Mgmt Considerations for Children with Learning Disabilities and DCD Flashcards
(118 cards)
1
Q
The medical perspective of the definition of learning disabilities focus on
A
etiology or cause
2
Q
Examples of a medical etiology or cause of learning disabilities
A
- brain injured
- minimal brain dysfunction
- psychoneurological disorder
3
Q
The educational perspective of the definition of learning disabilities focus on
A
behavior
4
Q
Examples of a behavioral cause of learning disabilities (educational perspective)
A
- intellectual disability
- reading/math/written expression disorder
5
Q
What are the 2 perspectives of the definition of learning disabilities?
A
- medical
- educational
6
Q
NJCLD stands for
A
National Joint Committee on Learning Disabilities
7
Q
LD stands for
A
learning disability
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
9
Q
According to the NJCLD, learning disorders are _______________ to the individual and are presumed to be due to what?
A
intrinsic; CNS dysfunction
10
Q
True/False: According to the NJCLD, disabling conditions or extrinsic influences may be the direct cause of a learning disability.
A
False
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
12
Q
According to the IDEIA, LD includes conditions such as
A
- perceptual disabilities
- brain injury
- minimal brain dysfunction
- dyslexia
- developmental aphasia
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
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
15
Q
According to the DSM–IV Classification under Developmental Disorders, learning disorders include
A
- reading disorder
- mathematics disorder
- disorder of written expression
16
Q
According to the DSM–IV Classification under Developmental Disorders, motor skills include
A
developmental coordination disorder
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
18
Q
The 3 categories of disorders according to the DSM–IV Classification under Developmental Disorders:
A
- learning disorders
- motor skills
- communication disorder
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
20
Q
SDD stands for
A
Specific Developmental Disorder
21
Q
A SDD of speech and language includes
A
acquired aphasia with epilepsy
22
Q
True/False: The prevalence of LD is greater in males than females.
A
True
23
Q
True/False: The prevalence of LD is greater in females than males.
A
False
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
25
Pregnancy and birth causes of LD could include
- LBW
- drug/alcohol exposure
- anoxia
- preterm
- prolonged labor
26
Common characteristics of LD include what type of clinical presentation?
variable
27
Common characteristics of LD include _____________ neuropsychological symptoms that interfere with the ability to __________, __________, or _____________ information.
composite; store; process; produce
28
LD may result in disorders of _________, ________________, ______________, _____________________, and ___________________.
speech; spatial orientation; perception; motor coordination; activity level
29
What suggests different patterns of organization in children with LD?
neuroimaging
30
Neuroimaging suggests different patterns of ________________ in children with LD.
organization
31
Current subgroups of LD being explored include
- verbal learning impairments
- nonverbal learning impairments
- motor coordination deficits
- social and emotional challenges
32
Difficulties in verbal learning result in problems with
- reading
- acquisition of written and spoken language
- arithmetic
33
Difficulties in nonverbal learning result in problem with
- visual-spatial organization
- social-emotional development
- sensorimotor performance
34
Difficulties in motor behavior result in
developmental coordination disorder
35
Accompanying behavioral disorders of LD may include
- hyperactivity
- lack of attention
- poor impulse control
36
Concerning the concepts of hemispheric specialization, describe the organization of the left hemisphere
- more focal and precise
| - facilitates accurate coding needed for speech
37
Concerning the concepts of hemispheric specialization, describe the organization of the right hemisphere
- more diffusely organized
| - permits dissimilar information to be processed simultaneously
38
Concerning the concepts of hemispheric specialization, how does the left hemisphere process information?
in a sequential, linear fashion
39
Concerning the concepts of hemispheric specialization, which hemisphere is more proficient in analyzing details?
left
40
Concerning the concepts of hemispheric specialization, which hemisphere has academic responsibilities?
left
41
What are the academic responsibilities of the left hemisphere?
