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Peds Test 3 > Mgmt Considerations for Children with Learning Disabilities and DCD > Flashcards

Mgmt Considerations for Children with Learning Disabilities and DCD Flashcards

1
Q

The medical perspective of the definition of learning disabilities focus on

A

etiology or cause

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2
Q

Examples of a medical etiology or cause of learning disabilities

A
  • brain injured
  • minimal brain dysfunction
  • psychoneurological disorder
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3
Q

The educational perspective of the definition of learning disabilities focus on

A

behavior

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4
Q

Examples of a behavioral cause of learning disabilities (educational perspective)

A
  • intellectual disability

- reading/math/written expression disorder

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5
Q

What are the 2 perspectives of the definition of learning disabilities?

A
  • medical

- educational

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6
Q

NJCLD stands for

A

National Joint Committee on Learning Disabilities

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7
Q

LD stands for

A

learning disability

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8
Q

According to the NJCLD, a learning disability is a ______________________ that refers to a ______________________ of disorders manifested by ______________________ in the _____________ and ________ of _________, ___________, __________, __________, __________, or ____________ abilities.

A

general term; heterogeneous group; significant difficulties; acquisition; use; listening; speaking; reading; writing; reasoning; mathematical

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9
Q

According to the NJCLD, learning disorders are _______________ to the individual and are presumed to be due to what?

A

intrinsic; CNS dysfunction

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10
Q

True/False: According to the NJCLD, disabling conditions or extrinsic influences may be the direct cause of a learning disability.

A

False

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11
Q

According to the IDEIA, LD is defined as a _____________ in _________________ of the basic psychological processes involved in ___________ or in _____________________, spoken or written,…

A

disorder; one or more; understanding; using language

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12
Q

According to the IDEIA, LD includes conditions such as

A
  • perceptual disabilities
  • brain injury
  • minimal brain dysfunction
  • dyslexia
  • developmental aphasia
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13
Q

True/False: According to the IDEIA, LD does not include a learning problem that is primarily the result of visual, hearing, or motor disabilities, of mental retardation, of emotional disturbance, or of environmental, cultural or economic disadvantage.

A

True

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14
Q

True/False: According to the IDEIA, LD is primarily the result of visual, hearing, or motor disabilities, of mental retardation, of emotional disturbance, or of environmental, cultural or economic disadvantage.

A

False

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15
Q

According to the DSM–IV Classification under Developmental Disorders, learning disorders include

A
  • reading disorder
  • mathematics disorder
  • disorder of written expression
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16
Q

According to the DSM–IV Classification under Developmental Disorders, motor skills include

A

developmental coordination disorder

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17
Q

According to the DSM–IV Classification under Developmental Disorders, communication disorders include

A
  • expressive language disorder
  • mixed receptive-expressive disorder
  • phonological disorder
  • stuttering
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18
Q

The 3 categories of disorders according to the DSM–IV Classification under Developmental Disorders:

A
  • learning disorders
  • motor skills
  • communication disorder
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19
Q

An ICD–10 Code: Disorders of psychological development includes specific developmental disorder (SDD) of

A
  • speech and language
  • scholastic skills
  • motor function
  • pervasive developmental disorder
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20
Q

SDD stands for

A

Specific Developmental Disorder

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21
Q

A SDD of speech and language includes

A

acquired aphasia with epilepsy

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22
Q

True/False: The prevalence of LD is greater in males than females.

A

True

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23
Q

True/False: The prevalence of LD is greater in females than males.

A

False

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24
Q

Current investigation of possible causes of LD focuses more on

A
  • pregnancy and birth
  • genetic/hereditary links - across generations
  • emotional/social environment influence
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25
Q

Pregnancy and birth causes of LD could include

A
  • LBW
  • drug/alcohol exposure
  • anoxia
  • preterm
  • prolonged labor
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26
Q

Common characteristics of LD include what type of clinical presentation?

A

variable

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27
Q

Common characteristics of LD include _____________ neuropsychological symptoms that interfere with the ability to __________, __________, or _____________ information.

