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GIFTED CHILD
GIFTED
- asks questions
- curious
- unexpected ideas
- draws inference
- initiates projects
- strong opinions
- manipulates info
__________________________________________
Potential or demonstrated achievement in
general intellectual ability.
Brief Summary of Giftedness
1. Extraordinary memory
2. High level of abstract thinking
3. Application of knowledge
4. Intellectual curiosity
5. Persistent goal- directed behavior
6. Facility of expression
7. Hobby interest
8. Advanced knowledge
INTELLIGENCE QUOTIENT ( IQ )
Serves as a basis for determination of
intellectual giftedness
Quotient is derived by dividing mental age
score by chronological age.
INTERPRETATION OF GIFTEDNESS
1. SUPERIOR
Markedly above average in the major aspects
of intelligence
Assume substantial positions in their
community during adulthood
2. GIFTED
3. EXTREMELY GIFTED
Small fraction of the gifted group.
Superior: > 116- 124 ( 1 in 10- 15 )
Gifted: > 132- 140 ( 1 in 49- 100 )
Extremely Gifted : > 172 ( 1 in 10,000- 100, 000 )
MULTIPLE INTELLIGENCE THEORY
Howard- .:
- Intelligence is not indicated solely
by IQ score but by having 1 or
multiple strengths in TEN
intelligences:
1. Verbal/ linguistics
2. Logical/ mathematical
3. visual/ spatial
4. bodily/ kinesthetics
5. musical
6. interpersonal
7. natural
8. intrapersonal
9. existential
10. moral/ behavioral
3. IMAGE OF MEDIOCRITY
Learn early to conceal their ability from
teachers in order to avoid additional work.
In order to win friend or avoid the stigma of
being called a nerd.
4. REVOLT AGAINST ROLE
Early success fails to help child develop good
working habits.
Difficulty or failure is due to unmet needs.
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SPECIAL CHILD
__________________________________________
Impairment, disability, and handicapped
CAUSES:
1. Inadequate nutrition
2. Abnormal prenatal conditions
3. Abnormal perinatal events
4. Infectious diseases
5. Accidents
6. Unknown
CONSEQUENCES OF DISABILITY
A. IMPACT ON THE CHILD
Loss of vision
( cataract: exposure of mother to German
measles )
Loss of hearing
Mental retardation
Loss or paralysis of the limbs
B. IMPACT ON THE FAMILY
Feeling of guilt
Time management
Family relationship
C. IMPACT ON SOCIETY
Rehabilitation measures
ROLE OF PHYSICIAN
1. Presentation of the diagnosis
2. Education of the family
3. Management of complications
4. Emotional; support
5. Define goals and objectives
6. Formulate strategy for future management
7. Assure routine health maintenance
SPECIAL EDUCATION PROGRAM
Designed to give educational opportunities to
commensurate with the abilities and needs of
special children.
Features:
1. Modified curriculum
2. Professionally trained teachers
3. Special methods and techniques
4. Special class site
5. Special facilities
Help Children through:
1. Socialization and skills development of the
mentally retarded.
2. Acceleration program to the fast learner.
3. Academic and vocational preparation of
the physically- impaired.
4. Skills training and rehabilitation of youth
5. Hospital- based for chronically ill patients.
___________________________________
ADOLESCENCE
_______________________________________
THREE LEVELS OF DEVELOPMENT:
A. BIOLOGICAL
Physical growth and personality formation.
B. PSYCHOLOGICAL
Sexual characteristics, identity establishment,
moving from dependent to independent
person
C. SOCIAL
Preparation for the forthcoming role of an
adult
FEATURES:
Tends to be a time:
1. of seeking status as an individual
2. when peer group relationship become of
major importance
3. when physical maturity is attained
4. of intellectual expansion and academic
experience
5. of development and evaluation of values
HEALTH SERVICES
1. DELIVERY OF HEALTH SERVICE
Between ages 11- 21 should have annual
preventive health visits
Should be developmentally appropriate and
sensitive to individual and socio- cultural
differences.
Health care providers should establish office
policies concerning confidential cases for
adolescents and should be made clear to the
youth and their parents.
2. HEALTH GUIDANCE
At least once during early, middle and late
adolescence.
To better understand physical, psychosocial
and psychosexual development.
To be actively involved in health care
decisions
Promote prevention of injuries
3. SCREENING
Annual hypertension, dyslipidemia and
coronary heart disease
Eating disorders
Tobacco use, alcohol, substance abuse,
misuse of over- the- counter and prescription
drugs
STD, Confidential HIV testing
4. IMMUNIZATION
Receive immune prophylactic immunizations
in accordance with the guidelines of the
Advisory Committee on Immunization
Practices
__________________________________________
GERIATRICS
__________________________________________
Subspecialty of medicine that focuses on
health care of elderly.
