopian blueprint based on behavioral principles.
SKOLD: See Screening Kit of Language Development.
skull fracture: A break in one of the hones of the head; a history of head trauma including a skull fracture diagnosed by X ray is unlikely to adequately explain the presence of a significant developmental disability. A depressed skull fracture with neurological impairments, seizures, and coma may, however, contribute to a later developmental disorder.
SLES: See Speech and Language Evaluation Scale.
Slingerland Multisensory Approach: An approach to reading and writing that teaches patterns for the automatic association of the auditory, visual, and kinesthetic modalities. The letters of the alphabet are taught first. Strategies are then taught for thinking through what is not simply memorized. It is an integrated language arts approach that incorporates the teaching of reading, spelling, handwriting, and oral and written expression.
Slingerland Screening Tests for Identifying Children with Specific Language Disability: A group-administered test designed to identify children with specific language disabilities. This instrument actually tests perceptual-motor functions thought to affect receptive and expressive language skills. The basic tasks required for all grades are the same, differing mainly in vocabulary difficulty. Subtests in each form include: copying from a sample; visual perception and memory of words, letters, and numbers; visual discrimination to perceive similarities and differences; visual perception and memory linked with kinesthetic-motor performance; brief exploration of groups of words, phrases, letters, and numbers; auditory perception and memory linked with visual-kinesthetic-motor association—groups of letters, numbers, and words are to be written; auditory-visual-kinesthetic linkage, adding the requirement of making auditory discrimination of single sounds within whole words; auditory-visual linkage without the kinesthetic-motor requirement of writing from dictation—a word, letter, or number is located from a group; echolalia (repetition of what is heard) test (individually administered to selected pupils) permits more careful evaluation of auditory perception and memory than can he made from verbal responses alone. These tests would seem to give more information regarding learning or cognitive style than language functioning. Forms include: A—grade 1 and beginning grade 2; B—grade 2 and beginning grade 3; C—grade 3 and grade 4; and D—grade 5 and grade 6.
Slosson Drawing Coordination Test (SDCT) for Children and Adults: A figure-copying test for children 1-12 years of age; accuracy scores below 85 warrant further evaluation. Age norms for accuracy are reported in the manual.
Slosson Full-Range Intelligence Test (S-FRIT): A brief verbal, performance, and memory screen for the purpose of tentative diagnosis of intellectual strengths and weaknesses in subjects 5-0 through 21-11. The instrument yields standard scores (with a mean of 100 and a standard deviation of 16) for general cognitive measures of Full-Range Intelligence Quotient (FRIQ), Rapid Cognitive Index (RCI), and Best g Index (BgI). Standard scores (with a mean of 50 and a standard deviation of 8) arc provided for cognitive subdomains by a Verbal Index (VI), Abstract Index (AI), Quantitative Index (QI), Memory Index (MI), and a combined abstract and quantitative Performance Index (PI).
Slosson Intelligence Test-Revised (SIT-R): An individually administered screening test to measure general verbal intelligence in subjects 4 years old to adult. The SIT-R generates a mental age equivalent (MAE) that can be converted to a total standard score (TSS) with a mean of 100 and a standard deviation of 16.
Slosson Oral Reading Test (SORT) for Children and Adults: A reading screening test for children from first grade through high school. The test stimuli are 10 lists of 20 single words of graded difficulty. The test yields a grade score; reliability and validity coefficients are contained in the manual.
slow learner: An imprecise educational term used to refer sometimes to children with borderline intellectual functioning (IQ 70-85), or to children with mental retardation (IQ 50-70), or both.
Sly syndrome: Mucopolysaccharidosis (MPS), type VII. A genetic syndrome of growth deficiency, coarse facies, cloudy corneas, and mental retardation. Affected individuals often have dislocated hips and are subject to frequent respiratory illness. Inheritance patterns are autosomal recessive; detection at 10 weeks' gestation is possible through chorionic villi sampling. Treatment is symptomatic.
SMA: See Serum Multichannel Analysis.
small for gestational age (SGA): Small for date; dysmature; a low-birth weight (less than 2,500 grams) infant whose weight is also below the 10th percentile for gestational age. Thus, there are SGA term and SGA premature infants.
SMH: severely mentally handicapped; see severe mental retardation.
Smith-Johnson Nonverbal Performance Scale: A performance intelligence test for children 2-4 years of age; instructions are in pantomime, and hearing impairment norms are provided.
Smith-Lemli-Opitz syndrome: A genetic syndrome with poor growth, anteverted nostrils, eyelid ptosis (drooping), syndactyly (webbing of the ringers or toes) of second and third toes, genital abnormalities in boys (e.g., hypospadias (lower urethral opening], cryptorchidism [undescended testes]), and moderate to severe mental retardation. Inheritance is autosomal recessive. The disorder is detectable at birth; it has occasionally been prenatally picked up by ultrasound findings.
Smith-Magenis syndrome (SMS): A genetic syndrome with mental retardation, characteristic facies (brachycephaly [irregular, flat head shape], midface hypoplasia [detective tissue development], and prognathism [a prominent jaw]), short stature, sleep disturbances, orifice stuffing, and onychotillomania (pulling out one's nails). The last behavior is pathognomonic (indicative) for this syndrome, which is due to a deletion on the short arm of chromosome 17. The syndrome is detectable in the neonatal period. Treatment involves supportive care.
Smith syndrome: Fetal alcohol syndrome phenotype (appearance) without a known history of prenatal alcohol exposure. This is also used as a nonculpatory synonym for fetal alcohol syndrome.
SMR: See severe mental retardation.
SMS: See Smith-Magenis syndrome.
Snellen Chart/Letters: An "eye chart"; a chart with lines of letters of graded sizes to allow translation of successful letter discrimination and/or identification into standardized distance visual acuity designations based on administration at 20 feet. Normal vision is described as 20/20 (in feet) or 6/6 (in meters), meaning that the subject can accurately discriminate at 20 feet (or 6 meters) what an individual without visual impairments can discriminate at 20 feet (or 6 meters). A diagnosed visual acuity of 20/200 indicates that what the subject can discriminate at 20 feet can be discriminated by a person without visual impairments at 200 feet. This test can be used with children 5-6 years of age and older (as soon as they know the alphabet). Other measures of visual acuity need to be used with children who do not know or cannot consistently discriminate alphabet letters because of age or nonvisual impairments, such as mental retardation or learning disabilities.
