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i have both a big head and mildly poor motor skills. but so do a lot of people.
How big a head? When medical types talk about a large head, they're meaning around the 97th percentile or greater. By definition, that's not a lot of people.
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and if it is a developmental disorder, just how developmental is it?
lets assume we're dealing with a person with aspergers who has no sensory issues and is at the mild end of the spectrum.
if we think improvement is possible, how much improvement? some? all? if its complete improvement, are we talking about a cure??
I think you're misunderstanding what 'developmental disorder' means.
A developmental disorder means one that - rather than having a simple steady effect throughout life or else affecting you after you're fully grown - interacts with and affects the course of child development processes. Things like milestone attainment, achieving the developmental tasks of various ages, and so forth. Doesn't mean those things won't happen, but they may happen at a different time or in a different way.
If you're thinking it means they won't develop, that's actually precisely the opposite of what it means. Deafness, even if present from birth, is not considered a developmental disorder because the child will (usually) have the same hearing acuity throughout their entire life. They're not going to learn how to hear, and most won't lose what little hearing they have, either. If you find a 4 year old with a hearing threshold of 90db (they can hear a jet plane take off but that's about it), you can be pretty certain that 16 years later they'll be a 20 year old with a hearing threshold of 90db.
Autism is different. If you find a nonverbal autistic 4 year old who's extremely aloof and not toilet trained, and meet them again 16 years later, about all you can predict is that they'll
probably still be autistic. But they could be anywhere from high IQ college student who's just a bit weird to a nonverbal aloof guy in diapers. Even if they're still nonverbal, aloof and in diapers, they won't be the same as they were when they were 4 on the measures relevant to autism. They'll have a bunch of different areas where they've grown and matured, albeit at a slow rate, and maybe areas that they've lost ground. That's because the basic way in which autism expresses itself is directly affected by the developmental processes the child is going through, and in turn it affects those processes as well.
This actually means that developmental disorders can show more progress. No amount of special education can make a deaf kid hear better. But the right treatments can sometimes move someone from LFA to MFA or even HFA, or else change things more subtly but still noticeably. Even our measurements have to be adapted for age - we don't change what is considered a normal hearing threshold depending on the age of the person being measured, but we do change what's considered normal academic attainment or social skills or activity level.
And on to the topic of cures... cure does not mean the same thing for a developmental disorder. It's a lot stickier a question. For a deaf person, it's easy - if someone goes from having a hearing threshold of 90db to a hearing threshold of 5db (meaning they can hear someone whisper), then they've been cured. Obviously. But if a dyslexic kid goes from being at the 1st percent for reading to being at the 50th percentile, have they be cured? It's hard to say. Because that same kid, a few years later, might fall behind again once the expectations change. Let's say he was a grade 2 kid who lacked the 'pre-reading' skills seen in average Kindergarteners, and specialized instructions has taught him to decode words. Then, in grade 4 or so, things shift from
learning to read to
reading to learn, and it turns out that while he can sound out words, the basics of reading take up so much energy for him that he has no time left over for understanding the text, and so he falls behind again. Or maybe he doesn't - maybe he doesn't find reading particularly harder and he can weather the new challenges, but instead he starts to fall behind in math, because the underlying learning difficulty was a subtle spatial processing issue that made it hard for him to tell specific letters apart, and as soon as he's faced with spatial math problems such as geometry, he falters.
And development doesn't stop once they're an adult, either. People used to think it did, but there are different developmental processes going on in adulthood too. 18-25 year olds are just figuring out what 'being an adult' entails, and learning a whole pile of skills in a short time. Sometimes around 23-30 they've got the basics figured out, and they're starting families and careers and figuring out what the rest of their lives will look like. Then the process of having kids matures them a whole bunch too, progressively changing them somewhat with each child's developmental stages (a father of an infant has very different concerns from a father of a teenager). Finally, their kids grow up and leave them, and they need to shift into 'post-parenting' and figure out what to do with all their new free time. Meanwhile the effects of aging are starting to hit, and they're looking at it getting progressively worse and trying to make plans for how they'll live in old age. Retirement is another big adjustment, and one many people don't handle well - death rates are very high in the year immediately following retirement. If they weather that transition, now they're old, and looking back on a mostly-completed life and trying to decide whether they did a good job. Some elderly people fall into despair and regret, realizing they made a mess of things and it's too late to fix it up. Others come to terms with the fact that not everything went perfectly, and take pride in what they did do well. Meanwhile, they're also coming to terms with the inevitability of death. (This isn't the sequence for everyone, but for the majority of people.)
A developmental disorder will look a bit different at each of those stages in adulthood, too. And not enough research has been done into
how these conditions interact with adult developmental stages.
01 Sep 2011, 10:10 pm
