Patel / Greydanus / Omar Neurodevelopmental Disabilities

Clinical Care for Children and Young Adults
1. Auflage 2011
ISBN: 978-94-007-0627-9
Verlag: Springer Netherlands
Format: PDF
Kopierschutz: 1 - PDF Watermark

E-Book, Englisch, 495 Seiten

Increasingly more and more children with developmental disabilities survive into adulthood. Pediatricians and other clinicians are called upon to care for an increasing number of children with developmental disabilities in their practice and thus there is a need for a practical guide specifically written for paediatricians and primary care clinicians that addresses major concepts of neurodevelopmental pediatrics. In the United States, the specialty training leading to a conjoint board certification by the American Board of Pediatrics and American Board of Psychiatry and Neurology, requires a total of 6 years of training (2 years of pediatrics, 1 year of neurology, 18 months of child neurology, 18 months of neurodevelopmental disabilities). As of December 2006, in the US, there were 241 pediatricians and 55 child neurologists certified in the subspecialty of Neurodevelopmental Disabilities. Thus most of the children with developmental disabilities are seen by pediatricians and therefore it is important for these pediatricians to be well informed of common issues in the field. The 60,000 or so pediatricians in the United States (and hundreds more in other countries) are the main target audience for a practical book on neurodevelopmental pediatrics.

Dilip R Patel, MD, FAAP, FSAM, FAACPDM, FACSM, is professor in the Department of Pediatrics and Human Development at the Michigan State University College of Human Medicine, East Lansing, Michigan, USA. He is a full time teaching faculty member in the Pediatric Residency Program at the Michigan State University Kalamazoo Center for Medical Studies, Kalamazoo, Michigan, USA. Dr Patel has subspecialty training and interests in neurodevelopmental disabilities, developmental-behavioral pediatrics, adolescent medicine and sports medicine. He has published numerous papers on a wide ranging topics in these areas and has edited several special symposia and books. E-mail: [e-mail] Donald E. Greydanus, MD, FAAP, FSAM, FIAP (H) is Professor of Pediatrics and Human Development at Michigan State University College of Human Medicine (East Lansing, Michigan, USA) and Director of the Pediatrics Residency Program at Michigan State University/ Kalamazoo Center for Medical Studies (Kalamazoo, Michigan, USA). Received the 1995 American Academy of Pediatrics' Adele D. Hofmann Award for 'Distinquished Contributions in Adolescent Health', the 2000 Mayo Clinic Pediatrics Honored Alumnus Award for 'National Contributions to the field of Pediatrics,' and the 2003 William B. Weil, Jr., M.D. Endowed Distinguished Pediatric Faculty Award from Michigan State University College of Medicine for 'National & International Recognition as well as Exemplary Scholarship in Pediatrics.' Received the 2004 Charles R. Drew School of Medicine (Los Angeles, CA) Stellar Award for Contributions to Pediatric Resident Education and awarded an honorary membership in the Indian Academy of Pediatrics-an honor granted to only a few pediatricians outside of India. Was the 2007 Visiting Professor of Pediatrics at Athens University, Athens, Greece and received the Michigan State University College of Human Medicine Outstanding Community Faculty Award in 2008.  