Vous êtes sur la page 1sur 21

SPECIFIC LEARNING

DISORDER

SPECIFIC LEARNING DISORDER


characterized by: persistent difficulty learning
academic skills in reading, written expression or
mathematics
find it difficult to keep up with their peers in certain
academic subjects
occurs 2 to 3 times more often in males than in
females

SPECIFIC LEARNING DISORDER WITH


IMPAIRMENT IN READING
Reading impairment 75% of children and adolescents
Difficulty in recognizing words, slow and inaccurate
reading, poor comprehension and difficulties with
spelling.
comorbid with other do in children, particularly, ADHD.
Epidemiology: 3-4x more common among boys, no
gender differential seen among adults
Comorbidity: high risk for additional learning deficits
including mathematics and written expression.

Diagnosis
characteristic diagnostic features: difficulty recalling,
evoking and sequencing printed letters and words,
processing sophisticated grammatical constructions and
making interferences

Clinical Features
identified by the age of 7 years
make many errors in their oral reading
Difficulty in distinguishing between printed letter
characters sizes
Reading speed is slow
Difficulty in sequencing words properly

Pathology and Laboratory


examination
No specific physical signs or lab measure
Psychoeducational testing
Diagnostic battery:
Standardized spelling test
Written composition, processing and oral language
Design copying and judgement of the adequacy of pencil use

Treatment
Remedial education
Small, structured reading groups
Children & adolescent: individual education program
(IEP)
High school students: IEP may not be sufficient

SPECIFIC LEARNING DISORDER WITH


IMPAIRMENT IN MATHEMATICS
difficulty learning and remembering numerals
Slow and inaccurate in computations
Poor achievement in 4 groups of skills:
a. Linguistic skills
b. Perceptual skills
c. Mathematical skills
d. Attentional skills
.comorbidity: deficits in both reading and written
expression

Diagnosis: Mathematical reasoning or calculation:


significantly below what is expected, for a period of 6 months.
Clinical Features: difficulty learning number names,
remembering the signs for addition and subtraction, learning
multiplication tables, translating word problems into
computations and performing calculations at the expected
pace.
Pathology & Lab examination: no physical signs or
symptoms
Keymath Diagnostic Arithmetic Test
Treatment: Remedial education

SPECIFIC LEARNING DISORDER WITH


IMPAIRMENT IN WRITTEN
EXPRESSION
Written expression: most complex skill acquired.
Deficits in written expression characterized by: writing
skills (poor spelling, errors in grammar and punctuations
& poor handwriting).
Comorbidity: language disorder & impairments in
reading and mathematics. ADHD occurs w/ greater
frequency in children
Clinical Features: grammatical errors and poor
paragraph organization. Reluctant to go to school,
refusal to do written assignment

Pathology and Lab exam: no physical signs.


Educational testing is used in making a diagnosis.
Treatment: Remedial treatment (direct practice in
spelling and sentence writing)

Motor disorders

Developmental Coordination
Disorder
Neurodevelopmental disorder
50% of children w/ DCD: ADHD or dyslexia
3 general areas of deficits: [1] poor predictive control of
motor movements [2] deficits in rhythmic coordination
and timing [3] deficits in executive function

Diagnosis: depends on poor performance in activities.


Based on a history of the childs delay in achieving early
motor milestones.
Informal screen: asking the child to perform tasks involving
gross motor coordination, fine motor coordination and handeye coordination.
Special tests (motor coordination): Bender Visual Motor
Gestalt test, The Frostig Movement Skills test battery and
Bruininks-Oseretsky Test of Motor Development
Treatment: Deficit-Oriented Approach and Task-specific
interventions

STEREOTYPIC MOVEMENT
Diverse range of repetitive behaviors
Movements (hand flapping, body rocking, hand waving,
hair-twirling, lip-licking, skin picking or self-hitting)
Stereotypic movements: self-soothing or self-stimulating
Head-banging, face slapping, eye poking or hand-biting
Increased frequency in children with autism and
intellectual disability

Diagnosis and clinical features: presence of multiple


repetitive stereotyped symptoms.
Extreme cases: severe mutilation and life-threatening
injuries
Pathology and Lab exam: no specific lab
measurement are helpful
Treatment: Behavioral technique (habit reversal) and
Pharmacological interventions (antipsychotics, SSRIs)

Tourettes disorder
Tics: brief rapid motor movements or vocalizations in
response to irresistible premonitory urges
more common in children (age 5-6 and peaks at 10-12
y/o)
Transient or chronic, with a waxing and waning course
Motor tics: m/c affected the muscle of face and neck
(eye-blinking, head-jerking, mouth-grimacing or headshaking)
Diagnosis: depends on a history of multiple motor tics
(over a period months or years)

Clinical Features: initial tics are in the face and neck.


Tics tend to occur in a downward progression.
Pathology and Laboratory Exam: no specific
laboratory diagnosis test
Treatment: Psychosocial, exposure and response
prevention, Antipsychotic agents (Risperidone,
Haloperidol and Pimozide), Noradrenergic (atomoxetine,
clonidine)

Persistent Chronic Motor or Vocal Tic


disorder
Chronic motor or vocal tic do: presence of either motor or
vocal tics, but not both
Wax and wane but must have persisted for >1 year
School-age boys: highest risk
Occurs in early childhood
Vocal tics, usually not loud or intense and are not primarily
produced by the vocal cords (grunts or noises caused by
thoracic, abdominal or diaphragmatic contractions)
Treatment: depends on several factors (severity & frequency of
tics, patients subjective distress, effects of tics on school or
work, socialization), Behavioral techniques (habit reversal)

Vous aimerez peut-être aussi