A

Adaptations – Adjustments of parenting styles and expectations, family schedules, teaching strategies, educational support systems and other environmental elements to match the needs and maximize the development of an individual learner.  Making positive adaptations usually results in behavioral benefits not only to the child, but to family life, school adjustment and other personal interactions outside home and school.

Adaptive Behavior – The ability of the individual to apply previously learned skills to new situations.  Adaptive behavior involves the expansion of cognitive and behavioral skills required for generalization.  Structured and guided assistance in using previously acquired skills in new situations can serve as a base for making more frequent and independent  behavioral generalizations.

Autism Diagnostic Observation Schedule – A systematic schedule of observations of a child in both natural and arranged situations.  Recording and analyzing the results of these observations can help a diagnostician determine if a child’s usual behavior encompasses the criteria for an Autistic Spectrum Disorder. The detail and summary results of the observations may also serve as a baseline for the evaluation of future development as well as the basis for prescriptive intervention actions by family, school and therapist.

Advocate – To take action on someone’s behalf (verb);   A person or group taking action on behalf of another (Noun).  Parents of children with developmental delays often organize to advocate for their youngster’s schooling, medical or therapeutic interventions and other needs.   Local advocacy groups are often identified in the phone book yellow pages and on the internet.

Alternative Communication – Any approach used to support, supplement or enhance the communication of someone who may not be able express themselves orally.  Alternative communication systems may include sign language, pictures, computer displays, manipulation of objects, voice output devices and other methods.   Such approaches are sometimes referred to as Augmentative Communication or jointly as Alternative/Agumentative Communication (ACC).

Applied Behavioral Analysis (ABA) – The identification and teaching of specific skills by using methods derived from  theories of  behavioral psychology.   Behavioral psychology is based upon an assumption that observable behaviors and events are the only qualities that can be measured and, therefore, can and should be the focus of therapeutic interventions.   A second basic assumption of ABA is that reinforcement, both positive and negative, adequately model the way the world works.  Therapeutic practices based on these principles are sometimes referred to as Intensive Behavioral Intervention (IBI).   Both long and short-term studies have demonstrated significant positive effect of ABA and IBI when used systematically as an intervention in working with children with autism.

Apraxia – A neurological disorder involving the loss of the ability to carry out purposeful actions even though the desire and ability to do so are present. There are several types of apraxia.  Paraxia of speech is the ability to understand spoken language and/or written language, and yet, be unable to produce speech.   In children speech apraxia can interfere with personal verbal interactions as well as with planning and executing unfamiliar tasks.  Other types of aparaxia include ideomotor (inability to carry out a motor command such as, “Touch your toes.,”  limb-kinetic (making  precise movements of the limbs), ideational (inability to create plans), oculomotor (difficulty with eye movements), and  verbal (inability to plan movements required for speech).  

Asperger Syndrome (AS) – A disorder which falls within the range of Autism Spectrum Disorders, but at the higher end of the scale for personal functioning.  Asperger may present itself in numerous ways, some of which may be very positive. Children with Asperger may go undiagnosed or be incorrectly diagnosed with various learning and/or personal-social disabilities.  Often children with Asperger Syndrome appear to be quite normal or even higher than normal in intelligence and achievement. They may, however, be lacking in social skills involving the give and take of conversation and responding to nonverbal communication cues.  Sometimes persons with Asperger may be lacking in empathic expression.  For some individuals, Asperger is accompanied by noticeably awkward physical movements. 

Assessment - The collection and organization of a wide range of cognitive, social, educational and personal information about a child organized  so as to present a fair representation of his/her behavior.  An individual assessment may involve direct observations in different contexts, family/school interviews and observations, formal and informal educational evaluations, norm-based sociological and psychological testing as well as data analysis.  The end result of the assessment process is usually a written report which clearly describes the child’s strengths and areas of need.   Assessment results can serve as a basis for clear specification of plans and strategies for capitalizing on strengths and meeting needs.  It is of utmost importance that assessments prepared by professionals be made available to parents.  Parents should also have the opportunity to discuss and question the professional regarding the significance and practical implications of the assessment. As with results of a Diagnostic Schedule,  Assessment result may also serve as a baseline for the measurement of  on-going development and the effectiveness of therapies.

Attachment Disorders – Functional disorders having a basis in failure to having formed strong, dependable and nurturing bonds with a consistent, significant and caring figure during infancy and early childhood.  Abuse and/or early neglect may contribute to the possibility that attachment disorders may develop.  Attachment disorders in later life are often characterized by difficulty in establishing intimate bonds involving friendships and family relationships.. Because of the lack of the significant and positive  nurturing and guiding figure(s) during early life, some persons fail to develop a sense of “right and wrong” and may exhibit symptoms of sociopathy including lack of empathy and lack of the understanding of the role that truth-telling and concern for others plays in maintaining positive social relationships.

Audiologist – An individual professionally trained in the study of hearing disorders, including evaluation of function and rehabilitation for individuals with hearing deficits.  The training, skills and advanced audiometric evaluation instruments of an audiologist reach far beyond those of “gross hearing screeners” who report simple pass/fail results which often have a high margin of error.  Children who have had persistent ear infections or other illnesses that are known to be associated with auditory problems should probably be referred to an audiologist for evaluation.

Audiometric Chamber - A small fully sound-proof room which provides complete isolation from outside sounds and other extraneous stimuli. An audiometric chamber helps provide diagnostic hearing evaluations that eliminate variables other than sounds systematically introduced into the chamber.  Most often the individual being tested wears headphones through which sounds are presented by an audiologist sitting outside the chamber.  The audiologist carefully selects and presents stimuli representing various sound qualities.  Results are usually graphically presented at the end of the test period and report full descriptions of the strengths and weaknesses of the reception of auditory stimulation present in the human environment and within the auditory range of reception.

Auditory - Having to do with the sense of audition (hearing).  The sense of audition is made up of  three major divisions.   The Conductive Mechanisms include the Outer Ear and the Middle Ear.   The Sensorineural Mechanisms involve the Inner Ear and the Auditory Nerve while the Central Auditory Mechanism includes the Central Auditory Pathway which transmits messages to the auditory cortex in the brain.

