Cognitive-Adaptive Disabilities

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Cognitive-Adaptive Disabilities Joseph L. Calles Jr,




KEYWORDS  Cognitive-adaptive disabilities  Developmental disorders  Pharmacologic treatment  Epidemiology

The term “cognitive-adaptive disabilities” (CADs) denotes a group of disorders associated with significant impairments in mental abilities and in functional capabilities. Subsumed under CAD are other terms that similarly denote global or specific dysfunctions (Box 1). As in other areas of medical practice, the early identification of and interventions for CADs is extremely important, the goals being prevention of mortality, reduction of morbidity, and improvement of functional status. To that end the American Academy of Neurology has developed a practice parameter for the evaluation of children with global developmental delays.1 The work-up should include thorough personal and family histories, complete physical, neurologic and dysmorphology examinations, and screening for visual and auditory disorders. If not already done as part of universal newborn screening, metabolic testing and evaluations for autistic and communication disorders should be considered. EPIDEMIOLOGY

The determination of prevalence of CADs has been fraught with methodologic problems, and has therefore yielded variable results. A relatively recent review on the epidemiology of mental retardation has reasonably estimated that the prevalence of severe mental retardation (intelligence quotient
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