1. Read the Educational Objectives and answer the self-assessment quiz at the beginning of this issue before you read the articles. This is designed to highlight key areas to be covered.
2. Read each of the articles in the issue carefully and thoroughly; do not neglect the charts, tables, and other illustrative material, as they have been carefully selected to enhance your knowledge and understanding.
3. The questions on patient management that follow are designed to provide a useful link between the articles in this issue and your everyday practice. Read the questions below, choose the correct answer to each, and record your answer on the CME Registration form printed at the end of the quiz.
4. Type or print your full name and address (including zip code) and your socialsecurity number in the spaces provided.
5. Send check or money order ($10) made out to Pediatric Annals CME Quiz. Mail with your CME Registration form to:
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New York, N.Y. 10022.
6. After your answers have been graded, you will be advised of your score and the answers to any incorrect or missed questions. Review those parts of the article dealing with any questions you answered incorrectly, and read the supplemental materials on this aspect of the subject that are listed in the bibliography. Unanswered questions will be considered incorrect and are so scored. A minimum score of 70 per cent must be obtained in order for credits to be awarded.
CME Quiz: Dyslexia CME
Record your answers on page 99
Type A Questions. Choose one letter after each of the numbers listed below and transfer to the coupon. Choose the one best answer.
1. "Minimal brain dysfunction" is a term that has been associated with numerous specific behavior 1. disorders.
A. All children with MBD have dyslexia.
B. The MBD children fall into four main categories - those having poor coordination, short attention span, language difficulties, or perceptual problems.
C. Children with MBD invariably have disorders in several different categories.
D. When MBD is manifested by poor coordination it will impede language development.
2. When a child is referred to you because he is "hyperkinetic," you should attempt to find out if 2. his hyperactivity occurs
A. Only when he is confronted with a specific task.
B. On weekends as well as weekdays.
C. Only in the classroom.
D. In any or all of the above situations.
3. Letter reversals by dyslexic children are usually distinctive. Of the following, the two most frequently reversed by dyslexies are
A. b and d.
B. g and q.
C. s and 2.
D. u and v.
4. Reading difficulties (dyslexia) occur
A. More frequently in boys than in girls.
B. More frequently in girls than in boys.
C. Equally in both sexes.
D. More frequently in black children than in white.
5. Patterning - attempting to improve the child's academic achievement by having him engage in such tasks as creeping and crawling - has been found helpful in
A. Improving coordination of children with developmental dyslexia.
B. Improving reading ability of children with developmental dyslexia.
C. Increasing the attention span of children with developmental dyslexia.
D. None of the above.
6. In Or. Gomez' opinion, "minimal brain dysfunction" is
A. A useful term to use in diagnosing specific learning disability manifested by fine motor incoordination.
B. Sometimes confused with Reye's syndrome.
C. A totally vague term with ill-defined boundaries.
D. Demonstrated as a clinical entity by the Isle of Wight studies.
7. The usefulness of stimulant therapy is well validated for hyperactive children but not for dyslexies. According to Dr. Kinsbourne, however,
A. It usually will help children with a confirmed diagnosis of developmental dyslexia,
B. It may benefit children of normal intelligence and normal powers of concentration who still find it unusually difficult to learn to read or write.
C. It may improve school performance in children who are both dyslexic and hyperactive.
D. It will compensate for cerebellar-vestibular dysfunction.
8. Psychiatric intervention has been found useful in treating dyslexic children in all but one of the following situations. Which answer does not belong?
A. When the dyslexies symptoms impair personal development.
B. When the EEG indicates cerebral lesions.
C. When symptoms interfere with the dyslexic's response to remedial reading instruction.
D. When the dyslexic's anxiety in the classroom is so great that the teacher's efforts are futile.
9. The parents of one of your eight-year-old patients report their son is having difficulty in learning to read. Before a diagnosis of dyslexia is made, you want to rule out other conditions that could cause reading problems and so test
D. Vision, intelligence, and hearing.
10. To help dyslexies understand the nature of their problem, specialists at the Rochester (Minn.) Reading Center use
A. A tuning fork.
B. A stereoscope.
C. Tongue applicators.
D. A bell-shaped curve.
11. Your 15-year-old patient has an average IQ. He states that he has been unable to learn to read and was diagnosed as a dyslexic in the fifth grade. In children with developmental dyslexia, it is not uncommon to find all but one of the following in the patient's history. Which answer does not belong?
