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Communication deviance ( CD ) occurs when a speaker fails to effectively communicate meaning to their listener with confusing speech patterns or illogical patterns. [1] These disturbances can range from vague linguistic references, contradictory statements to more encompassing non-verbal problems at the level of turn-taking . ... Some researchers theorize that, in the case of a high degree of egocentric communication in parents where the sender and the receiver do not speak and listen according to each other's premises, the child develops uncertainty. [7] The research of psychiatrists and psychoanalysts Lyman Wynne and Theodore Lidz on communication deviance and roles (e.g., pseudo-mutuality, pseudo-hostility, schism and skew) in families of people with schizophrenia also became influential with systems-communications -oriented theorists and therapists. [8] [9] See also [ edit ] Stilted speech Alogia Schizophrenia Psychosis References [ edit ] ^ Singer, MT; Wynne, LC (August 1966). "Principles for scoring communication defects and deviances in parents of schizophrenics: Rorschach and TAT scoring manuals". ... The Routledge Handbook of Family Communication . Oxon: Routledge. ISBN 978-1-136-94636-3 . ^ Huser Liem, Joan (1979). ... "Thought disorder index of Finnish adoptees and communication deviance of their adoptive parents".
For example, the definitions offered by the American Speech–Language–Hearing Association differ from those of the Diagnostic Statistical Manual 4th edition (DSM-IV). Gleanson (2001) defines a communication disorder as a speech and language disorder which refers to problems in communication and in related areas such as oral motor function. ... DSM-5 [ edit ] The DSM-5 diagnoses for communication disorders completely rework the ones stated above. ... The inability to hear is not in itself a communication disorder. Aphasia [ edit ] Aphasia is loss of the ability to produce or comprehend language . ... National Institute on Deafness and Other Communication Disorders (NIDCD). 2015-08-18. ^ James, D. M.; Stojanovik, V. (2007). "Communication skills in blind children: a preliminary investigation".
Social (pragmatic) communication disorder Other names SPCD Specialty Speech pathology Social (pragmatic) communication disorder (SPCD) is a disorder where individuals have difficulties with verbal and nonverbal social communication. [1] As well, SPCD lacks behaviors associated with restrictions and repetition. [2] Relates to Pragmatic Language Impairment and Autism Spectrum Disorder . ... "Evaluating social communication disorder" . Journal of Child Psychology and Psychiatry . 58 (10): 1166–1175. doi : 10.1111/jcpp.12785 . ... "Practitioner Review: Social (pragmatic) communication disorder conceptualization, evidence and clinical implications" . ... S2CID 33830045 . ^ Baird, & Norbury, G., & C.F (2015). "Social (pragmatic) communication disorders and autism spectrum disorder". ... "Practitioner Review: Social (pragmatic) communication disorder conceptualization, evidence and clinical implications" .
Social communication disorder Other names Social ( pragmatic ) communication disorder Social communication disorder ( SCD )—previously called semantic-pragmatic disorder ( SPD ) or pragmatic language impairment ( PLI )—is a disorder in understanding pragmatic aspects of language. ... The current view, therefore, is that the disorder has more to do with communication and information processing than language. ... The DSM-5 diagnostic criteria for social communication disorder is as follows: A. Persistent difficulties in the social use of verbal and nonverbal communication as manifested by all of the following: Deficits in using communication for social purposes, such as greeting and sharing information, in a manner that is appropriate for the social context. ... ISBN 978-0-9836494-5-8 . ^ "Social Communication Disorder & how it's treated" . ... Retrieved 2019-11-05 . ^ "Social Communication Disorder & how it's treated" .
"Identifying Compulsive Communicators: The Talkaholic Scale". Communication Research Reports . 10 (2): 107–114. doi : 10.1080/08824099309359924 . ^ Walther, Joseph B. (Aug 1999). "Communication Addiction Disorder: Concern over Media, Behavior and Effects" . ... Communication Quarterly . 43 (1): 39. doi : 10.1080/01463379509369954 . ^ McCroskey, James C.; Heisel, Alan D.; Richmond, Virginia P. (2001). "Eysenck's BIG THREE And Communication Traits: Three Correlational Studies". ... "Correlates Of Talkaholism In New Zealand: An Intracultural Analysis Of The Compulsive Communication Construct" . Communication Research Reports . 12 (1): 5360. doi : 10.1080/08824099509362039 . ^ a b Chillot, Rick (1997).
