1/9. A school-aged child with delayed reading skills.During a health supervision visit, the father of a 7.5-year-old African American second-grader asked about his son's progress in reading. He was concerned when, at a recent teacher-parent conference to review Darren's progress, the teacher remarked that Darren was not keeping up with reading skills compared with others in his class. She said that he had difficulty sounding out some words correctly. In addition, he could not recall words he had read the day before. The teacher commented that Darren was a gregarious, friendly child with better-than-average verbal communication skills. His achievement at math was age-appropriate; spelling, however, was difficult for Darren, with many deleted letters and reversals of written letters. A focused history did not reveal any risk factors for a learning problem in the prenatal or perinatal periods. Early motor, language, and social milestones were achieved on time. Darren had not experienced any head injury, loss of consciousness, or chronic medical illness. He had several friends, and his father denied any behavioral problems at home or at school. His teacher completed a DSM-IV-specific behavioral survey for attention-deficit/hyperactivity disorder (ADHD). It did not show any evidence of ADHD. Darren's father completed 1 year of college and is currently the manager of a neighborhood convenience store. His mother had a high school education; she recalled that she found it difficult to complete assignments that required reading or writing. She is employed as a waitress. Darren does not have any siblings. The pediatrician performed a complete physical examination, the results of which were normal, including visual acuity, audiometry, and a neurological examination. It was noted that Darren seemed to pause several times in response to questions or commands. On two occasions, during finger-nose testing and a request to assess tandem gait, directions required repetition. overall, he was pleasant and seemed to enjoy the visit. His pediatrician concluded that he had a learning problem but she was uncertain about the next step. She asked herself, "Is there anything else I can do in the office to evaluate Darren's problem with learning? Should I quickly refer him for educational testing or encourage a reading tutor? What questions can I ask his teacher that would be helpful? Am I missing a medical disorder?"- - - - - - - - - - ranking = 1keywords = achievement (Clic here for more details about this article) |
2/9. Evidence for a double dissociation between spatial-simultaneous and spatial-sequential working memory in visuospatial (nonverbal) learning disabled children.The paper describes the performance of three children with specific visuospatial working memory (VSWM) impairments (Study 1) and three children with visuospatial (nonverbal) learning disabilities (Study 2) assessed with a battery of working memory (WM) tests and with a number of school achievement tasks. overall, performance on WM tests provides evidence of a double dissociation between spatial-simultaneous processes, underpinning the memorization item positioning in a spatial configuration, and spatial-sequential processes, which allow memorization of the presentation order. In both groups of children of the two studies, a selective impairment either on spatial-sequential or on spatial-simultaneous working memory tasks was observed. These data support the existence of -simultaneous and -sequential modality-dependent processes in visuospatial working memory and confirm the importance of distinguishing between different subtypes of visuospatial (nonverbal) learning-disabled children.- - - - - - - - - - ranking = 1keywords = achievement (Clic here for more details about this article) |
3/9. Acquired aphasia in childhood: clinical and CT investigations.We studied eight children with acquired aphasia. All had left hemisphere lesions. In most, the correlation between the CT lesion site and the resulting aphasic syndrome duplicated an anatomic-clinical correlation described in adults. Rapid recovery of language fluency distinguished the children from reported adults. Late follow-up indicated poor scholastic achievements, reflecting an acquired handicap in new learning. Anatomic-clinical correlates and recovery patterns suggest that brain organization for language is similar but not identical in children and adults.- - - - - - - - - - ranking = 1keywords = achievement (Clic here for more details about this article) |
4/9. Neurological and neuropsychological effects of cerebral spinal fluid shunting in children with assumed arrested ("normal pressure") hydrocephalus.Normocephalic children found to have ventriculomegaly during evaluation of long-standing (4.5-8.5 years) neurological disorder were tested for academic achievement, intellectual quotient and neuropsychological functioning. Radioactive iodinated serum cisternography, pre and post-shunt electrophysiological studies (visual evoked responses, brainstem auditory evoked potentials, sleep electroencephalograms) and radiological studies (skull radiographs computed tomography) were recorded. Four children who have been followed more than one year after insertion of ventricular-peritoneal shunts are presented. All demonstrated improvement in psychometric findings along with some improvement in CT scan and EEG studies. The most marked initial changes were noted on measures of neuropsychological performance, accompanied later by improvement in measures of intelligence. Achievement test scores showed no consistent pattern of change. This sample suggests that there is a group of asymptomatic children with apparent clinically stable (arrested) hydrocephalus in whom abnormal neuropsychological testing indicates the need for cerebrospinal fluid shunting, with subsequent improvement.- - - - - - - - - - ranking = 1keywords = achievement (Clic here for more details about this article) |