Past Chair of the National Conference and Exhibition Planning Group (Committee on Scientific Meetings) of the American Academy of Pediatrics and member of the Pediatric Academic Societies' (SPR/PAS) Planning Committee (1998 to Present). Member of the Appeals Committee for the Pediatrics' Residency Review Committee (RRC) of the Accreditation Council for Graduate Medical Education (Chicago, IL) in both Adolescent Medicine and General Pediatrics. Numerous publications in adolescent health and lectureships in many countries on adolescent health. E-mail: [e-mail] Hatim A Omar, MD, FAAP, Professor of Pediatrics and Obstetrics and Gynecology and Director of the Section of Adolescent Medicine, Department of Pediatrics, University of Kentucky, Lexington. Dr. Omar has completed residency training in obstetrics and gynecology as well as Pediatrics. He has also completed fellowships in vascular physiology and adolescent medicine. He is the recipient of the Commonwealth of Kentucky Governor's Award for Community Service and Volunteerism He is the recipient of the Commonwealth of Kentucky Governer's Award for community service and volunteerism in 2000, KY teen Pregnancy Coalition Award for outstanding service 2002, Awards for suicide prevention from the Ohio Valley Society for Adolescent Medicine and Kentucky Pediatric Society in 2005 and 2007, Sexual Abuse Awareness Month Award for his work with sexual abuse victims from the KY association of sexual assault professionals in 2007, Special Achievement Award from the American Academy of Pediatrics 2007 and the Founders of Adolescent Medicine Award from the AAP in 2007. He is well known internationally with numerous publications in child health, pediatrics, adolescent medicine, pediatric and adolescent gynecology. E-mail: [e-mail]   Joav Merrick, MD, MMedSci, DMSc, is professor of pediatrics, child health and human development affiliated with Kentucky Children's Hospital, University of Kentucky, Lexington, United States and the Zusman Child Development Center, Division of Pediatrics, Soroka University Medical Center, Ben Gurion University, Beer-Sheva, Israel, the medical director of the Health Services, Division for Mental Retardation, Ministry of Social Affairs, Jerusalem, the founder and director of the National Institute of Child Health and Human Development. Numerous publications in the field of pediatrics, child health and human development, rehabilitation, intellectual disability, disability, health, welfare, abuse, advocacy, quality of life and prevention. Received the Peter Sabroe Child Award for outstanding work on behalf of Danish Children in 1985 and the International LEGO-Prize ('The Children's  Nobel Prize') for an extraordinary contribution towards improvement in child welfare and well-being in 1987. E-mail: [e-mail];

Autoren/Hrsg.

Patel, Dilip R.

Greydanus, Donald E.

Omar, Hatim A.

Merrick, Joav

Inhaltsverzeichnis

1;Foreword;5
1.1; References;7
2;Contents;8
3;Contributors;11
4;About the Editors;14
5;1 Neurodevelopmental Disabilities: Introduction and Epidemiology;16
5.1; Introduction;16
5.2; Intellectual Disability;18
5.3; Learning Disabilities;19
5.4; Communication Disorders;20
5.5; Autism Spectrum Disorders;21
5.6; Cerebral Palsy;22
5.7; Myelomeningocele;22
5.8; Dual Diagnosis;23
5.9; Hearing Loss;23
5.10; Vision Impairment;24
5.11; Conclusions;25
5.12;References;26
6;2 Basic Concepts of Developmental Diagnosis;29
6.1; Introduction;29
6.2; Definitions;30
6.3; Clinical Features;31
6.3.1; Infants;31
6.3.1.1; Predominant Delay in Motor Milestones;31
6.3.1.2; Atypical Development Affecting Social, Cognitive, and Language Milestones;32
6.3.2; Children;32
6.3.2.1; Atypical Language Development;32
6.3.2.2; Regression of Previously Acquired Skills or Failure to Acquire Expected New Skills;35
6.3.2.3; Early Learning Difficulties and Behavioral Symptoms;36
6.3.3; Adolescents;36