In 1994, it was estimated that roughly 35,000–40,000 United States residents are medically deafblind. [4] Helen Keller was a well-known example of a deafblind individual. [5] Furthermore, the deafblind community has its own culture , creating a community of deafblindness similar to the Deaf community and the blind community . ... Interpreting services (such as sign language interpreters or communication aides). Communication devices such as Tellatouch or its computerized versions known as the TeleBraille and Screen Braille Communicator. ... Multisensory methods have been used to help deafblind people enhance their communication skills. These can be taught to very young children with developmental delays (to help with pre-intentional communication), young people with learning difficulties, and older people, including those with dementia . ... Deafblind amateur radio operators generally communicate on 2-way radios using Morse code . [ clarification needed ] Technology [ edit ] Braille equipment includes a variety of multipurpose devices, which enhance access to distance communication. ... The Telebraille does not have a computer communications modem but does have a TTY (TDD) modem.
A congenital cardiac malformation characterized by a communication between the atrial chambers of the heart. ... Interatrial communications are most often asymptomatic in childhood but clinical manifestations can include: rapid breathing, shortness of breath, fatigue, sweating, palpitations, frequent respiratory infections, and poor growth. Symptoms often manifest by the age of 30 to 40 years. Adults with interatrial communications are at increased risk of developing pulmonary arterial hypertension, heart failure, arrhythmias, and stroke. ... Antenatal diagnosis A significant defect may be diagnosed during fetal life, although prenatal diagnosis is difficult as interatrial communication is an integral part of fetal circulation. ... For other types of interatrial communications, and in large secundum defects with deficient rims, open-heart surgery is indicated, and is complication-free in the majority of cases.
A number sign (#) is used with this entry because of evidence that atrial septal defect-6 (ASD6) is caused by heterozygous mutation in the TLL1 gene (606742) on chromosome 4q32. For a general phenotypic description and discussion of genetic heterogeneity in atrial septal defect, see ASD1 (108800). Molecular Genetics Based on data from mouse models of incomplete heart septation associated with inactivation of mouse Tll1, Stanczak et al. (2009) analyzed the candidate gene TLL1 in 19 unrelated patients with atrial septal defect and identified heterozygosity for 3 missense mutations in 3 patients (606742.0001-606742.0003, respectively). One of the patients had an isolated ostium primum defect; the other 2 patients, who had ostium secundum defects, displayed additional features including interatrial aneurysm and cardiac arrhythmias. INHERITANCE - Autosomal dominant CARDIOVASCULAR Heart - Atrial septal defect, type I or II - Aneurysm of interatrial septum (in some patients) - Atrial fibrillation (in some patients) - Bradycardia (in some patients) MOLECULAR BASIS - Caused by mutation in the tolloid-like 1 gene (TLL1, 606742.0001 ) ▲ Close
A number sign (#) is used with this entry because of evidence that atrial septal defect-5 (ASD5) is caused by heterozygous mutation in the ACTC1 gene (102540) on chromosome 15q14. For a phenotypic description and discussion of genetic heterogeneity in atrial septal defect, see ASD1 (108800). Mapping Matsson et al. (2008) studied 2 large Swedish families segregating autosomal dominant isolated secundum atrial septal defect (ASD) with variable clinical expression. Genotyping with microsatellite markers in 'family 1' revealed a specific haplotype in all affected individuals spanning a 15.1-cM region of chromosome 15q13-q21; analysis of 'family 2' identified a minimal haplotype with significant linkage to ASD consisting of markers GT44248, GATA12322, and ACTC. All affected individuals genotyped had identical allele sizes for the marker haplotype, suggesting a shared ancestral mutation for the 2 families.
A number sign (#) is used with this entry because atrial septal defect-2 (ASD2) is caused by heterozygous mutation in the GATA4 gene (600576) on chromosome 8p23. For discussion of genetic heterogeneity in atrial septal defect, see ASD1 (108800). Clinical Features Garg et al. (2003) identified a large kindred spanning 5 generations in which 16 individuals had congenital heart defects. Detailed clinical evaluations reviewed for all available family members demonstrated an autosomal dominant pattern of inheritance. All affected family members had atrial septal defects. Eight individuals had additional congenital heart defects, including ventricular septal defects (VSD), atrioventricular septal defects (AVSD), pulmonary valve thickening, or insufficiency of the cardiac valves.
