A B C D E F G H I J K L M N O P Q R S T U V W XYZ

Waardenburg syndrome

A genetic syndrome that includes pigmentary disturbances (poliosis [white forelock], heterochromia iridis [different colored eyes], vitiligo [white patches on the skin]), sensorineural (involving the inner ear or the auditory nerve) hearing loss, and lateral displacement of the inner canthi (widely spaced eyes, observed in Type I, but absent in Type II). Severe congenital bilateral hearing loss is present in 25% (Type I) - 50% (Type II) of cases; it accounts for 1.4% of all children with congenital deafness. Inheritance is autosomal dominant, with an incidence of 1 in 40,000. A similar association between albinism and deafness has been reported in cats. Named after the Dutch ophthalmologist Petrus Waardenburg (1886-1979).

Wachs Analysis of Cognitive Structures

A nonverbal Piagetian scale for preschool children from 3 to 6 years of age.

Wada test

A neurodiagnostic procedure in which a strong sedative (amobarbital sodium) is injected directly into a neck artery (the carotid) to discover how rapidly a loss of verbal skills follows, to compare the responses on both sides, and thus help document the lateralization of cerebral dominance. This is a serious procedure that is employed only when it is critical to document such lateralization, such as prior to ablative brain surgery.

WAIS-R

See Wechsler Adult Intelligence Scale-Revised.

walking

Ambulation.

Wallin

A six-hole pegboard used in a variety of infant tests. The Wallin A has round pegs and holes; the Wallin B has square pegs and holes. The ability to successfully complete both pegboards emerges between 18 and 24 months of age. Named for John Wallin (1876-1969).

Warburg syndrome

An association of congenital hydrocephalus (excess fluid in the brain) (sometimes with microcephaly [abnormally small head]), lissencephaly (smooth, rather than convoluted, brain surface), and ocular abnormalities contributing to blindness and early death. Recurrence risk for siblings is over 50%, but the genetics of this association remain unclear.

ward

A legal term indicating that a person has been judged unable to care for or make decisions for him- or herself in one or more areas of his or her life. This may occur due to age (e.g., abandoned children), disability (e.g., mental retardation), or health (e.g., stroke). After legal determination of this inability has been made, a guardian is assigned, and the person is then declared a ward.

Washer Visual Acuity Screening Technique (WVAST)

A screening test for near and far visual acuity in people with severe disabilities and low functioning. Intended for people with a mental age of 2-6 years and above, the test can be used to screen down to the 18-month level with conditioning.

water on the brain

Lay term for hydrocephalus. The "water" is actually the clear, straw-colored cerebrospinal fluid that circulates through and bathes the brain and spinal cord; an excess or buildup of this liquid under pressure inside (rather than "on") the brain causes the head to enlarge and the brain tissue to stretch and thin out. Radiologic examination will show marked dilation (enlargement) of the ventricles (fluid-containing spaces) in the brain.

watershed phenomenon

An analogy to explain the susceptibility of the parasagittal cortex of the brain to injury when blood perfusion (circulation) is reduced in full-term infants; such parasagittal injury leads to hemiplegia (paralysis of half the body), quadriplegia (paralysis of all four extremities), and mental retardation.

WCST-R

See Wisconsin Card Sorting Test-Revised.

Weaver syndrome

A rare syndrome with macrosomia (large body size) from birth through adulthood, camptodactyly (permanent flexion of fingers and toes), a peculiar facies, developmental delay, and a variety of orthopedic deformities. Etiology (cause) remains unknown.

Wechsler Adult Intelligence Scale-Revised (WAIS-R)

An individually administered 11-subtest measure of an adult's capacity for intelligent behavior. The WAIS-R extends and completes the line of test development that began with the publication of the Wechsler-Bellevue Intelligence Scale in 1939 and was followed by its revision, the WAIS, in 1955. The WAIS-R has both a verbal scale and a performance scale. Verbal subtests include information, digit span, vocabulary, arithmetic, comprehension, and similarities. Performance sub-tests include picture completion, picture arrangement, block design, object assembly, and digit symbol. The test provides subtest standard scores (with a mean of 10 and a standard deviation of 3), and deviation IQs (with a mean of 100 and a standard deviation of 15) for the verbal, performance, and full scales. The test is used with individuals 16-74 years of age. WAIS-R norms, reliability, and validation are excellent. The test takes approximately 1 hour to administer. The verbal scale can be used alone with individuals who have visual or motor impairments, and the performance scale can be used alone with individuals who cannot adequately understand or produce spoken language.