A

composite; store; process; produce

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28
Q

LD may result in disorders of _________, ________________, ______________, _____________________, and ___________________.

A

speech; spatial orientation; perception; motor coordination; activity level

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29
Q

What suggests different patterns of organization in children with LD?

A

neuroimaging

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30
Q

Neuroimaging suggests different patterns of ________________ in children with LD.

A

organization

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31
Q

Current subgroups of LD being explored include

A
  • verbal learning impairments
  • nonverbal learning impairments
  • motor coordination deficits
  • social and emotional challenges
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32
Q

Difficulties in verbal learning result in problems with

A
  • reading
  • acquisition of written and spoken language
  • arithmetic
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33
Q

Difficulties in nonverbal learning result in problem with

A
  • visual-spatial organization
  • social-emotional development
  • sensorimotor performance
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34
Q

Difficulties in motor behavior result in

A

developmental coordination disorder

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35
Q

Accompanying behavioral disorders of LD may include

A
  • hyperactivity
  • lack of attention
  • poor impulse control
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36
Q

Concerning the concepts of hemispheric specialization, describe the organization of the left hemisphere

A
  • more focal and precise

- facilitates accurate coding needed for speech

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37
Q

Concerning the concepts of hemispheric specialization, describe the organization of the right hemisphere

A
  • more diffusely organized

- permits dissimilar information to be processed simultaneously

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38
Q

Concerning the concepts of hemispheric specialization, how does the left hemisphere process information?

A

in a sequential, linear fashion

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39
Q

Concerning the concepts of hemispheric specialization, which hemisphere is more proficient in analyzing details?

A

left

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40
Q

Concerning the concepts of hemispheric specialization, which hemisphere has academic responsibilities?

A

left

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41
Q

What are the academic responsibilities of the left hemisphere?

A
  • recognizing words
  • comprehending material read
  • performing mathematical calculations
  • processing and producing language
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42
Q

Concerning the concepts of hemispheric specialization, the right hemisphere is advantageous for __________________ and ____________________.

A

spatial processing; visual perception

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43
Q

Concerning the concepts of hemispheric specialization, how does the right hemisphere process input?

A

in a more wholistic manner

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44
Q

Concerning the concepts of hemispheric specialization, how does the right hemisphere “grasp” information?

A

grasps the overall organization or “gestalt” of a pattern

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45
Q

Concerning the concepts of hemispheric specialization, which hemisphere has functional responsibilities?

A

right

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46
Q

What are the functional responsibilities of the right hemisphere?

A
  • synthesizes nonverbal stimuli
  • recognizes and interprets facial expressions
  • contributes to math reasoning and judgment
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47
Q

Examples of nonverbal stimuli include

A
  • environmental sounds

- voice intonations

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48
Q

Verbal learning impairments include

A
  • dyslexia
  • dyscalculia
  • dysgraphia
49
Q

Nonverbal learning disabilities include

A
  • visual-spatial organization
  • sensorimotor integration
  • social-emotional learning disorders
50
Q

Examples of dyslexia include

A
  • visual-spatial
  • audiophonic
  • mixed
51
Q

Examples of dyscalculia include

A
  • decoding
  • copying
  • sequencing
  • interpreting
52
Q

Examples of dysgraphia include

A
  • penmanship
  • linguistic
  • combination
53
Q

Specific motor impairments include

A

developmental coordination disorder

54
Q

Behavior disorders due to social/emotional challenges include

A
  • ADD
  • ADHD
  • anxiety
  • conduct disorder
  • frustration
55
Q

3 parts of developmental coordination disorder

A
  • “clumsy” child
  • developmental apraxia
  • developmental clumsiness
56
Q

DCD stands for

A

developmental coordination disorder

57
Q

DSM-IV-TR Criterion A for DCD

A

marked impairment in development of motor coordination

58
Q

DSM-IV-TR Criterion B for DCD

A

impairment that significantly interferes with academic achievement or ADL

59
Q

DSM-IV-TR Criterion C for DCD

A

not resulting from medical condition

60
Q

DSM-IV-TR Criterion D for DCD

A

not consistent with intellectual disabilities (if present)