Description Secundum atrial septal defect (ASD) is a common congenital heart malformation that occurs as an isolated anomaly in 10% of individuals with congenital heart disease. Uncorrected ASD can cause pulmonary overcirculation, right heart volume overload, and premature death (summary by Benson et al., 1998). Genetic Heterogeneity of Atrial Septal Defect The ASD1 locus has been mapped to chromosome 5p. Other forms of atrial septal defect that are associated with other congenital heart disease but no conduction defects or noncardiac abnormalities include ASD2 (607941), caused by mutation in the GATA4 gene (600576), and ASD4 (611363), caused by mutation in the TBX20 gene (606061). ASD3 (614089) and ASD5 (612794), in which atrial septal defect is not associated with other cardiac abnormalities, are caused by mutation in the MYH6 (160710) and ACTC1 (102540) genes, respectively.
A number sign (#) is used with this entry because of evidence that atrial septal defect-8 (ASD8) can be caused by heterozygous mutation in the CITED2 gene (602937) on chromosome 6q23.3. For discussion of genetic heterogeneity of atrial septal defect, see ASD1 (108800). Molecular Genetics Sperling et al. (2005) screened a cohort of 392 patients with congenital heart defects and 192 controls for mutations in the CITED2 gene and identified a 27-bp insertion (602937.0002) in a patient with a secundum atrial septal defect, and a 6-bp deletion (602937.0003) in a patient with a sinus venosus atrial septal defect and abnormal pulmonary venous return to the right atria. Functional analysis of the mutations, which were not found in controls, revealed that both significantly reduced the capacity of CITED2 to transrepress HIF1A (603348). INHERITANCE - Autosomal dominant CARDIOVASCULAR Heart - Atrial septal defect, secundum type (in some patients) - Atrial septal defect, sinus venosus type (in some patients) Vascular - Abnormal pulmonary venous return to right atria (in some patients) MOLECULAR BASIS - Caused by mutation in the CBP/p300-interacting transactivator, with glu/asp-rich C-terminal domain, 2 gene (CITED2, 602937.0001 ) ▲ Close
Overview An atrial septal defect (ASD) is a hole in the heart between the upper chambers (atria). The hole increases the amount of blood that flows through the lungs. The condition is present at birth (congenital heart defect). Small atrial septal defects might be found by chance and never cause a concern. Others close during infancy or early childhood. A large, long-term atrial septal defect can damage the heart and lungs. Surgery may be needed to repair an atrial septal defect and to prevent complications.
A number sign (#) is used with this entry because of evidence that atrial septal defect-9 (ASD9) is caused by heterozygous mutation in the GATA6 gene (601656) on chromosome 18q11. For discussion of genetic heterogeneity of atrial septal defect (ASD), see ASD1 (108800). Molecular Genetics Lin et al. (2010) analyzed the GATA6 gene in 270 unrelated Chinese patients with congenital heart defects and identified heterozygosity for a missense mutation in the GATA6 gene (S184N; 601656.0005) in 2 Chinese children with atrial septal defect. One of the ASD patients was a 3-year-old girl with an ostium secundum ASD and mild pulmonary arterial hypertension, whereas the other was a 4-year-old boy with an ostium secundum ASD and mild tricuspid valve disease and pulmonary valve replacement. The S184N mutation was detected in the unaffected father of the girl as well as in the clinically unaffected mother of the boy; the latter parent was found to have bicuspid aortic valve on echocardiography.
A sinus venosus ASD that involves the superior vena cava makes up 2 to 3% of all interatrial communication. It is located at the junction of the superior vena cava and the right atrium. ... If the defect involves two or more of the septal zones, then the defect is termed a mixed atrial septal defect. [22] Presentation [ edit ] Complications [ edit ] Due to the communication between the atria that occurs in ASDs, disease entities or complications from the condition are possible. ... In individuals with an ASD, a fixed splitting of S 2 occurs because the extra blood return during inspiration gets equalized between the left and right atria due to the communication that exists between the atria in individuals with ASD.
A rare neurovascular malformation characterized by a unilateral, direct communication between the arterial and venous system in the retina via abnormal, enlarged vessels, but without interposed capillaries.
