Audiology

Audiology is a field of clinical practice devoted to the study of hearing disorders, assessment of hearing, hearing conservation, and treatment and rehabilitation of people with hearing loss. 

Autism

Autism Spectrum Disorders (ASD’s) are defined by impairments in social interactions and communication, and the presence of restricted activities and interests.  ASD’s include Autistic Disorder and Asperger Disorder.  Symptoms typically appear in early childhood as social-communication difficulties and/or delayed developmental milestones.

There is no clear consensus on the prevalence of ASD’s, although research reports rates ranging from 16 to 67 per 10,000 children. 

Autistic Disorder is associated with developmental disability about 70% of the time.  There is an overrepresentation of autism in males with a ratio of 4 to 1 of males to females.  It is now believed that most children with ASD are probably born with it and that a preliminary diagnosis can be made well before the age of three.

Asperger Disorder tends to be diagnosed at a later age than Autistic Disorder.  An individual with Asperger Disorder does not possess a significant delay in language development, however he or she may have difficulty understanding the subtleties used in conversation, such as irony and humour.  Also, while many individuals with Autistic disorder have a significantly below average IQ, a person with Asperger disorder possesses average to above average intelligence. 

Asperger syndrome

Asperger syndrome is an autism spectrum disorder which is life long, which effects how a person relates socially to other people. Individuals have fluent speech but difficulties with conversation skills, and frequently have special interests which are unusual in their intensity and focus, and a significant preference for consistency in routines. People with Asperger syndrome find it difficult to tell others what they need and how they feel, to meet other people, make new friends, and to understand what other people think.  It differs from other autism spectrum disorders in that they have fewer problems with speaking and are of at least average intelligence.

Challenging Behaviour

Originally defined by Eric Emerson and recently refined by the Royal College of Psychiatrists, UK:  Behaviour can be described as challenging when it is of such intensity, frequency or duration as to threaten the quality of life and/or physical safely of the individual or others and is likely to lead to responses that are restrictive, aversive or result in exclusion. 

Developmental Disabilities

The language of disability is shifting.  Within Canada, the term “mental retardation” became pejorative over the last decades and the terms “developmental disability” and/or “intellectual disability” are now both used.  Often, these terms are used to refer to the diagnosis of mental retardation as defined as an IQ below 70 along with limitations in adaptive functioning and onset before the age of 18 years (DSM-IV).

The prevalence (how many people have a developmental disability at any given time) is between 1 and 3% of the population (Roeleveld, et al, 1997; Ouellette-Kuntz and Paquette, 2001)     .

The causes of developmental disabilities are varied and remain unknown in a large proportion of cases.  Often the known causes are grouped into two categories:

Genetic - harmful individual genes and aberrant chromosomes.
Environmental -including physical hazards before, during and after birth, as well as adverse domestic and social circumstances.

To a parent, family or caregiver a child is first and foremost an individual human with strengths and abilities.  He or she is a full citizen with rights, who needs a variable amount of “assistance” to achieve full inclusion and engagement in society.

Down syndrome

Down syndrome is a disorder that includes a combination of mental and physical symptoms that result from having an extra copy of all or part of chromosome 21 [chromosomes are the structures in cells that contain the genes].  It affects about 1 in 730 live births and according to the Canadian Down Syndrome Society there are approximately 35,000 Canadians with Down syndrome.  Affected individuals have some degree of intellectual disability, characteristic facial features and, often, heart defects and other health problems many of which are treatable. The severity of these problems varies greatly among affected individuals.

Dual Diagnosis

Dual Diagnosis refers to individuals who have a diagnosed emotional/psychiatric disturbance as well as a diagnosed developmental disability.  This definition was defined jointly by the Ontario Ministries of Health and Long-Term Care and Community and Social Services in 1997.

In a review of research literature, Reiss (1993) found rates of mental health problems of 15 to 50% in adults with developmental disabilities. 

There is now a clear acknowledgement that children and adults with developmental disabilities can develop the full range of psychiatric illnesses and that they have a higher rate of mental health disorders than the general population.  They are also more likely to be poorer, live in more challenging family circumstances and have fewer friends; all of which are known to be associated with an increased risk of mental health problems (Emerson & Hatton, 2007).  This study described three main reasons which appear to account for the high rates of mental health problems for persons with developmental disabilities:

The intellectual impairment associated with a developmental disability reduces the child’s capacity for finding creative and adaptive solutions to life’s challenges.
Persons with a developmental disability are at increased risk for exposure to poverty and social disadvantage.  They also have higher rates of stressful life events such as abuse that those without developmental disabilities.
Some particular causes of developmental disability predispose children to particular types of mental health problems.

For further information on Dual Diagnosis, please refer to the document “Improving Health Outcomes for Children and Youth with Developmental Disabilities” (provide link)

Interdisciplinary Team

A model of practice involving various clinicians, usually working in the same setting, who develop solutions to complex problems in a flexible and open-minded way.  They communicate and collaborate as they proceed to create an integrated report with one worker usually serving as co-ordinator.  The team has a shared set of goals and decision-making process to meet clients' needs. 

Psychology

Psychology is the scientific study of mind and behaviour which aims to understand why people behave as they do. Practitioners, called psychologists, are doctoral level professionals, who are concerned with diagnosing and treating mental and emotional disturbances, developmental disorders, and behaviour problems that can occur through the lifespan.  People often confuse psychology with psychiatry, which is a branch of medicine dedicated to the diagnosis and treatment of mental disorders.   

Primary Health Care

At a 1978 World Health Organization meeting participants agreed to the following definition:  "essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost that the community and the country can afford to maintain at every stage of their development in the spirit of self-determination

You might like to consider the American Academy of Family Physicians at http://www.aafp.org/online/en/home/policy/policies/p/primarycare.html                

For more information, please refer to the document “Improving Health Outcomes for Children and Youth with Developmental Disabilities.”                                 

Acronyms