61
Q

True/False: The incidence of DCD is greater in males than females

A

True

62
Q

True/False: The incidence of DCD is greater in females than males

A

False

63
Q

List the functional limitations associated with DCD

A
  • poor performance on academic task
  • reduced performance of ADL’s
  • problems with participating in age appropriate leisure activities
  • behavior problems
  • psychosocial problems
64
Q

Pathophysiology of DCD

A
  • no known cause

- multifactorial

65
Q

Regarding the pathophysiology of DCD, what are the homogeneous clinical signs?

A

There are none except for delay in age appropriate motor development

66
Q

Regarding the pathophysiology of DCD, describe movement time.

A

consistently demonstrate slower movement time, regardless of type of task

67
Q

Regarding the pathophysiology of DCD, describe the subtypes.

A

currently being defined

68
Q

Regarding the pathophysiology of DCD, describe the correlation

A

ex-post facto correlation with prematurity

69
Q

Regarding the pathophysiology of DCD, describe the possible cellular level cause.

A

neurotransmitter and receptor level rather than specific region of the brain

70
Q

Regarding the pathophysiology of DCD, there are possible ________________________ deficits. This relates to __________________.

A

multisensory processing; sensory integration disorder

71
Q

Regarding the pathophysiology of DCD, there is a possible link with ________________________, __________________________, and _________________________________.

A

kinesthetic perception; visual-spatial processing; multisensory integration deficits

72
Q

Gross motor characteristics of DCD

A
  • Diminished core strength and postural control
  • Delayed balance reactions
  • Often falling, tripping & bumping into things (acquiring more than the usual # of bruises)
  • Slower rate of motor performance (despite
    practice & repetition)
  • Delayed acquisition of motor milestones
  • Poor anticipation (inability to use past performance to prepare for subsequent tasks)
  • Reduced quality of running and ball skills
  • Difficulty learning bilateral tasks (e.g. riding bike, catching a ball, jumping rope)
  • Hesitance/avoidance of novel complex skills
  • Reduced safety awareness
  • Lack of smooth body transition/turning (e.g. playground slide; on/off playground equipment)
  • More sedentary lifestyle; more solitary play
  • Reduced safety awareness
  • Lack of smooth body transition/turning (e.g. playground slide; on/off playground equipment)
  • More sedentary lifestyle; more solitary play
  • Tendency not to follow game rules
  • Avoidance of team sports
73
Q

Fine motor characteristics of DCD

A
  • Diminished wrist/hand strength
  • Maladaptive or immature grasp pattern
  • Excess or inadequate pressure
  • Poor refinement of small motor movements (Lack precision when manipulating objects)
  • Drops / breaks items frequently
  • Delayed dressing skills (buttons, zippers, laces)
  • Trouble managing eating utensils or tools (scooping/piercing/scissors/pencils/hole punch)
  • Laborious & often illegible writing
  • Impaired drawing ability (Wobbly lines, innacurate junctures, coloring in lines)
  • Decreased ability completing art projects
  • Difficulty with constructive / manupulative play (e.g. Tinker toys/ legos/ blocks)
  • Associated difficulty with articulation deficits
74
Q

Visual motor characteristic of DCD

A
  • Difficulty with visually guided motor actions (Hand/eye; eye/foot)
  • Hesitancy or decreased safety on stairs
  • Inaccuracy due to timing of kick/ hit/ catch skill
  • Poor judgement of spatial relationships (e.g. difficulty with hopscotch / 4-square)
  • Difficulty with spatial planning (e.g. puzzles / building models/ constructional toys)
  • Labored writing/ spacing/ irregular letters
75
Q

