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Dyslexia
Developmental Reading Disorder (DRD) or Dyslexia is defect of the brains higher cortical processing of symbols. Children with DRD may have trouble rhyming and separating the sounds in spoken words. As measured by a standardized tests, the patient's ability to read (accuracy or comprehension) is substantially less than you would expect considering age, intelligence and education. This deficiency materially impedes academic achievement or daily living. Associated Features: Deficits in Expressive Language and Speech Discrimination are usually present. Expressive Writing Disorder is often present. Visual Perceptual Deficits are seen in only about 10% of cases. Disruptive Behavior Disorders may also be present, particularly in older children and adolescents. Differential Diagnosis: Some disorders have similar or even the same symptoms. The clinician, therefore, in his/her diagnostic attempt has to differentiate against the following disorders which need to be ruled out to establish a precise diagnosis. Mental Retardation Attention-Deficit / Hyperactivity Disorder Autistic Spectrum Disorders Mental Retardation Dyscalculia Dysgraphia Inadequate schooling Dyslexia is a specific learning disability that is neurological in origin. It is characterized by difficulties with accurate and / or fluent word recognition and by poor spelling abilities. These difficulties typically result from a deficit in the phonological component of language that is often unexpected in relation to other cognitive abilities. Secondary consequences may include problems in reading comprehension and reduced reading experience that can impede growth of vocabulary and background knowledge. Dyslexia in the Pre-school Child Delay or difficulty in development of clear speech and a tendency to jumble words and phrases over some time. Difficulty with dressing efficiently, tying shoe laces, and putting clothes on in the right order. Unusual clumsiness and difficulty with co-ordination. Poor concentration such as when stories are read to them. Ambidextrous or left-handedness. Inability to associate sounds with words. Inability to appreciate rhyme. Family history of similar difficulties. Not all dyslexic children show these all these signs. Many small children make these same mistakes and should not cause concern where any of these occur occasionally. Dyslexia is likely when difficulties are severe and persist over a number of years, or where there are several such difficulties in a milder form. At ages 5-7 Inability to learn the alphabet or the sounds represented by the letters. Inability to read except for a very few simple words. Inability to put sounds together to make words. Inability to use a pencil to write properly. Inability to remember sequences. Difficulty telling right from left. Continued difficulty with tying shoelaces, dressing Continued difficulty with co-ordinated activities. Inattention and poor concentration. At ages 7-11 Poor progress in academic subjects compared with classmates. Low frustration, often leading to behavioral problems or becoming withdrawn and quiet. Inability to learn multiplication tables. Inability to follow a number of instructions or remember more than one thing at a time. Inattention and poor concentration. At ages 11-16 Difficulty in organizing work. Problems copying. Problems with dictation. Difficulty writing down oral instructions. Growing lack of self-confidence and increasing frustration. Difficulty in studying for and coping with exams. Slowed by reading difficulties, most work takes very much longer than average. Continued problems with spelling, writing. Inconsistent in what they seem to know. Tendency to read inaccurately and without comprehension. Severe difficulty in learning foreign languages. At 16+ Students who continue in further education have usually developed strategies to get to grips with their problems. Most students will have identified a number of subjects at which they may excel. They often have the advantage of superior practical skills (e.g. woodwork, art or crafts). Many dyslexics progress to university or any other chosen field without discrimination or difficulty Cause: Genetic and neurobiological research essential confirms psychological research in this area. Family studies show a reading disorder is heritable, aggregates in families, and probably reflects autosomal dominant transmission. The brains of individuals with reading disorders are organized somewhat differently and appear to process the phonological information in a less efficient, more diffuse manner.
Encopresis
The voluntary or involuntary passage of stools causing soiling of clothes by a child over 4 years of age. Encopresis can be divided into two groups. The first in which there is a physiologic basis for the encopresis, the second in which there seems to be an emotional basis. 1. Encopresis frequently is associated with constipation and fecal impaction. 2. Other causes may be related to a lack of toilet training or training at too early an age or an emotional disturbance such as Oppositional Defiant Disorder or a Conduct Disorder. Accidentally or on purpose, the patient repeatedly passes feces into inappropriate places (clothing, the floor). For at least 3 months, this has happened at least once per month. The patient is at least 4 years old (or the developmental equivalent). This behavior is not caused solely by substance use (such as laxatives) or by a general medical condition (except through some mechanism that involves constipation). Associated Features: Medical Condition (bowel infection) Oppositional Defiant Disorder Conduct DisorderDifferential Diagnosis: Some disorders have similar or even the same symptoms. The clinician, therefore, in his/her diagnostic attempt, has to differentiate against the following disorders which need to be ruled out to establish a precise diagnosis. Constipation Fecal impaction Treatment: The goal of treatment is to prevent constipation and encourage good bowel habits. Here counseling and dietary advice is essential. Counseling and Psychotherapy [ See Counselling Section ]: Parental support and refrain from criticism or discouragement is important. Education of the parents and child, and biofeedback for the child is often used. Psychotherapy can help the child deal with associated shame, guilt, or loss of self-esteem. As an example, The child may suffer from low self-esteem and peer disapproval related to this problem. If routine bowel habits are not developed, the child may suffer from chronic constipation. Medical & Other: A diet high in fiber, including fruits, vegetables, and whole grain products and adequate fluid intake will promote the passage of softer stools and minimize the discomfort associated with bowel movements. Consultations with Pediatric Gastroenterologists to treat the more difficult cases.
Expressive Language Disorder
The scores obtained from standardized individually administered measures of expressive language development are substantially below those obtained from standardized measures of both nonverbal intellectual capacity and receptive language development. The disturbance may be manifest clinically by symptoms that include having a markedly limited vocabulary, making errors in tense, or having difficulty recalling words or producing sentences with developmentally appropriate length or complexity. The disorders main features are: Using standardized measures, the patient's scores of expressive language development are materially lower than those of both nonverbal intellectual capacity and receptive language development. Clinically, the patient may have severely limited vocabulary, make errors of tense, recall words poorly or produce sentences that are shorter or less complex than is developmentally appropriate. This disorder interferes with educational or occupational achievement or with social communication. It does not fulfill criteria for a Mixed Receptive-Expressive Language Disorder or a Pervasive Developmental Disorder. If the patient also has Mental Retardation, environmental deprivation or a speech-motor or sensory deficit, the problems with language are worse than you would expect with these problems. Associated Features: Language difficulties are in excess of those usually associated with these problems. Environmental Deprivation. Differential Diagnosis: Some disorders have similar or even the same symptoms. The clinician, therefore, in his/her diagnostic attempt, has to differentiate against the following disorders which need to be ruled out to establish a precise diagnosis. Mixed Receptive-Expressive Language Disorder Pervasive Developmental Disorder. Mental Retardation Speech-Motor Sensory Deficit Cause: Three to 5% percent of all children will possess expressive language disorder. Problems with receptive skills begins before the age of 4 where the child has difficulty understanding and using language. The cause of this disorder is unknown.
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