Auditory Brain Stem Response Testing (ABR) – A noninvasive test of audition which relies upon the measurement of neural impluses recorded from the auditory nerves and the brain. The neural transmissions are measured through the use of small electrodes placed behind each ear and on the forehead.  This type of testing is most often  recommended by an audiologist who has performed a hearing screening in the newborn nursery.  The test is also used for youngsters with serious communication deficits which make traditional audiometric testing difficult or impossible.

Autistic Spectrum Disorder (ASD) – A nonspecific term generally referring to a group of disorders that may be pervasive and include difficulty with social interactions and communication as well as cognitive functions.    In some instances ASD may be accompanied by repetitive and stereotyped behaviors.  Some forms of autism become evident in the first few years of life while other, usually less extreme variations, are not diagnosed until much later.   While numerous causes for autism have been and are being investigated, no specific causal relationships have been scientifically isolated as yet.  There is general consensus, however, that autism is a brain disorder, not having origin in the social environment. 

B

Behavior- An observable action.   Behaviors may be responses to things in the environment and/or to internal states such as level of understanding, feelings, emotions and variations in biological states.  Most likely some simple and most complex behaviors are the result of  the interaction of  two or more  causes.   Since behaviors are observable, when they are carefully recorded and summarized (Functional Analysis/Assessment), they may help to better understand  an individual’s approach to social interactions, communication and learning.  Functional Analysis may serve as the basis for developing strategies for behavioral change.

Best Practices/Treatment Protocol – Teaching techniques, parenting techniques, therapeutic practices, or other systematic approaches which have been consistently shown through research and evaluation to reliably produce desired results.   Parents, experienced  teachers, therapists, medical practitioners and other behavioral specialists rely upon their knowledge of Best Practices/Treatment Protocols to more efficiently work with their children or clients.

Broca’s Area – A specific area of the brain roughly located in the lower left frontal lobe.  Broca’s area is central to language processing and comprehension as well as speech production. Broca’s area is neurally linked to Wernicke’s area which is also crucial in functional human language production and processing.  Individuals who suffer damage to Broca’s area may develop a condition called Broca’s aphasia which makes it difficult to produce complex sentences (telegraphic speech).  With Broca’s aphasia, comprehension can remain largely in tact while speech production may be limited.  This  can create an extremely frustrating circumstance for the individual afflicted.

Brushing Therapy- A therapy developed to aid in reducing tactile defensiveness by using the process of desensitization.  Soft brushes similar to the finest of surgical brushes are used to lightly brush the arms, legs and back of individuals who show debilitating signs of tactile repulsion. A program of this sort should begin with such small steps that the problem behavior does not occur, i.e. the point of beginning the therapy should be at such a low intensity as to not evoke the defensive response.  Increasing intensity must be done  in extraordinarily small steps.  Careful design and supervision by a therapist specifically trained in the use of this therapy should always be followed. 

C

Childhood Autism Test (CHAT)- A screening tool developed for pediatricians for use during a child’s 18-month checkup.   Based on observations during the checkup, the pediatrician assesses five behaviors and also asks parents to answer,”yes/no” to an additional nine questions.   While CHAT is not intended to be a diagnostic instrument, it can alert a pediatrician to the possible need for professional assessment.   CHAT is only one of several screening tests for autism.

Childhood Disintegrative Disorder - A rare condition described many years before autism, but only recently recognized in professional diagnostics.  The condition usually has its onset in the later stages of early childhood (3-5 years) after a rather extended period of “normal” development.   Typically interest in the social environment and sometimes self-care abilities are diminished.  Language usage declines as well as general responsiveness to most aspects of the environment.   Although no specific medical cause has been identified, some evidence suggests that its origin stems from an unknown central nervous system pathology.  

Co-existing Disorders – Some individuals who have been diagnosed with Autism Spectrum Disorders may also have other disorders.  Co-existing conditions that may present with ASD include obsessive-compulsive behavior, poor impulse-control, seizures, mood disorders, anxiety, psychoses and developmental delays of various types.

Cognitive Abilities – The mental faculties used in receiving, storing and processing information so as to  produce an observable outcome or a covert increased capability for reasoning.

Communication – The imparting or exchange of information, thoughts and/or opinions through speech, writing or signs.

Consequence – The direct result of an action.   Consequences can be pleasant and reinforcing or unpleasant and punishing.  Pleasant consequences (positive reinforcers) tend to strengthen the link between an action and its consequence while unpleasant or punishing consequences (punishment) usually weakens the link.  Behaving in ways so as to avoid unpleasant consequents is considered negative reinforcement.  The consensus of psychological research concludes that children learn and progress best when the dominant reinforcement pattern is positive.   Research also indicates that persistent use of punishment tends to produce negative behaviors and attitudes.

Counter Conditioning – A technique used to change unwanted behavior through teaching a youngster to display a behavior that is counter to or mutually exclusive of the unacceptable behavior.   Counter conditioning and desensitization are often used together.  Careful planning and implementation are required and should most likely be undertaken under the direction of a therapist skilled in these techniques.

Consultant Therapy – A method of service delivery in which a service facilitator who is knowledgable in an area brings together professionals to work to identify the needs of a youngster.   Once needs are identified, specific behavioral goals should be set and a design to work toward them spelled out.  Usually, oversight of the initial assessment, the identification of goals, design of a workable plan and its execution are among the consultant therapist’s responsibilities.  When contracting with a consultant therapist, parents should make sure that they are provided and agree with the basic assessment of their youngster.  Parents should also receive a written proposal regarding goals set and specific plans to reach them.  Another integral part of the contract should be the specification of techniques that will be used to evaluate progress and how results are to be reported to the parents and other identified significant persons.

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D

Desensitization – A process of gradual and low intensity exposure to a situation that usually produces an undesired response.  Through spaced and repeated exposure to the situation at gradually increasing intensity, some undesired responses will disappear.  For example, a child who has shown extreme fear of a particular animal may be encouraged to view the animal from a distance.  If no fear response is expressed, the next viewing could be at a somewhat closer distance and so on.   Sometimes after a response has disappeared (extinction) for an extended time, it may reappear unexpectedly (spontaneous recovery).  In such instances, it may be necessary to go through the desensitization process again.  On the other hand, often the reappearance of the undesired response is a singular or infrequent event.