It later came to be used in a cultural context to refer to those who primarily communicate through sign language regardless of hearing ability, often capitalized as Deaf and referred to as "big D Deaf" in speech and sign. [2] [3] The two definitions overlap but are not identical, as hearing loss includes cases that are not severe enough to impact spoken language comprehension, while cultural Deafness includes hearing people who use sign language, such as children of deaf adults . ... In a cultural context, Deaf culture refers to a tight-knit cultural group of people whose primary language is signed , and who practice social and cultural norms which are distinct from those of the surrounding hearing community. This community does not automatically include all those who are clinically or legally deaf, nor does it exclude every hearing person. According to Baker and Padden, it includes any person or persons who "identifies him/herself as a member of the Deaf community, and other members accept that person as a part of the community", [4] an example being children of deaf adults with normal hearing ability. It includes the set of social beliefs, behaviors, art, literary traditions, history, values, and shared institutions of communities that are influenced by deafness and which use sign languages as the main means of communication. [2] [3] Members of the Deaf community tend to view deafness as a difference in human experience rather than a disability or disease . [5] [6] Neurologically, language is processed in the same areas of the brain whether one is deaf or hearing. [7] The left hemisphere of the brain processes linguistic patterns whether by signed languages or by spoken languages. [7] See also [ edit ] Hearing loss Models of deafness Deaf culture References [ edit ] ^ a b Elzouki AY (2012). ... American Sign Language: A Look at Its Story, Structure and Community . ^ Ladd, Paddy (2003). Understanding Deaf Culture: In Search of Deafhood .
The person with aphasia relearns and practices language skills and learns to use other ways to communicate. Family members often participate in the process, helping the person communicate. ... Although most people make significant progress, few people regain full pre-injury communication levels. Speech and language therapy aims to improve the ability to communicate. ... In a group setting, people with aphasia can try out their communication skills in a safe environment. ... These groups provide people with a sense of community and a place to air frustrations and learn coping strategies. ... In addition, this person may be able to help you communicate with your health care provider.
Symptoms that don't diminish over a year with medications should be reconsidered as possible primary negative symptoms. [27] See also [ edit ] Aphasia Communication deviance List of language disorders Mutism References [ edit ] ^ [1] ^ [2] ^ a b c d Shiel, William C.
Symptoms may include impaired social communications or interactions, bizarre behavior, and lack of social or emotional reciprocity . ... Due to the lack of these social skills, it may be hard for these patients to form or maintain relationships with others. [10] Communication impairments shown in people with LFA include lack of communication (both oral communication – i.e. nonverbal autism – and body language), repetitive use of words or phrases, and lack of imaginative play skills. [10] They also may respond only to very direct external social interaction from others. ... ICD-10 differentiates patients with high functioning and low-functioning autism by diagnosing the additional code of intellectual disability . [18] Therapy [ edit ] Augmentative and alternative communication [ edit ] Augmentative and alternative communication (AAC) is used for autistic patients who cannot communicate orally. Patients who have problems speaking may be taught to use other forms of communication, such as body language, computers, interactive devices, and pictures. [19] The Picture Exchange Communication System (PECS) is a commonly used form of augmentative and alternative communication with children and adults who cannot communicate well orally. ... Bentham e Books. pp. 4–5. ^ "Augmentative and Alternative Communication (AAC)" . American Speech-Language-Hearing Association . ^ a b c d "What Treatments are Available for Speech, Language and Motor Issues?"
If the absence of speech is determined to be a permanent condition, a range of assistive and augmentative communication devices are available to aid communication. ... Communication disorders may impact articulation, fluency ( stuttering ) and other specified and unspecified communication disorders. ... Retrieved 2020-04-19 . ^ "Speech and Communication Disorders" . medlineplus.gov . ... Retrieved 2020-04-14 . ^ "Communication aids for disabled children - Living made easy" . www.livingmadeeasy.org.uk . Retrieved 2020-04-14 . ^ "ALS Augmentative Communication Program | Speech-Generating Devices | Boston Children's Hospital" . www.childrenshospital.org .