Self-care characteristics of DCD

A
  • Slowness to develop independence in ADL
  • Overreliance on parental assistance with self care
  • Clothes improperly donned (backward/crooked)
  • Problems cutting nails; applying makeup; hair style
  • Problems blowing nose / applying band-aid
  • Difficulty applying toothpaste on toothbrush
  • Messy eater; spills often; doesn’t recognize food on face
  • Difficulty pouring from a container
  • Problems opening lunch box, unwrapping
    sandwich, opening containers
  • Problems peeling fruit (Challenges sequencing cutting utensil task while holding fruit without squeezing too tight)
  • Trouble packing a bag, backpack or suitcase
  • Difficulty sequencing daily routines
76
Q

Social and emotional characteristics of DCD

A
  • Often emotionally immature
  • May act out / become class clown
  • Can appear fiercely competitive (Hates to lose, complains rules are unfair)
  • Can be self-deprecating / calls self “stupid”
  • Often easily frustrated
  • May feel depressed / incompetent
  • Has difficulty making and maintaining friendships
  • Plays alone
  • Has feelings of low self-worth, poor self-esteem
  • Perceived by others as lazy, overprotected
  • Behavior often described as immature
  • Adolescents have fewer social past-times / hobbies
  • Problems persist into adulthood
77
Q

Describe some of the problems of DCD that persist into adulthood

A
  • Adults are often under-/un-employed
  • Alcohol abuse more frequent
  • Live with parents longer / marriage delayed (or never happens)
78
Q

Assessment Considerations for DCD

A
  • Postural Control and Gross Motor Performance
  • Fine motor performance
  • Praxis and motor planning
  • Performance difficulties related to physical fitness
79
Q

Regarding assessment considerations for DCD, what should be considered with the postural and gross motor performance?

A

– muscle tone & strength
– compensatory fixing patterns
– muscle “feel” (mushy, soft, hyperextensible)
– integration of primitive reflexes - asymmetries
– righting, equilibrium, vestibular function

80
Q

Regarding assessment considerations for DCD, what should be considered with the fine motor performance?

A
  • FM skills vs FM movements

- eye-hand coordination and handwriting

81
Q

FM stands for

A

fine motor

82
Q

Things to look for related to FM skills vs FM movements

A
  • proximal control & distal movements

- wrist stability, development of hand arches, separation of 2 sides of the hand

83
Q

What should be looked at when assessing wrist stability, development of hand arches, and separation of 2 sides of the hand?

A
  • translation
  • shift
  • rotation
84
Q

Regarding wrist stability, development of hand arches, and separation of 2 sides of the hand, define translation.

A

finger movement to move objects into and out of the palm of the hand

85
Q

Regarding wrist stability, development of hand arches, and separation of 2 sides of the hand, define shift.

A

alternation of pattern of thumb & 1st finger

86
Q

Regarding wrist stability, development of hand arches, and separation of 2 sides of the hand, define rotation.

A

turning an object within the hand

87
Q

Things to look for related to eye-hand coordination and handwriting

A
  • diadochokinesis, sequential finger/thumb touch,
    stererognosis
  • standardized tools (e.g. Peabody)
88
Q

Things to look for related to Praxis and motor planning

A

– the ability to carry out a new or unusual motor act, when there is potentially adequate cognitive and motor skill to do so.
– Motor planning deficits create difficulty performing in, acting on the environment

89
Q

Describe how motor planning deficits create difficulty performing in, acting on the environment

A
  • inability to figure out new activities
  • disorganized approach
  • poor anticipation of his/her actions
  • difficulty with peer interactions
  • frustration
90
Q

Things to look for related to performance difficulties related to physical fitness

A

– Problems with games / athletic activities
– Often demonstrate below average measures of
physical fitness

91
Q

Individuals with DCD often demonstrate below average measures of physical fitness in what areas?