Developmental Assessment – A structured evaluation of a child’s development which usually includes physical, language, intellectual, social, emotional and educational characteristics.  Most assessments are done by members of a multidisciplinary team of professionals led by a child psychologist or psychiatrist. Parental input of day-to-day observations plays a vital role in determining the initial direction the assessment will take.  The end result of a well planned and executed assessment is a written report which presents an overall picture of the child’s strengths and weaknesses as well as proposed goals and strategies to enhance development.  The summary is usually presented either during a team-parent conference or a one-to-one conference with the team leader and the parents.   The summary should serve as a base for a better understanding of the child and as a springboard for improving strategies for guiding the growth of the youngster.

Developmental Delay – A term used to describe the behavior or physical development of a child who does not demonstrate the skills or growth level other children of the same age usually do.  Development delays may encompass a wide range of skills or be specific to an individual skill or related set of skills.  Because of the rapid progress of development in young children, assessment of delays may not always be accurate for a longer period of time.  For example, some children who are described as “delayed” may experience a very rapid period of “catch up” and move smoothly into the “norms” for their chronological age group.

Developmental Screening - Various procedures, which are designed to identify children who should receive a more in-depth Developmental Assessment.   Among those who are   most likely to be involved in Developmental Screening, are pediatricians, family physicians, school psychologists, community health center practitioners and early childhood educators. Perhaps the most important venue for Developmental Screening is the “well-child visit” at the pediatrician or family physician’s office or in community health centers.   Regular well-child visits offer families and service providers the opportunity to identify, monitor and seek therapy or premeditative in-home practices which might be helpful in the case of obvious or potential developmental delays.    Early identification and intervention for children with developmental delays is mandated by The Individuals with Disabilities Education Act (IDEA).   Under amendments to this act in 1990 and 1997 states are required to provide early identification and provision of services to infants and toddlers with developmental delays and established conditions that are associated with developmental delays.  States (at their option) may also provide services for children who are identified as “at risk” for developmental delays.

Diagnostic and Statistical Manual, Fourth Edition (1994) and its Text Revision (2000) (DSMIV and DSMIV-TR)-A formal classification system used as a guideline by clinicians for specifying psychiatric disorders.   First published in 1952 by the American Psychiatric Association, DSM has become the standard for classification and compilation of mental health statistics by the National Institute of Mental Health (NIMH), US Bureau of the Census, The Center for Disease Control, the US Military, state health agencies and most insurance companies.

Direct Therapy – Any therapeutic process or treatment provided when a therapist works directly with a youngster.   (Also see Indirect Therapy.)

Discrete Trial – The discrete trial teaching methods is at the center of many behaviorally based strategies used in teaching children.  The discrete trial method requires identification of a specific task to be taught as well as its breakdown into simple components.  Once the task and the chain of behaviors required to complete the task has been identified, the teacher works with the learner to produce a single cycle of the desired behavior.  Sometimes this linking together of progressive steps in learning a task is termed Chaining. Using the principles of behavioral psychology, this process is repeated over time until the performance of the task occurs when the appropriate stimulus is presented. The focus of the therapist is to identify desired behaviors, arrange circumstances to elicit them and then provide reinforcement when the behavioral steps are produced.  Multiple repetitions of the discrete trial are essential for long-lasting learning to develop.

Discriminate and Discriminations – The ability to observe differences and distinguish accurately between objects, situations, persons and other characteristics of one’s environment and then  behave accordingly.   Inversely, being able to generalize from one situation to others that bear similarity is equally as important.  The skills involved in accurate discriminations and generalizations are important cognitive skills.  Early learning in seeing simple similarities and differences in various situations is important for developing more sophisticated cognitive skills.  Parent modeling (working with the child on a task) and “thinking aloud” (describing how and why the task is done) are extraordinarily helpful in  helping develop skills in both discrimination and generalization as well as other cognitive skills.

Dyslexia – A specific learning disability that is generally assumed to be neurological in origin.   It is usually characterized by difficulties with accurate or fluent written word recognition and decoding abilities.  Dyslexia often results in problems with  reading comprehension which  can impede growth in vocabulary development and the accumulation of reading-based knowledge.

Dyspraxia – Difficulty with the smooth coordinated voluntary movements required for some behaviors.  Related to, but less severe than apraxia.    Developmental dyspraxia

(Developmental coordination disorder, DCD) is often a life-long condition that is believed to affect approximately 10% of all children and is more prevalent in boys than girls.

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E

Echolalia- The repetition of words or phrases one has heard.  Echolalia may occur right after the words have been said (immediate echolalia) or may be delayed for some time (delayed echolalia).  

Sense of Equilibrium or Balance – The sensory system that registers the orientation of the head and, in turn, the body is located in the structures of the inner ear. The sense of equilibrium is closely aligned with the kinesthetic sense. These two senses work together to help provide constant information to our nervous system regarding the orientation of our bodies.  Working together, the two senses are sometimes referred to as  proprioception.

Expressive Language- A term usually used to refer to language which expresses thoughts, feelings, needs, etc. through oral speech and written communication.   Expressive Language may also include gestures, signing and communication through pictures and objects. 

Extinction of behavior (Behavioral Extinction) – The disappearance or reduction in frequency of a behavior by withholding reinforcement.  For example, a child who attempts to gain parental attention by tugging on the parent’s clothing is ignored until the tugging diminishes.  When extinction of a response is desired, careful planning and consistency in execution are important. If a behavior reappears after it has gone through extinction, it is said that spontaneous recovery has occurred.

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F

Fine Motor Skills – Motor skills are the actions carried out when the nervous system and muscles work together to produce an action.  Fine motor skills involve activities which require the coordination of the smaller muscles of the body.   In humans, the neural pathways that control the use of hands, particularly the dominant one, take up more space on the motor cortex than any other body part. The movement of the human tongue also takes a large space on the human motor cortex.

Food and Drug Administration (FDA)-The Food and Drug Administration is an agency of the U. S. Department of Health and Human Services.   The FDA is responsible for safety regulations of most types of foods, dietary supplements, drugs (including vaccines), medical devises, biological medical products, radiation devices, cosmetics, and blood products as well as veterinary products.  Programs of the FDA regulate almost every facet of prescription drugs, including testing manufacturing, labeling, advertising, marketing, efficacy and safety.  For both general and specific information regarding  FDA responsibilities, a good point at which to begin to get answers isat the agency’s web site, www.fda.gov .

