Neurodevelopmental disorders

• Neurodevelopmental disorders


  • Typically manifest early in development, often before the child enters grade school
  • Characterized by developmental deficits that produce impairments of personal, social, academic, or occupational functioning
• Range of developmental deficits

  Specific limitations of learning or control of executive functions to global impairments of social skills or intelligence
• Neurodevelopmental disorders frequently co-occur
• Co-occurring disorders


  • Autism spectrum disorder often has intellectual disability
  • Many children with ADHD also have a specific learning disorder
• For some disorders, the clinical presentation includes symptoms of excess as well as deficits and delays in achieving expected milestones
• Autism spectrum disorder


  Diagnosed when the characteristic deficits of social communication are accompanied by excessively repetitive behaviors, restricted interests, and insistence on sameness
• Intellectual disability (intellectual developmental disorder)


  Characterized by deficits in general mental abilities, such as reasoning, problem solving, planning, abstract thinking, judgment, academic learning, and learning from experience
• Mental retardation is no longer used in DSM-5
• Deficits in intellectual disability

  Result in impairments of adaptive functioning, such that the individual fails to meet standards of personal independence and social responsibility in one or more aspects of daily life, including communication, social participation, academic or occupational functioning, and personal independence at home or in community settings
• Global developmental delay


  Diagnosed when an individual fails to meet expected developmental milestones in several areas of physical and cognitive functioning
• Global developmental delay is used for individuals who are unable to undergo systematic assessments of intellectual functioning, including children who are too young to participate in standardized testing
• Communication disorders


  • Language disorder
  • Speech sound disorder
  • Social (pragmatic) communication disorder
  • Childhood-onset fluency disorder (stuttering)
• Communication disorders


  Characterized by deficits in the development and use of language, speech, and social communication, respectively
• Childhood-onset fluency disorder


  Characterized by 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 of physical tension
• Communication disorders begin early in life and may produce lifelong functional impairments
• Autism spectrum disorder


  Characterized by persistent deficits in social communication and social interaction across multiple contexts, including deficits in social reciprocity, nonverbal communicative behaviors used for social interaction, and skills in developing, maintaining, and understanding relationships
• Diagnosis of autism spectrum disorder requires the presence of restricted, repetitive patterns of behavior, interests, or activities
• Specifiers for autism spectrum disorder


  With or without accompanying intellectual impairment; with or without accompanying structural language impairment; associated with a known medical/genetic or environmental/acquired condition; associated with another neurodevelopmental, mental, or behavioral disorder; age at first concern; with or without loss of established skills; severity
• Specifiers provide clinicians with an opportunity to individualize the diagnosis and communicate a richer clinical description of the affected individuals
• Many individuals previously diagnosed with Asperger's Disorder (DSM-4) would now receive a diagnosis of Autism Spectrum Disorder (DSM-5) without language or intellectual impairment
• Asperger's Disorder (DSM-4)


  Differs from Autistic Disorder in several ways: early cognitive and language skills are not delayed significantly; restricted, repetitive, and stereotyped interests and activities are primarily observed in the all-encompassing pursuit of a circumscribed interest; social interaction patterns may appear motivated but are highly eccentric, one-sided, verbose, and insensitive
• Asperger's Disorder must be differentiated from other Pervasive Developmental Disorders, such as Rett's Disorder which has a characteristic pattern of head growth deceleration, loss of previously acquired purposeful hand skills, and the appearance of poorly coordinated gait or trunk movements, and is associated with marked degrees of Mental Retardation and gross impairments in language and communication
• Specific learning disorder


  Diagnosed when there are specific deficits in an individual's ability to perceive or process information efficiently and accurately, first manifesting during the years of formal schooling and characterized by persistent and impairing difficulties with learning foundational academic skills in reading, writing, and/or math
• Specific learning disorder may occur in individuals identified as intellectually gifted and manifest only when the learning demands or assessment procedures pose barriers that cannot be overcome by their innate intelligence and compensatory strategies
• Specific learning disorder can produce lifelong impairments in activities dependent on the skills, including occupational performance
• Specifiers for neurodevelopmental disorders

  Describe the clinical course and current symptomatology, including age at onset, severity, and associated medical, genetic, or environmental factors
• Attention Deficit Hyperactivity Disorder (ADHD)

  A neurodevelopmental disorder defined by impairing levels of inattention, disorganization, and/or hyperactivity-impulsivity, which often persists into adulthood with resultant impairments of social, academic and occupational functioning
• Stereotypic Movement Disorder


  Diagnosed when an individual has repetitive, seemingly driven, and apparently purposeless motor behaviors that interfere with social, academic, or other activities, and may cause self-injury
• Tic disorders


  Characterized by the presence of motor or vocal tics, which are sudden, rapid, recurrent, nonrhythmic, stereotyped motor movements or vocalizations
• Tourette's disorder


  Diagnosed when the individual has multiple motor and vocal tics that have been present for at least 1 year and that have a waxing-waning symptom course