It is noteworthy that the medical phenomena just described, as well as a wide range of other medical phenomena with neuropsychological substrates (e.g., HIV-AIDS, sickle cell anemia, hypoxic episodes, and degenerative disorders, genetic and metabolic disorders), may profit from educational modifications to accommodate neuropsychological anomalies associated with the disorder, as well behavioral intervention in the form of counseling for educators and parents concerning reasonable expectations and the need for behavioral support in form of behavioral modification or supportive therapy intervention.
Attention deficit hyperactivity disorder (ADHD) represents a manifestation of neuropsychological disorders estimated to occur in approximately 5% (or more, depending on source) of school-aged children. Boys are referred approximately 3-4 times more frequently than girls. Neuropsychological assessment is indicated for determining the exact nature of the disorder: (1) classic (hyperactive, restless, distractible); (2) inattentive (absent-mindedness without hyperactivity); and (3) temporal lobe (aggressive, memory problems). Whereas SPECT imaging can document the physiological basis of these types of ADHD, neuropsychological assessment is method of choice for documenting the presence and type of disorder and recommended intervention approaches.
Learning disabilities are found in some 5% (or more, depending on source) of school-aged children. In most states, a learning disability is documented by a 15-point or greater (i.e., 1 standard deviation or more), difference between ability as measured by individual
IQ test and school achievement, as measured by standardized individual achievement testing measuring basic skills such as reading, arithmetic, and spelling. Although arithmetic disorders are not particularly rare, language-related learning disabilities exert by far the greater impediment to learning and are the most frequent learning disorders noted. Language learning disorders can be of two generic types.
a. Language Learning Disabilities Language learning disability, reflecting generalized neurodeve-lopmental asymmetry involving the dominant cerebral hemisphere, is the more common type of learning disability seen for neuropsychological evaluation. The learning problem may involve recognition-decoding problems related to more posterior brain structures (e.g., angular gyrus), associative problems involving the accurate fasiculus-temporal lobe areas, expressive functions more related to frontal cortical areas, or any combination of these problems. Typically, problems are manifested to some extent in all three functional systems.
b. Specific Development Dyslexia Specific developmental dyslexia was first described in the late nineteenth century as congenital word blindness and is usually related to dysgenesis in the area of the supramarginal and angular gyri of dominant cerebral hemisphere. Anatomic differences in brain morphology have been demonstrated upon autopsy of individuals with this type of dyslexia. Tending to occur approximately 4:1 in boys over girls, there appears to be a genetic pattern. This problem may occur in individuals at any intellectual level and, in fact, is often not detected until around the 4th grade level due to ingenious subterfuges and compensatory mechanisms employed by individuals with this specific reading disorder. Whereas some cases of this disorder occasionally may be detected by school psychometric testing, the definitive diagnosis is dependent on neuropsychological assessment.
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