SNHI: See sensorineural hearing impairment.
Snijders-Oomen Nonverbal Intelligence Scale-Revised: A Dutch instrument to measure nonverbal intelligence in children 5½-17 years of age and children with hearing and/or speech-language impairments.
snout reflex: An infant reflex in which the stimulus of percussing (tapping) the upper or lower lip produces blinking and lip protrusion. The snout reflex is innervated by the facial nerve (cranial nerve VII); its prominence suggests the presence of a degenerative process.
SOAP: See problem-oriented medical record (POMR).
social desirability: A frequent source of test bias in which the test taker responds to questions with answers perceived as socially desirable rather than with responses that truly reflect the test taker's thoughts, feelings, and attitudes.
social history: A multidimensional, in-depth social work description and evaluation of a client's biological, psychological, and social history along with current functioning. The social history serves as the basis for service planning by many professionals including social workers, physicians, lawyers, teachers, and judges.
social intelligence (SI): The ability to understand and deal effectively with social and interpersonal events.
Social Maturity Scale for Blind Preschool Children (Maxfield-Buchholz): An adaptation of the Vineland Social Maturity Scale for preschool children (ages birth to 5) with visual impairment. Seven categories of social development are assessed: personal-social growth, dressing, eating, communication, socialization, and occupation. The instrument is normed against children who are legally blind and partially sighted. Validity and reliability coefficients are lacking.
social promotion: Passing a child to a higher grade despite the fact that he or she does not appear to have successfully mastered the prerequisite skills in the current grade; social promotion is based on the reasoning that it would do more harm to socially separate the child from his or her peers, that his or her self-image would be damaged by the failure, that he or she is growing physically too large to repeat a grade, or some combination of these. Research has shown that social promotion does not succeed, but merely delays more appropriate intervention based on a diagnostic assessment that uncovers the treatable reasons for failure.
social reinforcer: The reward of positive interpersonal contact.
Social Security: A group of federally funded social insurance programs to provide a minimum income for people in their old age, for workers with disabilities, and for worker survivors in case of death. The following programs are included in Social Security: Old Age Survivors Insurance (OASI), part of the original Social Security Act of 1935 for the aged; Survivors Social Security, added in 1939; Disability Insurance, amendments added in 1956 providing cash for workers with disabilities and their families; and Medicare, added in 1965.
social services: The range of professional activities and social programs enacted to help people in need. People in need may include troubled families, families that have lost the ability to produce their own income, families with members who have disabilities, children whose families are no longer able to care for them, people with mental illnesses, and others. Social services include the helping relationships provided bv social workers and other professionals and the linkage of those services with other direct services and entitlements such as Aid to Families with Dependent Children (AFDC) and Supplemental Security Income (SSI).
social skills training: Specific training in the skills necessary for successful peer interaction. Learning and attention disorders may hinder the development of social as well as academic skills. These limitations are being addressed in learning disability textbooks and through the development of commercially available social skills curricula.
social smile: A milestone in early infant development; the baby's smile should be in response to a social interaction such as being talked to and not a spontaneous behavior associated with, for example, burping. The social smile characteristically emerges at 6 weeks of age, but will not be noted until later in babies born prematurely. It is more frequently considered a language milestone than a milestone in the other streams of development. Sometimes referred to as a communicative smile.
social welfare: A nation's system of laws, programs, benefits, and services in the areas of health, education, and economic, social, and basic human needs. In the United States, there are both federal (nationally mandated and supported) social welfare programs (e.g.. Social Security) and state-determined programs (e.g., Medicaid). In state programs, those who are eligible, the range of entitlements, and the level of benefits may vary by state. Some states have superb social welfare programs, whereas others work to avoid expending funds for such programs.
social work: According to the National Association of Social Workers, social work is the professional activity of helping individuals, groups, or communities enhance or restore their capacity for social functioning and creating societal conditions favorable to this goal. Social workers provide clinical services (counseling and psychotherapy), information, and referral, and when necessary, facilitate access to services that individuals may be unable to obtain alone.
socioeconomic status (SES): A measure of one's relative standing in society by a hierarchical grouping of people on a scale of prestige and privilege. Status is determined by such factors as type and amount of income, nature of occupation, location and type of residence, and level of education. SES has implications for educational and economic opportunities, range of experiences and activities, and expectations regarding future achievement.
sociogram: A visual representation or map of social relationships among members of a group. Symbols representing each group member arc connected by lines indicating either real or preferred relationships. From this mapping, one can determine leadership, "in" versus "out" groups, cliques, and isolates.
sociopathy: Antisocial personality disorder; a possible outcome for inadequately treated conduct disorder, attention-deficit/hyperactivity disorder (ADHD), and learning disability.
soft neurological sign: A neurological finding that cannot he interpreted as physiological or pathological without taking into account the individual's age. All "abnormal" soft neurological findings are normal at some (usually younger) age. Soft signs do not contribute to the localization of central nervous system lesions but, rather, reflect a more generalized immaturity of the brain such as occurs in learning disabilities and mental retardation.
soft spot: Fontanel.
somatization disorder: Recurrent multiple psychosomatic complaints of several years' duration, of sufficient severity for medical consultation to be sought, not due to any underlying physical disorder. Anxiety and depression are frequently seen; females are more likely to be diagnosed with this disorder than are men.
somatodyspraxia: An impairment in learning new motor responses that results in motor clumsiness (dyspraxia); somatodyspraxia is hypothesized in sensory integration theory to be caused by impaired tactile (touch) discrimination and proprioceptive processing.
somatotopy: A homunculus (dwarf) projection; the mapping of a human figure on a section of the brain, reflecting either motor or sensory distortions.
somatotype: A body type that implies the presence of a specific personality type or trait. A constitutional theory of personality popularized by W. H. Sheldon in the first part of the 20th century included thin, fragile ectomorphs (worrisome, rigid, and inhibited temperament), obese endomorphs (socially outgoing temperament), and thick, muscular mesomorphs (assertive and competitive temperament). To a limited degree, somatotyping does contribute to the visual diagnosis of selected medical conditions such as genetic syndromes and endocrinological (hormonal) disorders, but its relevance outside of this restricted range is questionable. It appears to be a modern variant of physiognomy, another system with a similar grain of truth sufficient to maintain some research interest.
