Diagnosis
IQ-achievement discrepancy
Learning disabilities can be identified by psychiatrists, speech language pathologists, school psychologists, clinical psychologists, counseling psychologists, neuropsychologists, speech language pathologists, and other learning disability specialists through a combination of intelligence testing, academic achievement testing, classroom performance, and social interaction and aptitude. Other areas of assessment may include perception, cognition, memory, attention, and language abilities. The resulting information is used to determine whether a childs academic performance is commensurate with their cognitive ability. If a childs cognitive ability is much higher than their academic performance, the student is often diagnosed with a learning disability. The DSM-IV and many school systems and government programs diagnose learning disabilities in this way (DSM-IV uses the term "disorder" rather than "disability"). Although the discrepancy model has dominated the school system for many years, there has been substantial criticism of this approach among researchers. Recent research has provided little evidence that a discrepancy between formally measured IQ and achievement is a clear indicator of LD. Furthermore, diagnosing on the basis of a discrepancy does not predict the effectiveness of treatment. Low academic achievers who do not have a discrepancy with IQ (i.e. their IQ scores are also low) appear to benefit from treatment just as much as low academic achievers who do have a discrepancy with IQ (i.e. their IQ scores are higher than their academic performance would suggest). Since 1998 there have been attempts to create a reference index more useful than IQ to generate predicted scores on achievement tests.
A pulmonary consolidation is a region of normally compressible lung tissue that has filled with liquid instead of air. The condition is marked by induration (swelling or hardening of normally soft tissue) of a normally aerated lung. It is considered a radiologic sign. Consolidation occurs through accumulation of inflammatory cellular exudate in the alveoli and adjoining ducts. The liquid can be pulmonary edema, inflammatory exudate, pus, inhaled water, or blood (from bronchial tree or hemorrhage from a pulmonary artery). Consolidation must be present to diagnose pneumonia: the signs of lobar pneumonia are characteristic and clinically referred to as consolidation. Signs
Signs that consolidation may have occurred include:

Expansion of the thorax on inspiration is reduced on the affected side
Vocal fremitus is increased on the affected side
Percussion is dull in the affected area
Breath sounds are bronchial
Possible medium, late, or pan-inspiratory crackles
Vocal resonance is increased. Here, the patients voice (or whisper, as in whispered pectoriloquy) can be heard more clearly when there is consolidation, as opposed to the healthy lung where speech sounds muffled. A pleural rub may be present. A lower PAO2 than calculated in the alveolar gas equation

Diagnosis
Radiology
Typically, an area of white lung is seen on a standard X-ray. Consolidated tissue is more radio-opaque than normally aerated lung parenchyma, so that it is clearly demonstrable in radiography and on CT scans. Consolidation is often a middle-to-late stage feature/complication in pulmonary infections. See also
Pulmonary infiltrate

References


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