Learning Disability Ebooks Catalog

Adult Dyslexia

Adult Dyslexia

This is a comprehensive guide covering the basics of dyslexia to a wide range of diagnostic procedures and tips to help you manage with your symptoms. These tips and tricks have been used on people with dyslexia of every varying degree and with great success. People just like yourself that suffer with adult dyslexia now feel more comfortable and relaxed in social and work situations.

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Dyslexia Facts You Should Know

Dyslexia, Facts You Should Know Is A Unique Fact Filled E-book That Gathers Easy To Read Information About Dyslexia In One Place For The Interested Reader. Learn How to Cope With A Diagnosis of Dyslexia and What To Do Next. Every bit of this eBook is packed with the latest cutting edge information on Dyslexia. It took months to research, edit, and compile it into this intriguing new eBook. Here's what you'll discover in Dyslexia: Facts You Should Know: What is Dyslexia? History of Dyslexia. Is it Dyslexia or Something Else? How You Can Diagnose Yourself. Benefits of Catching Dyslexia Early. What is the Dyslexia Test? How to Get Everything You Will Need for Help in Coping with Dyslexia. Exploring Your Options for Schools and Programs. What is the Individualized Education Program? Alternatives to the Iep. The Roll Your Childs Teacher Plays. Your Part in Your Childs Education. Why Practice, Patience and Practicality are Most Important. Teens with Dyslexia. Success in Life: Adults Overcoming Dyslexia.

Dyslexia Facts You Should Know Summary


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Learning disability

The terms learning disability (LD) and learning difficulties are now used in preference to older ones such as mental handicap, mental retardation, or mental subnor-mality. Sometimes, patients with LD need to be admitted to hospital compulsorily under the Mental Health Act 1983 if so, the grounds are 'abnormally aggressive or seriously irresponsible conduct', and mental impairment is the term used.

Reading disorder

Reading disorder is a learning disorder that involves significant impairment of reading accuracy, speed, or comprehension to the extent that the impairment interferes with academic achievement or activities of daily life. People with reading disorder perform reading tasks well below the level one would expect on the basis of their general intelligence, educational opportunities, and physical health. Reading disorder is most commonly called dyslexia. Dyslexia, however, usually includes deficits in spelling and writing as well as reading. Reading disorder is a learning disorder characterized by a significant disparity between an individual's general intelligence and his or her reading skills. Learning disorders, formerly called academic skills disorders, are disorders that account for difficulty learning and poor academic performance when low performance cannot be attributed to mental retardation, low intelligence, lack of learning opportunities, or such specific physical problems as...

Context of the Referral

Thus, a psychological report is requested so that relevant information can be marshalled. This information leads to the implementation of therapeutic helping procedures or further diagnostic measures for example, a psychopharmacologi-cal consultation, neurological assessment, or learning disabilities evaluation.

Assessing Cognition Mental Status Examinations And Neuropsychological Evaluation

However, certain conditions make it difficult to assess mental status with only a brief examination. Very highly educated individuals may perform well on mental status testing because it is not sufficiently challenging for them. The presence of premorbid or comorbid conditions might lower performance, making it difficult to determine if there is further decline. These could include depression, learning disability, prior CNS injury or disease, specific language deficit, or sensory deficit, which can compromise assessment. In such cases, more comprehensive neuropsychological assessment may be useful.

Clinical features of FRAXE disease

In addition, a patient with an FMR2 loss-of-function mutation that does not involve repeat expansion has been described (Gecz et al. 1996). He has mild learning disabilities and speech delay, supporting a role for FMR2 in these functions, but his phenotype does not exclude the possibility that the repeat expansion mutation can affect additional genes or functions of the locus. In this respect, a transcript has been identified that is expressed in the opposite orientation from FMR2 from the same promoter (Gecz 2000a). Gecz and colleagues termed this transcript FMR3, and suggested that it may also play a role in the FRAXE phenotype. It is not clear what the function of the FMR3 transcript might be, but with the growing appreciation of the importance of RNA molecules in the control of numerous cell functions, the possibility for involvement must be considered.

Meiotic 22q112 Rearrangements

Diseases resulting from rearrangements of the human genome are referred to as genomic disorders and most are mediated by region-specific LCRs (1-5). The 22q11.2 region is particularly susceptible to meiotic chromosome rearrangements associated with genomic disorders including VCFS DGS (OMIM192430 OMIM188400) (6-8) the reciprocal duplication syndrome, dup(22)(q11.2 q11.2) (9-12), CES(MIM 115470) 13, and der(22) syndrome (14,15). All of these are congenital anomaly disorders with varying levels of learning disabilities and mental retardation. An illustration of the chromosomal breakpoints for these disorders is shown in Fig. 1.

