Neurodevelopmental and Intellectual Disorders
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Neurodevelopmental and Intellectual Disorders

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Questions and Answers

Which of the following is classified as a disorder related to cocaine use?

  • Intermittent explosive disorder
  • Cocaine-induced psychotic disorder (correct)
  • Encopresis
  • Female orgasmic disorder

    • What is an example of a disorder that results from inhalant use?

  • Dependent personality disorder
  • Mild neurocognitive disorder due to Alzheimer's disease
  • Crossed cerebellar diaschisis
  • Inhalant-induced major neurocognitive disorder (correct)

    • Which of the following disorders is most directly related to sleep disturbances?

  • Excoriation disorder
  • Kleptomania
  • Narcolepsy (correct)
  • Conduct disorder

    • Which condition is associated with a medical condition affecting mental health?

    <p>Major depressive disorder</p> Signup and view all the answers

    Which of the following disorders is characterized by inappropriate sexual behavior?

    <p>Exhibitionistic disorder</p> Signup and view all the answers

    Which disorder includes symptoms such as persistent sleepiness or sudden episodes of sleep?

    <p>Narcolepsy</p> Signup and view all the answers

    What disorder is characterized by lack of impulse control leading to stealing?

    <p>Kleptomania</p> Signup and view all the answers

    Which of the following indicates a mental health condition related to trauma exposure?

    <p>Hallucinogen-induced anxiety disorder</p> Signup and view all the answers

    Which of the following disorders is classified under neurodevelopmental disorders?

    <p>Attention-deficit/hyperactivity disorder</p> Signup and view all the answers

    What type of disorder is characterized by impairment in impulse control?

    <p>Disruptive, impulse-control, and conduct disorder</p> Signup and view all the answers

    Which condition is NOT classified as a major neurocognitive disorder?

    <p>Bipolar and related disorder</p> Signup and view all the answers

    Which of the following terms encompasses disorders related to sleep disturbance?

    <p>Sleep-wake disorders</p> Signup and view all the answers

    Which disorder is specifically characterized by compulsive behaviors and obsessions?

    <p>Obsessive-compulsive and related disorder</p> Signup and view all the answers

    Which disorder primarily involves chronic and excessive sleepiness?

    <p>Hypersomnolence disorder</p> Signup and view all the answers

    What condition is associated with distress or dysfunction due to a mismatch between gender identity and assigned sex at birth?

    <p>Gender dysphoria</p> Signup and view all the answers

    Which of the following is NOT a characteristic of personality disorders?

    <p>Cognitive impairment due to substance use</p> Signup and view all the answers

    Which type of disorder can result from the use of hallucinogens?

    <p>Substance-induced psychotic disorder</p> Signup and view all the answers

    Which disorder is primarily linked to difficulty in emotional expressions and interpersonal functioning?

    <p>Personality disorder</p> Signup and view all the answers

    Which of the following is an example of a tic disorder?

    <p>Tourette's disorder</p> Signup and view all the answers

    What type of conditions involve direct effects of substances on mood and cognition?

    <p>Substance-related disorders</p> Signup and view all the answers

    Which group includes disorders characterized by disturbances in a person’s perception of reality?

    <p>Schizophrenia spectrum and other psychotic disorders</p> Signup and view all the answers

    What must be included for a diagnosis of intellectual developmental disorder (IDD)?

    <p>Deficits in intellectual functions confirmed by clinical assessment</p> Signup and view all the answers

    Which severity level of IDD indicates the least amount of cognitive impairment?

    <p>F70 Mild</p> Signup and view all the answers

    Which aspect is NOT a criterion for identifying intellectual developmental disorder?

    <p>Exemption from receiving support services</p> Signup and view all the answers

    How do individuals with mild IDD typically function compared to their peers?

    <p>Exhibit no conceptual differences</p> Signup and view all the answers

    Which disorder includes severity specifiers indicative of current symptomatology?

    <p>Specific learning disorder</p> Signup and view all the answers

    What characterizes neurodevelopmental disorders in early childhood?

    <p>Deficits in brain processes affecting functioning</p> Signup and view all the answers

    Which of the following disorders often co-occurs with autism spectrum disorder?

