Diagnosing with both sides of the brain  

Oleh:

Accardo, Pasquale

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The Journal of Pediatrics vol. 135 no. 02 (Feb. 1999), page 142-143.
Topik: brain

Ketersediaan

Perpustakaan FK Nomor Panggil: J45.K.1999.02 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Because the pediatrician frequently deals with children who are either pre-verbal or only minimally verbally communicative, a large part of pediatric diagnosis is dependent on careful history taking from the parent and close physical observation. Diagnosis by “visual gestalt” thus became an important and effective component in the management of childhood illnesses. How to discriminate a sick child from a well child remains one of the most important, as well as one of the most difficult, techniques to teach pediatric house staff. And the lesson is one that is heavily dependent on right-brain thinking, a visual exercise. A little over 30 years ago, one major segment of visual diagnosis began to be codified, when The Journal of Pediatrics published a compendium of syndromes associated with short stature. This would later develop into what has since remained the standard textbook describing pediatric syndromes. The following year, the US Government Printing Office published an extremely inexpensive collection of color plates that had been collected from American Journal of Diseases in Children , depicting syndromes associated with mental retardation. “Syndromology” thus started out by focusing on deficits in the 2 major areas of interest to pediatricians: disorders of growth (short stature) and disorders of development (mental retardation). The number of identifiable syndromes associated with cognitive delay rapidly came to outnumber those associated with disturbances of growth or other organ system malformations. This proceeded at such a pace that soon dysmorphology began to be equated with the presumption of developmental problems, and (the now pejorative) “funny looking kids” were sometimes automatically considered to be mentally retarded. “Syndromes” and “mental retardation syndromes” were becoming synonymous. This was not completely erroneous because many syndromes were associated with some degree or type of cognitive impairment or other developmental disorder. The crack in this equation came with the discovery that specific syndromes, which had been at first described as uniquely associated with mental retardation, could actually present with a wide range of cognitive and linguistic deficits and sometimes exhibition of normal intelligence. Through a bias of ascertainment, the most severely involved cases had been used to construct the original profile of the condition. Previously, genetics textbooks had described a specific narrow IQ range associated with each syndrome. It was now being realized that a single etiologic condition might be associated with a spectrum of deficits.

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