Functional Analysis/Functional Assessment – The evaluation of an individual’s behavior by carefully identifying what happens before and after a selected behavior takes place.  The end goal of such an assessment is to identify the purposes and functions of the behavior for the individual. Hopefully, such identifications will assist in developing strategies, which can help promote desired behaviors and reduce those that are undesirable. Functional analysis/assessment for a child with delayed speech may examine the pragmatics of his/her language production.

Functions of language/communication – A term, which refers to some of the purposes for which people commonly use language.   Among the more frequently used functions of language are:  informative  (communicating information), expressive (reporting feelings and attitudes) directive (language used for the purpose of causing or preventing behavior) and interrogatory (asking questions, seeking information).

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G

Generalize and Generalizations- The ability to put previously learned behavior into use in a new situation that bears resemblance to an earlier situation (Response Generalization); the ability to see similarities in between  the qualities of different situations and react accordingly (Stimulus Generalization). The skills involved in both generalization and discrimination are crucial to flexibility and expansion of learning in new situations.  Over-generalizing can be problematic as it may lead to behavioral repetitions which were appropriate in one situation, but not in another. Lack of skill in generalizing can restrict learning in diverse situations which share some common characteristics.  Lack of skill in making distinctions between/among stimuli in different situations(discrimination) can also result in inappropriate responses.

Gross Motor Skills – Motor skills are the actions carried out when the nervous system and muscles work together.   Gross motor skills involve large muscle movements as seen in walking, running and jumping while fine motor skills involve small muscle movement such as writing, sewing and playing the piano.   Guided training and and appropriate practice in most motor skills, both gross and fine, usually leads to skill improvement.

Gustatory/ Gustation/Taste – Having to do with the sense of taste. There are five primary taste sensations in the human: salty, sour, sweet, bitter and umami (response to salts of glutamic acid such as monosodium glutamate (MSG) a flavor enhancer used in many processed foods.  Taste buds on our tongues contain taste cells for all five taste sensations and taste like other sensations finds it home in our brains.

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H

Habituation – The decline of a response following repeated exposure to the stimulus which produced the response.  Habituation is commonly referred to as boredom.  Once habituation has occurred, it may be necessary to allow a period of rest before reintroducing the stimulus and expecting a response.

Hanen Language Learning Programs – Hanen programs are designed to assist parents teachers, speech therapists and other professionals to create and take advantage of everyday activities to promote language development.   Hanen programs are built upon recognition that early intervention is crucial so that language learning becomes a natural, ongoing and enjoyable part of a child’s life.  Understanding the possible results of  language delays on both motivation  for and production of  functional speech sets the stage for active involvement of significant adults who interact with the young child.

Hanen strategies include:  Observing, waiting and listening;  Following the child’s lead through imitation, interpretation and commenting; Joining in play;  Asking questions that help the child continue a conversation; and Expanding the child’s message.  Using these strategies encourages the child to communicate more and should make language easier to process and learn.

Hyperlexia – A precocious ability to read words, letters and/or numbers.   Some children who evidence hyperlexia may have difficulty with normal spoken language acquisition and social communication and interaction.  Often hyperlexic children are diagnosed as having pervasive developmental delays or with high functioning autism.

Hypergraphia – A consuming urge to write.  In and of itself, hypergraphia may not be considered a disorder, but it can be associated with temporal lobe changes that are sometimes correlates of epilepsy and mania.

Hypersensitivity –Acute and often painful reactions to “normal” sensory experiences. Hypersensitivity can occur with any of the human sensory input systems and may lead to distortions in sensory interpretation and integration. Hypersensitivity is often a correlate of autism and other development delays.

Hyposensitivity –Showing subnormal or no reaction to “normal” sensory stimulation. As with hypersensitivity, hyposensitivity can involve any or all of the sensory systems.  A youngster with hyposensitivity may exhibit delayed responses or responses which are lessened in degree.


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I

International Classification of Diseases (ICD) – The World Health Organization (WHO) constitution mandates the specification of international classifications of disease to provide a useful referent that governments, health care providers and consumers can use as a common language.  Currently, in its tenth edition and available on-line, ICD provides codes to classify mental disorders in a specific section.  Since the 1990’s WHO

and the American Psychiatric Association (APA) have worked together to bring the APA Diagnostic and Statistical Manual (DSM) and ICD into concordance.

Interventions or Treatments – Actions taken by parents, educators, therapists, caregivers and service providers to help a child grow to his/her potential.   Interventions or Treatments should be undertaken after careful assessment and analysis of possible ways that a particular intervention can be useful or inversely possibly harmful.

Identification – The process of determining which youngsters might have an Autism Spectrum Disorder (ASD) or other disability.   Dissemination of information regarding possible symptoms of ASD and where to get diagnostic assessment is essential to sound programs of identification and treatment.  Parents, Grandparents,  Physicians, Teachers, Psychologists and Therapists can help to identify youngsters who might have a developmental delay which could be associated with autism or some other disorder.  Early identification is often crucial to intervention that may ameliorate problems that may arise as the youngster grows older. 

Indirect Therapy – A therapeutic approach in which the solution of problems is not centered so much on the child of concern, but on the parents and other caregivers.  The first step in Indirect Therapy is analyzing the strategies parents and caregivers tried on their own before seeking expert help.   Once this analysis is complete, the “experts” work with the adults in the child’s environment to modify or drop and replace strategies that have been unsuccessful.  These experts should also be available to help assess the effectiveness of the improved or new strategies.   Indirect Therapy is most often used with youngsters who are unable to collaborate directly with a therapist because of their young age or various mental/emotional conditions.   

Individual Family Service Plan (IFSP) – An action plan, which specifies and prioritizes a family’s needs and then identifies the services, which can be provided to meet them.  The best of plans are ongoing, individualized and flexible.   Built-in and regular “effectiveness checks” characterize a sound IFSP.

Intensive Behavioral Intervention (IBI) – The teaching of functional skills to individuals with Autism Spectrum Disorders, other developmental delays or emotional disorders.  The teaching process involves structured and intensive therapy and education based on the theories of behavioral psychology. Often IBI is undertaken in a controlled environment where interfering stimuli can be minimized.

Intake, Intake Interview – The initial step in the process of getting therapeutic help for a child and his/her family.   The intake interview is usually preceded by the completion of a questionnaire or form which lets a person describe what is felt to be the major problems faced.  The goal of the intake process is to gather as much information as will be helpful in describing and attempting to  remedy problems relevant to the family and individual children involved.