6.3.3.1; Academic Difficulties;36
6.4; Diagnosis;37
6.5; Conclusions;39
6.6;References;39
7;3 Psychological Assessment and Testing;42
7.1; Introduction;42
7.2; Disability or Delay;44
7.3; Collecting Background Information;45
7.4; Observational Data Collection;46
7.5; Testing Circumstances;46
7.6; Testing Conditions;47
7.6.1; Testing Environment;47
7.6.2; Appropriate Time Between Testing Referrals;48
7.6.3; Ethical Concerns and Cautions;48
7.6.4; Psychological Report;49
7.6.5; Norms;50
7.6.6; Statistical Concepts and the Bell Curve;50
7.6.7; Percentiles;51
7.6.8; Standard Scores;51
7.6.9; Confidence Intervals;52
7.6.10; A Word of Warning About Grade Equivalence;52
7.6.11; Neuropsychological Testing and Psychological Testing;52
7.6.12; Psychometric Testing Measures;53
7.6.13; Cognitive Assessment;53
7.6.14; Verbal or Language Skills;53
7.6.15; Non-verbal or Performance Skills;53
7.6.16; Executive Functioning;55
7.6.17; Memory Functions;55
7.6.18; Neuropsychological Measures;57
7.6.19; Academic or Achievement Assessments;58
7.6.20; Developmental or Adaptive Assessments;58
7.6.21; Behavioral Symptom Assessment;60
7.6.22; Emotional Functioning Assessment;60
7.6.23; Personality Assessment;60
7.6.24; The Psychological Assessment Report;60
7.6.25; Recommendations;63
7.6.26; Referrals;63
7.6.27; Other Recommendations;64
7.7; Conclusions;65
7.8;References;65
8;4 Inborn Errors of Metabolism;66
8.1; Introduction;66
8.2; Definition;67
8.3; Epidemiology;67
8.4; Etiopathogenesis;67
8.5; Clinical Features;69
8.5.1; Early-Onset Disorders;70
8.5.1.1; Silent Disorders;70
8.5.1.2; Disorders Presenting with Acute Metabolic Encephalopathy;70
8.5.1.3; Disorders Presenting with Metabolic Acidosis;71
8.5.1.4; Disorders Presenting with Hyperammonemia;71
8.5.2; Disorders Presenting Later on in Childhood;71
8.6; Diagnosis;71
8.6.1; Newborn Screening;74
8.7; Principles of Management;77
8.7.1; General Principles of Treatment;77
8.7.2; Specific Therapeutic Measures;77
8.8; Conclusions;77
8.9;References;79
9;5 Genetic Evaluation in Developmental Disabilities;81
9.1; Introduction;81
9.2; Family History;82
9.3; Prenatal History;82
9.4; Medical and Developmental History;82
9.5; Physical Evaluation;83
9.6; Testing;84
9.6.1; 15q13.3 Deletion;87
9.6.2; 16p11.2 Deletion;87
9.6.3; 17q21.31 Deletion;87
9.7; Summary;88
9.8;References;89
10;6 Neurodevelopmental Disorders in Common Syndromes;91
10.1; Introduction;91
10.2; Angelman Syndrome;92
10.3; Down Syndrome;93
10.4; Fragile X Syndrome;94
10.5; Klinefelter (XXY) Syndrome;95
10.6; Neurofibromatosis;97
10.7; Noonan Syndrome;97
10.8; Prader–Willi Syndrome;98
10.9; Rett Syndrome;99
10.10; Smith-Magenis Syndrome;100
10.11; Sotos Syndrome;101
10.12; Tuberous Sclerosis;101
10.13; Turner Syndrome;102
10.14; Velocardiofacial Syndrome;103
10.15; Williams Syndrome;104
10.16; Conclusions;105
10.17;References;105
11;7 Autism Spectrum Disorders;109
11.1; Introduction;109
11.2; Definition;110
11.2.1; Autistic Disorder;111
11.2.2; Asperger's Disorder;111
11.2.3; Childhood Disintegrative Disorder (CDD);111
11.2.4; Rett's Syndrome;111
11.2.5; Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS);111
11.3; Epidemiology;112
11.3.1; Genetic Factors;112
11.3.2; Environmental Factors;113
11.4; Clinical Features;113
11.5; Diagnosis;115
11.5.1; Clinical and Developmental History;115
11.5.2; Medical Assessment;115
11.5.3; Laboratory Tests;116
11.5.4; Autism Rating Scales;116
11.6; Treatment;117
11.6.1; Psycho-educational Interventions;118
11.6.2; Miscellaneous Interventions;119
11.6.3; Pharmacological Interventions;119
11.7; Conclusions;121
11.8;References;121
12;8 Attention Deficit Hyperactivity Disorder;123
12.1; Introduction;123
