By Frank R. Brown III Ph.D., M.D., Elizabeth H. Aylward Ph.D., Barbara K. Keogh Ph.D. (auth.)
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Additional info for Diagnosis and Management of Learning Disabilities: An Interdisciplinary/Lifespan Approach
On the other hand, both the "soft" neurological signs and the behavioral indicators may be part of a pattern which suggests increased vulnerability or risk for the development of learning disabilities. APPLYING A DISCREPANCY MODEL TO PRESCHOOLIDENTIFICATlON Delays of neurodevelopment (especially language), deficits of attention, and behavior problems are all indicators of possible learning disabilities in young children. Parents and teachers need to be sensitive to delays or peculiarities in speech, to short attention span, and to persistent uncontrolled behavior outbursts.
Many are aimed at gathering information from parents, teachers, or others close to the children being studied. Scales tap a range of child characteristics, some focussing on specific pre-academic behaviors and aptitUdes, others covering a broad range of content. The Preschool Behavior Questionnaire (Behar & Stringfield, 1974) is aimed specifically at identifying emotional/behavioral problems in children 3 to 6 years of age. Teachers or child-care workers are asked to rate children on 36 items tapping three domains: anxious-fearful, hyperactive-distractible, and hostile-aggressive.
Certainly the presence of risk factors in the pregnancy, labor, and delivery should alert the physician to carefully monitor subsequent neurodevelopment. We hope in the future 38 BROWN TABLE 3-1 Prenatal and Perinatal History-Risk Factors Associated with Learning Disabilities Pregnancy Labor and Delivery (cont'd) Maternal age Paternal age Parity Length of gestation Maternal weight gain Fetal activity Previous maternal obstetrical problems Problems: bleeding/spotting medications trauma toxemia radiation rash/infection fluid retention abnormal fetal movements alcohol tobacco Problems: premature rupture of membranes maternal fever toxemia abnormal bleeding fetal monitoring failure of labor to progress labor induced Caesarian section forceps/instrumentation resuscitation abnormalities at birth abnormal placenta Labor and Delivery Hospital Duration of labor Birth weight Apgars Analgesia/sedation Presentation Neonatal Duration of hospitalization Problems: respiratory distress syndrome cyanosis seizures oxygen therapy feeding problems infections jaundice metabolic congenital abnormalities apnea that the ability to identify milder (and more frequently occurring) insuits will improve.
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