PSY608 DSM Neurodevelopmental Disorders

Intellectual Developmental Disorder (Intellectual Disability)

A disorder with onset during the developmental period that includes both intellectual and adaptive functioning deficits in conceptual, social, and practical domains.

Diagnostic Criterion: A

Deficits in intellectual functions, such as reasoning, problem solving, planning, abstract thinking, judgement, academic learning, and learning from experience. Confirmed by clinical assessment and individualized, standardized intelligence testing.

Diagnostic Criterion: B

Deficits in adaptive functioning that result in failure to meet developmental and sociocultural standards for personal independence and social responsibility. Without ongoing support, the adaptive deficits limit functioning in one or more activities of daily life, such as communication, social participation, and independent living, across multiple environments, such as home, school, work, and community.

Diagnostic Criterion: C

Onset of intellectual and adaptive deficits during the developmental period.

Intellectual Developmental Disorder (Intellectual Disability) Specifiers

Mild

Moderate

Severe

Profound

Intellectual Developmental Disorder (Intellectual Disability) \n Differential Diagnosis: major and mild neurocognitive disorders

characterized by a loss of cognitive functioning. Example: an individual with intellectual developmental disorder who loses further cognitive capacity following a head injury.

Differential Diagnosis: communication disorders and specific learning disorder:

specific to communication and learning domains and do not show deficits in intellectual and adaptive behavior. They may co-occur with intellectual developmental disorder if full criteria are met for both disorders.

Differential Diagnosis: autism spectrum disorder

common among individuals with intellectual developmental disorder. Assessment of intellectual ability may be complicated by social-communication and behavior deficits.

Global Developmental Delay

Reserved for individuals under the age of 5 when the clinical severity level cannot be reliably assessed during early childhood.

This category is diagnosed when an individual fails to meet expected developmental milestones in several areas of intellectual functioning. This applies to individuals who are unable to undergo systematic assessments of intellectual functioning (cannot participate in standardized testing due to being too young).

This category requires reassessment after a period of time.

Unspecified Intellectual Developmental Disorder (Intellectual Disability)

Reserved for individuals over the age of 5 when assessment of the degree of intellectual developmental disorder is rendered difficult or impossible because of associated sensory or physical impairments (blindness, deafness, locomotor, severe problem behaviors, co-occurring mental disorder).

This category should only be used in exceptional circumstances and requires reassessment after a period of time.

Language Disorder

Diagnostic Criterion: A

Persistent difficulties in acquisition and use of language across modalities (spoken, written, sign language, or other) due to deficits in comprehension or production that include the following:

1. Reduced vocabulary

2. Limited sentence structure

3. Impairments in discourse

Language Disorder

Diagnostic Criterion: B

Language abilities are substantially and quantifiably below those expected for age, resulting in functional limitations in effective communication, social participation, academic achievement, or occupational performance, individually or in any combination.

Language Disorder

Diagnostic Criterion: C

C. Onset of symptoms is in the early developmental period.

Language Disorder

Diagnostic Criterion: D

The difficulties are not attributable to hearing or other sensory impairment, motor dysfunction, or another medical or neurological condition and are not better explained by intellectual developmental disorder (intellectual disability) or global development.

Language Disorder

Differential Diagnosis: Normal variations in language

Language disorder needs to be distinguished from normal developmental variations. This distinction may be hard to make before the age of 4. Regional, social, or cultural/ethnic variations of language (e.g., dialects) must be considered.

Language Disorder

Differential Diagnosis: Hearing or other sensory impairment

hearing impairment needs to be excluded as the primary cause of language difficulties. Language deficits may be associated with a hearing impairment, other sensory deficit, or a speech-motor deficit. When language deficits are in excess of those usually associated with these problems, a diagnosis of language disorder may be made.

Language Disorder

Differential Diagnosis: Autism spectrum disorder

frequently manifests with delayed language development. However, autism is often accompanied by behaviors not present in language disorder.

Language Disorder

Differential Diagnosis: Neurological disorders

language disorder can be acquired in association with neurological disorders, including epilepsy.

Language Disorder

Differential Diagnosis: Language regression

assess for neurological conditions, seizures, epilepsy, and autism spectrum disorder.

Speech Sound Disorder

Diagnostic Criterion: A

Persistent difficulty with speech sound production that interferes with speech intelligibility or prevents verbal communication of messages.

Speech Sound Disorder

Diagnostic Criterion: B

The disturbance causes limitations in effective communication that interfere with social participation, academic achievement, or occupational performance, individually or in any combination.

Speech Sound Disorder

Diagnostic Criterion: C

Onset of symptoms is in the early developmental period.

Speech Sound Disorder

Diagnostic Criterion: D

The difficulties are not attributable to congenital or acquired conditions, such as cerebral palsy, cleft palate, deafness or hearing loss, traumatic brain injury, or other medical or neurological conditions.

Speech Sound Disorder

Differential Diagnosis:

Normal variations in speech: regional, social, or cultural/ethnic variations of speech should be considered before making the diagnosis.

Speech Sound Disorder

Differential Diagnosis: hearing or other sensory impairment

Those who are deaf or hard of hearing may have speech sound production errors. When speech deficits are in excess of those usually associated with these problems, a diagnosis of this disorder may be made.

Speech Sound Disorder

Differential Diagnosis: structural deficits

Speech impairment may be due to structural deficits (e.g., cleft palate).

Speech Sound Disorder

Differential Diagnosis: dysarthria

Speech impairment may be attributed to a motor disorder, like cerebral palsy. Neurological signs and distinctive features of voice differentiate dysarthria from speech sound disorder.

Speech Sound Disorder

Differential Diagnosis: selective mutism

Limited use of speech. This is an anxiety disorder that is characterized by a lack of speech in one or more contexts or settings. This may develop in children with a speech disorder because of embarrassment about their impairments.