SORT for Children and Adults: See Slosson Oral Reading Test for Children and Adults.
Sotos syndrome: Cerebral gigantism; a syndrome in which the child has a large body size (birth weight over 8½ pounds), large hands and feet, poor coordination, and variable mental retardation. The rapid growth slows down by middle childhood. Because of their large size and motor clumsiness, children with Sotos syndrome often appear slower or to have more severe retardation than is actually the case. They also tend to have macrocephaly (abnormally large head), dolichocephaly, (prominent forehead), prognathism (prominent jaw), and an advanced bone age. Etiology (cause) is sporadic; several families with parent-to-child transmission suggest the possibility of autosomal dominance, with the majority of cases representing fresh mutations. Sotos syndrome is usually detected in the neonatal or early childhood period. Treatment involves endocrine management and special education.
sound blending (phonemic synthesis): Synthesizing the individual sound components (i.e., phonemes) of a word, leading to recognition of the word as a whole. This synthesis is an important aspect of developing word attack skills in reading. However, by presenting sounds in isolation, several forms of distortion are introduced into the speech signal, presenting a considerable challenge to individuals with auditory processing problems.
sound-symbol association: The knowledge that specific sounds go with specific visual symbols. This knowledge is important for learning to read, particularly when a synthetic phonics (see phonic analysis [phonics]) approach is used.
Souques finger phenomenon: Automatic extension of the ringers when the shoulder is flexed; this phenomenon is common in hemiplegia (paralysis of half the body).
Southern California Postrotary Nystagmus Test (SCPNT): A test in which the person being tested is spun around 10 times in 20 seconds on a special "nystagmus board," and the duration of the resulting nystagmus (involuntary eye movements) is measured with a stopwatch. This is repeated in the opposite direction. Longer than normal durations of nystagmus are interpreted as compatible with learning disabilities.
s.p.: Status post; indicates that the person had a previous condition (disease or operation) that may be relevant to the current situation. For example, "s.p. appendectomy" indicates that the person no longer has an appendix; "s.p. encephalitis" indicates that the person had encephalitis (brain inflammation) in the past. There is no automatic suggestion of recency, relevance, or sequelae. Thus, most adults are "s.p. chickenpox."
Spache Diagnostic Reading Scales: See Diagnostic Reading Scales (revised edition).
Spasmus nutans: Head rolling or nodding associated with nystagmus (involuntary eye movements) in preschool children who may otherwise be typically developing. Malnutrition, neglect, and mental retardation may result in a slightly higher frequency of this benign, self-limited condition. Onset is usually before 1 year of age, and it disappears by 3 years. Unlike bobble-head doll syndrome, the bobbing is usually dysrhythmic, intermittent, and inconstant.
spastic cerebral palsy: The most common physiological subtype of cerebral palsy. Spasticity refers to an increase in muscle tone that is not the same throughout passive range of motion; rather, the extremity (arm or leg) exhibits a sudden "give" or loss of passive resistance or what is called "clasp-knife" hypertonicity. Strabismus (squint), contractures, and seizures are common associated deficits in spastic cerebral palsy. This type of cerebral palsy is further broken down according to a topographical classification into monoplegia, hemiplegia (paralysis of half the body), triplegia, diplegia (paralysis on both sides of the body), quadriplegia (paralysis of all four extremities), and paraplegia. Cerebral palsy that is not spastic is categorized as extrapyramidal because spasticity is considered a major finding in pyramidal tract involvement (hypertonicity, increased deep-tendon reflexes, and upgoing Babinski reflexes).
spasticity: "Clasp-knife" hypertonicity; velocity-dependent increase in resistance to passive movement, resulting in increased muscle tone with exaggerated deep-tendon reflexes, clonus, and upgoing Babinski reflexes. The adjective spastic describes tone or a type of cerebral palsy and should never be used to characterize a person.
spatial orientation: The perception of the position and configuration of objects in space from the observer's viewpoint; it is said to involve imagining movement of the entire stimulus without movement of its parts. Orientation enters into tasks requiring a geographic sense of direction, such as map reading and piloting a plane through three-dimensional space.
spatial relationships: Above/below, right/left, right side up/upside down, inside/outside, near/far, before/behind. This factor has emerged as significant in research comparing differences in spatial ability of males and females (see also spatial visualization).
spatial visualization: Spatial visualization involves the ability to mentally manipulate a stimulus configuration and the movements of parts within the configuration. The ability enters into the abstract reasoning required in solving math problems. This factor has emerged in research comparing differences in spatial ability of males and females (see also spatial orientation).
special: Uncommon or unique. Describes what is different about any person. The term special should not be used to categorically describe or specifically characterize people with disabilities; the term can have the patronizing ring of a false compliment or can be interpreted as a euphemism for a more accurate description of a person's needs, limitations, or abilities. Terms like special, handicapable, and physically challenged are generally considered condescending. They reinforce the idea that disabilities cannot be addressed directly and honestly. The word special is acceptable, however, in reference to the citation of laws and regulations regarding services, rights, and provisions for people with disabilities.
special education: Education designed to meet the individual needs of children with disabilities. Originally designated in PL 94-142, the Education for All Handicapped Children Act of 1975, children with disabilities are those evaluated as having mental retardation, deafness, serious emotional disturbances, orthopedic impairments, hearing impairments, visual impairments, learning disabilities, speech impairments, deaf-blind multiple disabilities, or other health impairments, and who, because of these impairments, need special education and related services.
special education service delivery model—alternative: Criticism of the traditional "pull-out" service delivery model (see also special education service delivery model—traditional) has led to the development of several models emphasizing the integration of people with milder disabilities. Some of these newer models include Class Within a Class (CWC), Adaptive Learning Environment Model (ALEM), Integrated Classroom Model (ICM), and full inclusion with all individualized education program (IEP) goals being met in the general classroom.
special education service delivery model—traditional: In order to place students in the least restrictive environment (LRE), school districts are required to provide a continuum of services. These may include 1) general class with consultative assistance from special education personnel, 2) general class and consultation plus special materials from special education, 3) general class plus special education itinerant teaching services, 4) general class plus assistance from special education teachers in a resource room, 5) special class in a general school, 6) special class in a special (separate) day school, 7) home or hospital programs (usually temporary), and 8) residential schools.
specialist: A professional who has taken further training in a specific area of professional competence. A physician (M.D. or D.O.) will take further training (usually at least 3 years after internship) in a specific area of medical practice such as pediatrics, surgery, psychiatry, or neurology. In addition to their state-regulated license to practice medicine, most physician specialists are further nationally certified in their specialty area by a national accrediting board.
specific developmental disorder: A subclass of developmental disorders that is characterized by inadequate development of specific academic, language, speech, and motor skills not due to other diagnosed disorders or deficient educational opportunities.
specificity: The true negative rate; conegativity. A statistic that describes a screening test's ability to successfully identify those tested who do not have the condition for which they are being tested. Specificity is the ratio of true negatives (negative test result, absent condition) to all negative test results (whether the condition is present). The closer this ratio is to 1.0, the better the screening test.