    <p>Intellectual developmental disorder</p> Signup and view all the answers

    What role do specifiers play in clinical documentation for autism spectrum disorder?

    <p>They indicate the presence of genetic factors</p> Signup and view all the answers

    What is a common support need for adults with severe IDD?

    <p>Assisting with daily physical care and health</p> Signup and view all the answers

    What is a significant feature of specific learning disorder?

    <p>Manifests during formal schooling only</p> Signup and view all the answers

    Which description accurately depicts individuals with severe cognitive impairments?

    <p>They exhibit marked differences in social behavior</p> Signup and view all the answers

    What key factor is required for the diagnosis of autism spectrum disorder?

    <p>Restricted patterns of behavior or interests</p> Signup and view all the answers

    What defines developmental coordination disorder?

    <p>Deficits in coordinated motor skills</p> Signup and view all the answers

    What is a common characteristic among individuals with profound IDD?

    <p>Dependency on others for daily physical care</p> Signup and view all the answers

    Which condition is characterized by disturbances in speech fluency?

    <p>Childhood-onset fluency disorder</p> Signup and view all the answers

    Which component is NOT typically assessed when diagnosing IDD?

    <p>Cultural factors</p> Signup and view all the answers

    What support might individuals with mild IDD need in adulthood?

    <p>Help with grocery shopping and transportation</p> Signup and view all the answers

    ADHD typically overlaps with which disorder?

    <p>Oppositional defiant disorder</p> Signup and view all the answers

    Which of the following is a defining characteristic of IDD?

    <p>Significant impairment in adaptive functioning</p> Signup and view all the answers

    What represents a significant impairment associated with intellectual developmental disorder?

    <p>Failure to meet personal independence standards</p> Signup and view all the answers

    In what way do individuals with moderate IDD engage socially?

    <p>They may understand social cues inaccurately</p> Signup and view all the answers

    Which disorder involves involuntary motor or vocal tics?

    <p>Tic disorders</p> Signup and view all the answers

    What type of disorder is characterized by deficits in verbal and nonverbal communication skills?

    <p>Social communication disorder</p> Signup and view all the answers

    Which phase term is associated with adverse discrimination and social exclusion?

    <p>Phase of life problem</p> Signup and view all the answers

    What is a major consequence of incarceration discussed in relation to psychological impact?

    <p>Challenges upon release from prison</p> Signup and view all the answers

    What condition can occur as a result of discontinuing antidepressant medication?

    <p>Antidepressant discontinuation syndrome</p> Signup and view all the answers

    What is not typically a problem faced by victims of abuse?

    <p>Educational success</p> Signup and view all the answers

    Which disorder is often co-occurring with intellectual developmental disorder in individuals with more severe forms?

    <p>Stereotypic movement disorder</p> Signup and view all the answers

    What is a key characteristic of language disorders in children?

    <p>Deficits in word recall and narrative ability</p> Signup and view all the answers

    Which of the following is not a common co-occurring mental disorder with intellectual developmental disorder?

    <p>Obsessive-compulsive disorder</p> Signup and view all the answers

    How does the AAIDD define intellectual disability?

    <p>As a multidimensional construct</p> Signup and view all the answers

    Which assessment modification is essential for individuals with autism when determining intellectual ability?

    <p>Making adjustments for behavioral deficits</p> Signup and view all the answers

    What distinguishes Unspecified Intellectual Developmental Disorder (F79) from other classifications?

    <p>It is reserved for individuals over age 5 with assessment difficulties</p> Signup and view all the answers

    Which of these is a common result of communication disorders over the lifespan?

    <p>Limited social participation</p> Signup and view all the answers

    Which symptom should warrant prompt diagnostic attention in individuals with intellectual developmental disorder?

    <p>Self-injurious behavior</p> Signup and view all the answers

    What can complicate assessments of intellectual abilities in individuals with autism spectrum disorder?

    <p>Behavior deficits</p> Signup and view all the answers

    What factor greatly affects children with receptive language impairments compared to those with expressive impairments?

    <p>Resistance to therapy</p> Signup and view all the answers

    What is a common health issue faced by individuals with intellectual developmental disorder compared to the general population?