Wechsler Individual Achievement Test (WIAT)

An individually administered battery to assess educational achievement in eight areas: basic reading, mathematics reasoning, spelling, reading comprehension, numerical operations, listening comprehension, and oral and written expression. There is a WIAT Screener that assesses the first three of these areas. The WIAT was standardized with the Wechsler Intelligence Scale for Children-Third Edition (WTSC-III).

Wechsler Intelligence Scale for Children-Revised (WISC-R)

A 12-subtest measure of intelligence for children 6-0 to 16-11 years of age. The WISC-R generates three IQ scores: full scale, verbal, and performance. IQs are obtained by comparing the child's scores to those earned by a representative sample of age peers. IQ scores have a mean of 100 and a standard deviation of 15; each of the 12 subtests has a mean of 10 and a standard deviation of 3. The verbal scale measures the ability to use language in cognitive processes through six subtests: information, similarities, arithmetic, vocabulary, comprehension, and digit span. The performance scale evaluates motor abilities and visual spatial processing through six subtests: picture completion, picture arrangement, block design, object assembly, coding, and mazes. In addition to IQ scores, the WISC-R also provides three factor scores (Kaufman factors) that identify meaningful dimensions of psychological processing and can be helpful in evaluating a child's strengths and weaknesses. They are obtained by summing scaled scores of specific sub-tests. Three factors have been identified. The verbal comprehension (VC) factor score measures verbal knowledge and reflects the application of language skills to new situations. The perceptual organization (PO) factor reflects the ability to organize and to interpret visually presented material within a prescribed amount of time. The freedom from distractibility (FFD) factor score measures the ability to attend and concentrate, but may also include a partial measure of numerical ability and short-term memory. The WISC-R was published in 1974, 25 years after David Wechsler's original scale (the WISC) had been developed as a downward extension of the Wechsler-Bellevue Intelligence Scale for Adults. The WISC-R has good validity, high reliability, and excellent standardization. Its limitations include a restricted range of possible full-scale IQs (40-l60) and the limited applicability of norms for ages 6-0 to 6-3 and 16-7 to 16-11 years of age. It was one of the most widely used and accepted intelligence tests for children. Certain physical abilities are required in order for a child to respond to WISC-R subtests. Children must he able to hear to take most verbal subtests, although vision may sometimes be used as an alternative administration modality. Arm and hand use is a prerequisite for almost all performance subtests, although some adaptations are possible. Allowances for alternative adaptative administration and the existence of two separate scales facilitate the testing of children with such disabilities.

Wechsler Intelligence Scale for Children-Third Edition (WISC-III)

An individually administered intelligence test for children 6-0 to 16-9 yearsof age. The WISC-III yields a verbal IQ, performance IQ, and a full-scale IQ. The verbal suh-tcsts include information, similarities, arithmetic, vocabulary, comprehension, and digit span. The performance subtests include picture completion, coding, picture arrangement, block design, object assembly, symbol search, and mazes. Four factor-based index scores can also be calculated: verbal comprehension index (VCI) from information, similarities, vocabulary, and comprehension; perceptual organization index (POI) from picture completion, picture arrangement. block design, and object assembly; freedom from distractibility index (FDI) from arithmetic and digit span; and processing speed index (PSI) from coding and symbol search. The subtest standard scores each have a mean of 10 and a standard deviation of 3; the deviation IQs and the factor indices each have a mean of 100 and a standard deviation of 15. This 1991 revision is better validated for clinical groups of children with learning disabilities and other developmental disabilities.

