Developmental-Behavioral Disorders

We are most pleased to present Volume 3 of Developmental-Behavioral Disorders: Selected Topics, designed to serve as a companion for standard reference textbooks that address cogent issues in developmental pedi­ atrics. Periodic publications such as Selected Topics and theme-related articles, as well as continuing education programs, attempt to supple­ ment in a timely fashion the rapidly changing knowledge base in devel­ opmental-behavioral pediatrics. These media are important as forums for enhancing the quality of clinical practice, teaching skills, and re­ search activities. The need is critical for periodically disseminating and updating information about issues in developmental medicine, in as much as this field of study continues to expand at a meteoric pace. During the past several decades, developmental medicine has been recognized as a defined subspecialty in pediatrics. The spectrum of problems encompassed by this discipline is relatively broad and at times clinically overwhelming. The ultimate goal of preventing delays, disor­ ders, and/or dysfunctions from becoming chronic handicapping condi­ tions has, by volume per se, created clinical dilemmas for pediatric health care providers. There are numerous facets of providing efficient and effective care, which in the field of developmental-behavioral pediatrics are often exaggerated impediments to the delivery of services by pri­ mary health care specialists, e. g. , time, clinical skills, need for inter­ disciplinary management, medical-legal responsibilities, financial reim­ bursements. These issues, as well as clinical problems, are still very much part of the information base to be disseminated to concerned pro­ fessionals.