Token economy system

The primary goal of a token economy is to increase desirable behavior and decrease undesirable behavior. Often token economies are used in institutional settings (such as psychiatric hospitals or correctional facilities) to manage the behavior of individuals who may be aggressive or unpredictable. However, the larger goal of token economies is to teach appropriate behavior and social skills that can be used in one's natural environment. Special education (for children with developmental or learning disabilities, hyperactivity, attention deficit, or behavioral disorders), regular education, colleges, various types of group homes, military divi

Body Proportions At Different Ages

Development Fetus Month Month

The virus that causes rubella (German measles) is a powerful teratogen. Australian physicians first noted its effects in 1941, and a rubella epidemic in the United States in the early 1960s caused 20,000 birth defects and 30,000 stillbirths. Exposure in the first trimester leads to cataracts, deafness, and heart defects, and later exposure causes learning disabilities, speech and hearing problems, and type I diabetes mellitus. Widespread vaccination has slashed the incidence of this congenital rubella syndrome, and today it occurs only where people are not vaccinated. A child with fetal alcohol syndrome has a characteristic small head, misshapen eyes, and a flat face and nose (fig. 23B). He or she grows slowly before and after birth. Intellect is impaired, ranging from minor learning disabilities to mental retardation.

Methodological Issues

For a parent there is an untimeliness about the death of a child whether that child is in its early years or has become an adult. A source of practical and emotional support may be lost with the death of an adult child. If the dead person was not valued by their community then the bereaved survivor will feel isolated in grief as can happen with the bereaved parents of children with learning disabilities (Cathcart, 1996).

Disorders of Supranuclear Eye Movements

Refixation Saccades

Convergence spasm may occur during horizontal saccades and produce a pseudoabducens palsy because the abducting eye moves more slowly than the adducting eye.113 This phenomenon can cause reading difficulties early in the course of dorsal midbrain syndrome because it provides an obstacle to refixation toward the beginning of a new line of text. Indeed, older children may present with numerous pairs of corrective

Cognitive Therapy for Different Populations and in Different Settings

Given the common features of cognitive therapy and these widely differing areas of application, it is not surprising that cognitive therapy has evolved in several different formats to ensure it is acceptable and effective to a range of groups of people (children, adolescents, adults, older adults and people with learning disabilities), in different therapy formats (self-help, individual, couples, families, groups, organisations) and across different levels of service delivery (primary, secondary and tertiary care). There is increasing interest in cognitive therapy for children, in part because the approach appears acceptable to children and adolescents and pragmatic in these service settings (Friedberg & McClure, 2001). A comprehensive review of the outcome literature for children and adolescents suggests that cognitive therapy is effective for generalised anxiety, simple phobias, depression and suicidality (Fonagy et al., 2002 Kazdin & Weisz, 1998). As with adult populations, the...

Stanford Binet Intelligence Scale

Blindfolded Test Subject

The Stanford-Binet Intelligence Scale was originally developed to help place children in appropriate educational settings. It can help determine the level of intellectual and cognitive functioning in preschoolers, children, adolescents and adults, and assist in the diagnosis of a learning disability, developmental delay, mental retardation, or giftedness. It is used to provide educational planning and placement, neuropsycholo-gical assessment, and research. The Stanford-Binet Intelligence Scale is generally administered in a school or clinical setting.

Collecting Assessment Information

Educational issues (e.g., Does this student have a learning disability ) call for measures of intellectual abilities and academic aptitude and achievement. Questions that relate to neuropsychological functions (e.g., Are there indications of memory loss ) call for measures of cognitive functioning, with special emphasis on measures of capacities for learning and recall.

Basis of Inferences and Impressions

For example, statistical rules may prove helpful in determining whether a student has a learning disability, but say nothing about the nature of this student's disability they may predict the likelihood of a criminal defendant's behaving violently, but offer no clues to the kinds of situations that are most likely to evoke violence in this particular criminal defendant or they may help identify the suitability of a person for one type of position in an organization, but be mute with respect to the person's suitability for other types of positions in the same organization. In each of these instances, moreover, a statistical rule derived from a group of people possessing certain demographic characteristics (e.g., age, gender, socioeconomic status, cultural background) and having been evaluated in a particular setting may lack validity generalization to persons with different demographic characteristics evaluated in some other kind of setting. Garb (2000) has similarly noted in this...