SPECT: See single photon emission computed tomography.
spectrum concept: The possibility that several differently classified disorders may be the result of the same general genetic pattern. These disorders are then considered to be genetically related (e.g., attention-deficit/hyperactivity disorder (ADHD), alcoholism, and antisocial personality disorder.
spectrum of developmental disabilities: An approach to classifying neurodevelopmental disorders that focuses on the major category of impairment: cognitive (e.g., mental retardation), motor (e.g.. cerebral palsy), and central processing (e.g., learning disability, language disorder). Complementary to the continuum of developmental disabilities.
speech: Oral communication using a system of vocal symbols.
Speech and Language Evaluation Scale (SLES): A teacher rating scale for screening speech and language abilities in the areas of articulation, voice, fluency, form, content, and pragmatics. The scale can be used by the classroom teacher for screening, referral, and follow-up assessment. Administration time is approximately 20 minutes.
speech disorder: See articulation disorder.
speech-language pathologist: An individual with a degree and/or certification in communication disorders who is qualified to make diagnoses, prescribe therapy, and employ therapeutic measures for the remediation and amelioration of speech and language problems.
speech-language pathology: The study of communication disorders for the purposes of diagnosis and treatment. Communication disorders include disorders of speech, language, and voice.
speech reception threshold (SRT): Intelligibility threshold: the faintest intensity (decibel level) at which an individual identifies and repeats 50% of the simple spoken words presented.
speechreading: A form of aural rehabilitation (educational methods for people with hearing impairments) that utilizes visual cues to determine what is being said. People with hearing impairment "read" speech through interpretation of the speaker's lips, facial movements, hand and body expressions, and gestures. Formerly known as lipreading.
spend down: The required reduction of all assets to a minimal level before meeting financial eligibility for federal and state entitlements.
SPH: Severe to profound mental handicap; see severe and profound mental retardation.
sphingolipidosis: A group of hereditary disorders with abnormal metabolism of chemicals called sphingolipids present in the brain. Whereas each disorder presents with its own clinical picture, the disorders share the symptoms of progressive loss of vision and mental retardation. With the exception of the type E variant, all other affected individuals have a significantly shortened life span. Prenatal diagnosis is available for types A and B in high-risk populations. Type A is more commonly found in persons of Ashkenazic Jewish descent. Once diagnosed, treatment is supportive care for patients and their families.
Spica cast: A cast that immobilizes an extremity (arm or leg) by incorporating part of the body near that extremity.
spike wave complex: Spike and slow-wave complex; an electroencephalographic (EEG) finding in which a spike (a sharp pointed deviation) is followed by a slow wave (a rounded curve deviation). At the rate of 3 per second, this pattern complex is associated with absence (petit mal) seizures. At the slower rate of 1-2.5 per second, this pattern complex is associated with severe and intractable epilepsy referred to as Lennox-Gastaut syndrome.
spina bifida: Neural tube defect (NTD); a constellation of malformations of the central nervous system that presents with a failure of fusion of the hones in the vertebral column (upper spine) and with an accompanying herniation (protuberance) of neural components, including meningocele (protuberance of the lining of the spinal cord) and myelomeningocele (protuberance of both the spinal cord and its lining). In addition, there is generally abnormal cellular migration in the brain leading to an Arnold-Chian malformation and hydrocephalus (excess fluid in the brain). Syringomyelia (cavitation in the spinal cord) can also be found. Vertebral abnormalities (e.g., misshapen and partial vertebrae) can lead to scoliosis and kyphosis (curvatures of the spine). Deformities of the lower extremities (most commonly clubfcct and rocker-bottom feet) may also be present. Other anomalies (malformation, deformation, disruption, or dysplasia) such as heart defects, kidney agenesis (absence of formation), and congenital intestinal obstructions (e.g., duodenal atresia, pyloric stenosis) are present in a greater than normal incidence. Clinically, the peripheral (noncentral) neurological problems depend on the level of the lesion. Low sacral lesions cause bladder and sphincter paralysis, but no motor impairment. Lesions in the lumbar region generally result in some degree of flaccid paraplegia with poor function of the anal and bladder sphincters. Higher lesions can result in hypertonic bladders with normal rectal sphincter tone. Treatment of myelomeningocele requires the expertise of pediatric surgical subspecialties, including orthopedics for lower extremity and back problems; neurosurgery for initial closure (fusion or ossification), shunt placement, and monitoring; and urology for management of incontinence, infection, and reflux of urine into the kidneys causing hydronephrosis (kidney enlargement due to obstructed flow). Care should also address managing bowel incontinence, as this contributes to a significant social disability. About 40% of children with myelomeningocele will have some degree of mental retardation; however, many children have normal overall cognitive abilities with accompanying learning disabilities. Inheritance is multifactorial.
spina bifida occulta: A failure of fusion of the posterior (back) part of the vertebra without any protuberance of nerve tissue or meninges (covering of brain and spinal cord). Although the skin over the spine is generally intact, there may be associated dermal sinuses (tunnels in the skin), nevi (moles), dimples, or a hirsute (hairy) patch. A relatively common occurrence (10% of the general pediatric population), spina bifida occulta may be associated with abnormalities in the formation of the spinal cord, especially in the presence of neurological impairments. Lesions may be present at more than one level of the spinal cord. Surgical repair is indicated in the presence of infection (meningitis [inflammation of the spinal cord and brain membranes) or deep abscess in a dermal sinus) or with progressive loss of neurological function.
spinal accessory nerve: The 11th cranial nerve; cranial nerve XI involvement causes the shoulder to sag and the tongue to deviate to the affected side.
spinal tap: A procedure in which a needle with a bore is inserted between the vertebrae of the spinal column into the cerebral spinal fluid (CSF) that surrounds the spinal cord of the lower back. The CSF can be removed and tested for evidence of infection (i.e., meningitis [inflammation of the spinal cord and brain membranes]) or a bleed (i.e., hemorrhage); the pressure of the fluid in the CSF system can also be measured. This procedure is performed with the individual in cither a lateral reclined position living on one side) or a sitting position.