12.2; Definition;124
12.3; Epidemiology;124
12.4; Diagnosis;124
12.5; ADHD Comorbidities;125
12.6; Treatment;128
12.6.1; Pharmacotherapy;128
12.7; Stimulants;129
12.7.1; Methylphenidate Products;130
12.7.2; Amphetamine Products;131
12.7.3; Contraindications for Stimulant Use;135
12.7.3.1; Stimulant Side Effects;137
12.7.4; Monitoring Patients on Stimulants;138
12.8; Non-stimulant Medications;139
12.8.1; Atomoxetine;139
12.8.2; Alpha-2 Agonists;140
12.8.2.1; Clonidine;140
12.8.2.2; Guanfacine;140
12.8.2.3; Tricyclic Antidepressants;141
12.8.2.4; TCA Monitoring;143
12.8.2.5; Bupropion;144
12.8.2.6; Venlafaxine;144
12.8.2.7; Miscellaneous;145
12.9; Conclusions;146
12.10;References;147
13;9 Sleep in Children and Adolescents with Neurobehavioral Disorders;153
13.1; Introduction;153
13.2; Attention-Deficit Hyperactivity Disorder;153
13.3; Autism Spectrum Disorder;155
13.4; Bipolar Disorder;155
13.5; Eating Disorders;155
13.6; Management;156
13.7; Conclusions;157
13.8;References;157
14;10 Learning Disabilities;159
14.1; Introduction;159
14.2; Terminology;161
14.3; Definition of Learning Disabilities;162
14.4; Types of Learning Disabilities;163
14.4.1; Reading;163
14.4.2; Language;163
14.4.3; Written Expression;164
14.4.4; Mathematics;164
14.5; Etiologic Concepts;164
14.6; Epidemiology;164
14.7; Diagnosis;165
14.8; Differential Diagnosis;165
14.9; Co-morbidity;166
14.10; Assessment;166
14.11; Multidisciplinary Assessment Team;167
14.12; Treatment;168
14.13; Management;168
14.14; Outcomes;168
14.15; Conclusions;169
14.16;References;170
15;11 Intellectual Disability;172
15.1; Introduction;172
15.2; Definition;173
15.3; Epidemiology;174
15.4; Clinical Features;175
15.5; Diagnosis;176
15.6; Treatment;179
15.7; Conclusions;181
15.8;References;181
16;12 Developmental Language Disorders;183
16.1; Introduction;183
16.2; Definitions and Classification;186
16.2.1; Late Language Emergence;186
16.2.2; Language Impairment;186
16.2.3; Learning Disability;188
16.2.4; Language Impairment Secondary to Other Conditions;190
16.3; Epidemiology;191
16.4; Clinical Features;191
16.5; Diagnosis;196
16.6; Treatment;197
16.7; Conclusions;198
16.8;References;199
17;13 Disorders of Speech and Voice;202
17.1; Introduction;202
17.2; Definitions;204
17.3; The Development of Speech;204
17.3.1; Development of Speech Sounds;205
17.3.2; Development of Fluency;206
17.3.3; Development of Resonance;206
17.3.4; Development of Voice;206
17.4; Disorders of Speech and Voice;207
17.4.1; Clinical Assessment of Speech and Voice;208
17.4.2; Disorders of Speech Sound Production;210
17.4.2.1; Perceptual Characteristics of Speech Sound Disorders;210
17.4.2.2; Organic Causes of Speech Sound Disorders;210
17.4.2.3; Neurologic Causes of Speech Sound Disorders;210
17.4.2.4; Developmental, Functional, Idiopathic, or Behavioral Causes of Speech Sound Disorders;211
17.4.3; Disorders of Speech Fluency;211
17.4.3.1; Perceptual Characteristics of Fluency Disorders;211
17.4.3.2; Neurologic Causes of Fluency Disorders;212
17.4.3.3; Developmental, Functional, Idiopathic, or Behavioral Causes of Fluency Disorders;212
17.4.4; Resonance Disorders;213
17.4.4.1; Perceptual Characteristics of Resonance Disorders;213
17.4.4.2; Organic Causes of Resonance Disorders;213
17.4.4.3; Neurologic Causes of Resonance Disorders;213
17.4.4.4; Functional Causes of Resonance Disorders;214
17.4.5; Voice Disorders;214
17.4.5.1; Perceptual Characteristics of Voice Disorders;214
17.4.5.2; Organic Causes of Voice Disorders;215
17.4.5.3; Neurologic Causes of Voice Disorders;215
17.4.5.4; Developmental, Functional, Idiopathic, or Behavioral Causes;215
17.5; When to Refer;215
17.5.1; Suspected Speech Sound Disorders;216
