1SpecificlearningDisorders學(xué)習(xí)障礙2DefinitionLearningDisordersAttention-Deficit/HyperactivityDisorderDyslexia【閱讀障礙】CommunicationDisordersIntellectualDisability3DefinitionDyslexiaischaracterizedbyanunexpecteddifficultyinreadinginpersonswhootherwisepossessthenecessaryintelligenceandmotivationthatshouldpermitaccurateandfluentreading.智力正常，無感覺器官、運(yùn)動(dòng)功能缺陷，非原發(fā)情緒障礙或教育剝奪所致。4Learning

difficultySpecificLearningdisabilitiesDD/MRauditory/visualprocessingdisorderothers5Epidemiologyprevalencerates5-10%inclinic-andschool-identifiedsamples17.5%inunselectedpopulationbasedsamplesDyslexiaaffectsbothboysandgirls;epidemiologicsamplesindicateslightlymoreboys.6Pathogenesistherearedifferencesintheleftbrainregionsbetweendyslexicandnon-impairedreaders.左大腦半球異位性白質(zhì)或?qū)ΨQ性改變7Informationinput

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outputMemoryThinkingreadingcalculatewritingSpelling8Etiologyreflectstheinteractionbetweengeneticandenvironmentalfactors.Numeroustheoriesincludethoseimplicatingdeficitsinthetemporalprocessingofauditoryandvisualstimuliandthosethathypothesizelanguagespecificimpairments.Familyhistoryisoneofthemostimportantriskfactors9Clinicalmanifestations臨床表現(xiàn)Reflectingtheunderlyingphonologic潛在的語音weakness,dyslexicsmanifestproblemsinbothspokenandwrittenlanguage.語言理解表達(dá)障礙閱讀障礙：語塞，鏡像現(xiàn)象；視空間障礙10Spokenlanguagedifficultiesaretypicallymanifestbymispronunciations,lackofglibness口若懸河,speechthatlacksfluencywithmanypausesorhesitationsand“ums”heard,word-findingdifficultieswiththeneedfortimetosummonanoralresponseandtheinabilitytocomeupwithaverbalresponsequicklywhenquestioned;thesereflectsound-based,andnotsemantic語義orknowledge-baseddifficulties.11Difficultiesinspellingtypicallyreflectthephonologicallybased12DevelopmentprocedureDuringthepreschoolandkindergartenyears,at-riskchildrendisplaydifficultiesplayingrhyminggamesandlearningthenamesforlettersandnumbers.Kindergartenassessmentsoftheselanguageskillscanhelpidentifychildrenatriskfordyslexia.Althoughadyslexicchildenjoysandbenefitsfrombeingreadto,heorshemightavoidreadingaloudtotheparentorreadingindependently13Strugglesindecodingandwordrecognitioncanvaryaccordingtoageanddevelopmentallevel.Olderchildrenhavebeenfoundtoimprovereadingaccuracyovertime,albeitwithoutcommensurategainsinreadingfluency;theyremainslowreaders.14Anxietyattention-deficit/hyperactivitydisorderComorbidity15DiagnosisHistorydistinguishedfromotherdisordersthatcanprominentlyfeaturereadingdifficultiesbytheunique,circumscribednatureofthephonologicdeficit,onethatdoesnotintrudeintootherlinguisticorcognitivedomains.Familyhistory16Assessmenttestsoflanguage(particularlyphonology),readingincludingfluency,andspellingrepresentacoreassessmentforthediagnosisofdyslexiainchildrenadditionaltestsofintellectualability,attention,memory,generallanguageskills,andmathematicsmaybeadministeredaspartofamorecomprehensiveevaluationofcognitive,linguistic,andacademicfunction17Thereisnosingletestscorethatispathognomonicofdyslexia.18Differentialdiagnosis“Slowlearners”(IQ71to84)MentalretardationEmotionalproblemsPhysicalhandicapPsychiatricdisordersVisualhandicapHearinghandicap19Managementdemandalife-spanperspective