Implications of Verbal Performance Discrepancy

In patients with developmental or maturational problems, it is often found that some areas of cognitive functioning are strongly developed and intact while other areas are markedly underdeveloped. Such a configuration can be reflected in an improbable difference between verbal and performance functioning. Learning disabilities may involve maturational delays in which disturbances of motor coordination or visual-motor coordination can be affected to such an extent that performance functioning is substantially impaired. In this instance, a contrast between verbal and performance capacities can readily be seen. The presence of a learning disability involving a developmental delay with minimal organic dysfunction may also impair verbal processing. Such pathology can also be reflected in discrepant functioning between verbal and performance skills on the intelligence test.

Cognitive Differences

In addition to affecting perceptual and psychomotor abilities, biological differences between the sexes influence cognitive abilities and personality. A somewhat dated, but still valuable, summary of such differences may be found in Maccoby and Jacklin (1974 also see Eagly & Carli, 1981). One of the most obvious areas of sex differences in cognitive abilities is verbal-linguistic ability. Girls learn to talk and read sooner and, to some extent, better than boys. The incidence of dyslexia (reading disorder) is greater among boys, a larger percentage of boys being in remedial reading classes (Finucci & Childs, 1981 Halpern, 1992). Girls appear to retain their superiority in verbal abilities in elementary school, performing better than boys on tests of spelling, punctuation, reading comprehension, and verbal analogies.

Familiar Words PseudowordsConsonant Strings

Fmri Memory

Pediatric fMRI research allows developmental disorders such as developmental dyslexia to be studied within the age range in which they typically first appear, and thus provides opportunities both for early prevention intervention and dynamic tracking of cortical changes associated with gains in cognitive skills.

Cognitive and Psychiatric Disturbances

In recent years, awareness of cognitive dysfunction in MS patients has increased, although abnormalities have been variably reported in 0 to 90 of cases (104,105). A follow-up study of 45 patients with MS, initially studied early in their disease course, found that only 20 of 37 initially cognitively normal individuals remained so after 10 years (106). Clearly, severe dementia is unusual in MS, but more subtle abnormalities of cognitive function are common. These are often unnoticed by patients, families, or physicians, but they may be detected on more formal neuropsychiatric evaluation. The most frequently encountered difficulties are with memory, attention-concentration, and conceptual reasoning-problem solving (104-109). Although cognitive impairments are variable, they typically follow patterns usually associated with subcortical lesions. Several recent studies have provided evidence of impaired driving in patients with MS and cognitive dysfunction (110-112). Aphasia, apraxia,...

Impact of Demographic Socioeconomic and Health Characteristics

It is further important to remember emotional states such as anxiety and thought problems will affect a client's communication in a second language more dramatically than the first, as facility with a second language is more tenuous. A Sioux male who learned English second might look highly disturbed and in need of hospitalization to an English-speaking clinician. If this same client were able to speak with a clinician familiar with his first language, however, it might become evident the client is highly stressed but not in need of emergent intervention. Suzuki and Kugler (1995) also warn that the dysfluen-cies common when acquiring a new language can look like symptoms of a language disorder such as dyslexia.

Commonly Occurring Disorders

Indian and Native youth and adults are at high risk for or have a high prevalence of the following mental retardation, speech impediments, learning disabilities, developmental disabilities, Attention Deficit Hyperactivity Disorder, Conduct Disorder, psychoactive substance abuse and dependence, depression, simple phobias, social phobias, separation anxiety, overanxious disorder, obsessive-compulsive disorder, and posttraumatic stress disorder (Manson et al., 1997 Manson & Brenneman, 1995 Manson, Walker, & Kivlahan, 1987). In addition, American Indian and Alaska Native youth experience high rates of Fetal Alcohol Effects or Fetal Alcohol Syndrome, otitis media, which can contribute to language and speech delays (McShane, 1982), suicide (Blum, Harmon, Harris, Bergeisen, & Resnick, 1992), and child abuse and neglect (Manson et al., 1997).

The psychiatric multidisciplinary team

Teams for general adult psychiatry are usually responsible for a given sector, defined geographically (for example, by postcode) or by GP. Other teams, often covering a wider area, deal with specialties such as old-age psychiatry, child psychiatry, learning disability, substance misuse, forensic psychiatry, psychotherapy, and rehabilitation.

Prison Medical Service

As previously indicated, surveys of prisoners indicate that up to 50 per cent or more can be diagnosed as having some sort of mental abnormality. Sociopathy and substance misuse are the main diagnoses, but learning disability, functional psychosis, organic brain disease, and epilepsy are also found in excess. In some cases this disorder has not been recognized. Others are in prison because no psychiatric hospital place can be found for them. However, the presence of certain psychiatric disorders, such as personality disorder, substance misuse, or treated chronic mental illness, does not necessarily mean that prison is inappropriate.