Wechsler Preschool and Primary Scale of Intelligence-Revised (WPPSI-R)

A 12-subtest standardized measure of intellectual abilities in young children 3-7 years of age. WPPSI-R verbal subtests include information, comprehension, arithmetic, vocabulary, similarities, and sentences. WPPS1-R performance subtests include geometric design, block design, mazes, picture completion, animal pegs, and (the one new addition over the original WPPSI) object assembly. The WPPSI-R overlaps 1 year with the WISC-R: 9 of the 12 subtests are downward extensions and adaptations of their WISC-R analogues; the 3 novel subtests include animal pegs, sentences, and geometric design. Animal pegs and sentences are optional and are not used to calculate IQ. Norms, reliability, and validity are excellent. In keeping with the WISC-R and WAIS-R, WPPSI-R scores have a mean of 100 and a standard deviation of 15. Administration time is approximately 1 hour and l5 minutes.

Wechsler tests

A family of tests developed by David Wechsler (1896-1981) to measure intelligence in adults and children. These tests currently include the Wechsler Adult Intelligence Scale-Revised (WAIS-R), the Wechsler Intelligence Scale for Children-Third Edition (WISC-III), and the Wechsler Preschool and Primary Scale of Intelligence-Revised (WPPSI-R). Because Wechsler believed that intelligence is an aggregate of multiple abilities and should be measured as such, his tests are composed of numerous subtests that measure both verbal and nonverbal (performance) aspects of intelligence.

WeeFIM

See Functional Independence Measure for Children.

weighting

Mathematically assigning to any given test item that proportion of the total score it will determine.

Wender sign

Wender foot sign; unilateral or bilateral foot tapping or crossed-knee foot jiggle as a sign of adult attention-deficit/hyperactivity disorder (ADHD) or alcoholism.

Wender Utah Rating Scale (WURS)

A 61-item checklist to aid in the diagnosis of attention-deficit/hyperactivity disorder (ADHD) (active or residual) in adults. Such a diagnosis in adults requires a childhood history of ADHD in addition to current symptomology. The WURS checklist rates a variety of childhood behaviors on a 5-point scale (from 0 for not at all to 4 for very much).

Wepman Auditory Discrimination Test

A test of auditory discrimination in which 40 pairs of words (10 identical and 30 differing by only a single phoneme or sound) are read to the child, who then responds as to whether they are the same or different. Although this test is supposed to measure auditory processing, the results are influenced by hearing acuity, short-term memory, and attention; very hyperactive children tend to score quite low on this test.

Werdnig-Hoffmann syndrome

Spinal muscular atrophy; a genetic neurological disorder that leads to severe muscle weakness in infancy and early childhood with fatal respiratory compromise. Inheritance is autosomal dominant.

Wernicke aphasia

The loss of the ability to find the correct word (i.e., anomia) secondary to damage to a specific area of the temporal lobe (Brodmann area 39, the angular gyrus, Wernicke area, posterior [back] speech cortex). Paraphrasia (using circumlocutions or talking around the word that cannot be found) is a common sign of Wernicke aphasia.

West syndrome

Blitz-Nick-Salaam Krämpfe. The triad of infantile spasms, hypsarrhythmia (a continuous disorganized pattern of high-voltage slow waves and spikes), and mental retardation. Onset is usually between 4 and 7 months of age; boys are more commonly affected than girls. West syndrome can be separated into a symptomatic group (in which a specific cause is identified or other evidence of brain damage is present) and an idiopathic (unknown) group (in which no evidence of brain damage or other cause is found). Etiological (casual) conditions include phenylketonuria, maple syrup urine disease, leucine-sensitive hypoglycemia (low blood sugar level), porencephaly (a large piece of brain missing), rubella, Sturge-Weber syndrome, and tuberous sclerosis. Signs of brain damage include preexisting developmental delay, atypical neurological findings, other types of seizures, and atypical radiographic findings (e.g., on computed tomography [CT] scan). The prognosis for infants with West syndrome is poor, but is better for those without any known etiology (idiopathic or cryptogenic [with no known etiological factors] cause). Dr. J. West wrote a letter to the Lancet in 1841 with the first case description of infantile spasms in his son.