SPLATT: See split anterior tibial tendon transfer.
splint: A flexible or rigid appliance for the immobilization of broken hones or dislocated joints.
split anterior tibial tendon transfer (SPLATT): An orthopedic surgery procedure to treat varus (inward) foot deformity in children with spastic cerebral palsy.
splitting: The tendency to classify as separate entities items that at first appear to go together; see also heterogeneity.
SPMR: See severe and profound mental retardation.
spooning: A hand posture of curved hyperextension. Spooning can be present in a variety of neuromuscular disorders, but is most often a sign of minor neurological dysfunction. It is one component of athetoid posturing of the hand in cerebral palsy, and it tends to be exaggerated under stress.
Sprengel deformity: Asymmetry of the scapula, with one shoulder blade being higher than the other, accompanied by some limitation in abducting (turning outward) and elevating the shoulder with the higher scapula.
squint: See strabismus.
SRT: See speech reception threshold.
SSI: See Supplemental Security Income.
SSPE: See subacute sclerosing panencephalitis.
stability: Maintenance of equilibrium with resistance to sudden change of position, achieved through co-contraction of muscle groups so that a joint remains fixed while allowing other muscles to move.
stadiometer: One of a number of instruments to accurately measure height; usually composed of a measuring strip fixed to a wall and a vertically sliding headboard.
staffing: An interdisciplinary team meeting in which members of the team utilize their respective expertise to assist in diagnosing and evaluating a disease or disability. Team members representing several disciplines make recommendations with regard to educational programming, psychological or family intervention, medication, and various ancillary (assistive) therapies. The staffing may include the professionals who performed specific components of the evaluation, teachers, parents/guardians, and other involved professionals. The collaborative effort helps promote a comprehensive and multifaceted view of the individual being evaluated and recognizes the need to consider the condition from several different, but related, perspectives.
stage: A hierarchical level of development, with each level characterized by structural and qualitative changes. There is an implicit, but unproven, assumption that such stages are invariant and universal. The concept remains heuristic and controversial.
staggering: Reflex foot movements to maintain upright posture when the body is externally displaced.
stance phase: That part of the gait cycle when the index foot is in contact with the ground (from heel strike to toe-off); double stance is that part of the gait cycle when both feet are in contact with the ground. Stance phase represents 60% of the gait cycle.
standard deviation (SD): A statistic that equals the square root of the variance. It is a commonly used measure of the extent to which individual scores differ from the mean. A small standard deviation indicates that the group under study is homogeneous with respect to the characteristic in question; a large standard deviation indicates the opposite. Approximately 68% of children fall within one standard deviation of the mean. The different Wechsler intelligence scales have a standard deviation of 15 around a mean of 100 for IQ scores and a standard deviation of 3 around a mean of 10 for subtest scores. Thus, approximately 68% of the children will achieve IQ scores between 85 and 115 and subtest scores between 7 and 13.
standard error of measurement: See error of measurement.
standard score: A score that is adjusted to indicate how many standard deviations a score is above or below a given mean. Commonly used types of standard scores include z-scores, T-scores, deviation IQs, and stanines. Standard scores allow the comparison of the performance on one test to a performance on another.
standardization sample: Norm group; the group of subjects whose performance on a specific test becomes the basis of comparison for future individual performances on the same test. The standardization of well-normed tests is based on the performance of a large, representative group of subjects. Norms are scores (percentile ranks, stanines, standard scores, mean, standard deviation) obtained by comparing the subjects' performance to the standardization sample. The norm group should be relevant to the examinee. For example, the performance of a 12-year-old African American female cannot be accurately judged when compared to norms obtained from a sample of 8-year-old Caucasian males. The Kaufman Assessment Battery for Children (K-ABC) is one of the few tests normed on a sample that included proportional representation of exceptional children.
standardized test: A test with a consistent and uniform procedure for administering, scoring, and interpreting results such that each examinee is assessed in the same manner as was done in the standardization sample or norm group. Deviations from procedure may change the meaning of the resulting test score. The Wechsler Intelligence Scale for Children-III (WISC-III) and the Woodcock-Johnson Psychoeducational Battery-Revised are examples of tests that are uniform in administration, scoring, and the wording to be used by the examiner.
standing height: The height in the standing position is typically 1-2 centimeters shorter than height (length) in the recumbent, or lying down, position.
Stanford-Binet Intelligence Scale: Fourth Edition (SBFE): A battery of 15 subtests measuring intelligence over an age range of 2-23 years. The original Stanford-Binet scale was published in 1916 and introduced the concept of the ratio IQ. The rest was revised in 1937 and again in 1960; in 1973 updated norms were published. Some continuity is maintained between the SBFE and prior editions. Item types common across editions include vocabulary, comprehension. picture absurdities, paper folding and cutting, copying, repeating digits, memory for sentences, reproducing a bead chain from memory, similarities, formboard items, and quantitative items. The SBFE has new items in these areas as well as some new item types. Not all 15 subtests are administered to all subjects. In addition to six subrests that are always administered (vocabulary, comprehension, pattern analysis, quantitative, bead memory, and memory for sentences), age of the subject determines the use of the other subtests (absurdities, verbal relations, copying, matrices, paper folding and cutting, number series, equation building, memory for digits, and memory for objects). Approximate administration time is 1 hour.
Stanford Diagnostic Reading Test, Third Edition (SDRT): A diagnostic reading test with four levels (red, green, brown, and blue) to measure specific strengths and needs in reading.
stanine: A single-digit scoring system with a mean of 5 and a standard deviation of 2. All stanines except 1 and 9 are one half of a standard deviation in width. Thcy differ from standard scores, such as z-scores, T-scores, and deviation IQs, in that stanine scores are normalized or forced to fit the normal curve as closely as possible.