Disputes About Reception Into Care

Understand why they are seen as inadequate (Cleaver and Freeman 1995). A number have grown up in care themselves and do not want this for their children. Others may have mild to moderate learning difficulties or mental health problems. A small number are self-absorbed and either preoccupied in their own need or see the child as a means for their own gratification. The children, whatever the family difficulties, are usually very frightened, may be psychologically frozen and paralysed or may become depressed or angry and defiant. Once in care, they may blossom physically but many may miss their parents and be distressed and preoccupied, or for a period they may switch off and become detached. Many of these children have diagnosable psychopathology as well as poor physical health (McCann et al., 1996).

Assessment Of These Children

An Asian family consisted of a parent and step-parent with a daughter who had learning difficulties and had possibly been sexually abused. Mother was deaf and they spoke Muslim Gujarati. There needed to be a signer, an interpreter and a religious adviser. Often, in such a case, the family will be seen for assessment because a crisis has arisen. Unemployment may have occurred or physical or mental illness or domestic violence. The assessment tries to clarify how troubled and damaged the children are and whether the situation will ameliorate once the crisis is past or whether this was a chronically unacceptable situation that the crisis has brought into the open. In this case, could the girl remain living at home

Clinical Description Of The

The condition was first described some 40 years ago (Prader et al., 1956). The clinical phenotype of PWS is characterized by neonatal hypotonia and developmental delay, followed by hyperphagia and major obesity, short stature, secondary hypogonadism, mild dysmorphism, small hands and feet, and mild to moderate mental retardation with learning disability. Consensus diagnostic criteria have been established and proven to be satisfactory for the clinicians (Holm et al., 1993). The frequency of the syndrome is on the order of 1 in 10,000 to 1 in 15,000 (Cassidy, 1984).

Cognitive remediation

The goals of cognitive remediation are to bolster specific cognitive capacities that are weak and also to teach compensatory strategies. Cognitive remediation is used primarily with two groups of people those who have suffered from a traumatic brain injury (a stroke, tumor, or a head injury) and those who have learning disabilities. For people with brain injury, remediation typically targets the following neuropsychological func tions attention and concentration memory planning monitoring one's work or behavior and making adjustments based on feedback. Remediation is also used to help children and adults cope with learning disabilities. Learning disabilities can interfere with progress in reading in understanding and communicating through spoken language in writing in arithmetic in understanding such nonverbal information as telling time or understanding visual information and in comprehending social interactions and cues. Difficulties with concentration, problem-solving,...

Neurogenetic Syndromes

In the field of neurogenetic conditions, fragile X syndrome (FXS) is somewhat unique in that the primary genetic cause of the disease has been traced to the inactivation of a single gene. Affecting approx 1 4000-6000 live births, FXS is the most common form of inherited mental retardation resulting from a known gene (40). The physical characteristics include macroorchidism, large ears, and a long face (41). A distinct neurobehavioral phenotype, which differs between males and females, is present. Males with FXS are typically quite affected, with mild to severe mental retardation and learning disability. Deficits are present in short-term memory speech and

Teaching Students How To Construct An Assessment Battery

First, an intellectual measure should be included, even if the person's intelligence level appears obvious, because it allows the assessor to estimate whether there is emotional interference in cognitive functioning. For this we recommend the WAIS-III or the WISC-III, although the use of various short forms is acceptable if time is an important factor. For people with language problems of one type or another, or for people whose learning opportunities have been atypical for any number of reasons (e.g., poverty, dyslexia, etc.), a nonverbal intelligence test might be substituted if an IQ measure is necessary. The Wechsler tests also offer many clues concerning personality functioning, from the pattern of interaction with the examiner, the approach to the test, the patient's attitude while taking it, response content, as well as from the style and approach to the subtest items, and the response to success or failure. If these issues are not relevant for the particular referral...

Testing of Preschool Children

One of the areas currently receiving pronounced clinical interest concerns the development of preschool children. A collateral emphasis is on the early observation of preschoolers in order to detect any signs of pathology or a potential learning disability that might interfere with later personal adjustment and school success. Often, such disturbances surface as a result of problems in the child's home life that can be alleviated by intervention. Some disturbances can also reflect the need for special educational placement to reduce emerging learning problems. The emphasis placed on early detection is based on the observation that early intervention in any difficulties that materialize during the preschool years permits a better prognosis in the amelioration of such dysfunctions. Thus, there is a more optimistic possibility about the effect of early direct intervention in the parental situation with therapy or counseling as well as with individual psychotherapy for the preschooler.