17.5.2; Suspected Fluency Disorders;216
17.5.3; Suspected Resonance Disorders;216
17.5.4; Suspected Voice Disorders;216
17.6; Evaluation of Speech and Voice Disorders;217
17.6.1; Evaluation of Speech Production;217
17.6.2; Evaluation of Speech Fluency;217
17.6.3; Evaluation of Speech Resonance;218
17.6.4; Evaluation of Vocal Function;218
17.7; Management;218
17.8; Conclusions;219
17.9;References;220
18;14 Tic Disorders;222
18.1; Introduction;222
18.2; Definition;223
18.3; Clinical Features;223
18.3.1; Transient Tic Disorder;223
18.3.2; Chronic Motor or Vocal Tic Disorder;224
18.3.3; Tourette's Disorder (Syndrome);224
18.3.4; Tic Disorder Not Otherwise Specified;225
18.4; Epidemiology;225
18.5; Diagnosis;226
18.6; Treatment;226
18.6.1; Pharmacotherapy;227
18.6.2; Alpha-Agonists;227
18.6.3; Antipsychotics;230
18.6.4; Miscellaneous Drugs;232
18.6.5; Stimulants;232
18.6.6; Other Treatments;232
18.7; Conclusions;233
18.8;References;233
19;15 Medical Management of Cerebral Palsy;236
19.1; Introduction;236
19.2; Definition;236
19.3; Epidemiology;237
19.4; Clinical Features;238
19.5; Diagnosis;238
19.5.1; Classification;239
19.6; Prognosis;239
19.7; Management;240
19.7.1; Seizures;242
19.7.2; Cognition and Learning;242
19.7.3; Nutrition and Growth;243
19.7.4; Swallowing;244
19.7.5; Gastrointestinal;244
19.7.6; Respiratory;246
19.7.7; Orthopedic;246
19.7.8; Abnormal Tone;247
19.7.9; Vision;248
19.7.10; Hearing;248
19.7.11; Urologic;248
19.7.12; Dental;249
19.7.13; Sialorrhea;249
19.7.14; Pain;249
19.7.15; Sleep;250
19.8; Transition;251
19.9; Conclusions;251
19.10;References;251
20;16 Myelomeningocele;257
20.1; Introduction;257
20.2; Epidemiology;258
20.3; Clinical Features;258
20.4; Diagnosis;259
20.5; Treatment;261
20.6; Conclusions;261
20.7;References;261
21;17 Pain in Individuals with Intellectual and Developmental Disabilities;263
21.1; Introduction;263
21.2; Assessing Pain in Individuals with IDD;264
21.2.1; The Complexity of Assessing Pain in Individuals with IDD;265
21.2.2; Existing Pain Scales;266
21.2.2.1; The Facial Action Coding System (FACS);266
21.2.2.2; The Evaluation Scale for Pain in Cerebral Palsy (ESPCP);266
21.2.2.3; The Non-communicating Children's Pain Checklist (NCCPC);268
21.2.2.4; The Pain Indicator for Communicatively Impaired Children (PICIC);269
21.2.2.5; The Pediatric Pain Profile (PPP);269
21.2.2.6; The Pain and Discomfort Scale (PADS);269
21.2.2.7; The Non-communicating Adult's Pain Checklist (NCAPC);270
21.3; Pain Management for Individuals with IDD;271
21.3.1; Physical Therapies;271
21.3.2; Pharmacological Treatments;272
21.3.3; Psychological Techniques;274
21.3.4; Operant Techniques;274
21.3.5; Modeling;275
21.3.6; Distraction;275
21.3.7; Relaxation Techniques;276
21.3.8; Use of Psychological Treatments During Acute Versus Chronic/Recurrent Pain;277
21.4; Implementing Pain Assessment and Management in Clinical Practice;278
21.5; Conclusions;279
21.6;References;279
22;18 Vision Impairment;285
22.1; Introduction;285
22.2; Categorization of Visual Impairment;287
22.2.1; Anatomic or Descriptive Classification;287
22.2.2; Classification According to Severity;288
22.2.3; Classification According to Etiology;290
22.2.4; Causes of Vision Impairment Can Be Classified as to Onset;290
22.3; Examination;290
22.4; Common Causes of Vision Impairment;294
22.4.1; Amblyopia;296
22.4.2; Strabismus;296
22.4.3; Cataract;297
22.5; Examples of Specific Clinical Entities;297
22.5.1; Down Syndrome;297
22.5.2; Cortical Visual Impairment;299
22.6; Additional Aspects of Treatment;300
22.7; Conclusions;302
22.8;References;303
23;19 Impact of Neurodevelopmental Disorders on Hearing in Children and Adolescents;305