    <p>Greater prevalence of undiagnosed conditions</p> Signup and view all the answers

    Which aspect is emphasized in the assessment of communication disorders?

    <p>The cultural context of language</p> Signup and view all the answers

    In which developmental period does the onset of symptoms for language disorders typically occur?

    <p>Early developmental period</p> Signup and view all the answers

    What main characteristic defines communication as mentioned in relation to disorders?

    <p>Influencing behavior or ideas of others</p> Signup and view all the answers

    What is the primary reason that individual cognitive profiles are favored over a single IQ score in understanding intellectual abilities?

    <p>Individual cognitive profiles provide a more comprehensive understanding.</p> Signup and view all the answers

    Which of the following best describes adaptive functioning in individuals with intellectual developmental disorder?

    <p>It assesses how well a person meets community standards in personal independence and social responsibility.</p> Signup and view all the answers

    What is the significance of Criterion C in the diagnosis of intellectual developmental disorder?

    <p>It indicates that deficits must be present during childhood or adolescence.</p> Signup and view all the answers

    How do co-occurring disorders impact the assessment of intellectual functioning?

    <p>They can lead to invalid scores due to communication or sensory impairments.</p> Signup and view all the answers

    What factor contributes to higher prevalence rates of intellectual developmental disorder in youth compared to adults?

    <p>Increased identification and diagnosis during developmental periods.</p> Signup and view all the answers

    Which of the following is NOT considered a domain of adaptive functioning?

    <p>Emotional intelligence</p> Signup and view all the answers

    What role does cultural sensitivity play in assessing intellectual developmental disorder?

    <p>It allows for an understanding of the individual’s background and community functioning.</p> Signup and view all the answers

    Which of the following conditions can lead to acquired forms of intellectual developmental disorder?

    <p>Head trauma or illnesses like meningitis.</p> Signup and view all the answers

    What is a common consequence for individuals with intellectual developmental disorder regarding social behavior?

    <p>Gullibility that may lead to exploitation by others.</p> Signup and view all the answers

    What is indicated by the prevalence rates of intellectual developmental disorder being roughly equal across different ethnoracial groups in the United States?

    <p>Diagnostic criteria are applied uniformly across groups.</p> Signup and view all the answers

    Which of the following evaluations are components of a comprehensive assessment for intellectual developmental disorder?

    <p>Genetic evaluation and physical examination.</p> Signup and view all the answers

    Which characteristic is often associated with genetic syndromes related to intellectual developmental disorder?

    <p>Specific physical appearance or behavioral phenotypes.</p> Signup and view all the answers

    What do deficits in adaptive functioning specifically refer to in the context of intellectual developmental disorder?

    <p>Problems in meeting community standards of independence.</p> Signup and view all the answers

    What term describes the presence of intellectual and adaptive deficits during childhood or adolescence for diagnosis?

    <p>Developmental Criterion</p> Signup and view all the answers

    What is the age range during which childhood-onset fluency disorder typically presents?

    <p>2 to 7 years</p> Signup and view all the answers

    Which of the following factors is not commonly associated with stuttering?

    <p>Emotional intelligence</p> Signup and view all the answers

    What percentage of children is expected to recover from childhood-onset fluency disorder according to longitudinal research?

    <p>65%-85%</p> Signup and view all the answers

    Which of the following is a primary diagnostic consideration when assessing social communication deficits?

    <p>Autism spectrum disorder</p> Signup and view all the answers

    What common feature does social (pragmatic) communication disorder share with other disorders?

    <p>Language impairment</p> Signup and view all the answers

    Which type of dysfluency may occur due to attempts to learn a new language?

    <p>Normal speech dysfluency</p> Signup and view all the answers

    What aspect of childhood-onset fluency disorder becomes noticeable as the child grows older?

    <p>Avoidance of public speaking</p> Signup and view all the answers

    Which condition typically has symptoms that are more pronounced in early adolescence due to social complexity?

    <p>Social (pragmatic) communication disorder</p> Signup and view all the answers

    Which is a common misconception regarding stuttering and social (pragmatic) communication disorder?