- recognizing words
- comprehending material read
- performing mathematical calculations
- processing and producing language
42
Concerning the concepts of hemispheric specialization, the right hemisphere is advantageous for __________________ and ____________________.
spatial processing; visual perception
43
Concerning the concepts of hemispheric specialization, how does the right hemisphere process input?
in a more wholistic manner
44
Concerning the concepts of hemispheric specialization, how does the right hemisphere "grasp" information?
grasps the overall organization or "gestalt" of a pattern
45
Concerning the concepts of hemispheric specialization, which hemisphere has functional responsibilities?
right
46
What are the functional responsibilities of the right hemisphere?
- synthesizes nonverbal stimuli
- recognizes and interprets facial expressions
- contributes to math reasoning and judgment
47
Examples of nonverbal stimuli include
- environmental sounds
| - voice intonations
48
Verbal learning impairments include
- dyslexia
- dyscalculia
- dysgraphia
49
Nonverbal learning disabilities include
- visual-spatial organization
- sensorimotor integration
- social-emotional learning disorders
50
Examples of dyslexia include
- visual-spatial
- audiophonic
- mixed
51
Examples of dyscalculia include
- decoding
- copying
- sequencing
- interpreting
52
Examples of dysgraphia include
- penmanship
- linguistic
- combination
53
Specific motor impairments include
developmental coordination disorder
54
Behavior disorders due to social/emotional challenges include
- ADD
- ADHD
- anxiety
- conduct disorder
- frustration
55
3 parts of developmental coordination disorder
- "clumsy" child
- developmental apraxia
- developmental clumsiness
56
DCD stands for
developmental coordination disorder
57
DSM-IV-TR Criterion A for DCD
marked impairment in development of motor coordination
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DSM-IV-TR Criterion B for DCD
impairment that significantly interferes with academic achievement or ADL
59
DSM-IV-TR Criterion C for DCD
not resulting from medical condition
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DSM-IV-TR Criterion D for DCD
not consistent with intellectual disabilities (if present)
61
True/False: The incidence of DCD is greater in males than females
True
62
True/False: The incidence of DCD is greater in females than males
False
63
List the functional limitations associated with DCD
- poor performance on academic task
- reduced performance of ADL's
- problems with participating in age appropriate leisure activities
- behavior problems
- psychosocial problems
64
Pathophysiology of DCD
- no known cause
| - multifactorial
65
Regarding the pathophysiology of DCD, what are the homogeneous clinical signs?
There are none except for delay in age appropriate motor development
66
Regarding the pathophysiology of DCD, describe movement time.
consistently demonstrate slower movement time, regardless of type of task
67
Regarding the pathophysiology of DCD, describe the subtypes.
currently being defined
68
Regarding the pathophysiology of DCD, describe the correlation
ex-post facto correlation with prematurity
69
Regarding the pathophysiology of DCD, describe the possible cellular level cause.
neurotransmitter and receptor level rather than specific region of the brain
70
Regarding the pathophysiology of DCD, there are possible ________________________ deficits. This relates to __________________.
multisensory processing; sensory integration disorder
71
Regarding the pathophysiology of DCD, there is a possible link with ________________________, __________________________, and _________________________________.
kinesthetic perception; visual-spatial processing; multisensory integration deficits
72
Gross motor characteristics of DCD
- 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
Fine motor characteristics of DCD
- 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
Visual motor characteristic of DCD
- 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
Self-care characteristics of DCD
- 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
Social and emotional characteristics of DCD
- 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
Describe some of the problems of DCD that persist into adulthood
- Adults are often under-/un-employed
- Alcohol abuse more frequent
- Live with parents longer / marriage delayed (or never happens)
78
Assessment Considerations for DCD
- Postural Control and Gross Motor Performance
- Fine motor performance
- Praxis and motor planning
- Performance difficulties related to physical fitness
79
Regarding assessment considerations for DCD, what should be considered with the postural and gross motor performance?
– muscle tone & strength
– compensatory fixing patterns
– muscle "feel" (mushy, soft, hyperextensible)
– integration of primitive reflexes - asymmetries
– righting, equilibrium, vestibular function
80
Regarding assessment considerations for DCD, what should be considered with the fine motor performance?