Wharton duct relocation

A surgical procedure that reduces the salivary flow from the submandibular gland as a treatment for drooling.

wheelchair bound

An inaccurate phrase used to refer to an individual in a wheelchair. It is objectionable because it creates a false impression; without the wheelchair, the individual would be bound (confined) to a bed or chair. The preferable wording is "uses a wheelchair." This phrasing emphasizes function and ability; the wheelchair and other aides are employed by individuals to enhance their quality of life by enabling mobility, not by restricting it.

whistling face syndrome

Freeman-Sheldon syndrome; craniocarpotarsal dysplasia. A genetic syndrome with a peculiar facies (a masklike face with a small mouth giving the impression of puckering to whistle), small narrow nostrils, club feet, and flexion contractures of the fingers. Mental retardation is an occasional finding. Inheritance is autosomal dominant (rarely, autosomal recessive).

white matter

Areas of the brain that contain the myelinated nerve axons. These are the units that transfer messages from one brain area to another. White matter diseases affect the cells that manufacture the myelin (a fatty insulation material) sheaths (coverings).

white matter disease

Leukodystrophy. A group of degenerative diseases of the central nervous system in which motor signs of pyramidal tract involvement occur early, whereas cognitive deterioration and seizures occur late in the course of the disorder. (Brain white matter controls motor functions; gray cells are involved in thinking.)

white pupil

Leukocoria; a physical finding that suggests the possibility of cataract, coloboma (an eye lesion), retinoblastoma (a tumor), or retinal (eye) detachment.

whorl

A spiral pattern that occurs in nature; variations from expected whorl patterns in fingerprints and hair can contribute to a dysmorphology (atypical appearance) diagnosis; the depigmented skin lesions of incontinentia pigmenti may also occur in a whorl pattern.

WIAT

See Wechsler Individual Achievement Test.

Wide Range Achievement Test-Third Edition (WRAT-3)

A measure of reading, spelling, and arithmetic. There are two equivalent test forms (blue and tan) normed by age that can be used for pre- and postintervention assessment of people 5-75 years of age and that provide standard scores, percentiles, and grade equivalents for each of the three areas of learning.

Wide Range Assessment of Memory and Learning (WRAML)

An individually administered test of memory for children 5-17 years of age, with nine subtests and a general memory index: administration time is about 1 hour.

widow's peak

A downward V-shaped extension of the frontal hairline; a minor variation from normal that can be a component of certain syndromes (e.g., Waardenburg syndrome).

Wiedemann-Rautenstrauch syndrome

Congenital pseudohydrocephalic syndrome; a generic syndrome that presents at birth with pseudohydrocephalus, a senile triangular facies, congenital teeth, an extensive deficiency of subcutaneous (inner) fat, and. usually, mental retardation. Inheritance is probably autosomal recessive.

Wiig CRIL

See Wiig Criterion-Referenced Inventory of Language.

Wiig Criterion-Referenced Inventory of Language (Wiig CRIL)

A criterion-referenced assessment of language for children 4-15 years of age; it complements norm-referenced testing and helps plan intervention in the areas of semantics (the meaning of words), morphology (word structure), syntax (grammar), and pragmatics.

Wildervanck syndrome

A genetic syndrome including the Klippel-Feil syndrome, the Duane syndrome (a sixth nerve palsy limiting the outward movement of the eve), and a congenital hearing impairment. Inheritance is X-linked dominant, or polygenic-multifactorial limited to females.

Wildervanck-Smith syndrome

See Treacher Collins syndrome.

Williams syndrome

Finn facies syndrome; Williams-Beuren syndrome; Fanconi-Schlesinger syndrome. A dysmorphic (with an unusual facies [especially full lips]) syndrome, mild to moderate mental retardation, a hoarse or metallic voice, and congenital heart disease (i.e., supravalvular aortic stenosis). Affected individuals may also exhibit "cocktail party chatter" syndrome with an outgoing loquaciousness that makes them appear more intelligent due to an inflation of verbal rote skills compared to other cognitive abilities. Etiology (cause) remains unknown, although abnormalities in calcium metabolism and connective tissue have been suspected.