    <p>Stuttering is purely psychological.</p> Signup and view all the answers

    What might be a mistaken diagnosis for a child with reading difficulties who stutters?

    <p>Specific learning disorder</p> Signup and view all the answers

    What characteristic distinguishes childhood-onset fluency disorder from normal speech dysfluencies?

    <p>More frequent on meaningful words</p> Signup and view all the answers

    What can be a contributing factor leading to stuttering in children?

    <p>Heightened levels of stress and anxiety</p> Signup and view all the answers

    Which of the following is a commonly recognized risk factor for social (pragmatic) communication disorder?

    <p>Family history of communication disorders</p> Signup and view all the answers

    What is a common characteristic of speech sound disorders?

    <p>They interfere with speech comprehension or communication.</p> Signup and view all the answers

    Which of the following statements about language disorder is most accurate?

    <p>Language impairment is often the initial symptom of intellectual developmental disorder.</p> Signup and view all the answers

    Which of the following factors must be considered in the assessment of language development in bilingual children?

    <p>Regional, social, or cultural/ethnic variations of language.</p> Signup and view all the answers

    What is the primary reason for the need to exclude hearing impairment in the diagnosis of language difficulties?

    <p>Hearing impairment can lead to misdiagnosis of language disorders.</p> Signup and view all the answers

    In what way do autism spectrum disorder and language disorder differ notably?

    <p>Autism often includes additional behavioral symptoms not found in language disorder.</p> Signup and view all the answers

    What may be a symptom of seizures in relation to language development?

    <p>Sudden language loss.</p> Signup and view all the answers

    Which statement is true regarding the co-occurrence of language disorders and speech sound disorders?

    <p>Language disorders may accompany speech sound disorders, but rarely after age 6.</p> Signup and view all the answers

    What is a significant potential impact of Childhood-Onset Fluency Disorder (stuttering)?

    <p>It can create anxiety about speaking and limit social participation.</p> Signup and view all the answers

    Which of the following is NOT a characteristic of speech sound disorders?

    <p>Developmental coordination disorder is always present.</p> Signup and view all the answers

    What is an important aspect of diagnosing Childhood-Onset Fluency Disorder?

    <p>Eliminating all possible speech-motor deficits.</p> Signup and view all the answers

    Which factor is likely to exacerbate dysfluency in children with fluency disorder?

    <p>Increased stress and anxiety.</p> Signup and view all the answers

    What factor is crucial for the differential diagnosis of language disorders?

    <p>Recognizing variations in language use based on cultural/ethnic background.</p> Signup and view all the answers

    Males are reported to stutter more than females. What could be a reason for this?

    <p>Differences in neurological structure/function may exist.</p> Signup and view all the answers

    Which of the following is a potential indicator of a need for autism spectrum disorder assessment in young children?

    <p>Critical declines in communication behaviors.</p> Signup and view all the answers

    What is required for the diagnosis of autism spectrum disorder to be made when considering social communication deficits?

    <p>The social communication deficits must be clearly in excess of the intellectual limitations.</p> Signup and view all the answers

    Which of the following is NOT a criterion for diagnosing autism spectrum disorder?

    <p>Intellectual disability.</p> Signup and view all the answers

    Which severity level in autism spectrum disorder indicates substantial support is needed for marked social communication deficits?

    <p>Level 2</p> Signup and view all the answers

    What does the specifier 'without accompanying language impairment' indicate in the context of autism spectrum disorder?

    <p>The individual has normal language functioning despite social communication deficits.</p> Signup and view all the answers

    Which of the following is an example of a restricted, repetitive pattern of behavior as defined in autism spectrum disorder?

    <p>Insistence on sameness in routines.</p> Signup and view all the answers

    How are the severity specifiers for autism spectrum disorder intended to be used?

    <p>To describe current symptomatology and support needs.</p> Signup and view all the answers

    What does a diagnosis of social communication disorder imply when assessed in relation to autism spectrum disorder?

    <p>The individual has marked social communication deficits that do not meet criteria for autism spectrum disorder.</p> Signup and view all the answers

    Which of the following statements accurately reflects symptoms of autism spectrum disorder in relation to early development?