5/9. Taxonomy of family life styles: II. Homes with slow-learning children.A battery of instruments dealing with family social environment and family and child characteristics and behavior was administered to 218 families with slow-learning children in EMR and educably handicapped programs. cluster analysis was performed on family environment variables. Seven unique family clusters, each with distinctive patterns of characteristics, were identified: child-oriented, cohesive; learning-oriented, high residential quality; low disclosure, unharmonious; disadvantaged, noncohesive; achievement-oriented, low residential quality; expression-oriented with few sociocultural interests; and outerdirected with little achievement-orientation. Comparisons among the clusters and ethnographic/interviewer observations revealed significant differences in other family and child characteristics and behavior. Development of a classification system for families with retarded children was discussed.- - - - - - - - - - ranking = 2keywords = achievement (Clic here for more details about this article) |
6/9. The use of neuropsychological data to detect altered neurological functioning in a child with myelomeningocele.Although children with myelomeningocele often display atypical patterns on psychometric testing, this case study demonstrates the sensitivity of neuropsychological instruments to detect altered neurological functioning in a patient with spina bifida. The subject had a history of myelomeningocele at the lumbosacral level and placement of a ventriculoperitoneal shunt. During a routine neuropsychological evaluation, a 44-point discrepancy between his verbal (verbal IQ = 98) and nonverbal abilities (performance IQ = 54) on the Wechsler intelligence for Children-Revised was found. In comparison to high average academic achievement, test findings suggested depressed memory skills and extreme slowing in psychomotor speed. A pattern of acute decline in overall cognitive functioning was suggested. magnetic resonance imaging revealed a left frontoparietal brain mass, which was surgically removed. Follow-up neuropsychological testing 9 months postsurgery indicated an increase in nonverbal intelligence with improved psychomotor speed and information processing. This case study illustrates the importance of obtaining baseline evaluations in this neurologically high-risk population as well as the clinical usefulness of psychometric data in diagnostic workups.- - - - - - - - - - ranking = 1keywords = achievement (Clic here for more details about this article) |
7/9. Specific neurocognitive deficits in Cornelia de lange syndrome.Cornelia de lange syndrome (DLS) is a dysmorphogenic disorder typically associated with severe mental retardation. This report describes a rare case with normal-range verbal intelligence and specific cognitive deficits suggestive of a developmental visuospatial disorder. This was apparent in selective deficits in the ability to integrate visual percepts, copy spatial configurations, and manipulate representations of objects in space. Visual memory and psychomotor skills were also impaired. These deficits occurred within the context of normal language abilities and language-related academic achievement. The observed pattern of neuropsychologic impairment, in addition to aspects of socioemotional development, was similar to that seen in children with developmental right-hemisphere dysfunction. These findings suggest that the factors underlying DLS can be associated with fairly specific aberrations of cortical functioning.- - - - - - - - - - ranking = 1keywords = achievement (Clic here for more details about this article) |
8/9. Psychologic and psychoeducational consequences of thyroxine therapy for juvenile acquired hypothyroidism.The observation of severe behavioral reactions or learning problems in three teenagers treated with L-thyroxine for juvenile acquired hypothyroidism prompted us to conduct a prospective study of achievement and behavioral characteristics of patients with newly diagnosed juvenile acquired hypothyroidism. On diagnosis of juvenile acquired hypothyroidism and before treatment with L-thyroxine, 23 children and adolescents underwent a comprehensive battery of psychoeducational tests, which was repeated after 3, 12, and 24 months of replacement therapy. Results revealed that adverse behavioral reactions and learning problems were relatively rare in these children, although symptoms of juvenile acquired hypothyroidism were associated with increased distractibility, hyperactivity, and poorer achievement. The least gain in achievement was made by children with more severe hypothyroidism at diagnosis; children with the best psychologic outcome were those who achieved euthyroidism more slowly. We conclude that severe behavioral manifestations of L-thyroxine therapy for juvenile acquired hypothyroidism are uncommon, but mild behavioral symptoms and poorer school achievement may occur in about 25% of patients, who represent the most severe cases at diagnosis.- - - - - - - - - - ranking = 4keywords = achievement (Clic here for more details about this article) |
9/9. The good boy syndrome and malignant academic failure in early adolescence.The shift into adolescence coincides with an increase in academic demands that reveals a large diagnostic range of difficulties underlying academic underachievement or failure at this developmental stage. A group of compliant boys of high intelligence and proved abilities, previously apparently well-adjusted and well-liked, unexpectedly come to attention because of sudden academic failure. Their puzzling difficulties indicate a serious underlying disorder, including depression, which requires intensive treatment. Intrasystemic superego conflicts of ideals form an intrinsic part of the psychic picture.- - - - - - - - - - ranking = 1keywords = achievement (Clic here for more details about this article) |