Wilson disease

Hepatolenticular degeneration. An inborn error of copper metabolism, Wilson disease clinically involves primarily liver and brain (especially the basal ganglia) with neurological presentations (dystonia [impaired muscle tone], drooling, and other bulbar symptoms, gait disturbances, and mild intellectual impairment) occurring between 10 and 20 years of age. Learning disabilities and emotional disturbances are occasionally prominent. Physical findings include liver enlargement, Kayser-Fleischer ring (a pigmented ring around the outside of the cornea), and motor dysfunction in the absence of sensory and reflex abnormalities. Diagnosis can he confirmed by a serum ceruloplasmin (a copper-binding protein) level and an ophthalmological examination for the eye findings. Chelation treatment involves the administration of a copper-binding chemical, such as penicillamine. Neurological prognosis is variable. Inheritance is autosomal recessive. Named after the British neurologist Samuel A.K. Wilson (1878-1937).

windswept hip deformity

Both hips and knees are flexed, hut one hip is abducted and externally rotated and the other is adducted (pulled inward) and internally rotated (and often subluxed [dislocated] also); this deformity pattern occurs in people with severe cerebral palsy and gives a misleading impression of leg-length discrepancy.

Wisconsin Card Sorting Test-Revised (WCST-R)

An individually administered neuropsychological test used to assess the ability of children and adults to form abstract concepts and to both shift and maintain the set. Tile subject is asked to categorize 64 or 128 cards as belonging to one of four stimulus card groupings; each card has one to four examples of one to four different shapes in one to four different colors (e.g., two red triangles or three blue squares). Perseveration errors are interpreted as indicative of dorsolateral frontal lobe damage and sometimes chronic alcoholism. Norms are available for ages 6-5 to 89.

WISC-R

See Wechsler Intelligence Scale for Children-Revised.

WISC-III

See Wechsler Intelligence Scale for Children-Third Edition.

withdrawal syndrome, neonatal

Infants of drug-addicted mothers (IDAMs) may exhibit the following acronymic "withdrawal" syndrome; wakefulness, irritability, tremulousness, tachypnea (rapid breathing), hyperactivity, high-pitched cry, hyperreflexia (increased reflexes), diaphoresis (sweating), diarrhea, respiratory distress, rhinorrhea (runny nose), apnea (temporary cessation of breathing), autonomic nervous system dysfunction (poor temperature control), weight loss, respiratory alkalosis (alteration of the body's acid-base balance due to a loss of acid from the rapid breathing), lacrimation (excess tears), and seizurcs.

WJ-R

See Woodcock-Johnson Psycho-Educational Battery-Revised.

Woodcock-Johnson Psycho-Educational Battery-Revised

(WJ-R) A wide-ranging set of individually administered tests designed to measure cognitive abilities, scholastic aptitude, and academic achievement in people 2-95 years of age. There are two forms for the achievement tests, and for both the achievement and cognitive tests there arc standard and supplemental batteries. The cognitive tests are based on the Horn-Cattell theory, an extension of the fluid/crvstallized model of intelligence. Seven broad cognitive factors are included: 1) long-term retrieval, 2) short-term memory, 3) processing speed, 4) auditory processing, 5) visual processing, 6) comprehension-knowledge, and 7) fluid reasoning. Each of the tests in this standard battery measures one of the cognitive factors. The supplemental battery consists of 14 subtests: The first 7 subtests correspond to the 7 cognitive factors in the standard battery; the other 7 subtests are used selectively to probe specific cognitive areas. The 21 WJ-R subtests may be combined in various ways to form several clusters: broad cognitive ability (extended), long-term retrieval, short-term memory, processing speed, auditory processing, visual processing, comprehension-knowledge, fluid reasoning, reading aptitude, mathematics aptitude, written-language aptitude, knowledge aptitude, oral language, and oral-language aptitude. All seven tests from the standard battery can be combined for a broad cognitive ability score. An early developmental scale can he used with children as young as 2 years of age. The nine subtests on the achievement standard battery can be combined to form clusters of broad reading, broad mathematics, broad written language, broad knowledge, and skills, with the latter two being applicable to younger children. The five supplemental subtests, in combination with the standard battery, yield cluster scores for basic reading skills, reading comprehension, basic mathematics skills, mathematics reasoning, basic writing skills, and written expression. Six subtests from the standard achievement battery can be used with children as young as 2 years of age as measures of early development. Raw scores may be converted to percentile ranks, standard scores (with a mean of 100 and a standard deviation of 15), and relative mastery index (the percentage of material the examinee has mastered, of which members of a reference group have mastered 90%). Norms may be based on cither age or grade. If both achievement and cognitive batteries are administered, it is possible to calculate aptitude/ achievement discrepancies in the areas of oral language, reading, mathematics, written language, and knowledge, which are expressed by both percentile ranks and the standard deviation differences. There are also procedures to determine intraachievement and intracognitive discrepancies that provide a profile of relative strengths and weaknesses. Scoring is tedious.