23.1; Introduction;305
23.2; Auditory Neuropathy Spectrum Disorder (ANSD);306
23.2.1; Epidemiology;307
23.2.2; Diagnosis and Treatment;307
23.3; Case Study 1;309
23.4; Congenital Symptomatic Cytomegalovirus (CMV);312
23.4.1; Epidemiology;312
23.4.2; Contribution of CMV to Risk Factors for Hearing Loss and Childhood Hearing Loss;313
23.4.3; Diagnosis and Treatment;314
23.4.4; Antiviral Drugs and Hearing Impairment;314
23.5; Case Study 2;315
23.6; Trisomy 21 or Down Syndrome (DS);317
23.6.1; Ear Abnormalities and Hearing Loss;318
23.6.2; Epidemiology;319
23.6.3; Diagnosis and Treatment;319
23.7; Case Study 3;321
23.8; Case Study 4;325
23.9; Conclusions;325
23.10;References;325
24;20 Sexuality and Gynecological Care;329
24.1; Introduction;329
24.2; Sexuality Education;330
24.3; Psychological Effects of Disability on Sexuality;330
24.4; Sexual Abuse;331
24.5; Clinician Counseling Concepts;332
24.6; Principles of Gynecological Care in Children and Adolescents with Neurodevelopmental Disabilities;333
24.7; Pediatric Gynecological Care;335
24.7.1; Vulvar Rash;335
24.7.2; Vaginal Discharge;337
24.7.3; Vaginal Bleeding;337
24.8; Adolescent Gynecology;338
24.8.1; Menstrual Disorders/Concerns;340
24.8.2; Contraception;341
24.8.3; Sexual Dysfunction;342
24.9; Conclusions;343
24.10;References;344
25;21 Dental Aspects;348
25.1; Introduction;348
25.2; Our Experience in Israel;349
25.3; What Have We Learned from Our Experience?;351
25.4; Dental Issues;354
25.4.1; Periodontal Disease;354
25.4.2; Dental Caries;355
25.4.3; Malocclusion;355
25.4.4; Missing Teeth, Delayed Eruption, and Enamel Hypoplasia;356
25.4.5; Oral Habits;356
25.4.6; Injuries;356
25.5; Dental Care and Down Syndrome;356
25.6; Recommendations;358
25.7;References;358
26;22 General Medical Care for Individuals with Developmental Disabilities;360
26.1; Introduction;360
26.2; Infancy and Childhood;362
26.3; Adolescence;362
26.4; Adulthood and Aging;364
26.4.1; Functional Behavior;366
26.4.2; General Health and Health Services Utilization and Coordination;366
26.4.3; Cardiovascular Disease (CV) and Risk Factors;367
26.5; Health Needs of Adults with Intellectual Disability;367
26.5.1; Mild and Moderate Intellectual Disability;367
26.5.2; Health Concerns in Severe and Profound Intellectual Disability;369
26.5.3; Health Concern in Down Syndrome;369
26.5.4; Epilepsy and Cerebral Palsy;370
26.6; Community Aspects;371
26.7; Conclusions;372
26.8;References;372
27;23 Principles of Team Care for Children with Developmental Disabilities;376
27.1; Introduction;376
27.2; Teams and Team Processes;377
27.3; Conceptualization of Multiple Discipline Teams;379
27.3.1; Discipline;379
27.3.2; Multiple Disciplinary;379
27.3.3; Unidisciplinary or Intradisciplinary;379
27.3.4; Multidisciplinary;379
27.3.5; Interdisciplinary;380
27.3.6; Transdisciplinary;380
27.3.7; Virtual or Electronic Teams;380
27.4; Evolution and Comparative Characteristics of Teams;381
27.5; Developing Effective Teams;381
27.6; Outcomes of Team Approaches in Health-Care Delivery;381
27.7; Conclusion;383
27.8;References;384
28;24 Working with Families and Caregivers of Individuals with Developmental Disabilities;387
28.1; Introduction;387
28.2; Definitions;388
28.2.1; Manifestation of Disability;388
28.2.2; Epidemiology;388
28.2.3; Clinical Features;388
28.2.4; Diagnosis;389
28.2.5; Impact of the Family's Environment;389
28.2.6; Social Impact on Family;390
28.2.7; Financial Impact;390
28.2.8; Parent–Professional Relationships;390
28.2.9; Assessment of Family Relationships;391
28.2.10; Treatment;392
28.3; Summary;392
28.4;References;393
29;25 Allied Health Professionals and Intellectual Disability: Moving Toward Independence;394
