Diagnosis and Management of Learning Disabilities: An by Frank R. Brown III Ph.D., M.D., Elizabeth H. Aylward Ph.D.,

By Frank R. Brown III Ph.D., M.D., Elizabeth H. Aylward Ph.D., Barbara K. Keogh Ph.D. (auth.)

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Oral motor functioning is inferred from the neurodevelopmental history and observation in such areas as feeding and speech articulation. Certainly a history of feeding difficulties and/or persistence of drooling is suggestive of significant delays. An additional manifestation of oral motor dysfunction is delayed speech articulation. In general, children's speech should be nearly 100% intelligible to the parents by age 30 months and to strangers by 36 months. NEURODEVElOPMENTAL HISTORY AND EXAMINATION FOR THE SCHOOL-AGE CHILD The neurodeveIopmental history and examination process described previously serves well for children under 5 years of age and permits identification of preschool children at risk for subsequent learning difficulties based on delays in neurodevelopment.

Possible challenges to the validity of results range from the obvious to the subtle, but, nonetheless, all need to be taken into account when planning and implementing programs for early identification of children who are learning disabled. Two points are particularly important when testing children. The first has to do with the language and cultural background of children being assessed. Non- or limited-English speaking children, or children whose home language is dialect based, are clearly at a disadvantage when test material is presented in standard English.

These problems often were referred to early on as hyperkinesis or hyperactivity, but are now thought to comprise a condition of attentiondeficit hyperactivity disorder (ADHD). The major characteristics or "symptoms" of ADHD (developmentally inappropriate attention span and excessive motor activity) are not always linked. but the frequency of association has led to the use of the term AD HD to refer to this complex of problems. The condition is more common in boys than in LEARNING DISABILITIES IN PRESCHOOL CHILDREN 25 girls, is identifiable early in life, and is often associated with behavioral and learning problems.

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