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Flashcards in Special Populations Deck (26):

prevalence of disabilities and incidence of legal blindness in these populations

>3,000,000 individuals have one or more handicapping conditions
(legal blindness is 200x more frequent in these populations)


how is developmental disability defined and what are some characteristics

-severe, chronic, mental or physical impairment
-occurs at conception or soon after birth
-characteristics: continue indefinitely, varied functional abilities
-need for early identification/intervention


definition and characteristics of cerebral palsy

-multiply handicapping condition from brain maldevelopment or damage before, during, or shortly after birth
-characterized by motor dysfunction and associated problems


general signs of cerebral palsy and %

-locomotor difficulty (100%)
-speech disorders (90%)
-visual disorders (70+%)
-mental retardation (50%)
-seizures (35%)
-hearing impaired (20%)
-swallowing and drooling (10%)


spasticity is common in cerebral palsy (80%), what are the subclassifications of this?

-hemiplegia (one side of body, common in full term children)
-quadriplegia (both arms, both legs, head and trunk)
-diplegia (trunk and all 4 extremities, mostly legs, common in preterm infants)
-paraplegia (involves the legs)
(others w/small incidence are athetosis, rigidity, ataxia, tremor, or mixed)


incidence and etiology of cerebral palsy (and %)

incidence: 2: 1,000
-inherited (10%)
-prenatal (50%)
-perinatal (33%)
-postnatal (17%)


what are some visual characteristics of cerebral palsy?

-Strabismus (60%, mainly esotropia)
-Refractive Error (60%, mainly hyperopia)
-Amblyopia (20%)
-Gaze Restrictions (18%)


what are some ocular disease characteristics of cerebral palsy?

-optic atrophy (7%)
-nystagmus (6%)


3 examining pearls for patients with cerebral palsy

-leave in wheelchair (want proper positioning)
-may use preferential looking
-strabismus may be neurological in nature: discuss before surgery referral


why does down syndrome occur and how common is it?

-an extra chromosome 21 or an extra part of it in each cell body (trisomy 21)
-most common chromosomal abnormality encountered
-incidence: 1:600 to 00 live births (1:50 with women older than 44)


some facts about down syndrome (defects that are more common, characteristics, etc.)

-detected with ultrasound/amniocentesis
-associated with congenital heart defects
-acute leukemia more common
-mental retardation is universal
-good socialization skills


3 etiologies of down syndrome (modes of genetic transmission)

-nondisjunction trisomy 21 (most common): extra 21 chromosome
-translocation (normal number of chromosomes, but a portion of a chromosome 21 or 22 attaches to another of 13, 14, or 15)
-mosaicism (1%): some affected cells, some normal cells


common identifying features of down syndrome

-short stature
-brachycephalic skill
-flat occipital lobe
-low set ears
-flat nasal bridge
-small oral cavity and protruding tongue


common ocular features of down syndrome

-epicanthal folds
-upward slanted eyes/ oblique palpebral fissures
-iris anomalies like brush field's spots (pale grey irregular discoloration in the mid peripheral iris) and iris hypoplasia (95%)
-retinal changes (early bifurcation of vessels, RPE disturbances)


visual characteristics of down syndrome

-strabismus (40%, mainly high AC/A esotropia)
-refractive error (42-73%, mainly hyperopia but myopia common too)
-accommodative dysfunction (92% had amps <10 D and 50% were <4D)
-nystagmus (8%)


ocular disease characteristics of down syndrome

-blepharitis/ conjunctivitis (40%)
-keratoconus (15%)
-cataracts, expect early-9yo due to premature aging complex


autism is a behavioral syndrome characterized by abnormalities in:

-understanding and using language
-responses to sensory stimulation
-responses to change and insistence on routines
-social interaction


incidence and stats on autism

-CDC estimates 1% of children, more frequent in boys
-recurrence risk of 9% in subsequent child


4 characteristics of autism

-atypical, delayed, or unequal development
-atypical responses to sensory stimuli (tactile, auditory, visual, and/or gustatory dysfunction)
-disorders of communication/social interactions
-significant deficits in speech/language development


visual characteristics of autism

-strabismus (21-84%, IXT: variable)
-poor fixations and pursuits
-refractive error (no specific trends)


visual behaviors seen in autism

-limited or no eye contact
-visual avoidance
-extreme lateral gaze
-eye pressing
-hand flicking
-light gazing


treatment options for patients with autism

-highly structured special education
-strict regulation in diet
-medication (ADHD meds? SSRIs?)


2 types of behavioral therapy that may be used in patients with autism

-applied behavior analytics (ABA): developed by Lovas
-relationship development intervention (RDI)


what is the "Applied behavior analytics (ABA)" developed by Lovas

-applied behavior analytics (ABA): developed by Lovas
-A= antecedent (directive)
-C= consequence
(most mainstream, "do something and get reward or punishment")


what is the relationship development intervention (RDI) developed by Gutstein?

-parent centered through lifestyle changes
-lays missing pathways
-improves flexible thinking


2 examination pearls for children with autism

-limit distractions (remove clutter)
-stimulate large muscle groups (oral stimulation, chewing, eating)