DSM-5 Categories and Criteria for Diagnosis

Co-occuring Neurodevelopmental disorders

1. ASD and intellectual developmental disorders (intellectual disabilities) and anxiety disorders

2. ADHD (attention-deficit hyperactivity disorder) and learning disorders and ODD (oppositional defiant disorder) and conduct disorder

3. Communication disorders associated with anxiety disorders

4. OCD (obsessive compulsive disorder) and tics

ASD (Autism spectrum disorder)

Deficits of social reciprocity, excessively repetitive behaviors, nonverbal communicative behaviors used for social interaction, restricted interests, insistence of sameness, and deficits of skills in developing, maintaining, and understanding relationships.

Intellectual developmental disorder

Deficits in reasoning, problem solving, planning, abstract thinking, judgement, academic learning, and experience-based learning; can lead to Global developmental delay which is diagnosed when someone fails to meet their expected developmental milestone in the area of intellectual functioning. People with this disorder typically have IQ test scores approximately 2 standard deviations or more below the population mean.

Language disorder

Deficits in the development and use of language.

Speech sound disorder

Deficits in the development and use of speech that interfere with social participation, academic achievement, occupational performance, speech intelligibility or prevents verbal communication of messages; more susceptible to boys

Social (pragmatic) communication disorder

Deficits in both verbal and nonverbal communication skills (understanding social cues, conversation/storytelling rules, making educated assumptions) that result in social impairment not correlated with symptoms of intellectual developmental disorder or ASD. Symptoms appear in children aged 4-5 years old.

Childhood-onset fluency disorder

Disturbances of the normal fluency and motor production of speech (including repetitive sounds or syllables, prolongation of consonants or vowel sounds, broken words, blocking, or words produced with an excess physical tension)

Specifiers

Descriptive tools added to a mental health diagnosis to provide extra detail about the severity, course, or specific features of a disorder; associated with a known genetic disorder or medical condition or environmental factor (eg: previously diagnosed people with Asperger’s disorder would now receive the diagnosis of ASD without language or intellectual impairment)

Asperger’s disorder

Previously defined as a distinct condition for individuals with autistic traits who had normal or high intelligence and no early language delay (ASD without language/intellectual impairment)

ADHD

Impaired levels of inattention, disorganization and/or hyperactivity disorder (includes overactivity, fidgeting, inability to stay seated, intruding other people’s activities, and inability to wait.

ODD (Operational defiant disorder)

Chronic arguing, anger, and defiance toward authority figures. Characterized as an “externalizing disorder”.

Conduct Disorder (CD)

Severe rule-breaking and actions that violate the basic rights of others. Characterized as an “externalizing disorder”.

Specific learning disorder

Specific deficits in an individual’s ability to perceive or process information for learning academic skills efficiently and accurately (including reading, writing, math).

Neurodevelopmental motor disorders

Developmental coordination disorder, stereotypic movement disorder, and tic disorders.

Developmental coordination disorder

Deficits in the acquisition and execution of coordinated motor skills; characterized by clumsiness and the slowness/inaccuracy of performing motor skills that interfere with day to day life.

Stereotypic movement disorder

Repetitive, driven, purposeless motor behaviors that interfere with social and academic activities (eg: hand flapping, body rocking, head banging, self biting, or hitting)

Tic disorders

Presence of motor or vocal tics including sudden, rapid, recurrent, nonrhythmic, stereotyped motor movements or vocalizations.

Tourette’s Disorder

Characterized by multiple motor and vocal tics that have been present for at least 1 year and have a waxing-waning symptom course.

Waxing-waning symptom course

Disorder go through cycles where symptoms increase and decrease in intensity over time, but do not completely disappear.

Criterion A of intellectual development disorders

Deficits in general mental abilities and everyday adaptive functioning (verbal comprehension, working memory, perceptual reasoning, quantitative reasoning, abstract thought, and cognitive efficacy).

Criterion B of intellectual development disorders

Inability to meet developmental and socio-cultural standards for personal independence and social responsibility (adaptive functioning); met when at least one domain of adaptive functioning is sufficiently impaired that ongoing support is needed in order for the person to perform adequately across various environments like home, school, work, and community.

Criterion C of intellectual development disorders

The onset of intellectual and adaptive deficits occurs during the developmental period (childhood and adolescence through age 22).

Conceptual (academic) domain of Criterion B

Competence in memory, language, reading, writing, math reasoning, acquisition of practical knowledge, problem solving, and judgment of novel situations.

Social domain of Criterion B

Awareness of others’ thoughts, feelings, and experiences, empathy, interpersonal communication skills, friendship abilities, and social judgement

Practical domain of Criterion B

Learning and self-management across life settings including personal care, job responsibilities, money management, recreation, self-management of behavior, and school/work task organization.

Behavioral Phenotype

Specific behaviors that are characteristic of particular genetic disorders (eg: Lesch-Nyhan syndrome: caused by a deficiency of HPRT, which leads to a severe overproduction of uric acid and neurological and behavioral abnormalities)

Neurocognitive disorders

Characterized by a loss of cognitive functioning (eg: Alzheimer’s disease and losing cognitive capacity following a head injury)

Four subtypes of disorders of intellectual development in ICD-11

Mild, moderate, severe, and profound

Global developmental delay

Diagnosis reserved for individuals under the age of 5 years when someone fails to meet expected developmental milestones in several areas of intellectual functioning and who is unable or too young to undergo systematic assessments of standardized testing. Thus, the clinical severity level cannot be reliably assessed during early childhood and requires a reassessment after a period of time.

Unspecified intellectual development disorder

Reserved for people over the age of 5 years when assessment of the degree of intellectual developmental disorder is rendered difficult or impossible by available procedures because of associated sensory or physical impairments including blindness, prelingual deafness, locomotor disability, presence of severe behavior problems, or co-occuring mental disorders. Requires reassessment after a period of time.

Language disorder

Persistent difficulties in the acquisition and use of language across modalities due to deficits in comprehension or production that include 1. reduced vocabulary, 2. limited sentence structure, and impairments in discourse. Language abilities are quantifiably below those expected for age resulting in deficits in effective communication, social participation, academic achievement, or occupational performance and onset of symptoms is in the early developmental period (usually affects vocabulary and grammar); language disorder diagnosed at age 4 will likely be stable overtime and persist into adulthood.

The 2 assessed areas of language learning for diagnosis of language disorder

Expressive ability (production of vocal, gestural, or verbal signs) and Receptive ability (process of receiving and comprehending language messages).

Dysarthia

Speech impairment may be attributable to a motor disorder such as cerebral palsy. (Eg: Worster-Drought syndrome - a condition that effects the muscles of the mouth and throat)

Selective Mutism

Characterized by a lack of speech in one or more contexts or settings. May develop in children with a speech disorder because of embarrassment regarding their impairments, but many children still exhibit normal speech in “safe” settings.