In addition to a negative correlation to eye fixation studies showed a smaller amygdala was associated with impairment in nonverbal communication skills as well. [8] This suggests that the amygdala is critical in developing all types of communicative abilities, not just verbal. ... Language outcomes [ edit ] For nonverbal grade school children and adolescents with autism, communication systems and interventions have been implemented to enhance language and communication outcomes. ... Furthermore, most studies on nonverbal autism and speech-generating device communication were based on more basic skills, such as naming pictures and making requests for stimuli, while studies in advanced communication are limited. [12] See also [ edit ] Facilitated communication : a scientifically discredited technique which purports to help non-verbal people communicate Low-functioning autism : verbal abilities may be lacking Language delay and speech delay Late talkers : sometimes mistaken as nonverbal autistics Nonverbal communication References [ edit ] ^ a b c Patten, Elena; Ausderau, Karla K; Watson, Linda R; Baranek, Grace T (2013). ... "Long-term effects of PECS on social-communicative skills of children with autism spectrum disorders: A follow-up study". International Journal of Language & Communication Disorders . 49 (4): 478–85. doi : 10.1111/1460-6984.12079 .
In some cases, a child's communication is delayed considerably behind his/her same-aged peers. ... If speech is not practical for a patient, the SLP will work with the patient to decide upon an augmentative and alternative communication (AAC) method or device to facilitate communication. ... While there are a large number of types of AAC, there are fundamentally two categories: aided and unaided. Unaided systems of communication are those that require both communication parties to be physically present in the same location. Examples of unaided systems include gestures, body language , sign language , and communication boards. Communication boards are devices upon which letters, words, or pictorial symbols might be displayed; the individual may interface with the communication board to express him/herself to the other individual. ... The Processing Period, from roughly 1945-1965, further developed the assessment and interventions available for general communication disorders; much of these focused on the internal, psychological transactions involved in the communication process.
Vertical eye movements and blinking can be used to communicate. Locked-in syndrome may be caused by brain stem stroke, traumatic brain injury, tumors, diseases of the circulatory system (bleeding), diseases that destroy the myelin sheath surrounding nerve cells (like multiple sclerosis), infection, or medication overdose. ... Speech therapists can help people with locked-in syndrome communicate more clearly with eye movements and blinking. However, electronic communication devices, including patient-computer interfaces such as infrared eye movement sensors and computer voice prosthetics, are allowing people with locked-in syndrome to communicate more freely and have access to the internet.
Locked-in syndrome (LIS) is a neurological condition characterized by the presence of sustained eye opening, quadriplegia or quadriparesis, anarthria, preserved cognitive functioning and a primary code of communication that uses vertical eye movements or blinking. ... Diagnostic methods Diagnosis is based on clinical features. Willingness to communicate is frequently noticed by patient's relatives or caregivers and eye movement response to verbal commands should systematically be searched for in apparent vegetative state cases. ... In the chronic phase, rehabilitation relies on chest physiotherapy, recovery of independent swallowing and continence, and development of fingers, head and neck motricity. Eye-based communication codes must be established very early with the patient. Brain-computer interfaces (BCI) are of growing help to provide more direct and spontaneous ways of communication. Prognosis Prognosis is poor as some patients do not survive the acute phase, or experience very limited recovery.
Specialty Neurology , Psychiatry Locked-in syndrome ( LIS ), also known as pseudocoma , is a condition in which a patient is aware but cannot move or communicate verbally due to complete paralysis of nearly all voluntary muscles in the body except for vertical eye movements and blinking. The individual is conscious and sufficiently intact cognitively to be able to communicate with eye movements. [3] Electroencephalography results are normal in locked-in syndrome. ... Those with locked-in syndrome may be able to communicate with others through coded messages by blinking or moving their eyes, which are often not affected by the paralysis. ... Other courses of treatment are often symptomatic . [17] Assistive computer interface technologies such as Dasher , combined with eye tracking , may be used to help people with LIS communicate with their environment. [ citation needed ] Prognosis [ edit ] It is extremely rare for any significant motor function to return. ... "Use of safe-laser access technology to increase head movements in persons with severe motor impairments: a series of case reports". Augmentative and Alternative Communication . 22 (3): 222–29. doi : 10.1080/07434610600650318 .