STARCH: A variant of the acronym TORCH, amended to include acquired immunodeficiency syndrome (AIDS). See STORCH, TORCH.
staring spells: See absence seizure.
startle response: In the newborn, the startle response is very similar to the Moro reflex with extension of the extremities (arms or legs) followed by flexion; as the Moro fades between 2 and 6 months of age, the initial component of the startle is a protective flexion of the upper extremities. The startle can be part of the alerting response to sound in the first weeks of life.
state: A key variable in Prechtl's neurological examination of infants; the depth of sleep, degree of alertness, and presence of crying are scored; the intent's stare influences neurological findings and behavioral repertoire.
station: The position or posture assumed in standing (or sitting).
status epilepticus: A continuous seizure or multiple seizures occurring over a short period of time. Practically, status epilepticus is a seizure lasting 30 minutes or longer. Status epilepticus does not refer to the type of seizure, but only to its continuous and prolonged nature. Thus, one may have tonic-dome status epilepticus, absence status epilepticus, complex partial (psychomotor) status epilepticus, and so forth. Status epilepticus is a medical emergency that requires treatment to stop the seizure and prevent brain damage that can occur secondary to such a prolonged seizure. Initial management includes the basic principles of cardiopulmonary resuscitation (CPR), maintaining the airway, breathing, and cardiac function. The remainder of the evaluation and treatment is aimed at determining the cause of the seizure activity and using an appropriate anticonvulsant medication to stop it. The outcome of status epilepticus depends on the cause and duration of the seizures. Prolonged status epilepticus often leads to brain damage manifested by a decrease in cognitive functioning, motor impairment (hemiplegia [paralysis of half the body], diplegia [paralysis on both sides of the body]), movement disorders, or cerebellar dysfunction. Rapid diagnosis and treatment have been shown to decrease the morbidity and mortality of status epilepticus.
status marmoratus: Hypoxic-ischemic encephalopathy (brain damage due to lack of oxygen) that involves the basal ganglia and produces extrapyramidal cerebral palsy. The name derives from the marbled (i.e.. marmoratus) appearance of the basal ganglia at autopsy.
steadiness tester: A mechanical device to measure attention deficits, motor impersistence, hyperactivity, resting tremors, and choreiform (involuntary twitching) movements by having the child hold a stylus (pointer) in a hole (sometimes of varying sizes) without touching the sides. "Touch time" decreases with age and neurological maturation.
Steinert syndrome (myotonic dystrophy): An extremely variable genetic syndrome that represents a type of muscular dystrophy with mild motor symptoms and cataracts. Apathetic facies, a "hatchet face," or "lugubrious" appearance have been described in addition to dysarthria (difficulty pronouncing words). Mental retardation is rare, but learning disabilities arc common. Inheritance occurs through an autosomal dominant gene located on the long arm of chromosome 19. When the syndrome is suspected, prenatal diagnosis is possible but is extremely complicated. Incidence is on the order of 1 in 10,000. Treatment is normally unnecessary, owing to the mildness of the disorder.
step length: The distance covered in one step.
stepping: A primitive reflex in which a newborn baby held in supported standing appears to "walk." Such newborn walking is readily elicited in the first 6 weeks of life, but then rapidly fades. Head extension facilitates the reflex.
stereognosis: Form perception; the ability to identify objects by feel or touch. A component of the neurological assessment; problems with stereognosis are attributed to parietal lobe dysfunction.
stereotactic neurosurgery: A group of procedures in which brain nuclei (control centers) arc destroyed in order to improve movement. Thalamotomy to treat Parkinson disease in adults provided the paradigm; success in applying this type of procedure to cases of severe cerebral palsy has been limited to those of extrapyramidal type.
stereotypy: Constantly repeated meaningless gestures or movements such as hand flapping. Stereotypy is common in autism and in self-stimulatory behaviors seen in individuals with severe mental retardation.
sternum: The breastbone.
Stickler syndrome: Hereditary progressive arthro-ophthalmopathy. A genetic syndrome with flat facies, progressive myopia (nearsightedness), and arthritis. Infants may present with the Pierre-Robin sequence, and a marfanoid habitus (appearance) may be noted later; up to half of Pierre-Robin anomalies (malformation, deformation, disruption, or dysplasia) may represent cases of Stickler syndrome. Total retinal (eye) detachment has been noted in over half the reported cases. Inheritance is autosomal dominant with a recurrence risk of 50%. Ophthalmological care for prevention and care of eye problems is indicated.
stiff baby syndrome: See hyperexplexia.
stigmata: Signs of a diagnosis or condition, usually physical.
stimulant: Psychostimulant medication: a class of drugs used to treat attention deficit disorders and hyperactivity in children and adults. These drugs include dextroamphetamine (Dexedrine, DA), methylphenidate (Ritalin, MPH), and pemoline (Cylert). They are less effective in preschool children and people with mental retardation. The side effects of all these drugs are similar, with anorexia (loss of appetite) or appetite suppression primary.
stimulus: Any object, action, or factor that causes an organism to act or that elicits a response; the input to a stimulus—response arc.
stoma: Mouthlike opening; especially a surgically created drainage opening (e.g., colostomy, ureterostomy).
storage disease: A subgroup of inborn errors of metabolism that tend to present late in infancy. These disorders are usually genetic in etiology (cause) and are characterized by the inability to break down certain compounds in the body, which then build up in the cells and cause damage and poor function of the involved organ system(s). The central nervous system is often involved, with a presentation of the loss of developmental milestones or developmental regression. Other organs that can be involved include the liver and the reticuloendothelial system (the organs that make and clear blood cells). Mucopolysaccharidoses are examples of storage diseases.