29.1; Introduction;394
29.1.1; Moral, Ethics, Empowerment, and Advocacy;395
29.1.2; Valuable Individuals;395
29.1.3; Pity Versus Compassion;395
29.1.4; Physical Integration Versus Social Integration?;396
29.1.5; Research in Individuals with ID;396
29.1.6; Mediation of the Person with ID to Others;397
29.1.7; Keep an Eye on the Helpless and Give Them a Voice;397
29.2; Therapeutic Intervention;397
29.3; A Case Story;402
29.4; Therapeutic Needs;403
29.5; Unmet Therapeutic Needs;403
29.6; Holistic Evaluation;404
29.7; Intervention;405
29.8; Intervention Across the Life Span;406
29.9; Early Intervention;407
29.10; Intervention in Adults with ID;408
29.11; Direct Care;409
29.12; Dosage;410
29.13; Indirect Care and Counseling;412
29.14; Conclusions;415
29.14.1; As Preventive Measures;416
29.14.2; In Regard to Ongoing Health Management;416
29.15;References;416
30;26 Adoption;423
30.1; Introduction;423
30.2; Historical Perspective;424
30.3; Epidemiology;426
30.4; Medical and Developmental Concerns;428
30.4.1; Emotional and Adjustment Difficulties in Adopted Children;429
30.4.2; Infant–Mother Attachment Theory;431
30.5; Intervention and Preventive Services;431
30.6; Summary;432
30.7;References;433
31;27 Palliative Care and End-of-Life Issues;435
31.1; Introduction;435
31.2; Infants, Children, and Youth;436
31.3; Adulthood;437
31.3.1; Causes of Death;438
31.3.2; Palliative Care and End of Life;439
31.4; Conclusions;440
31.5;References;441
32;28 Transition from Child-Oriented to Adult-Oriented Health Care;442
32.1; Introduction;442
32.2; The Process of Transition;443
32.3; Modulating Factors;444
32.3.1; The Adolescent and the Family;444
32.3.2; The Physician and the Medical Team;445
32.3.3; The System of Health Care;445
32.3.4; Access to Adult Subspecialty Care;446
32.3.5; Hospital Care;446
32.3.6; The Nature of Chronic Disease or Disability;446
32.4; Health-Care Transition Programs;447
32.5; Conclusions;448
32.6;References;449
33;29 Psychosocial Functioning in Youth with Chronic Illness;451
33.1; Introduction;451
33.2; Psychosocial Functioning;452
33.2.1; Academic and Social Functioning;452
33.2.2; Involvement in Risky Behaviors;453
33.2.3; Psychiatric Functioning;454
33.2.4; Family Functioning;455
33.3; Treatment Considerations;456
33.3.1; Adherence to Treatment;458
33.4; Conclusion;461
33.5;References;462
34;30 Parents and Siblings;465
34.1; Introduction;465
34.2; Parental Reaction to the Birth of a Child with Disability;466
34.3; Parental Guilt;469
34.4; Influence on Parental Married Life;470
34.5; Influence on Siblings;471
34.6; Conclusions;473
34.7;References;473
35;31 Parenthood;475
35.1; Introduction;475
35.2; Sexuality and Persons with Disability;476
35.3; Earlier Studies on Intellectual Disability and Parenthood;476
35.4; Prevalence of Parenthood;477
35.5; The Concept of Marriage in Judaism;477
35.6; Legal Aspects of Jewish Marriage;478
35.7; Children;479
35.8; Interaction in Families with Intellectual Disability;479
35.9; Discussion;481
35.10; Conclusions;483
35.11;References;484
36;Appendix A;485
36.1; About Michigan State University College of Human Medicine;485
36.1.1; Mission and Service;485
36.1.2; Research Activities;486
37;Appendix B;487
37.1; About Division of Adolescent Medicine University of Kentucky;487
37.1.1; Collaborations;487
37.1.2; The Vision;488
37.1.3; Target Areas of Interests;488
38;Appendix C;489
38.1; About National Institute of Child Health and Human Development, Jerusalem, Israel;489
38.1.1; Mission;489
38.1.2; Service and Academic Activities;489
38.1.3; Research Activities;490
38.1.4; National Collaborations;490
38.1.5; International Collaborations;490
38.1.6; Targets;491
39;Index;492