(See also Intensive interaction ) At-home and community support [ edit ] Many people with developmental disabilities live in the general community, either with family members, in supervised-group homes or in their own homes (that they rent or own, living alone or with flatmates ). ... Supports of this type also include assistance to identify and undertake new hobbies or to access community services (such as education), learning appropriate behavior or recognition of community norms, or with relationships and expanding circles of friends. ... They include heightened placement efforts by the community agencies serving people with developmental disabilities, as well as by government agencies. ... The Committee has been examining additions to existing community employment services, and also new employment approaches. ... "Crisis and Revolution in Developmental Disabilities: The Dilemma of Community Based Services. The Behavior Analyst Today, 3 (4, " : 434–443.
Pain can be referred to the upper teeth and be mistaken for toothache [3] · Fluid can flow from the mouth through the communication and into the maxillary sinus. ... Complications [ edit ] OAF is a complication of oroantral communication. Other complications may arise if left untreated. ... OCLC 698080410 . ^ a b c d e f g h i j k Khandelwal P, Hajira N (January 2017). "Management of Oro-antral Communication and Fistula: Various Surgical Options" . ... "Surgical Management of Oro-Antral Communications Using Resorbable GTR Membrane and FDMB Sandwich Technique: A Clinical Study" . ... "Evaluation of different treatment modalities for closure of oro-antral communications and formulation of a rational approach" .
Sinus pericranii Specialty Vascular surgery Sinus pericranii ( SP ) is a rare disorder characterized by a congenital (or occasionally, acquired) epicranial venous malformation of the scalp. [1] Sinus pericranii is an abnormal communication between the intracranial and extracranial venous drainage pathways. ... Mechanism [ edit ] Sinus pericranii is a venous anomaly where a communication between the intracranial dural sinuses and dilated epicranial venous structures exists. That venous anomaly is a collection of nonmuscular venous blood vessels adhering tightly to the outer surface of the skull and directly communicating with intracranial venous sinuses through diploic veins. ... You can help by adding to it . ( April 2017 ) Treatment [ edit ] The surgical treatment involves the resection of the extracranial venous package and ligation of the emissary communicating vein. In some cases of SP, surgical excision is performed for cosmetic reasons.
Devi et al. (1995) reported the cases of 2 unrelated male infants with similar findings of communicating hydrocephalus, endocardial fibroelastosis (EFE), and congenital cataracts. ... Chromosome analyses were normal. Both children developed communicating hydrocephalus between 1 and 3 months after birth. ... Cardiac - Endocardial fibroelastosis (EFE) Misc - Polyhydramnios - Infantile death Eyes - Congenital cataracts Neuro - Communicating hydrocephalus Inheritance - Genetic vs. viral ▲ Close
HEC syndrome Other names Hydrocephalus-endocardial fibroelastosis-cataract syndrome HEC syndrome is a syndrome characterized by hydrocephalus , endocardial fibroelastosis and cataracts . [1] References [ edit ] ^ Devi A, Eisenfeld L, Uphoff D, Greenstein R (1995). "New syndrome of hydrocephalus, endocardial fibroelastosis, and cataracts (HEC syndrome)". Am J Med Genet . 56 (1): 62–6. doi : 10.1002/ajmg.1320560114 . PMID 7747788 . External links [ edit ] Classification D ICD - 10 : Q87.8 OMIM : 600559 MeSH : C535855 External resources Orphanet : 2119 Online Mendelian Inheritance in Man (OMIM): 600559 This article about a disease , disorder, or medical condition is a stub . You can help Wikipedia by expanding it . v t e
Clinical Features Walsh et al. (2002) studied a family that traced its ancestry to the Jewish community of Mosul, Iraq. This community dated to 586 B.C. and was highly endogamous, with considerable emigration but little immigration, for more than 2,500 years. ... Mapping By genomewide linkage analysis, Walsh et al. (2002) identified a locus for DFNB30 on chromosome 10p in 23 members of an Israeli family that can be traced to the Jewish community of Mosul, Iraq. They found evidence of linkage to an interval between D10S1749 and D10S1654 with a lod score of 4.3. ... INHERITANCE - Autosomal recessive HEAD & NECK Ears - Hearing loss, sensorineural, progressive (moderate to severe) MISCELLANEOUS - Onset in the second decade and by age 50 is severe in high and middle frequencies and moderate at low frequencies - Based on a family from an endogamous Jewish community of Mosul, Iraq (last curated August 2015) MOLECULAR BASIS - Caused by mutation in the myosin IIIA gene (MYO3A, 606808.0001 ) ▲ Close