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Trisomy 21 (Down syndrome)

Small auricle and anomalies of folds.

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.

Protuberant abdomen and umbilical hernia. Characteristic flat facies with hypertelorism, depressed nasal bridge, and protrusion of tongue, as well as single palmar simian crease in 2-year-old girl with Down syndrome.

Hypodontia in patient with Down syndrome.

Wide gap between first and second toes and onychomycosis.

Personality factors

Attention-Deficit Hyperactivity Disorder

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:

Children with ADHD find it more difficult to focus and to complete their schoolwork.

appears to daydream, has trouble maintaining attention (unless the subject is something of interest) easily distracted (again, unless the subject is something of interest) difficulty following directions and completing tasks doesn`t like and avoids tasks requiring sustained 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 spoken to (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

Children with ADHD tend to get distracted from schoolwork rather easily, and they often behave disruptively

The involved genes or chromosomes are not definitively known. Vulnerability to ADHD may be due to many genes of small effect.

Hypotheses exist that include in utero exposures to toxic substances, food additives or colorings, or allergic causes. However, diet, especially sugar, is not a cause of ADHD.


- 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.

Repetitively stacking or lining up objects is a behavior sometimes associated with individuals with autism.

- 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.

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.

- 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.