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Joint Attention – The propensity of a person to engage another’s attention to share objects or events.   Children display joint attention skills by making overtures for others to pay attention to what they themselves are attending.  Inversely, joint attention is also exhibited when a child follows the line of visual regard and pointing gestures of another person and fixes attention on an object or activity.  Deficits in the abilities involved in joint attention are among some of the earlier symptoms of children affected by Autism Spectrum Disorders.  Early detection and therapeutic intervention to direct and practice joint attention may result in better outcomes in the development of cognitive, language and social skills.

Just Noticeable Difference - The smallest change in a sensory stimulant (either physical or sociopsychological) that is consistently detectible by an individual.   In the social context, JND can refer to such subtleties as the slight change in facial expressions that can show different emotions.   Children with variations of Autism Spectrum Disorder and other developmental delays or emotional states (such as attachment disorders) may have difficulty distinguishing between and among stimuli that vary only slightly, but have significant social meaning. 

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K

Kinesthesia/Kinesthetic Sense- Kinesthesia is the sense of movement based upon sensory messages from the muscles, tendons and joints.   Sometimes kinesthesia is referred to as the “muscle sense”.  Kinesthesia is frequently used interchangeably with proprioception, but some physiologists differentiate the two by excluding the sense of equilibrium from the description of  kinesthesia while including it in the description of proprioception.  Both proprioception and kinesthesia are interoceptive,  that is the sensory capacity draws its information from inside the body, unlike our five classical senses which draw information from stimuli outside the body (exteroceptive).

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L

Language – A system used to facilitate communication among higher animals and more recently among computers.   Human languages use patterns of sounds and gestures or body language to transmit information.   Gestures and intonation are used in oral language to communicate the emotional tone of the communication.  Most modern human languages use written symbols to represent oral transmissions in such a way that there is little loss of information.  Expert writers and readers are often able to vividly present/detect emotional tone through the context of the written word.  It is generally accepted that the critical period for language learning is in the very early years of the human life span.  Extreme delays in language development may be associated with cognitive and social difficulties.

Lovaas Model of Applied Behavior Analysis (Lovaas Method) - An intensive therapeutic method based on the principles of Behavioral Psychology.    To have significant and long-lasting effects, the Lovaas Method usually specifies forty hours a week of one-on-one therapy using applied behavioral analysis (ABA).  Emphasis is placed on the use of discrete trials as the central teaching method.  Therapy usually continues for a number of years and is recognized for its effectiveness as an intervention for children with autism.  However, because of the labor intensity of this method, it is often impractical, but the techniques used may be employed on a lesser scale and sometimes prove productive.

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M

Modeling – Presenting a model for behavior via which others may learn through observation and imitation.   Young children are most likely to model adults or other children who are seen as significant and/or powerful in some way.  Modeling is perhaps the most basic of learning paradigms and is one of the primary ways that young children learn.  Many even complex behaviors can be learned through modeling. Breaking a complex behavior into it’s subsets and modeling the subsets one at a time and gradually adding them together in sequence (chaining) is an efficient way to teach through modeling.. 

Modified Check List for Autism in Toddlers (M-CHAT) – A 23-item yes/no checklist designed for administration by parents, pediatricians, psychologists, educators and other professionals as a rough screening device for autism in toddlers.   The checklist was developed at the University of Connecticut Department of  Psychology.   Its main purpose is to help narrow the time between a parent’s initial expression of concern about a child’s development and the time that a definitive diagnosis of autism is made.   At the time of the introduction of the checklist, the initial concern from a parent was expressed to a professional at an average age of about 1.5 years and a definitive diagnosis of autism was made at an average age of four (4) years.  With the checklist available, the diagnosis is now made much earlier because parents, physicians and others significant persons  have worked together more quickly to get a professional referral for thorough examination and diagnosis.  For autism spectrum disorders, it is now generally accepted that early identification and intervention  offer the best options for effective treatment choices.   A simple web search will identify a number of sites where the M-CHAT checklist is available on line.

Motor Skills – Skills that involve the use of the skeletal muscles.  Large muscle movement such as holding one’s head up, balancing, crawling, walking etc. are usually referred to as gross motor skills.  Fine motor skills include the abilities involved in manipulating small objects, eye-hand coordination, hand to hand object transfer and other fine movements. . For humans, the pincer grasp (thumb and forefinger) is among the most frequently used fine motor skills.   The areas of the brain having to do with motor skills have a disproportionately large surface involved with the use of the hands as compared to other body parts.   Generally, large muscles develop before smaller ones so gross motor skills emerge as the basis for the development of the more precise fine skills. It is generally assumed that practice in fine and motor skills can have a larger effect that practice in large motor skills.

Motor planning –The ability to conceive, organize and carry out a sequence of motor actions.  Often practiced visual imaging and even creating a paper and pencil design is helpful in motor planning and execution.

Multidisciplinary Practice or Team – A team approach to understanding and working through a problem by using  theories and practices from a number of disciplines.

For example, when working with a youngster on the autism spectrum, pediatricians, psychologists, educators, occupational therapists, speech therapists and others will work together to develop and administer a plan that will help with diverse but interrelated problems.  Sometimes it is useful to have the team clearly headed by one of these professionals who will assume major responsibility for seeing to the coordination of effort and the production of a report that is both descriptive and prescriptive.

It should also be the responsibility of the team leader to maintain oversight of the outcomes of any strategies implemented.


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N

Naturalistic Observation – An information gathering process in which a person is observed without interference in various settings in his/her own environment.  For children with autism, such an observation might help a therapist develop insights for positive interventions for behavior by parents and any others who play a significant role in the child’s nurturing and education..

Neurobiological Disorders – Disorders which are centered in the nervous system.  Among broad categories of possible causes are genetics, oxygen deprivation, brain trauma, abnormalities in prenatal development of the brain, strokes, infectious and degenerative diseases of the nervous system, auto-immune disorders, brain tumors and exposure to environmental toxins and auto-immune disorders which attack nerve cells.