A. He does well in mathematics.
B. His spelling is good.
C. He often takes the wrong bus.
D. During childhood he was often punished for his failure to learn to read.
12. Today a dyslexic child has a better chance of learning to read than was the case half-a-century ago. This is due to
A. Antidyslexic medications.
B. Development of electroencephalography.
C. Spread of Berlitz and other chains of language schools.
D. Better understanding of dyslexia and the development of effective remediation methods.
13. In teaching dyslexic children to read, authors in this issue recommend
A. Requiring the child to learn most words as whole units through sight recognition.
B. Emphasizing speed reading.
C. Using visual, auditory, and kinesthetic-tactile pathways to implement learning.
D. Using eye-movement exercises.
14. In making the diagnosis of dyslexia, the examiner must rule out
A. Peripheral sensory deficits.
B. Progressive central nervous system disorders.
C. Lack of motivation.
D. All of the above.
Type B Questions. In the following questions, more than one answer may be correct. Answer:
A If 1 , 2, and 3 are correct
B If 1 and 3 are correct
C If 2 and 4 are correct
D If only 4 is correct
15. Marked improvement in reading can be anticipated when dyslexic children are
1. Punished when they become confused.
2. Trained to discriminate and sequence speech sounds.
3. Allowed to work by themselves without supervision during remedial reading classes.
4. Trained to be aware of kinesthetic biofeedback.
16. You are investigating programs to help a nine-year-old dyslexic learn to read. Authors in this issue suggest you avoid programs that
1 . Will place the child in a small group of other dyslexic children.
2. Are offered in private schools when no public programs are available.
3. Give the child daily help during the reading, spelling, and English periods.
4. Will isolate the child and require him to work on his own.
17. An eight-year-old boy with a normal attention span appears to be dyslexic. According to Dr. Duane,
1 . Use of methylphenidate, pemoline, or dextroamphetamine is often helpful in such cases.
2. An electroencephalogram is indicated as a routine diagnostic measure.
3. A probable cause is a lesion in the angular gyrus.
4. A complete neurologic examination should be carried out before making the clinical assessment.
18. Many dyslexics have been able to survive academically in spite of their language disability through various coping mechanisms, such as
1 . Taping lectures and then taking notes from the tape.
2. Having a friend type notes from a rough draft.
3. Arranging to take tests orally.
4. Attracting attention by hyperactivity in the classroom.
19. The U.S. Congress, through Public Law 91-230, has provided federai funding to help children with reading disabilities due primarily to
1 . Visual handicaps.
2. Hearing disorders.
3. Environmental, cultural, or economic disadvantage.
4. Specific learning disability.
20. A child is brought to you for the first time when he Is nine years old, and the mother reports that the child's teacher suspects dyslexia. In taking the family and patient history, you make a special effort to obtain the child's weight at birth because
1. Babies born after 40 weeks' gestation are more likely to develop dyslexia.
2. It will be necessary to record this on insurance forms if the child is to be eligible for federal assistance.
3. Most dyslexic children are born prematurely.
4. Low-weight-for-date infants are at risk for neurologic defects.
QUIZ ANSWERS WILL APPEAR IN THE FEBRUARY ISSUE
ANSWERS TO THE CME QUIZ IN THE AUGUST ISSUE
All readers taking the CME test in our September issue (Management of Asthma and Other Allergic Disorders) will be given automatic credit for correct answers to Questions 7 and 1 1 . Transmission difficulties resulted in a misplaced decimal point in the correct answer to Question 7, with the result that all four answers as printed are wrong. In Question 11 , the correct wording - the physician "declines" to order terbutaline - appeared in print as "decides."
cut on line.