Developmental disabilities. A continuum.
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Central Nervous System Diseases↗
Biomedical subjects
J H Snow
Publications and source records attributed to J H Snow.
Early maturation of motor-delayed children at school age.
Children underwent motor and sensory testing during each of 3 consecutive years beginning at kindergarten entrance. Children were assigned to either a motor-normal or motor-delayed group based on results from testing during the 1st year of the study. Motor-normal subjects (n = 17) had standard scores on a global motor-sensory test that fell within one standard deviation of the mean. Motor-delayed subjects (n = 12) had a global motor-sensory test standard score indicating greater than one standard deviation of motor delay and, in addition, were delayed by a minimum of one standard deviation on four of five of the motor-sensory test subtests. At the conclusion of the 3-year study, the mean standard score of the motor-delayed group remained greater than one standard deviation below the performance of the motor-normal group as measured by the global motor-sensory test. Statistical analysis using repeated measures analysis of variance indicated that the motor-delayed group made gains but did not close the gap between themselves and the motor-normal group during the 3-year study. Group x time interaction effects showed that during the study, significant gain was made by the motor-delayed group on the motor coordination subtest of the motor-sensory test. The study supports the conclusion that motor-delayed children without early intervention fail to outgrow their motor delays by age 8 years.
Adolescent↗
Mental flexibility and planning skills in children and adolescents with learning disabilities.
Mental flexibility (skill with shifting response set) and visual planning skills were examined with a group of 60 children and adolescents with learning disabilities. The sample consisted of 44 boys and 16 girls with an age range of 9 to 15. Scores from the Trail Making Test and the Wisconsin Card Sorting Test were cluster-analyzed and subgroups were formulated. The results of the cluster analysis indicated a two-group solution to be most appropriate. One subtype was clearly dysfunctional on the classifying variables, while the other subgroup approached average levels. The two subtypes were compared on measures of intellectual functions, academic skills, auditory memory, visual memory, visual-motor integration, motor speed, and tactile integration. Significance was found on several different tests. The results are discussed in terms of potential cortical dysfunction evidenced by the subgroups.
Adolescent↗
Relationship of head circumference to measures of school performance.
To study the possible relationship of head circumference (HC) to learning problems in children, a retrospective study was done, using records from 360 subjects who had been evaluated between the years 1976 and 1981. The data selected from the records included standardized academic test results, e.g., IQ scores and school achievement test results, as well as determinations of visual motor abilities. Statistical analyses demonstrated a positive correlation between full scale IQ (FSIQ) and HC (p less than 0.005). The incidence of specific learning disabilities based on significant academic and achievement discrepancies was 54% in those with HC greater than 2 S.D., 39% for normocephalic, and 23% for those with HC less than 2 S.D. Comparison of HC with results from the Wide Range Achievement Test (WRAT) demonstrated a tendency for those children with HC greater than 2 S.D. to have lower arithmetic scores when compared to results of children with normocephaly. Scores for spelling and reading ability did not demonstrate this tendency. The results of this study were found to be somewhat incongruous to those of previous studies of similar children. Further studies using large unselected populations are needed to better define the risks to learning that may be related to the extremes of head circumference.
Adolescent↗
Integration of soft signs in academically normal and academically at-risk children.
The development of motor and sensory proficiency and the integration of soft signs were analyzed for 38 children with average achievement and 29 children achieving below grade level. Motor coordination, speed, and inhibition, as well as the development of sensory function, were evaluated at the time of entrance to kindergarten and again during the first grade. The performance of both groups progressed on tasks measuring motor speed and coordination as well as tactile integration. Although the children achieving below grade level continued to perform the majority of tasks poorly in comparison with the children performing at grade level, on most of the measures they evidenced definite catch-up or greater gain than the children performing at grade level. Their progress on the motor speed and coordination tasks supports the hypothesis of a developmental lag in these areas. Results of tests of motor inhibition were notable for an absence of progression. That children achieving below grade level did not advance in this area would argue against the hypothesis of a developmental lag for all soft signs. Although results of this longitudinal study are preliminary, findings to date would allow for the possibility that both deficits and lags are responsible for the differences between the academically normal and academically at-risk children.
Achievement↗
Measures of attention deficit. Part I: Questionnaires.
Despite much progress in the diagnosis and management of children with attentional problems, hyperactivity, and learning difficulties, current diagnostic techniques remain inadequate to readily distinguish a primary attentional disorder from a more complex secondary problem. Developmental and behavioral questionnaires to supplement office evaluation of hyperactivity, neuromaturation, and selected cognitive processes continue to be improved. These measures suffer from different biases, focus on different childhood characteristics and associated problems, and approach childhood interaction with the environment differently. Several are psychometrically more sound, and several provide the physician with developmental and social information that may help improve the habilitative prescription. The general pediatrician can use these questionnaires to complement his or her evaluation and follow-up of children who present with learning and behavioral problems. Prior to choosing an instrument, the clinician should review the advantages of each and choose the one most suited to his or her practice.
Attention Deficit Disorder with Hyperactivity↗
Measures of attention deficit. Part II: Clinical perspectives and test interpretation.
After a detailed behavioral and developmental history has been supplemented by the use of formal questionnaires, the diagnosis of an attentional disorder can be further clarified by the judicious selection of psychoeducational and pediatric physical and neurodevelopmental examinations. The most common difficulty in the interpretation of psychoeducational test subscores and profiles is the significant overlap between the patterns generated by attentional deficits and those associated with memory-based learning disabilities. Certain other medical and behavioral conditions need to receive careful consideration prior to finalizing the diagnosis of Attention Deficit Hyperactivity Disorder (ADHD). A thorough but focused general examination coupled with the pediatric neurodevelopmental examination can contribute to this differentiation.
Algorithms↗
Comparison of scintigraphy, sonography, and computed tomography in the evaluation of hepatic neoplasms.
A comparison of scintigraphy, ultrasonography, and computed tomography (CT) in 94 proven patients with clinically suspected liver disease is reported. CT proved to be the most accurate in detecting masses and assessing the complete extent of intrahepatic disease. The most reliable combination was CT and scintigraphy. The specific advantages and disadvantages of each method are discussed. The diagnostic scheme followed in the imaging evaluation of an hepatic mass in our clinical practice is discussed.
False Negative Reactions↗