Cognitive retraining

Professionals from a variety of fields, such as psychology, psychiatry, occupational therapy, and speech-language pathology, may be involved in cognitive retraining. The techniques of cognitive retraining are best known for their use with persons who have suffered a brain injury. Cognitive retraining has also been used to treat dementia, schizophrenia, attention-deficit disorder, learning disabilities, and cognitive changes associated with aging.

Mouse Models Generated By Chromosome Engineering

Del22qll.2 syndrome (also known as DiGeorge syndrome DGS , velocardiofacial syndrome VCFS , and conotruncal anomaly face syndrome) with an incidence of 1 in every 4000-5000 births, is the most frequent chromosomal microdeletion syndrome known (52). The common deletion is caused by LCR-mediated recombination (53-55). Typical patient phenotype includes cardiovascular defects, thymic, parathyroid, craniofacial anomalies, and learning disabilities. Many of the features (e.g., heart outflow tract, craniofacial, velopharyn-

Exceptional Learner Programs And Students

Work here focuses on the contributions of educational psychology on understanding the school-based and developmental needs of exceptional learners. Within this domain we include the field of school psychology, which includes a major emphasis on the evaluation and development of programs and interventions for exceptional learners. Educational psychology has had an impact on the study of individuals with learning disabilities as well as those of high cognitive ability. Investigations in these areas have ranged from basic processes to applied research on intervention programs. Students who demonstrate behavioral excess represent another important target population for the application of research on classroom management and behavior change supported by educational psychology. Learning Disabilities Learning disabilities represent one of the most prevalent forms of learner problems it is also a field of study that is replete with controversy as to classification, assessment, and...

Child And Adolescent Disorders An Overview

TABLE 2.1 DSM-IV-TR Categories for Developmental and Learning Disorders Usually First Diagnosed in Infancy, Childhood, Categories Autistic disorder, Rett's disorder, childhood disintegrative disorder, Asperger's disorder Learning disorders Categories Reading disorder, mathematics disorder, disorder of written expression

The MHC and disease general considerations

Tiwari and Terasaki's book published in 1985 (Tiwari and Terasaki, 1985), listed hundreds of HLA-associated diseases, even though the first demonstration of a strong association, that of HLA-B27 and ankylosing spondylitis (AS), came only a decade earlier. Meanwhile, many more associations have been added to the list but, apart from Narcolepsy, which shows an almost absolute association with DQB1*0602, none have been as strong as the association of HLA-B27 with AS (Lechler and Warrens, 2000). There are conflicting reports for many of the weaker associations, which include everything from aging and dyslexia to autism and sleepwalking (Lecendreux et al., 2003). In some of these studies insufficient numbers of cases and controls were examined to obtain

Environmental Protection Laws

The adverse health effects of environmental pollution are well known. Air pollution increases deaths from cardiopulmonary diseases, (Peters and Pope, 2002) and is associated with increases in asthma incidents (Cummins and Jackson, 2001) and infant mortality. (Kaiser, et al., 2004) When traffic was reduced in Atlanta for the 1996 Olympic Games, peak ozone concentrations decreased by 27.9 and the number of asthma medical emergencies fell by 41.6 . (Friedman, et al., 2001) Water can be contaminated with either chemical carcinogens or bacteria (Frumkin, et al., 2004 Savitch, 2000). Indoor toxins such as asbestos, lead from paint, molds, and irritant chemicals can cause cancer, asthma, and learning disabilities or mental impairments (Samet and Spengler, 2003). Finally, toxins from industrial solid waste disposal sites can have significant harmful effects on nearby residents (Lord, 1995).

Language in the Intelligence Test Report

In parts of the report in which intellectual functioning is discussed, findings of mental deficiency, learning disabilities, and organic impairment also need to be presented with minimal emphasis on underlying technical considerations. A descriptive analysis, which clarifies what the subject can and cannot be expected to do and states what treatment and further assessments are advisable, is more helpful

Spasticity And Cerebral Palsy

Spasticity in childhood is most commonly encountered as a feature of cerebral palsy, which results from an insult to the developing brain. Cerebral palsy may be classified by the type of motor involvement (spastic, dystonic, or mixed), or by the distribution of involvement (quadriplegia, diplegia, hemiplegia). Loss of fine motor control, impaired balance, weakness, and delayed motor milestones also occur. The progressive, deforming forces of spasticity can lead to secondary muscle contractures and orthopedic deformities, such as hip dislocation and scoliosis 10,11 . This disorder varies widely in severity and may be associated with other problems such as hy-drocephalus, seizures, learning disabilities, language problems, or sensory processing disturbances. Developmental delay is often but not always a feature of CP. Spasticity in children is particularly problematic because of the interference with normal growth.