Aims to promote health and prevent
diseases.
GERONTOLOGY: Study of aging process.
EPIDEMIOLOGY OF AGING
1992: > 65 years old- 342 million
1996: 540 million
2020: projected to be > 1 billion
ANATOMICAL AND PHYSIOLOGICAL CHANGES
IN AGING
1. CHANGES IN HEIGHT
Loss in trunk length----changes in posture,
growth of vertebrae, forward bending of
spine, compression of disc between
vertebrae.
2. CHANGES IN BODY WEIGHT
FEMale: increase until mid- 50s
Weight loss in late 60s and 70s
Male: increase until late 60s, decline
thereafter at a rate slower than female.
3. CHANGES IN BODY SYSTEM
a. SKIN
o Aging skin requires > 30 days to
renew epithelium
o Loss of elasticity, wrinkles, lines, age
spots, dry and thin fragile skin
o Lowered activity of the sweat glands
b. HAIR
o Hair graying: loss of pigment cells
from hair bulbs
o Decrease number of hair follicles in
scalp
o Growth of hair in scalp, pubic and
armpit declines
o Increased growth of hair in the
eyebrows and nostrils
c. NAILS
o Develop longitudinal striations
o Slower rate of growth
o Toenails grow at 15 % slower than
fingernails
d. MUSCLES
o Decrease in strength, endurance,
size and weight relative to total body
weight due to inactivity nutritional
deficiency, diseases and long
standing conditions.
e. SENSORY
o SIGHT: most common: presbyopia
- harder to focus on nearby
objects due to decrease in
PREVENTIVE GERIATRICS
HEALTH MAINTENANCE
Most effective interventions that a physician
should undertake to increase not only the
lifespan but more of improving the quality of
life.
A. DISEASE SCREENING
Recommended by US Preventive Services
Task Force
Primary Prevention
o Preventive strategy
1. BP Screening: yearly
2. Influenza Immunization: yearly
3. Obesity screening: yearly
4. Pneumonia Immunization: once at
age 65 every 2 years
5. Smoking cessation: every visit
6. Tetanus Immunization: every 10
years
7. Aspirin to prevent MI: daily
8. Cholesterol Screening: every 5
years
9. Diabetes Screening: yearly
10. Hormone Replacement: yearly
Secondary Prevention
1. Sigmoidoscopy: yearly/ every 3- 5
years
2. Hearing impairment screening: yearly
3. Mammography: every 1- 2 years
4. Pap Smear: every 3 years
5. Visual impairment screening: yearly
6. Skin exam: yearly
7. BSE: monthly
8. Cognitive impairment screening: yearly
9. PSA: yearly
10. TSH: yearly
B. NUTRITION
o Calorie intake should be balanced
against the expenditure of energy
requirements
o Daily energy expenditure decreased
by:
- 17 kcal between ages 5664 years old
- 24 kcal between ages 7584 years old
o
DEMENTIA
__________________________________________
Syndrome of cognitive decline and variable
non- cognitive features of behavioral and
psychiatric symptoms and disturbances.
ALZHEIMERS DISEASE
Progressive neurologic disorder that results
in memory loss.
CHARACTERISTICS:
1. PREDEMENTIA
o Mild cognitive impairment
o Memory loss
o Difficulty in remembering recently learned
facts
o Inability to acquire new information
o Apathy: most persistent neuropsychiatric
symptom
2. EARLY DEMENTIA
o Difficulties with language, executing
functions, perceptions and movements
o Episodic memories ( older memories )
o Semantic memories ( facts learned )
o Implicit memory ( memory of the body on
how to do things )
o Language problem: shrinking vocabulary,
decreased word fluency
3. MODERATE DEMENTIA
o Progressive deterioration hinders
independence
o Unable to perform activities of daily living
CAUSES:
1. CHOLINERGIC HYPOTHESIS
o Decrease synthesis of acetylcholine
o Oldest
2. AMYLOID HYPOTHESIS
o Amyloid B deposit
o 1991
3. TAU HYPOTHESIS
o Tau protein abnormality initiate cascade
4. DEMYELINIZATION
DIAGNOSIS
Patients history from relatives clinical
observation
Medical Imaging: CT, MRI, SPECT, PET
MMSE
Pharmacologic Management: Donepezil,
Rivastigmine, Galantamine
MINI- MENTAL STATUS EXAM
Quick and simple cognitive exam: cognitive
function
Includes:
o Personal information
o Orientation
o Word registration
o Attention
o Recall
Total Score: 30
CLASSIFICATION OF ALZHEIMERS DISEASE
TYPE
Score
MMSE
24- 26
21- 23
10-20
< 10