- FM skills vs FM movements
| - eye-hand coordination and handwriting
81
FM stands for
fine motor
82
Things to look for related to FM skills vs FM movements
- proximal control & distal movements
| - wrist stability, development of hand arches, separation of 2 sides of the hand
83
What should be looked at when assessing wrist stability, development of hand arches, and separation of 2 sides of the hand?
- translation
- shift
- rotation
84
Regarding wrist stability, development of hand arches, and separation of 2 sides of the hand, define translation.
finger movement to move objects into and out of the palm of the hand
85
Regarding wrist stability, development of hand arches, and separation of 2 sides of the hand, define shift.
alternation of pattern of thumb & 1st finger
86
Regarding wrist stability, development of hand arches, and separation of 2 sides of the hand, define rotation.
turning an object within the hand
87
Things to look for related to eye-hand coordination and handwriting
- diadochokinesis, sequential finger/thumb touch,
stererognosis
- standardized tools (e.g. Peabody)
88
Things to look for related to Praxis and motor planning
– 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
Describe how motor planning deficits create difficulty performing in, acting on the environment
- inability to figure out new activities
- disorganized approach
- poor anticipation of his/her actions
- difficulty with peer interactions
- frustration
90
Things to look for related to performance difficulties related to physical fitness
– Problems with games / athletic activities
– Often demonstrate below average measures of
physical fitness
91
Individuals with DCD often demonstrate below average measures of physical fitness in what areas?
- Strength
- Muscular endurance
- Flexibility
- Cardiorespiratory endurance (as reflected by tests of aerobic/ anaerobic capacity)
92
Gubbay Test of Motor Proficiency
* 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
DCD associated impairments of body structure and function
- 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
DCD activity limitations
* 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
Soft signs include
- poor strength
- poor coordination
- jerky movements
96
DCD Participation Restrictions
* 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
2 types of treatment of children with learning disabilities who also have motor deficits
- Indirect
| - Direct
98
Describe indirect treatment of children with learning disabilities who also have motor deficits
- perceptual
- perceptual-motor skills
- psycholinguistic abilities
- integration of subcortical function to improve specific skills
99
Examples of indirect treatment techniques
- SI
- NDT
- PNF
100
Describe direct treatment of children with learning disabilities who also have motor deficits
* specific cognitive and adaptive skills
* teach to the child's strengths
* compensate for weaknesses
101
What type of model is a direct model?
educational
102
Examples of direct treatment techniques
- motor skill training
| - monitoring physical fitness
103
Supportive Treatment Practices
* 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
5 areas of function for the PT in the educational environment as identified by Kaslish & Presseller:
```
– Screening and evaluation
– Program planning
– Delivery of treatment activities
– Providing consultation services
– In-service training
```
105
What are the subcortical structures that Ayres emphasizes?
- brainstem
- thalamus
- vestibular
106
Types of SI dysfunction
– vestibular-proprioceptive discrimination
– somatodyspraxia
– tactile defensiveness & gravitational insecurity
– visuomotor & visual construction
– auditory-language
107
What does vestibular-proprioceptive discrimination influence and what does this result in?
postural-ocular movements and bilateral integration and sequencing; results in hypo- / hyper- reactivity to movement
108
Somatodyspraxia includes what?
poor tactile & proprioceptive discrimination
109
What types of concerns do auditory-language SI dysfunctions cause?
praxis concerns
110
Praxis concerns are caused by SI dysfunctions of what type?
auditory-language
111
Poor tactile & proprioceptive discrimination are caused by SI dysfunctions of what type?
somatodyspraxia
112
Hypo-/hyper- reactivity to movement is caused by SI dysfunctions of what type?
vestibular-proprioceptive discrimination
113
What percentage of children with LD have motor coordination or visuomotor problems?
90%
114
By definition, DCD is not related to
- muscle pathology
- peripheral sensory abnormality
- CNS disorder that causes spasticity, athetosis, or ataxia
115
What type of tone is DCD often associated with?
mild-moderate hypotonia
116
Describe the timing associated with those who have DCD
poor
117
Describe the force of production associated with those who have DCD
poor
118
Apraxia is associated with what type of brain lesion?
- lesions in anterior half of the periventricular white & frontal lobe