Performance Subtests Wechsler Scales

This subtest involves the ability to learn new material readily and efficiently. It requires attention and concentration in a context of speed with visual-motor coordination. Consequently, this subtest is valuable in assessing the ability for new, imitative learning where speed is appropriate. These requirements make the subtest especially useful in assessing organic impairment and clarifying learning disability problems. In evaluating such diagnostic problems, it is useful to note the accuracy with which the symbols are reproduced in order to determine signs of perceptual distortions. For the same reason, reversals should especially be noted. Because speed, accuracy, and the ability to learn new associations are needed for success on this subtest,

Disorder of written expression

Disorder of written expression, formerly called developmental expressive writing disorder, is a learning disability in which a person's ability to communicate in writing is substantially below the level normally expected based on the individual's age, intelligence, life experiences, educational background, or physical impairments. This disability affects both the physical reproduction of letters and words and the organization of thoughts and ideas in written compositions. Disorder of written expression is one of the more poorly understood learning disabilities. Learning disabilities that manifest themselves only in written work were first described in the late 1960s. These early studies described three main types of written disorders Several studies have estimated that between 3 and 5 of students have disorder of written expression. However, it is difficult to separate this disorder from other learning disorders. Deficits in written work may be attributed to a reading, language, or...

The NF1 Mutational Profile

The mutational profile of the NF1 gene at chromosome 17q11.2 is complex, as both constitutional and somatic mutations occur that result in generalized or segmental (localized) NF1 disease and tumor development (Table 1). NF1 is inherited as an autosomal dominant trait, but also occurs sporadically in approx 30-50 of cases. In 80-90 of cases owing to intragenic NF1 inactivating mutations, no correlation has been detected between mutation type and or location and the development of specific manifestations (7-9). Approximately 5 of NF1 cases are because of submicroscopic, contiguous gene deletions (10-12). Most NF1 microdeletions are de novo and are predominantly of maternal origin, although familial cases do occur (13-17). Subjects with NF1 microdeletions tend to have a high tumor burden and may have facial anomalies, early age at onset of dermal neurofibromas, vascular anomalies, learning disabilities, astrocytomas, and malignancy (12-14,18,19). Formal studies regarding NF1...

Focusing the Report

A psychological report can provide many kinds of information. A psychiatrist attempting to decide a differential diagnostic problem, for example, would seek one type of information. A guidance counselor helping a withdrawn student would require something else. The teacher of a student with a learning disability needs information clarifying the source of the student's particular problem. The therapist of a patient troubled by frequent loss of jobs has another question in mind. Sometimes even the person making the referral is confused about the problem and potential solutions and requires help in conceptualizing the issues that need to be addressed.

Dangerous Systems

The rules, policies and practices can be another source of danger. Consider the rules of confidentiality. They have a desirable goal, but create problems in practice. The author has yet to find an audience of practitioners, medical or social work, which has not had problems in getting information about patients or clients from another profession. The problem has existed for decades, at least, and yet it has not been tackled. A major problem is the 'level' of responsibility involved. It is beyond the power of individual risk-taking practitioners to get the problems sorted. It is even beyond their managers and supervisors, and their employers. It needs to be tackled at governmental and or professional association level. But these people do not seem to perceive, or understand, their contribution to making risk-taking more dangerous. Another example would be the response to relatively minor offences committed by people with a mental disorder and or learning disability. Few see much point...

Future Prospects

While research efforts at FRAXA FMR1 have continued at a blistering pace, with exciting new understanding of the potential function of FMR1 and even the potential for treatment (Bear et al. 2004), the fragile sites and their associated genes and diseases at FRAXE and FRAXF have received much less attention. For FRAXF, this is likely appropriate since individuals lacking FAM11A expression due to FRAXF full mutations are apparently normal and this mutation is therefore not known to be pathogenic. FRAXE has received more attention, and numerous studies demonstrated that the repeat expansion mutation is rare in individuals with mental retardation or learning disabilities, with estimates of the frequency in the general population in the 1 50 000 to 1 100 000 range. While this is vastly less common than the FRAXA FMR1 Fragile X syndrome ( 1 3500), it is not significantly less common than some of the other triplet repeat disorders. In addition, the size of the FMR2 gene suggests it may be a...