Woodcock Language Proficiency Battery

This battery measures language in three areas: oral language (picture vocabulary, antonyms and synonyms, analogies), reading (letter-word identification, word attack, passage comprehension), and written language (dictation, proofing, punctuation and capitalization, spelling, usage). There are English and Spanish forms of the test.

Woodcock Reading Mastery Test-Revised (WRMT-R)

A test of reading ability that is used for children from kindergarten to college seniors and adults to 75 years of age. The organization of the WRMT-R is hierarchical and includes five levels: total reading, clusters (readiness, basic skills, reading comprehension), tests, subtests (and vocabulary), and item error. Across the first three levels, a full array of norm-referenced scores can be obtained (grade and age equivalents, percentile ranks, standard scores with a mean of 100 and a standard deviation of 15, normal curve equivalents with a mean of 50 and a standard deviation of 21.06, T scores with a mean of 50 and a standard deviation of 10, stanines with a mean of 5 and a standard deviation of 2, relative performance index, and instructional range) for as many as 10 dimensions. Readiness is assessed by reading passages made up of newly learned rebus symbol—word associations and by naming upper- and lower-case letters in a variety of type styles. Reading is assessed by reading written words on sight; applying phonic and structural analysis skills to pronounce unfamiliar words; reading a stem aloud and orally providing an antonym or synonym or completing an analogy; and by providing a key word missing from a silently read passage. Scoring is tedious, but a computer scoring program is available. Care should be taken when interpreting basic skills and comprehension scores in kindergarteners who are at or below average for the group as a whole, since a raw score of zero can result in an above-average percentile score.

Wooster-Drought syndrome

See pseudo-bulbar palsy.

word association test

A projective technique in which the individual is presented with a list of words one at a time and asked to respond with the first word or idea that comes to mind. The examiner is most interested in the length of time required to respond and the degree of uniqueness or peculiarity of the associations the subject makes. When used as part of an assessment for developmental disabilities, the examiner must he sensitive to the effects of language impairments, processing problems, attention deficits, and other neurological impairments on the individual's response style and the quality of the answers produced.

word attack

Techniques that enable a child to decode an unknown word to pronounce it and to understand it in context. These techniques include phonic analysis (phonics), structural analysis, contextual clues, and dictionary skills.

word blindness, congenital

Antiquated term originally coined by Adolf Kussmaul (1822-1902) in 1877 to describe a case of acquired dyslexia. The term was adopted and used by J. Hinshelwood in his classic 1917 monograph by that title.

Word Test

A norm-referenced test of semantic (meaning systems) knowledge for children ages 7-11 years with six sub-tests: associations, synonyms, antonyms, definitions, semantic absurdities, and multiple definitions.

Word Test-Adolescent

A norm-referenced test of semantic (meaning systems) knowledge for children ages 12-17 years of age that uses four tasks: brand names, synonyms, signs of the times, and definitions.

working memory

See short-term memory.

WPPSI-R

See Wechsler Preschool and Primary Scale of Intelligence-Revised.

WRAML

See Wide Range Assessment of Memory and I.earning.

WRAT-3

See Wide Range Achievement Test-Third Edition.

WRMT-R

See Woodcock Reading Mastery Test-Revised.

wryneck

See torticollis.

WURS

See Wender Utah Rating Scale.

WVAST

See Washer Visual Acuity Screening Technique.