Neurons – Neurons are the basic cells of a nervous system.  In humans neurons form the core components of the brain, spinal cord and peripheral nerves.  By communicating through chemical and electrical synapses, neurons receive, process and transmit messages.  Sensory neurons carry messages from the senses to the Central Nervous System (CNS).   Motor neurons carry messages from the Central Nervous System to muscles and glands.   Interneurons communicate between the sensory and motor neurons. Over the past twenty years or so, understanding the chemical/electrical transmission processes has added to our potential for treating many disorders which have their origin in the CNS.  In the human it is well documented that major neural development occurs during the prenatal period.   Included in these prenatal developments are all the basic structures and functions:  the origin and differentiation of neurons, the migration of neurons to their functional positions, the outgrowth of axons and dendrites and the generation of synapses.

Neurologist – A physician who is trained in the diagnosis and treatment of disorders of the nervous system.

Neurological Disorder – A disorder which has its origin in the neurological functions of the body.

Nonverbal communication – Communication without the use of spoken language.   Informal nonverbal communication can include gestures, facial expressions and body positions (body language) while formal nonverbal techniques include well structured and standard “signs” such as used in American Sign Language.   In additional to these two Nonverbal communication methods, often unspoken understanding and presuppositions as well as cultural and environmental conditions may serve as the basis for nonverbal understandings and communication.

Norms – A numerical value or description which best represents the typical developmental level or performance of a group at a given point in time.   Norms are often used to compare an individual to the way the “most usual member of a group” behaves, grows or performs on a test.   When using norms for comparison, it is essential that the group to which the individual is being compared (reference group) be as similar as possible to the individual in most major ways.   For example, physical growth curves developed from measurements gathered on Japanese children born and reared in Japan might not be applicable to American children born and reared in the USA.  Most “intelligence” tests, group academic achievement tests, physical growth assessments, etc. use measurements from  a select reference group for establishing norms.  In attempting to make sense of such tests or assessments, it is important to know the basic characteristics of both the individual and the reference group.  It is also necessary to understand the statistical concepts of average or norm, normal probability curv, standard deviation and percentile rank.  Most published tests or norm referenced behavioral assessments provide clear statements regarding reference group as well as the basic explanations of statistical concepts required to understand the individual’s performance in relation to others who have also been assessed.

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Occupational Therapy (OT) – Therapies which focus on helping an individual achieve independence in all areas of life.  Occupational therapists who work with children attempt to provide positive and enjoyable activities to help improve cognitive, motor and personal skills.  In turn, such improvements should enhance self esteem and a sense of accomplishment.   Occupational therapists can also help evaluate a child’s skills for various activities such as play, academics and tasks of daily living.   In so doing, the therapist will most often use a multidisciplinary approach, and address the interplay of social, psychological, biological and environmental factors for the child.  Using the information gained from such an evaluation as well as other professional evaluative reports, the therapist can devise an individual therapeutic program to help meet a child’s needs.

Off-Label Use/Off Label Prescribing – Off label use is also known as Unapproved Use.   Off-label Prescribing means that a physician is prescribing a medication, medical procedure or medical devise for a purpose different from the one for which the product was tested and approved for use by the Food and Drug Administration (FDA). The practice is fairly wide spread and brings with it many ethical and legal questions.   Parents should always make an effort to know if drugs, procedures or devices prescribed for their youngsters have actually been tested and approved for the particular age and condition of the youngster.

Olfactory Sense – The sense of smell.   In humans smells are sensed by olfactory neurons in the olfactory epithelium which lies on the roof of the nasal cavity about three inches above and behind the nostrils.   The senses of smell and taste work together to contribute to flavor.


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Pervasive Developmental Disorder (PDD) – A diagnostic category (DSM IV) which includes a group of five disorders characterized by delays in the development of several basic functions including communication and socialization.  The five disorders are Autism, Rett Syndrome, Childhood Disintegrative Disorder, Asperger Syndrome and Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS).

Pervasive Developmental Disorder Screening Test (PDDST) – A 71-item test divided into three levels developed as a screening test for youngsters between 18 months and three years of age.   Each of the three levels takes approximately five minutes to complete.  As with all screening devices, there should be more intense follow up with additional testing and observation to assess the validity of  results of the screening.

Perception – The process of interpreting and organizing sensations in such a way as to structure meaningful experiences of the world.   Perception is highly individualized and internalized and is, therefore, difficult to examine objectively.  Sensation, on the other hand, usually refers to immediate and relatively unprocessed sensory experiences.  Sensation and perception are very difficult to separate and most likely are parts of a continuous and interwoven  process of giving meaning to experience.

Physical Therapy – Therapeutic services provided to develop or restore, maximize and maintain functional movement and motor skills, both gross and fine.  The therapist’s studied view of the individual client’s body and its movement needs and potential is crucial to diagnosis and the prescription of realistic objectives and treatment strategies.

Picture Exchange Communication System (PECS) - An alternative form of communication for functionally non-verbal individuals.   PECS is often incorporated into a behaviorally based program which allows an individual to exchange a picture card for something he or she likes and wants.   PECS is possibly best known for its use with autistic youngsters.

Pragmatics of Language – The rules of social language; the practical functions of  language allowing one to communicate in such a way as to achieve one’s goals.  Such factors as eye contact, personal distance between speaker and listener, taking turns in  conversation,  staying on topic and appropriately using  both verbal and nonverbal signals  make it more likely that an individual will elicit positive reactions from his/her conversation partner.   Learning such subtle, but important dimensions of conversing are crucial for effective and pleasant  social interactions.

Productive Language – The language which a person uses to speak or write in order to communicate.  The usual progression to productive language is to move from receptive language (understanding what is said)  to productive language (expressing thoughts through speech, writing, signing or body language).   In the normal course of a child’s

development, receptive language precedes productive language.  For both productive and receptive language, early experience plays a large role in human verbal development.

Prompt – A cue or slight assistance, either verbal or behavioral, that is given to help an individual  begin and/or move through a task. Using cues or prompts can be an effective technique for developing a “smooth flow” of linked behaviors.

Pronoun  Reversal – The inappropriate interchange of  a  first person pronoun with a second or third person pronoun.  For example, a child might refer to herself as “she” rather than use the first person pronoun “I”.   Pronoun reversals are common in young children and those with autism.  Reverals are also often linked with echolalia.

Proprioception – The sense that provides information as to whether the body is moving with required effort  as well as where the various body parts are located in relation to each other.   Proprioception is often described as the awareness of movement derived from muscular, tendon and articular sources.  Sometime the term is used interchangeably  with kinesthesia.