Childhood Onset Fluency Disorder (Stuttering)

Diagnostic Criterion: A

A. Disturbance in the normal fluency and time patterning of speech that are inappropriate for the individual's age and language skills, persist over time, and are characterized by frequent and marked occurrences of one (or more) of the following:

1. Sound and syllable repetitions.

2. Sound prolongations of consonants as well as vowels.

3. Broken words (e.g., pauses within a word).

4. Audible or silent blocking (filled or unfilled pauses in speech).

5. Circumlocutions (word substitutions to avoid problematic words).

6. Words produced with an excess of physical tension.

7. Monosyllabic whole-word repetition (e.g., "I-I-I see him").

Childhood Onset Fluency Disorder (Stuttering)

Diagnostic Criterion: B

The disturbance causes anxiety about speaking or limitations in effective communication, social participation, or academic or occupational performance, individually or in any combination.

Childhood Onset Fluency Disorder (Stuttering)

Diagnostic Criterion: C

The onset of symptoms is in the early developmental period.

Childhood Onset Fluency Disorder (Stuttering)

Diagnostic Criterion: D

The disturbance is not attributable to a speech-motor or sensory deficit, dysfluency associated with neurological insult (e.g., stroke, tumor, trauma), or another medical condition and is not better explained by another mental disorder.

Childhood Onset Fluency Disorder (Stuttering)

Differential Diagnosis: sensory deficits

dysfluencies of speech may be associated with a hearing impairment or other sensory deficit or a speech-motor deficit. When the speech dysfluencies are in excess of those usually associated with these problems, this diagnosis may be made.

Childhood Onset Fluency Disorder (Stuttering)

Differential Diagnosis: normal speech dysfluencies

The disorder must be distinguishable from normal dysfluencies that occur frequently in young children, which include whole-word or phrase repetition, incomplete phrases, interjections, unfilled pauses, and parenthetical remarks.

Childhood Onset Fluency Disorder (Stuttering)

Differential Diagnosis: specific learning disorder, with impairment in reading

Children who have dysfluencies when they read aloud may be mistakenly diagnosed with a reading disorder. Oral reading fluency typically is measured by timed assessments. Slower reading rates may not accurately reflect the actual reading ability of children who stutter.

Childhood Onset Fluency Disorder (Stuttering)

Differential Diagnosis: bilingualism

There may be dysfluencies resulting from attempts to learn a new language. Dysfluencies that indicate a fluency disorder typically appear in both languages.

Childhood Onset Fluency Disorder (Stuttering)

Differential Diagnosis: medication side effects

Stuttering may occur as a side effect and may be detected by a temporal relationship with exposure to the medication.

Childhood Onset Fluency Disorder (Stuttering)

Differential Diagnosis: adult-onset dysfluencies

This is the diagnosis if the dysfluencies occur during or after adolescence.

Childhood Onset Fluency Disorder (Stuttering)

Differential Diagnosis: Tourette's disorder

These disorders should be distinguishable by their nature and timing.

Social (Pragmatic) Communication Disorder

Diagnostic Criterion: A

Persistent difficulties in the social use of verbal and nonverbal communication as manifested by all of the following:

1. Deficits in using communication for social purposes, such as greeting and sharing information, in a manner that is appropriate for the social context.

2. Impairment of the ability to change communication to match context or the needs of the listener, such as speaking differently in a classroom than on a playground, talking differently to a child than to an adult, and avoiding use of overly formal language.

3. Difficulties following rules for conversation and storytelling, such as taking turns in conversation, rephrasing when misunderstood, and knowing how to use verbal and nonverbal signals to regulate interaction.

4. Difficulties understanding what is not explicitly stated (e.g., making inferences) and nonliteral or ambiguous meanings of language (e.g., idioms, humor, metaphors, multiple meanings that depend on the context for interpretation).

Social (Pragmatic) Communication Disorder

Diagnostic Criterion: B

The deficits result in functional limitations in effective communication, social participation, social relationships, academic achievement, or occupational performance, individually or in combination.

Social (Pragmatic) Communication Disorder

Diagnostic Criterion: C

The onset of the symptoms is in the early developmental period (but deficits may not become fully manifest until social communication demands exceed limited capacities).

Social (Pragmatic) Communication Disorder

Diagnostic Criterion: D

The symptoms are not attributable to another medical or neurological condition or to low abilities in the domains of word structure and grammar, and are not better explained by autism, intellectual developmental disorder (intellectual disability), global developmental delay, or another mental disorder.

Social (Pragmatic) Communication Disorder

Differential Diagnosis: autism spectrum disorder

The two disorders can be differentiated by the presence in this disorder of restricted / repetitive patterns of behavior, interests, or activities and their absence of social (pragmatic) communication disorder. A comprehensive history should be obtained. A diagnosis of social (pragmatic) communication disorder should be considered only if the current symptoms or developmental history fails to reveal evidence of symptoms that meet the diagnostic criteria got restrictive / repetitive patterns of behaviors, interests, or activities of this disorder causing current impairment.

Social (Pragmatic) Communication Disorder

Differential Diagnosis: ADHD

Primary deficits of this disorder may cause impairments in social communication and functional limitations of effective communication, social participation, or academic achievement.

Social (Pragmatic) Communication Disorder

Differential Diagnosis: social anxiety disorder

The symptoms of social (pragmatic) communication disorder overlap with those of this disorder. The differentiating feature is the timing of the onset of symptoms. In social (pragmatic) communication disorder, the individual has never had effective social communication; in this disorder, the social communication skills developed appropriately but are not utilized because of anxiety, fear, or distress about social interactions.

Social (Pragmatic) Communication Disorder