STORCH: An acronym for the more common congenital or perinatal (around birth) infections that have many clinical similarities among them and can often be differentiated only by laboratory diagnosis. These include Syphilis, Toxoplasmosis, Other infections, Rubella, Cytomegalovirus, and Herpes simplex virus. Their common symptomology includes intrauterine growth retardation (stunting), jaundice (yellowing of the skin) or hepatitis (inflammation of the liver), hepatosplenomegaly (enlargement of the liver and spleen), cataracts or retinal (eye) involvement, microcephaly (abnormally small head), encephalitis (brain inflammation), and hearing defects. Hepatosplenomegaly and a skin rash are prominent in ongenital syphilis; retinopathy and brain calcifications are common with toxoplasmosis; cataracts and heart disease with rubella; microcephaly, hearing loss, hepatitis, and a bleeding tendency with cytomegalovirus; skin rash, retinopathy, and encephalitis with herpes. They all can contribute to the occurrence of mental retardation.
stork bite: See salmon patch.
strabismus: Crossed eye, squint. A condition in which each eye looks at a different object, rather than the norm in which both eyes look at the same object. The causes of strabismus are muscle weakness, central nervous system disease (i.e., stroke, hemiplegia [paralysis of half the body]), or amblyopia (poorer vision in one eye). The eve deviation may he outward (i.e., exotropia), inward (i.e., esotropia), upward (i.e., hypertropia), or downward (i.e., hypotropia). Strabismus is treated by an ophthalmologist (a medical doctor trained in eye diseases) using glasses, patching, or occasionally surgery. Some forms of strabismus are inherited in an autosomal dominant manner. Strabismus is common in spastic cerebral palsy and myelomeningocele (protuberance of both the spinal cord and its lining).
stranger anxiety: Childhood anxiety in the presence of unfamiliar people; also known as 8-month anxiety or organic bashfulness. Severity may be muted in households with multiple caregivers. Age-inappropriate lack of wariness of strangers may reflect either cognitive limitations or emotional pathology (origin).
Stransky reflex: The stimulus of suddenly releasing the abducted (turned outward) fifth (little) toe produces the response of dorsiflexion (upgoing movement of the toes) of the first (big) toe. A sign of pyramidal tract dysfunction.
Strauss syndrome: Brain-damaged child syndrome; the neurobehavioral constellation of distractibility, perseveration, conceptual rigidity, emotional lability (changeability), and difficulty with figure—ground perception that was first reported in children with both mental retardation and cerebral palsy and was then extended to children without obvious evidence of brain pathology (origin). These symptoms became known as minimal brain damage (a term now outdated) and later were subsumed under the term attention-deficit/hyperactivity disorder (ADHD).
straw drinking: A developmental feeding milestone with a wide range for age of first achievement; 12 to 36 months.
Straw Peter syndrome: A literary reference describing the hyperactive child syndrome. The term comes from Struwwelpeter (1845), a 19th-century German children's book written by pediatrician Heinrich Hoffman (1809-1894). The title character's name has been variously translated as Straw Peter or Slovenly Peter, but is more accurately Shaggy-headed Peter, a possible reference to the minor dysmorphic (atypical) feature of electric hair often found in children with hyperactivity. Peter's friends, Cruel Fred and Fidgety Phil, personify other aspects of the syndrome. See attention-deficit/hyperactivity disorder (ADHD).
strephosymbolia: Twisted symbols, letter reversals; an individual sign of learning and reading disorders that was stressed as fundamental by Samuel Orton (1879-1948).
stretch reflex: The reflex contraction of a muscle when passively stretched; the resistance of the muscle to being longitudinally stretched.
stride length: The distance covered in two steps, or one complete gait cycle.
stridor: A harsh, high-pitched, shrill sound during inspiration associated with upper airway obstruction. Congenital laryngeal stridor is often associated with weakness in the walls of the windpipe. Such stridor may reflect an isolated airway abnormality that will resolve over time or a congenital defect that is part of a wider syndrome.
stroke: A cerebrovascular accident (CVA). Damage to the brain caused by either a tear in a blood vessel with bleeding (i.e., hemorrhage) in the brain or a blockage in the vessel, reducing blood flow and oxygen to the tissue. Strokes can occur at or before birth and at any time during childhood. They are commonly associated with certain medical conditions such as sickle cell anemia, leukemia, or problems with the heart valves. They can also occur with malformations of the vessels in the brain such as a berry aneurysm. The damage from a stroke is usually to one side of the brain and thus presents with one-sided neurological findings. Resolution of the stroke with healing usually results in an improvement, but not always a complete disappearance of the impairments, Motor function is affected on the opposite side of the body from the brain damage, whereas cognitive function is affected on the same side.
Stroop test: A neuropsychological measure of ease in shifting perceptual set and suppressing habitual responses in order to conform to changing demands. For example, in one version of the test, the subject must name the color ink in which non-matching color names are printed; any resulting decrease in color-naming speed is referred to as the "color-word interference effect" and can be interpreted as suggesting left frontal lobe damage.
structural analysis: A word attack skill involving the recognition of prefixes and suffixes that may be added to a root word in order to compound words or to change the meaning in a predictable fashion. Examples are prefixes unhappy, premature; suffixes running, hopped; compound words raincoat, football.
structural theory: The psychoanalytic division of mental function into the id, the ego, and the superego.
stupor: A state of decreased consciousness in which the individual can only be aroused by painful stimuli.
Sturge-Weber syndrome: Encephalofacial angiomatosis; a disorder with unilateral vascular malformations (birthmarks) on the face and eyes and ipsilateral (on the same side) involvement of the meninges (covering of the brain and spinal cord). The vascular (blood vessel) abnormalities are nonraised hemangiomas (similar to a port-wine stain) that can be seen on the face, generally in the distribution of the fifth cranial nerve. The hemangiomas of the meninges are involved, with cerebral calcifications ("railroad track" lines on skull X ray). Seizures are present in 56% of cases, and 30% will exhibit hemiplegia (paralysis of half the body). Many, but not all, of these children have mental retardation. Seizure control is often difficult. Etiology (cause) is unknown, but the clinical picture is consistent with a defect in the cephalic (head) neural crest that migrates to the meninges, the choroid of the eve, and the skin above the eye. Diagnosis can be made in the neonatal period. Treatment involves seizure management and special education.
stuttering: A disorder in the rhythm of speech that includes sound, syllable, and word repetitions, prolongations, pauses, and hesitations often accompanied by anxious, tense, and avoidant behaviors. Stuttering is more common in males with a familial susceptibility bur no clearly defined generic transmission pattern. Stuttering is not indicative of occult (internal) developmental disorders.