Psychological Screening – Psychological Screening involves the use of brief assessment instruments, observations and/or interview techniques designed to identify persons who should probably undergo more in-depth and comprehensive evaluation. 

Psychotrophic/Psychoactive Medications – Chemical substances that act mainly on the central nervous system where they modify brain functions and may result in changes in perception, consciousness, mood and behavior.  Currently there is great debate and on-going research about the use of many psychoactive medications for the treatment of children.  Children placed on Psychotropic medications  should be consistently observed  to determine its effectiveness for the purposes used.  Observations should also focus examine any side-effects of the medication, both physical and psychological.  Only persons with an M.D. and appropriate licensing are legally allowed to prescribe Psychoactive Medications. Today many psychoactive medications are prescribed as “Off Label Usage”, meaning they have not been scientifically tested for the group to which it is being given, but have been tested for another group.   For example, a psychotropic medication tested on adults may be prescribed for an adolescent or younger child.  There are many ethical and legal questions that can arise about “Off Label Usage.”  Parents should be systematic in determining if medications prescribed for their youngster have been actually approved by the FDA for such usage.   While “Off-Label” prescribing does not violate FDA law and does not by itself constitute malpractice it can be legally risky for the physician.  It is the right of the patient (or his/her guardian) to fully understand the rationale for any off-label prescription. Since any approved product may be prescribed  by a licensed practitioner for uses other than those stated on the product label, knowing why the prescription is made is essential for the patient’s understanding of the treatment process.  Legal questions regarding “off-label” prescribing are complex and have a  relatively short history in the courts.

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Reactive Attachment Disorder (RAD) – A term used to describe disorders of personal and social attachment.  A failure to form normal attachments to primary care-giving figures in early childhood is usually the first evidence of  RAD.  Unusual early experiences such as neglect, abuse, frequent changes of caregivers  and abrupt caregiver separation may contribute to this disorder.   It is believed that children between the ages of six months and three years are in a critical period for secure attachments to form, and thus, would be more likely than other ages to respond negatively to such potentially “triggering” events.  RAD is sometimes confused with neuropsychiatric disorders such as autism spectrum disorders, pervasive developmental disorders and childhood schizophrenia. Reactive Attachment Disorders can serve as the basis for many variations of difficulty with intimate interpersonal relationships.     


Receptive Language – Basic language comprehension.  Children with receptive language can exhibit a variety of observable behaviors from which one can infer that understanding language has taken place.  For example, a child can hear and follow simple instructions.  Responding to the names of familiar persons or objects even when they are not present is evidence of receptive language.  Evidence of receptive language usually comes before speech develops.

Reinforcement – Most often refers to a pleasant event that occurs immediately after or as a direct result of an action.   Such events tend to increase the strength of the action and the likelihood that it will be repeated.   This type of reinforcement is termed “positive reinforcement”.  Another type of reinforcement (negative) can also work to increase strength and likelihood of  behavior.   In negative reinforcement, an individual performs an action to escape the occurrence of an event that may be perceived as unpleasant .  For example, a child may refrain from throwing food if when food is thrown, all food is taken away for a period of time.   Today, a frequently used form of negative reinforcement is “time out.”   Fairly robust psychological research indicates that behaviors are more quickly learned and retained when positive reinforcement is used.  However, there is also evidence that overuse of positive reinforcement can lead to reinforcement dependence. Substantial evidence also shows that the use of punishment can lead to hostitility toward the punisher and sometimes generalized hostility.  .

Reliability of Test Results – Test Reliability refers to the consistency of a set of measures made by a measuring instrument in yielding the same or similar results.  For example, if a child is administered an IQ test one day and scores 100 and ten days later the same test is given and the child scores 80, it would appear that for some cause, the test scores are not highly  reliable.  Statistical Reliability Indices serve as a basic guide to a test’s reliability.  These indices may range from .00 where is this complete inconsistency to +1.00 where test scores are identical (both rare events).  Most psychological tests and observations for children yield lower reliability scores for younger children than for older.   There are probably many reasons for this, among which is the rapid growth and development which a child undergoes early in life as compared with later. Because most psychological tests do not have perfect reliability, it is important to have a wide set of samples of a child’s behavior from different  sources when important decisions about therapeutic intervention are being made.

Respite Care –  Relief given a primary caregiver (such as a child’s parents) which provides opportunities to take temporary breaks from the physical and emotional demands of caring for a person who has disabilities which make him/her extraordinarily dependent on the caregiver.

Rhett Syndrome – Rhett Syndrome is complex neurologically based developmental disorder most often assumed to be hereditary in origin.  Rhett is usually observed in females.  Following an early period of seemingly “normal” development (six to eighteen months), regression and/or arrested development becomes evident.   Among problems presented are seizures, respiratory distress, loss of communication skills, difficulty with gross motor skills and reduced growth of the head with age.

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S

Self-stimulation/self-regulation (Stim/Stimming) – Self initiated repetitive movements and/or sounds which appear to relieve stress and may provide soothing or stimulating sensory input.  Some examples of self-stimulation are body rocking, head banging, spinning, finger-flicking, hand flapping, unusual manipulations of inanimate objects and repetitive vocal productions.

Sensory defensiveness – A tendency to overreact or react negatively to sensory stimulation which is generally considered non-irritating to most people.   When an individual exhibits defensiveness to a multiple and wide-ranging set of stimuli, a diagnosis of sensory defensiveness may be made.  Among the more commonly exhibited  sensory defensive behaviors are intolerance of high pitched noises,  distress at some forms of light, extreme repulsion toward some scents,  overreaction to various types of tactile stimulation and the avoidance of eye contact.

Sensory deficit – An absent, diminished or atypical neurological transmission of input  from one of the sensory capacities to the central nervous system.  Sensory deficits may lead to inappropriate responses.

Sensory Integration – The organization of various sensory inputs so that they can be used by the individual to form a “unified view” of his/her environment and, in turn, make responses, both covert (thinking) and overt (behaving) that conform with that view.

Sensory Integration Therapy (SI) - A systematic approach to working with an individual to better organize sensory stimulation and develop appropriate responses. Therapy is most often guided by an occupational therapist and usually  involves the guided use of body movement so as to provide proprioceptive, tacticle and vestibular stimulation.