Fragile X Syndrome

1991) and risk for expansion to the full mutation increases with the number of repeats (Fu et al., 1991). As amplification of the gene increases, it becomes more unstable, leading to mitotic instability as well as mei-otic instability (Fu et al., 1991 Oberle et al., 1991 Pieretti et al., 1991). The mitotic instability of the full repeat causes longer and shorter expansions, resulting in mosaicism with respect to size (premutation together with a full mutation) or with respect to degree of methylation (from 10 to 100 of leukocytes with an unmethylated full mutation). Several cases of intellectually normal males with a high proportion of unmethylated leukocytes have been reported, suggesting that methylation is critical for lack of transcription of FMR1 gene and expression of the phenotype (de Vries et al., 1996 Hagerman, Hull et al., 1994 Nolin, Glicksman, Houck, Brown, & Dobkin, 1994 Rousseau et al., 1994). In addition, several cases have been found with atypical mutations at the...

Eating disorders

Exploration of objects with the mouth is normal up to 2 years of age, but may continue for years in children who are blind, have learning disability, or lack environmental stimulation. Sucking lead-painted objects may cause mental and physical damage.

After The Evaluation

On some occasions, people who have been evaluated or their legal guardians may request modification of a psychologist's assessment report. One valid reason for altering or revising a report would be to allow for the correction of factual errors. Another appropriate reason might involve release of information on a need-to-know basis for the protection of the client. For example, suppose that in the course of conducting a psychological evaluation of a child who has experienced sexual abuse, a significant verbal learning disability is uncovered. This disability is fully described in the psychologist's report. In an effort to secure special education services for the learning problem, the parents of the child ask the psychologist to tailor a report for the school focusing only on matters relevant to the child's educational needs that is to say, the parents would prefer that information on the child's sexual abuse is not included in the report sent to the school's learning disability...

Cultural Knowledge

Clinicians treating Asian American clients must be cognizant of the possible role that stigma plays in the help-seeking and treatment process. For example, an Asian American family may seek treatment in a distant location rather than seek treatment in their own community and risk being seen by someone who may recognize them (which in turn might brand family members as having a mental health problems and thereby lessen the marriageability of family members). Some Asian American parents may not agree to having their child assessed for learning disabilities in schools because they fear that an appointment with a psychologist would imply that the child has mental health problems.


In 1963, theory became reality when researchers devised a dietary treatment for this otherwise devastating illness (fig. 4A). The diet is very restrictive and difficult to follow, but it does prevent mental retardation. However, treated children may still have learning disabilities. We still do not know how long people with PKU should adhere to the diet, but it may be for their entire lives.

Bruce F Pennington

Fragile X syndrome, PKU, William's syndrome, and other neurogenetic disorders. Examples of the second strategy are genetic studies of attention deficit hyperactivity disorder (ADHD), autism, dyslexia, developmental speech and language disorders, schizophrenia, Tourette's syndrome, and other psychiatric disorders. Because the details of most of the discoveries using each strategy are described elsewhere, we will not review specific discoveries except in an illustrative way. Instead, this chapter focuses on methods and the general implications of what has already been discovered for developmental cognitive neuroscience. The backward strategy, exemplified by recent work on the neuropsychology and genetics of dyslexia and ADHD, usually has the advantage of greater prevalence and larger samples. But given the ubiquitous problems of etiological heterogeneity and phenocopies (the same phenotype is produced by environmental causes), it is almost certain that not all the individuals in these...


CMV is one of the most ubiquitous viral infections in humans in the world, with prevalence rates reported from 20 to 95 . In some countries of Southeast Asia, Africa, and the South Pacific islands prevalence rates are reported above 90 , while in the United States and parts of Europe the prevalence is reported to be around 50 . Transmission occurs through shedding of the virus from nasopharyngeal secretions, urine, saliva, tears, genital secretions, breast milk, and blood. Maternal infections usually occur because of sexual transmission, and high number of sexual partners and early age of intercourse are predictors of occurrence of CMV. Perinatal transmission occurs through exposure of the fetus, in utero, to virus from reactivated or acute maternal disease. The virus can remain dormant in the host and cause latent infection and its sequella are exacerbated if the host has immune compromise. Exposure of the fetus to a primary CMV infection poses a risk of adverse outcome at any stage...


Autism is believed to be associated with abnormalities of cerebellar and brain-stem function. Twin studies suggest a genetic predisposition. Prevalence is 20 per 100 000 children, and it is more common in boys. Learning disability, often due to a specific cause such as rubella, is present in 70 per cent of cases, whereas parental intelligence is in the normal range. Neurological impairments are found in 25 per cent, and 30 per cent develop epilepsy during adolescence.

Substance Dependence

These persons often lead chaotic personal lives, are likely confused, and frequently have difficulty with trust issues, in a fashion seemingly similar to persons with paranoid personality disorder (Moring, 1997). Comprehension difficulties are a significant issue in these cases (Schaeffer, Parsons and Errico, 1989). While deficits are typically neither as profound nor as pervasive as those encountered with, for example, developmental or learning disabilities, they may still provide a substantial barrier to collaboration and communication (Kaplan and Sadock, 1998).