STYCAR: See Screening Tests for Young Children and Retardates.
subacute sclerosing panencephalitis (SSPE): A degenerative disease of the central nervous system associated with a persistent measles virus infection of the brain. The insidious course of this slow virus infection includes mental deterioration, myoclonic seizures, visual impairment, and a variety of movement disorders progressing to opisthotonus (an arching of the back) and decorticate rigidity. The electroencephalogram (EEG) shows suppression bursts.
subarachnoid hemorrhage: Bleeding into the subarachnoid space in the head; usually seen in hypoxic (lowered oxygen to the brain) premature infants; it has a good prognosis for recovery, although hydrocephalus (excess fluid in the brain) may occur.
subcutaneous: Under the skin.
subluxation: Incomplete or partial dislocation of a bone at its joint.
submucous cleft: A palpable defect in the hard palate that is not immediately visible because it is covered with normal oral mucosa; it can be suspected in the presence of a bifid (cleft) uvula and a white line running down the middle of the roof of the mouth. Submucous clefts can contribute to severe articulation disorders.
subspecialist: A physician (M.D. or D.O.) who has completed a fellowship training program (at least 2 years beyond the requirements for specialty certification) in a restricted area of a specialty. Examples include pediatric surgery (under the area of surgery), neonatal-perinatal medicine (under pediatrics), and nephrology (under internal medicine). A Certificate of Special Qualifications nationally certifies most subspecialty practitioners.
substance abuse: The use of a substance (either legal or illegal) that deviates from accepted social, medical, or legal patterns.
substance dependence: The psychological and/or physiological dependence on a drug, either legal or illegal.
subtest scatter: The degree of variability of an individual's scores on specific components of a test. The highs and lows comprise a profile that indicates strengths and weaknesses in particular areas as defined in specific subtests. The term is most commonly used with intellectual assessment, though it may be applied to any multiple subtest battery of basic skills, adaptive behavior, or academic achievement. The precise role that this scatter has in diagnosing and differentiating among populations and conditions has not been definitively determined. Scatter occurs frequently in the general population, so care must be taken when determining if scatter is rare or different from that of the general population before associating it with significant deviance or abnormality. However, characteristic scatter has been reported consistently for specific groups. For example, low scores on arithmetic, comprehension, information, and digit span subtests of the Wechsler Intelligence Scale for Children-Revised (WISC-R) have been shown to characterize the performance of several groups of children with learning disabilities. Yet such categories and score performance profiles of the WISC-R often have no clinical significance when subjected to metaanalysis (a quantitative method for integrating data across studies). Thus, learning disabilities arc more likely to he indicated by individual differences than by set profiles. Scatter has been associated with behavior, emotional, and organic problems, as well as with learning disabilities. Analysis of subtest scatter, although not recommended by itself as a diagnostic standard, is helpful in the diagnostic process and in educational intervention planning.
subthalamic syndrome: Hemichorea and hemiballismus; a syndrome of chorea and/or balhlismus on one side of the body secondary to a lesion in the contralateral (opposite) subthalamic nucleus (corpus Luysii).
subtraction: The most common source of error that occurs during calculation of test scores and subscores (especially in relation to determining a child's age).
subtrainable: An older term lumping together severe and profound mental retardation; now considered pejorative.
sucking: Propulsion of food into the mouth by creating negative pressure in the oral cavity by a complex interaction of the lips, tongue, and cheeks. This phase of oral feeding follows suckling between 6 and 9 months of age and is characterized by vertical (up and down) tongue movements and jaw opening/closing.
suckling: An early infantile version of sucking. Suckling is an oral motor reflex that represents the earliest intake phase for liquids with a definite backward (more pronounced)-forward, horizontal (in-out) tongue movement in a rhythmic licking action. Suckling begins in the second to third trimester of gestation and may persist to 12 months of age. It is innervated by cranial nerves V, VII, IX, and XII.
sulcus: A groove or furrow, especially one separating the gyri (hills) on the surface of the brain.
sunset sign: See setting sun sign.
supernumerary: An excess number (e.g., a sixth finger on a hand, a third nipple on the chest).
supersensitivity: A hypothetical mechanism of recovery after brain damage in which surviving neurons in the damaged system become increasingly sensitive to neurotransmitter molecules, thus allowing them to function in a deprived state.
supination: Forearm movement that turns the palm upward.
supine: An anatomical position in which the individual is lying face upward on the back (opposite of prone).
Supplemental Security Income: (SSI) A federally funded income maintenance program that provides people with developmental disabilities a minimum monthly income. Although administered through the Social Security Administration, SSI funds are separate from social insurance funds that support Social Security income to retired elderly people without disabilities. In practice, SSI may be partially supplemented or supplanted by other entitlement programs; however, the goal for the individual is to maintain a minimum monthly income. Established in 1972, SSI consolidated previous programs for people who are blind and those with hearing impairments into one program. Eligibility to receive SSI requires evidence of both disability and low income.
support group: Self-help group; voluntary small groups formed for mutual help and to accomplish a specific purpose. Although support groups may employ professional facilitators, they are typically composed of peers who have pined together to help and support each other in satisfying a common need, coping with a common problem, or targeting and seeking a desired social change. Such groups employ face-to-face interactions and assume personal responsibility by group members. Many parents of children with developmental disabilities find support group input a vital tool for education and emotional support in meeting the demands of their children and families. Active support groups include the Down Syndrome Association, Prader-Willi Syndrome Association, Williams Syndrome Association, and the Rett Syndrome Association.
supported employment: On-the-job coaching that supports the worker with mental retardation [or other developmental disabilities] in a competitive employment situation. The term supported employment embraces the processes of ]ob placement, job coaching, and continuous support in and on the job.
supported living: A coordinated system of supports clustering around the individual with disabilities and designed to facilitate that person's choices to live, work, learn, and actively participate with people without disabilities in the community. Supported living is based on the philosophy that people with developmental disabilities have a right to make responsible decisions consistent with the choices afforded people without disabilities. The system includes life skills and vocational training, protective oversight, environmental adaptations, and physical assistance. The aim is to normalize the individual with developmental disabilities into the mainstream society by bringing services to him or her, rather than placing the individual in a segregated facility that provides such services.
suppression burst activity: An electroencephalographic (EEG) pattern with a depressed or flat background accompanied by high-voltage bursts of slow waves with intermingled spikes. This pattern is frequent in comatose people.
suprabulbar paresis: See pseudobulbar palsy.
surfactant: A phospholipid (chemical) that contributes to the elasticity of pulmonary tissue (the lungs). Preterm babies have less surfactant, so that it is harder for their lungs to breathe. Artificial surfactant is now being used in the treatment of respiratory distress syndrome (RDS) in such babies.
surfactant replacement therapy: A treatment for respiratory distress syndrome (RDS) that increases the survival