    <p>Symptoms may not become fully manifest until social demands exceed capacities.</p> Signup and view all the answers

    Which associated condition must be separately recorded when present alongside autism spectrum disorder?

    <p>Catatonia</p> Signup and view all the answers

    What is the key feature that differentiates autism spectrum disorder from other developmental disorders?

    <p>Persistent impairment in reciprocal social communication and interaction.</p> Signup and view all the answers

    When assessing the support needed for individuals with autism spectrum disorder, what should be considered?

    <p>The levels of social communication deficits and restricted behaviors.</p> Signup and view all the answers

    Which factor does NOT influence the manifestations of autism spectrum disorder in individuals?

    <p>Personal interests in art</p> Signup and view all the answers

    In the context of autism spectrum disorder, what is hyper-reactivity to sensory input categorized as?

    <p>A symptom of restricted behavior.</p> Signup and view all the answers

    What is the main reason why diagnosis of autism spectrum disorder is considered most valid and reliable?

    <p>It includes a comprehensive review of multiple sources of information.</p> Signup and view all the answers

    Which statement correctly describes the deficits in social-emotional reciprocity in young children with autism?

    <p>They may show reduced or absent imitation of others' behavior.</p> Signup and view all the answers

    Which of the following criteria defines difficulties related to social-emotional reciprocity in autism spectrum disorder?

    <p>Limited ability to recognize or respond to emotional cues in others.</p> Signup and view all the answers

    What role do known genetic or medical conditions play in assessing autism spectrum disorder?

    <p>They can give context but do not guarantee diagnosis.</p> Signup and view all the answers

    In autism spectrum disorder, restricted patterns of behavior are NOT characterized by which of the following?

    <p>Highly varied interests</p> Signup and view all the answers

    What is a common misconception about the diagnosis of autism spectrum disorder?

    <p>Symptoms only need to be present during childhood.</p> Signup and view all the answers

    Which of these is a poor indicator of autism spectrum disorder onset?

    <p>Improvements in play skills</p> Signup and view all the answers

    What common symptom is NOT typically associated with autism spectrum disorder?

    <p>High social-emotional reciprocity</p> Signup and view all the answers

    What demographic factor shows a discrepancy in the prevalence of autism spectrum disorder?

    <p>Gender</p> Signup and view all the answers

    Which aspect of autism spectrum disorder if present, might indicate an individual's ability to mask difficulties?

    <p>High verbal fluency</p> Signup and view all the answers

    Which of the following statements about restricted interests in autism is inaccurate?

    <p>Normal variations in interest are often reported.</p> Signup and view all the answers

    Which statement about the impact of treatment history on social communication deficits is correct?

    <p>It influences the manifestation of deficits based on current support.</p> Signup and view all the answers

    Which symptom is indicative of rigid thinking patterns in individuals with autism?

    <p>Distress at small changes</p> Signup and view all the answers

    Which of the following statements regarding the assessment tools for autism is correct?

    <p>They ensure consistency over time across different clinicians.</p> Signup and view all the answers

    What is a common early symptom of autism spectrum disorder in young children?

    <p>Delayed language development</p> Signup and view all the answers

    Which factor is considered most significant in predicting individual outcomes in autism spectrum disorder?

    <p>Presence of language impairment</p> Signup and view all the answers

    What observation is often made regarding the diagnosis of autism spectrum disorder in females compared to males?

    <p>Females have better reciprocal conversation skills.</p> Signup and view all the answers

    What is a characteristic of individuals with autism spectrum disorder during adulthood?

    <p>Difficulty establishing independence</p> Signup and view all the answers

    Which of the following is associated with a higher risk of premature mortality in individuals with autism spectrum disorder?

    <p>Comorbid chronic medical conditions</p> Signup and view all the answers

    When diagnosing autism spectrum disorder in adulthood, what factor may complicate the process?

    <p>Need for detailed developmental history</p> Signup and view all the answers

    In contexts of autism spectrum disorder, social communication deficits are often influenced by which of the following?

    <p>Cultural norms for social interaction</p> Signup and view all the answers

    What term describes the behaviors that are specifically associated with the engagement and interests of individuals with autism spectrum disorder?