A
  • Strength
  • Muscular endurance
  • Flexibility
  • Cardiorespiratory endurance (as reflected by tests of aerobic/ anaerobic capacity)
92
Q

Gubbay Test of Motor Proficiency

A
  • Standardized for children 8 – 12 yrs of age
  • 8 tests – inexpensive / easily created with readily available equipment
  • Targets skills challenging for children with DCD
93
Q

DCD associated impairments of body structure and function

A
  • soft signs
  • poor visual perception
  • joint laxity
  • poor spatial organization
  • poor sequencing
  • inadequate information processing
  • poor feedback
  • poor short- and long- term memory
  • poor visual memory
94
Q

DCD activity limitations

A
  • Awkward gait
  • Delayed GM / FM with poor motor quality
  • Delayed oral-motor skills
  • Low self esteem
  • Distractibility
  • Dependent self help
  • limited participation in PE
  • poor written communication
  • poor language skills
  • reduced social interaction
  • depression
  • low academic work
95
Q

Soft signs include

A
  • poor strength
  • poor coordination
  • jerky movements
96
Q

DCD Participation Restrictions

A
  • Limited indoor and outdoor play with peers
  • Strained child-parent relationship
  • Social isolation
  • Limited vocational success
  • Design of objects such as tamper-proof packaging / tying shoes/ poor written communication/ PE
97
Q

2 types of treatment of children with learning disabilities who also have motor deficits

A
  • Indirect

- Direct

98
Q

Describe indirect treatment of children with learning disabilities who also have motor deficits

A
  • perceptual
  • perceptual-motor skills
  • psycholinguistic abilities
  • integration of subcortical function to improve specific skills
99
Q

Examples of indirect treatment techniques

A
  • SI
  • NDT
  • PNF
100
Q

Describe direct treatment of children with learning disabilities who also have motor deficits

A
  • specific cognitive and adaptive skills
  • teach to the child’s strengths
  • compensate for weaknesses
101
Q

What type of model is a direct model?

A

educational

102
Q

Examples of direct treatment techniques

A
  • motor skill training

- monitoring physical fitness

103
Q

Supportive Treatment Practices

A
  • Include other children for peer support
  • Cooperative rather than competitive activities
  • Incorporate rhythmic activities
  • Use age-appropriate skills
  • Look for other developmental co-morbidities like LD, ADHD, etc
104
Q

5 areas of function for the PT in the educational environment as identified by Kaslish & Presseller:

A 
– Screening and evaluation 
– Program planning 
– Delivery of treatment activities 
– Providing consultation services 
– In-service training
105
Q

What are the subcortical structures that Ayres emphasizes?

A
  • brainstem
  • thalamus
  • vestibular
106
Q

Types of SI dysfunction

A

– vestibular-proprioceptive discrimination
– somatodyspraxia
– tactile defensiveness & gravitational insecurity
– visuomotor & visual construction
– auditory-language

107
Q

What does vestibular-proprioceptive discrimination influence and what does this result in?

A

postural-ocular movements and bilateral integration and sequencing; results in hypo- / hyper- reactivity to movement

108
Q

Somatodyspraxia includes what?

A

poor tactile & proprioceptive discrimination

109
Q

What types of concerns do auditory-language SI dysfunctions cause?

A

praxis concerns

110
Q

Praxis concerns are caused by SI dysfunctions of what type?

A

auditory-language

111
Q

Poor tactile & proprioceptive discrimination are caused by SI dysfunctions of what type?

A

somatodyspraxia

112
Q

Hypo-/hyper- reactivity to movement is caused by SI dysfunctions of what type?

A

vestibular-proprioceptive discrimination

113
Q

What percentage of children with LD have motor coordination or visuomotor problems?

A

90%

114
Q

By definition, DCD is not related to

A
  • muscle pathology
  • peripheral sensory abnormality
  • CNS disorder that causes spasticity, athetosis, or ataxia
115
Q

What type of tone is DCD often associated with?

A

mild-moderate hypotonia

116
Q

Describe the timing associated with those who have DCD

A

poor

117
Q

Describe the force of production associated with those who have DCD

A

poor

118
Q

Apraxia is associated with what type of brain lesion?

A
  • lesions in anterior half of the periventricular white & frontal lobe

Peds Test 3 (2 decks)

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