

Grammar


Tenses


Present

Present Simple

Present Continuous

Present Perfect

Present Perfect Continuous


Past

Past Simple

Past Continuous

Past Perfect

Past Perfect Continuous


Future

Future Simple

Future Continuous

Future Perfect

Future Perfect Continuous


Parts Of Speech


Nouns

Countable and uncountable nouns

Verbal nouns

Singular and Plural nouns

Proper nouns

Nouns gender

Nouns definition

Concrete nouns

Abstract nouns

Common nouns

Collective nouns

Definition Of Nouns

Animate and Inanimate nouns

Nouns


Verbs

Stative and dynamic verbs

Finite and nonfinite verbs

To be verbs

Transitive and intransitive verbs

Auxiliary verbs

Modal verbs

Regular and irregular verbs

Action verbs

Verbs


Adverbs

Relative adverbs

Interrogative adverbs

Adverbs of time

Adverbs of place

Adverbs of reason

Adverbs of quantity

Adverbs of manner

Adverbs of frequency

Adverbs of affirmation

Adverbs


Adjectives

Quantitative adjective

Proper adjective

Possessive adjective

Numeral adjective

Interrogative adjective

Distributive adjective

Descriptive adjective

Demonstrative adjective


Pronouns

Subject pronoun

Relative pronoun

Reflexive pronoun

Reciprocal pronoun

Possessive pronoun

Personal pronoun

Interrogative pronoun

Indefinite pronoun

Emphatic pronoun

Distributive pronoun

Demonstrative pronoun

Pronouns


Pre Position


Preposition by function

Time preposition

Reason preposition

Possession preposition

Place preposition

Phrases preposition

Origin preposition

Measure preposition

Direction preposition

Contrast preposition

Agent preposition


Preposition by construction

Simple preposition

Phrase preposition

Double preposition

Compound preposition

prepositions


Conjunctions

Subordinating conjunction

Correlative conjunction

Coordinating conjunction

Conjunctive adverbs

conjunctions


Interjections

Express calling interjection

Phrases

Sentences


Grammar Rules

Passive and Active

Preference

Requests and offers

wishes

Be used to

Some and any

Could have done

Describing people

Giving advices

Possession

Comparative and superlative

Giving Reason

Making Suggestions

Apologizing

Forming questions

Since and for

Directions

Obligation

Adverbials

invitation

Articles

Imaginary condition

Zero conditional

First conditional

Second conditional

Third conditional

Reported speech

Demonstratives

Determiners


Linguistics

Phonetics

Phonology

Linguistics fields

Syntax

Morphology

Semantics

pragmatics

History

Writing

Grammar

Phonetics and Phonology

Semiotics


Reading Comprehension

Elementary

Intermediate

Advanced


Teaching Methods

Teaching Strategies

Assessment
THYROID DISORDERS
المؤلف:
FRANK GARVEY AND JACKY VINCENT
المصدر:
Caring for People with Learning Disabilities
الجزء والصفحة:
P132-C8
2025-10-22
342
THYROID DISORDERS
Thyroid dysfunction is common in adults with Down’s syndrome, with a steady decline in thyroid function increasing with age. Both hypo- and hyper-thyroidism can occur in adults with Down’s syndrome, although hypothyroid ism is much more common and often caused through an autoimmune process whereby the immunological defense system targets its own body tissues and organs.
Hypothyroidism is caused by a deficiency of thyroxine – a naturally occurring hormone, secreted by the thyroid gland. It is more commonly known as an ‘underactive’ thyroid. It occurs because the thyroxin gland stops making sufficient thyroxine. Typical symptoms include putting on weight, increasing tiredness and lethargy, constipation and generalized aches and pains (British Thyroid Foundation 2005a). Table 1 outlines further clinical features.
The clinical picture of an adult with Down’s syndrome suffering from hypothyroidism can be similar to those of both depression and dementia, and careful assessment is required to aid the correct diagnosis and follow-on treatment. This similarity of presenting symptoms is known as differential diagnosis, and therefore careful investigation and diagnosis are needed. Indeed,
Table 1 Clinical features of hypothyroidism
___________________________________________
• Hearing difficulties
• Facial puffiness
• Husky voice
• Weight gain
• Intolerance of cold
• Hair loss
• Dry skin
• Slow pulse rate
• Constipation
• Lethargy
• Apathy, mental dullness
___________________________________________
Table 2 Clinical features of hyperthyroidism
___________________________________________
• Anxiety
• Irritability
• Palpitations
• Weight loss
• Heat intolerance
• Increased sweating
• Fine tremor
• Menstrual disturbance
• Increased pulse rate
• Warm, sweaty skin
• Diarrhea
• Retracted eyelids – making the eyes look out-standing
___________________________________________
Dennis (2000), representing the Down’s Syndrome Association, advises that because of this differential diagnosis, regular blood tests should be carried out on adults with Down’s syndrome to assess their thyroid function. It also recommends that carers be alert to the possibility of the thyroid gland slowing down and report these concerns to their GP or learning disability team.
Hyperthyroidism is more usually known as ‘overactive thyroid’. The thyroid gland makes too much thyroxine, resulting in some of the following symptoms: noticeable weight loss coupled with an increase in appetite, inability to sleep, restlessness and irritability, palpitations and sweating (British Thyroid Foundation 2005b). Table 2 outlines further clinical features.
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