    <p>Restricted and repetitive behaviors</p> Signup and view all the answers

    How does participation in vocational rehabilitation affect transition-age youth with autism spectrum disorder?

    <p>Improves competitive employment outcomes</p> Signup and view all the answers

    Which of the following statements reflects a misconception about autism spectrum disorder?

    <p>Autism spectrum disorder is a degenerative disorder.</p> Signup and view all the answers

    Which group is described as having more frequently delayed diagnoses of autism spectrum disorder?

    <p>Socially oppressed ethnic and racialized children</p> Signup and view all the answers

    What type of additional disorder is closely associated with individuals who have autism spectrum disorder?

    <p>Attention-Deficit/Hyperactivity Disorder (ADHD)</p> Signup and view all the answers

    In the context of autism spectrum disorder, what role do compensation strategies play in adulthood?

    <p>They increase stress due to maintaining an image.</p> Signup and view all the answers

    Which condition distinguishes itself from ADHD by exhibiting serious aggression towards others?

    <p>Intermittent Explosive Disorder</p> Signup and view all the answers

    What symptom is commonly mistaken for inattention in children with Specific Learning Disorder?

    <p>Frustration and Lack of Interest</p> Signup and view all the answers

    Which disorder can have similar symptoms of social dysfunction as seen in ADHD but is marked by distinct features like social disengagement?

    <p>Autism Spectrum Disorder</p> Signup and view all the answers

    Which feature is NOT essential in diagnosing Disruptive Mood Dysregulation Disorder compared to ADHD?

    <p>Disorganized Attention</p> Signup and view all the answers

    In relation to ADHD, which factor is used to differentiate it from PTSD in children?

    <p>Detailed Trauma History</p> Signup and view all the answers

    Which condition is characterized by impulsivity that might be confused with ADHD, but features episodic symptoms?

    <p>Bipolar Disorder</p> Signup and view all the answers

    Individuals with which disorder may display behaviors that overlap with ADHD symptoms but are distinct in their cognitive challenges?

    <p>Specific Learning Disorder</p> Signup and view all the answers

    The impulsive behaviors seen in ADHD can overlap with certain behaviors in which of the following personality disorders?

    <p>Borderline Personality Disorder</p> Signup and view all the answers

    What cognitive domain impairment may be affected in neurocognitive disorders that is also relevant to ADHD diagnosis?

    <p>Complex Attention</p> Signup and view all the answers

    Which of the following is NOT a common condition misdiagnosed alongside ADHD?

    <p>Chronic Health Conditions</p> Signup and view all the answers

    Comorbidity in ADHD is commonly observed with which of the following disorders in females?

    <p>Oppositional Defiant Disorder</p> Signup and view all the answers

    What key behavior is observed in children with ADHD that can also be confused with Tourette's Disorder?

    <p>Fidgetiness</p> Signup and view all the answers

    The inability to concentrate seen in depressive disorders primarily occurs during which state?

    <p>Depressive Episode</p> Signup and view all the answers

    What must be present for a proper diagnosis of ADHD?

    <p>Symptoms must be present in at least one setting.</p> Signup and view all the answers

    Which of the following is least likely to be considered a symptom of hyperactivity in adults?

    <p>Severe impulsivity</p> Signup and view all the answers

    What is the approximate heritability percentage of ADHD?

    <p>74%</p> Signup and view all the answers

    Which factor is NOT associated with the greater risk of developing ADHD?

    <p>High birth weight</p> Signup and view all the answers

    In what circumstances could ADHD symptoms appear after the age of 12?

    <p>They may indicate another disorder or substance use effects.</p> Signup and view all the answers

    Which of the following is NOT a common characteristic of individuals diagnosed with ADHD?

    <p>Increased social skills</p> Signup and view all the answers

    What is a common reason for the variability in ADHD prevalence across different regions?

    <p>Cultural interpretations of behavioral norms</p> Signup and view all the answers

    What is a significant feature associated with severe ADHD?

    <p>Severe issues in social and familial adjustments</p> Signup and view all the answers

    Which of the following factors does NOT influence the symptoms of ADHD?

    <p>Environmental cleanliness</p> Signup and view all the answers

    What symptom is commonly associated with ADHD that may negatively affect academic performance?

