Learning disability(M.R) 2. Prof. elham Aljammas April 2014

Elimination Disorders ENCOPRESIS Prevalence:1% of 5 years old children Common in boys than girls . Diagnostic criteria : 1.Repeated passage of feces into inappropriate places (e.g clothing ,floor)whether involuntary or intentional 2.At least one each month for 3-months 3.chronological year for at least 4.years. 4.The behavior is not due exclusively to the direct psychological effect of substance e.g Laxative or general medical conditions.

Treatment: 1.Individual psychotherapy. 2.behavioral Technique. 3.Parental guidance .family therapy. 4.treat associated problems.

ENURESIS Prevalence: age 5 years---------------7% boys & 3% girls Age 18 years---------------1% boys & rare in girls Diurnal > in girls . Diagnostic criteria of enuresis: 1.Repeated voiding of urine into the bed or clothes whether voluntary or intentional . 2.chronological age at least 5 years.. 3. The condition is not directly due to psychological effect or substance(diuretic) . 4.it is of clinical significance if it is manifested 2 per week for at least 3 months ..

It runs in families: MZ>DZ Small bladder It does not seem to be related to specific stage of sleep. Mainly have no existing mental Reflected impairment of care giver Associated with low self esteem It can be precipated by sibling birth or parental separation Spontaneous at age 6-8 years – puberty

Treatment Behavioral-Calendar or reward dry map Bell or buzzer Psychotherapy Pharmacological; rarely used

LEARNING DISORDERS: communication disorders   Moto skills disorders,reading disorders,mathematic disorders. Moto skills disorders(developmental coordination disorders) Communication disorders(expressive language disorder,mixed expressive receptive language disorders. Phonological disorders.(stuttering) Prevalence: motor skills=5% Stuttering1% Communication disorders 3% M/F 2/1 , Mathematic > Girls Coexist with ADD & Disruptive disorder Family incidence increase CT&MRI –Lack of normal hemispheric asymmetry in parietal & temporal lobes Left handedness increases in communication disorders Increase hearing impairment

Treatment : Speech therapy Special class placement Psychological-increase self esteem School teacher School counseling Family therapy

Care for people with learning disability General provisions General practioners , pediatricians are responsible for early detection & assessment.(psychologist, speech therapist,nurses,OT,Psychotherapy. .& self help group for family

Special services 1.Prevention & early detection of learning disability 2.Regular assessment of person's disability 3.Advice ,support & practical measures for families 4. Housing & social support to maximize self care. 5. Medical nursing & other services 6.psychological & psychiatric services

Preventive Measures Genetic counseling Prenatal care Compensatory education Education, training & occupation Residential care Medical & psychiatric services Effect of the disability on the family. 1.Social 2.psychological 3.physical