Sensory Integration Therapy is implemented in an effort to improve the way the brain processes and organizes sensory experiences to allow the individual to make refined and appropriate responses.

Separation Anxiety – A normal emotion which usually occurs as a developmental marker for healthily developing infants who have formed positive and secure attachments to their primary caregiver.   Normal separation anxiety is associated with the infant’s development of selfhood and the cognitive skills which result in the understanding of object and person permanence. 

Separation Anxiety Disorders/Attachment Disorders- Psychological conditions in which a child (or an adult) shows excessive anxiety  when separated from the primary caretaker or from significant other persons to whom the individual has strong emotional attachments.  It is thought that separation anxiety disorder is a likely result of  inadquate, insecure, punitive  and/or disrupted attachment during the first few years of life.  In early childhood some symptoms of separation anxiety or attachment disorder  may include

Sign/Signed Language – A form of communication which uses various manual components of “body language” such as body orientation, hand and arm movements, lip patterns and facial gestures instead of vocalizations.  Many sign languages are grammatically rich and complex and have developed and flourish in deaf communities throughout the world.  Recently, popular interest was gained in encouraging the use of sign language by youngsters before they begin to use spoken language. While not scientifically documented, some believe that learning sign will lead to improvement in intelligence test results. Sign language can be useful for youngsters with developmental speech delays of various origins.  Gallaudet University established in 1864 in Washington D.C., remains the world’s only liberal arts university for the deaf.   Gallaudet is a valuable resource for persons interested in the body of knowledge regarding sign languages.

Social Adaptation/Adjustment/Maturity – The ability of an individual to respond to and interact with other people in ways that are age appropriate.  Social maturation means developing independent personal skills which lead to self sufficiency.  Social adaptation also requires the development of empathic skills which contribute to the good of the social group(s) in which the individual participates.   

Social Skills – Appropriate and positive social behaviors that are generally accepted as vital to positive social interactions and communication with others.   Social skills include a range of  behaviors among which are normatively appropriate oral language, gestures, body position in relation to others, eye contact, body movements and emotional states displayed.

Tactile – Having to do with the sense of touch, one of the sensory input systems of the human body.

TEACCH- (Treatment and education of autistic and related communication handicapped children) -A structured early intervention teaching and support strategy developed for families whose children have been diagnosed on the autism spectrum. TEACCH is an evidence-based service, training and research program which works with people on the autism spectrum of all ages and levels of skill.  The materials and suggested methods were developed at the Department of Psychiatry, University of North Carolina, Chapel Hill, NC.

Thimerosal in Vaccines/Thimerosal Debate – Thimerosal, a mercury-containing organic compound, has been used as a preservative in vaccines to kill or prevent the growth of microorganisms, particularly bacteria and fungi.  Use of preservatives in multi-dose vials of vaccines for children was begun in 1928 after a large number of children in India died from staphylococci infections following vaccination for diphtheria.   Recognizing the well-documented potential toxicity of  thimerosal, reseachers have done numerous studies to try to determine the appropriate quantities and usages of the preservative in various medical products.  Currently, the U.S. Food and Drug Administration (FDA) holds the position that the cumulative research done to date does not yield results which suggest that current thimerosal usage in vaccines for children is in any way causally related to the increased frequency of diagnosis of autism over the past ten to twenty years.   However, based on anecdotal evidence, many parents of autistic children and organizations for their support take the position that there is a causal link between thimerosal containing vaccinations and the onset of autism.  For parents who wish, medical practicioners can use thimerosal-free vaccines for their children.

Transition – Changes from one environment to another where new perceptions and skills are required to adjust.   For example, a child may enter an early intervention program after having spent the first two or three years at home in the care of  family.  This would require a period of transition so that eventually, the movement from one environment to the other would become smooth and anxiety free.

Tomatis Listening/Learning Method - The Tomatis Method is based on the assumption that effective listening (not hearing) skills allow us to listen not only to the outside world, but also to our own thoughts and feelings (inner voice).  Tomatis advocates believe that among the leading causes of learning and developmental disorders (such as Dyslexia, ADD, PDD and Autism) is reduced ability to process sound and listen well.  The ability to bring focused listening into an effective interplay with our inner voice helps us  organize what we perceive, feel and learn into a meaningful framework.  The Tomatis Method  emphasizes  the development of  efficient filtering and prioritizing  skills to make  the interaction between the inner voice and  relevant information from outside sources organized in more useful ways.   There are over 250 Tomatis Listening/Learning Centers throughout the world.


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Validity of Test Results – Test Validity refers to the degree to which a test measures exactly what it proposes to measure.  For test results to be accurately interpreted and used for predictive and prescriptive purposes, it is important for it to be valid.  There are three types of validity, content, concurrent and predictive. 

Vestibular/Balance System– The sensory system through which most of the input about movement and equilibrium (balance) enters our nervous systems.   The vestibular system is mainly made up of three fluid-filled semicircular canals located in the inner ear.  Two of these canals send information regarding our body’s rotational and linear movements to the brain.  The vestibulo-ocular reflex (VOR) helps stabilize images on the retina during head movement by stimulating muscles controlling eye movement in the direction opposite the head movement.

Visual Supports – The use of visual representations (pictures, graphic symbols, objects. etc.) as a substitute or enhancement of verbal descriptions of objects, activities, schedules and other information.   Visual supports have been found to be useful in working with children who have receptive and/or expressive speech deficiencies of various origins.  Visual supports may allow persons lacking language facility to be more independent. They may also facilitate language exchanges between individuals/groups.

Visual Schedule –A set of pictures or objects which are arranged to show the order of events or activities that are to be undertaken.

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Wernicke’s Area – A part of the human cortex.  For most people Wernicke’s Area is located on the left hemisphere and toward the back of the brain, near the auditory cortex and has connections to the primary auditory cortex. Wernicke’s Area  is active in language comprehension and in speech production. Damage to Wernicke’s Area can interfere with both oral comprehension and the production of  a natural rhythm and normal syntax in speech.  Such damage is known as Wernicke’s or Receptive Aphasia.

Work System - The use of visual supports to specify expectations and communicate them to persons who have productive and/or receptive speech deficiencies that make the use of  typical oral communication difficult.  The Work System is an example of the use of Visual Supports to enhance independence.