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Trisomy 21 (Down syndrome)

Note up-slanting palpebral fissures, bilateral

epicanthal folds, small nose with flat nasal

bridge, open mouth with tendency for

tongue protrusion, and small ears with

overfolded helix.

Characteristic flat facies with hypertelorism,

depressed nasal bridge, and protrusion oftongue, as well as single palmar simian

crease in 2-year-old girl with Down

syndrome.

Hypodontia in patient with Down

syndrome.

Small auricle and anomalies of folds.

Protuberant abdomen and umbilical hernia.

Wide gap between first and second toes and

onychomycosis.

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Attention-Deficit Hyperactivity Disorder

Children with ADHD find it more difficult to

focus and to complete their schoolwork.

Children with ADHD tend to get distracted

from schoolwork rather easily, and they often

behave disruptively

Causes:

Genetics

The involved genes or chromosomes arenot definitively known. Vulnerability to

ADHD may be due to many genes of

small effect.

Environment

Hypotheses exist that include in utero

exposures to toxic substances, foodadditives or colorings, or allergic causes.

However, diet, especially sugar, is not a

cause of ADHD.

Personality factors

Although there remains much evidence

for the genetic etiology of ADHD, one

study indicated that the contribution of

personality aspects in combination with

genetics may be significant. Specifically,the presence of high neuroticism and low

conscientiousness in conjunction with

genetic vulnerability may constitute a risk

factor in the expression of ADH

Manifestations of ADHD:

appears to daydream, has troublemaintaining attention (unless the subject

is something of interest)

easily distracted (again, unless the subjectis something of interest)

difficulty following directions andcompleting tasks

doesn`t like and avoids tasks requiringsustained mental focus (including

schoolwork)

enjoys loud, excessive play has trouble with short term/mid term

memory, often forgetting details,doesn't

grasp monetary values

appears to ignore or not hear when spokento (exceptionally selective hearing)

constantly on the move, can't sit still,fidgets

has no concept of time compulsive, speaks and/or acts before

thinking

verbose (talks non-stop) difficulty waiting turns, interrupts or

disrupts conversations and activities

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Autism

Repetitively stacking or lining up objects is a

behavior sometimes associated with

individuals with autism.

A young boy with autism who has arranged

his toys in a row

Manifestations of Autism:

LANGUAGE AND COMMUNICATION.- The child may not babble, may be mute

- The development of speech and language

may be abnormally delayed or absent

- May act as though deaf /or not respond when

called by name or even by gesture.

- May echo or repeat words, phrases,

sentences /or gestation over and over again.

- Facial expressions and gestures may be

unusual or absent.

- Incorrect understanding of speech - words

may be used incorrectly.

- A flat monotonous tone or inappropriate van

ate in tone are observed.- Difficulty in initiating and/or sustaining

conversations.

SOCIAL INTERACTION

- Prefer to play alone

- Little awareness of other or of their feelings.

- Difficulty in forming relationships

- Indifference to or dislike being hugged.

- Aloofness and indifference to other although

most show an attachment in a simple level of

family.

BEHAVIOUR AND IMAGINATION

- Symbolic or imagination play may be absent.

- May be routine bound. Insist on sameness

and resist change

- Inappropriate use of toys in play

- Morbid attachment to objects-may hold onto

a teddy for the whole day.

- Throw tantrums, screams often for no

apparent reason.

- A tendency to focus on minor or trivial

aspects of thing in the environment instead of

being aware of the meaning of the complete

situation.

- Hyperactivity or under-activity.

- Laughing for no reason

- Some may have exceptional abilities e. g out

standing memory of music etc.