    <p>Difficulty following instructions</p> Signup and view all the answers

    What ratio reflects the prevalence of ADHD between males and females in children?

    <p>2:1</p> Signup and view all the answers

    What could be an outcome in children with ADHD if their symptoms lead to conduct disorder?

    <p>Increased risk of antisocial personality disorder in adulthood</p> Signup and view all the answers

    Which of the following is an unreliable indicator for diagnosing adult ADHD?

    <p>Adult self-reports of childhood symptoms</p> Signup and view all the answers

    What aspect of ADHD is specifically associated with higher prevalence in special populations?

    <p>Lower rates of diagnostic evaluation</p> Signup and view all the answers

    What distinguishes autism spectrum disorder from intellectual developmental disorder?

    <p>Presence of social withdrawal and repetitive behaviors</p> Signup and view all the answers

    When is a diagnosis of intellectual developmental disorder appropriate instead of autism spectrum disorder?

    <p>When there is no discrepancy in social communicative skills</p> Signup and view all the answers

    Which anxiety disorder is most commonly observed among individuals with autism spectrum disorder?

    <p>Social anxiety and agoraphobia</p> Signup and view all the answers

    What symptom overlap complicates the classification of anxiety disorders in autism spectrum disorder?

    <p>Repetitive behaviors and social withdrawal</p> Signup and view all the answers

    What is the significance of early developmental course in distinguishing autism spectrum disorder from personality disorders?

    <p>Normal early development is typical in personality disorders</p> Signup and view all the answers

    Which factor is necessary for the diagnosis of ADHD in individuals aged 17 or older?

    <p>Five symptoms of inattention</p> Signup and view all the answers

    Which criterion must be met for diagnosing ADHD’s combined presentation?

    <p>Presence of both inattention and hyperactivity</p> Signup and view all the answers

    In which instance would a diagnosis of selective mutism be applicable?

    <p>The child demonstrates communication in most settings</p> Signup and view all the answers

    How many symptoms are necessary for a diagnosis of ADHD for children under the age of 12?

    <p>Six symptoms of inattention</p> Signup and view all the answers

    What is considered a defining feature shared by obsessive-compulsive disorder and schizophrenia in relation to behavior?

    <p>Repetitive behavior</p> Signup and view all the answers

    Which presenting feature is commonly associated with autism spectrum disorder?

    <p>Avoidant/restrictive food intake disorder</p> Signup and view all the answers

    What is the current classification of symptoms severity in ADHD?

    <p>Mild, moderate, and severe</p> Signup and view all the answers

    What characterizes a diagnosis of both autism spectrum disorder and schizophrenia?

    <p>Overlapping traits requiring dual diagnosis</p> Signup and view all the answers

    What combination of factors is indicated to predict literacy problems in offspring?

    <p>Family history of reading difficulties and parental literacy skills</p> Signup and view all the answers

    Which risk factor is associated with specific learning disorder?

    <p>Very low birthweight</p> Signup and view all the answers

    What factor is NOT associated with an increased risk of suicidal behavior among adolescents with specific learning disorder?

    <p>Experience of consistent academic success</p> Signup and view all the answers

    Which statement accurately reflects the prevalence of specific learning disorder?

    <p>It shows consistency in prevalence across various linguistic and cultural backgrounds.</p> Signup and view all the answers

    What is a significant predictor of later difficulties in reading and mathematics for preschoolers?

    <p>Marked problems with inattentive and externalizing behaviors</p> Signup and view all the answers

    Which of the following factors is NOT typically considered in assessing specific learning disorder?

    <p>Presence of intuitive guessing strategies</p> Signup and view all the answers

    What is a main consequence of inadequately addressing specific learning disorders across the lifespan?

    <p>Higher rates of unemployment and lower income</p> Signup and view all the answers

    Which factor is NOT associated with the manifestation of dyslexia?

    <p>Socioeconomic status</p> Signup and view all the answers

    What aspect makes differential diagnosis of specific learning disorder difficult?

    <p>Presence of comorbid neurodevelopmental disorders</p> Signup and view all the answers

    Which of the following associations is accurate regarding ADHD and specific learning disorder?