Before Intervention

This chapter has provided illustrations of the utility and promise of structural and functional MRI and how these techniques can be used to map changes in the human brain as a function of development. For example, a number of regional changes have been reported in the developing human brain, particularly in regions of association cortex that have been linked to higher cognition (language and memory). And, pushing the methodology a step further, we can investigate changes in the human brain associated with learning and intervention. At least three examples of anatomical and functional brain changes associated with behavioral and or pharmacologic treatment were provided in this chapter. These examples, work on the developmental disorders of ADHD, OCD, and dyslexia, represent but a select sample of disorders investigated with this methodology. Ultimately, phMRI studies may be sensitive probes in further elucidating brain regions involved in these, and other, developmental disorders and...

Inv Dup22

Inv Dup Chromosome

A proportion of CES chromosomes have one or two copies of the DGS VCFS region in additional to four copies of the CES region. Duplications of the DGS VCFS region have been associated recently with variable symptoms including learning disabilities, cognitive and behavioral abnormalities, palate defects, hearing loss, heart defects, growth deficiency, developmental and motor delays, and urogenital anomalies (56). This likely represents only a spectrum of the microduplication 22q11.2 syndrome, because the patients were ascertained during testing specific for the DGS VCFS deletion. In any case, one would assume that the addition of extra copies of the DGS VCFS region would worsen the phenotype of CES, but this has not been observed. However, because only 10 CES patients have been characterized in this way (9), this lack of correlation is likely to be because of the extreme variability of the overall syndrome masking more subtle changes brought on by additional copies of the DGS VCFS

Adoption Disputes

Considerable emphasis is being placed on speeding up the process. Many children, where no parent is involved and Social Services are stretched drift into care but where the adoption is disputed, time does allow the parent and child to explore whether rehabilitation or regular good contact is possible or not. An attempt to make adoption less contentious has involved the possibility of open adoption, but its implementation depends on the adoptive parents. Anna's mother had learning difficulties and schizoaffective disorder. Anna was in and out of care whenever mother needed admission. Two years later this 5-year-old had been back and forth to one foster family and had had more time with them than with her mother. Open adoption was proposed mother was distressed. But with further contact with her social worker, prospective adoptive parents and Anna, mother decided that it was better for Anna to be adopted if she could continue to see her. The prospective adopters recognised it would be...


The needs of bereaved spouses and bereaved children have been addressed in the bereavement literature, albeit inadequately, but the needs of people with learning disabilities were neglected until relatively recently. Oswin (1981, 1991) pioneered this work in the UK and during the 1990s there was increased awareness of the gaps in service provision and more resources have been developed to aid comprehension and discussion about death and bereavement (Blackman, 2003 Cathcart 1991, 1994, 1995 Harper and Wadsworth, 1993 Hollins and Sireling, 1991). A systematic study of 50 parent-bereaved people with learning disabilities compared them with a matched control group using a semistructured bereavement questionnaire, the Aberrant Behaviour Checklist, the Psychopathology Instrument for Mentally Retarded Adults and the Life Event Checklist. Highly significant differences between the groups were found but carers did not attribute behaviour problems or psy-chopathology to the bereavement (Hollins...


A recent systematic review (Mann et al, 2005) indicates that 'physician education in depression recognition and treatment and restricting access to lethal methods reduce suicide rates.' However, it is important to remember that not only depression but also all mental disorders (apart possibly from learning disability and dementia) carry an increased risk of suicide (Harris and Barraclough, 1997).

Play therapy

At times, children in play therapy will also receive other types of treatment. For instance, youngsters who are unable to control their attention, impulses, tendency to react with violence, or who experience severe anxiety may take medication for these symptoms while participating in play therapy. The play therapy would address the child's psychological symptoms. Other situations of dual treatment include children with learning disorders. These youngsters may receive play therapy to alleviate feelings of low self-esteem, excessive worry, helplessness, and incompetency that are related to their learning problems and academic struggles. In addition, they should receive a special type of tutoring called cognitive remediation, which addresses the specific learning issues. lems. Children who are experiencing physical problems should see a physician for a medical evaluation to clarify the nature of the problem and, if necessary, receive the appropriate medical treatment. Likewise, children...

Further assessments

Psychometric tests, measuring such parameters as intelligence, memory, perception, behaviour, and personality, may be useful aids to assessment in patients with organic brain damage, or in assessing child or learning-disability patients. However, they are not routinely used in general psychiatry, because the clinical psychologists who used routinely to administer them have now -probably rightly - become more concerned with therapy than with diagnostic assessment.