Inhalt

I. Introduction: General Issues in Developmental Disorders.- 1 State of the World's Children: Developmental-Behavioral Disorders in a Global Context.- 1. Introduction.- 2. Children in History.- 3. Children Today.- 4. Recent Nutrition Data.- 5. Children Tomorrow.- 6. Conclusions.- References.- 2 PL 99-457: A New Challenge and Responsibility for Physicians.- 1. Introduction.- 2. Physician Involvement.- 2.1. Identification.- 2.2. Medical Evaluation.- 2.3. Communication with the IFSP Team.- 2.4. Family Support.- 2.5. Participation in the IFSP Process.- 2.6. Advocacy.- 3. Barriers to Physician Involvement.- 4. Overcoming Barriers.- Selected Readings.- 3 An Ethical Issue in Developmental Pediatrics: Analysis and Discussion of a Case History.- Case History-S. L., a Newborn with Partial Trisomy-13.- Reference.- Selected Readings: Ethical-Legal Issues.- 4 A Physician's Primer of Developmental and Psychologic Test Instruments.- 1. Introduction.- 2. Possible Developmental Delay.- 2.1. Developmental (Cognitive/Motor) Delay.- 2.2. Language Delay.- 2.3. Behavioral/Adaptive Delays.- 3. Cases Involving Suspected Developmental Delay.- 4. Difficulties in School Performance.- 4.1. Intelligence.- 4.2. Academic Achievement.- 4.3. Perceptual/Visual Motor.- 4.4. Attention/Concentration.- 4.5. Behavioral.- 5. Cases Involving Suspected School Problems.- 6. Conclusions.- References.- II. Developmental Disorders.- 5 Neonatal Brain Care: Does Early Developmental Intervention Work?.- 1. Introduction.- 2. Supplemental Stimulation.- 3. Protection at All Costs.- 4. Contingency-Based and Developmentally-Based Interventions.- 5. Summary.- References.- 6 Early Identification of Cerebral Palsy.- 1. Introduction.- 2. Types of Cerebral Palsy.- 3. Early Clinical Signs of Cerebral Palsy.- 3.1. Amiel-Tison et al. (1977).- 3.2. Ellenberg and Nelson (1981).- 3.3. Harris (1987).- 3.4. Research Conclusions.- 4. Summary.- References.- 7 Movement Disorders and Paroxysmal Behaviors in Children and Adolescents.- 1. Introduction.- 2. Disorders Characterized by Alteration in the State of Consciousness and Abnormal Movements.- 2.1. Seizure Disorders.- 2.2. Pseudoseizures.- 3. Disorders Characterized Primarily by an Alteration in Consciousness.- 3.1. Syncope Due to Inadequate Cerebral.- 3.2. Postural Hypotension.- 3.3. Steal Syndromes.- 3.4. Cardiac Arrhythmias.- 3.5. Breath Holding Spells.- 3.6. Syncope Due to Hypoxia or Hypoglycemia.- 4. Disorders Characterized Primarily by Abnormal Movements.- 4.1. Disorders Characterized by Hyperkinesia.- 4.2. Disorders Characterized Primarily by Abnormalities of Posture and Tone.- 4.3. Disorders Characterized Primarily by Akinesia.- 5. Other Paroxysmal Disorders.- 5.1. Rett Syndrome.- 5.2. Mannerisms.- References.- 8 Epilepsy: Implications for Intelligence, Learning, and Behavior.- 1. Introduction.- 2. Epilepsy and Intelligence.- 3. Epilepsy and Learning Difficulties.- 4. Epilepsy and Childhood Emotional and Behavioral Disorders.- 4.1. Anticonvulsants and Behavior Disorders.- 4.2. Temporal Lobe Epilepsy and Psychiatric Disorders.- 5. Summary.- References.- 9 Learning Disabilities: "The Good News/The Bad News".- 1. Introduction.- 2. Toward a Definition.- 3. Significant Discrepancy.- 4. Research.- 5. The Future.- References.- 10 Lessons I've Learned from Learning Disabilities.- 1. Introduction.- 2. Overlooked Learning Disability.- 2.1. Emotional Disturbance and Underachievement.- 2.2. Headaches and Fatigue.- 3. Miscellaneous Lessons I Have Learned.- 3.1. "Abnormal Depth Perception" in a Clumsy Child.- 3.2. Involuntary Movements with Accompanying Behavioral Upset.- 3.3. Refusal to Speak in an Anxious Child.- 3.4. Cerebral Palsy with Accompanying Depression.- 3.5. Newly Acquired Perceptual Disorder in an Intelligent Child.- 3.6. Situational Depression with a Well-Controlled Seizure Disorder.- 3.7. Acute Psychosis with Temporal Lobe Epilepsy.- 3.8. Declining School Performance and the Misdiagnosis of Seizures.- 3.9. Adolescent Stroke with Complicating Emotional Handicap.- 3.10. Seizures Misdiagnosed as Tics.- 3.11. Unappreciated Visual Difficulties Simulating Visuo-Perceptual Handicap.- 3.12. Clumsiness and Overactivity with a Posterior Fossa Brain Tumor.- 4. Summary.- Reference.- 11 Head Injury: After Acute Care, Then What?.- 1. Introduction.- 1.1. General Considerations.- 1.2. Fantasy and Reality.- 2. Definitions/Incidence.- 3. Phases of Recovery, Acute Stages.- 3.1. General Considerations.- 3.2. Physical Recovery.- 3.3. Agitated Behavior.- 4. Phases of Recovery, Potential Chronic Handicaps.- 4.1. General Considerations.- 4.2. Attention and Memory Deficits.- 4.3. Intellectual Impairment.- 4.4. Communication Disorders.- 4.5. Learning Disabilities.- 4.6. Problems in Vocational Performance.- 4.7. Social Adjustment Difficulties.- 4.8. Poor Self-Image.- 5. Rehabilitation Strategies.- 5.1. General Considerations.- 5.2. Cognitive Remediation.- 5.3. Educational/Vocational Rehabilitation.- 5.4. Psychotherapy/Psychopharmacology.- 6. Prognosis.- 6.1. The Patient.- 6.2. The Family.- 7. Summary/Personal Perspectives.- References.- 12 Clefting Syndromes: A Review.- 1. Introduction.- 2. Embryological Considerations.- 3. Incidence and Epidemiology.- 4. Genetic Considerations.- 4.1. Threshold Traits.- 4.2. Etiologic Distinction.- 5. Syndromic versus Nonsyndromic Clefts.- 6. Summary.- References.- 13 Fragile X Syndrome.- 1. Introduction/Incidence.- 2. Genetic Background.- 3. Physical Characteristics.- 4. Behavioral Manifestations.- 5. Mental Retardation.- 6. Cognitive Profile.- 7. Neurological Problems.- 8. Neuroendocrine Disorders.- 9. Nonpenetrant Males.- 10. Females and Fragile X Syndrome.- 11. Recent Genetic Findings/Genetic Counseling.- 12. Theraphy.- 13. Summary.- References.- 14 Down's Syndrome.- 1. Introduction/Incidence/Etiology.- 2. Characteristics.- 2.1. Cardiac Problems.- 2.2. Gastrointestinal Problems.- 2.3. Ophthalmological Disorders.- 2.4. Disorders of the Ears, Nose, and Throat.- 2.5. Orthopedic Disorders.- 2.6. Endocrine Disorder.- 2.7. Neurological Problems.- 2.8. Leukemia.- 2.9. Dental Problems.- 3. Summary.- References.- 15 Controversial Therapies in Developmental Disabilities.- 1. Introduction.- 2. Additive-Free Diet.- 2.1. The Feingold Hypothesis.- 2.2. Expe…