    <p>Comorbidity with ADHD predicts worse mental health outcomes.</p> Signup and view all the answers

    Which of the following is a common manifestation of specific learning disorder?

    <p>Difficulty reading words accurately or quickly</p> Signup and view all the answers

    What is a requirement for diagnosing specific learning disorder?

    <p>Observable difficulties in academic performance over time</p> Signup and view all the answers

    Which statement best describes the nature of specific learning difficulties?

    <p>They have a biological origin affecting information processing.</p> Signup and view all the answers

    How are learning difficulties characterized in terms of their impact on daily life?

    <p>They substantially interfere with academic performance or daily activities.</p> Signup and view all the answers

    What distinguishes mild learning difficulties from moderate or severe ones?

    <p>Mild difficulties may be compensated with appropriate support.</p> Signup and view all the answers

    In which academic area might an individual with specific learning disorder show deficits?

    <p>Comprehension and reading fluency</p> Signup and view all the answers

    What defines persistence in learning difficulties as required for diagnosis?

    <p>Restricted progress in learning for at least 6 months</p> Signup and view all the answers

    What type of evidence can help confirm specific learning disorders?

    <p>Collection of standardized test scores showing low achievement</p> Signup and view all the answers

    Which of the following defines a key characteristic of dyslexia?

    <p>Struggles in linking letters with their corresponding sounds</p> Signup and view all the answers

    Which condition must be ruled out for accurate diagnosis of specific learning disorder?

    <p>Vision impairment</p> Signup and view all the answers

    What is one characteristic of the academic skills affected by specific learning disorders?

    <p>They require explicit teaching and learning.</p> Signup and view all the answers

    Which outcome is most likely for individuals with severe specific learning disorder?

    <p>Need for intensive specialized teaching to become proficient</p> Signup and view all the answers

    What may cause learning difficulties to become fully manifest later in school years?

    <p>Increasing academic demands exceeding capabilities</p> Signup and view all the answers

    How does specific learning disorder markedly differ from intellectual disabilities?

    <p>It does not involve overall cognitive functioning deficits.</p> Signup and view all the answers

    What may delay the diagnosis of specific learning disorder?

    <p>Failure to demonstrate academic difficulties by formal schooling age</p> Signup and view all the answers

    Which cognitive deficits are commonly associated with specific learning disorders?

    <p>Deficits in cognitive processing required for reading and math</p> Signup and view all the answers

    Which symptom is least likely to be observed in preschool-age children with specific learning disorder?

    <p>Excellent motor skill coordination</p> Signup and view all the answers

    What may contribute to the co-occurring symptoms of specific learning disorder?

    <p>Genetic differences and cognitive processing deficits</p> Signup and view all the answers

    How does specific learning disorder typically manifest in elementary school-age children?

    <p>Difficulty with fluent word decoding and math facts</p> Signup and view all the answers

    What is a common behavioral manifestation of specific learning disorder in children?

    <p>Oppositional behavior toward academic activities</p> Signup and view all the answers

    Which factor is least likely to increase the risk of specific learning disorder?

    <p>Strong mathematical skills in early childhood</p> Signup and view all the answers

    What aspect of specific learning disorder symptoms typically changes with age?

    <p>The persistence or shifting of learning difficulties</p> Signup and view all the answers

    Which statement accurately reflects the nature of specific learning disorder?

    <p>It is a lifelong condition with variable courses of expression.</p> Signup and view all the answers

    Which population percentage is reported to be affected by specific learning disorder?

    <p>5%-15%</p> Signup and view all the answers

    What is a common academic difficulty faced by adults with specific learning disorder?

    <p>Inability to make inferences from written text</p> Signup and view all the answers

    What is NOT a typical early childhood predictor of specific learning disorder?

    <p>Ability to recognize letters</p> Signup and view all the answers

    What is a shared cognitive deficit across different specific learning disorder subtypes?

    <p>Difficulties in phonemic awareness</p> Signup and view all the answers

    What does the variability in the expression of specific learning disorder indicate?

    <p>Influence of environmental and individual factors</p> Signup and view all the answers

    Which of the following is NOT a criterion for diagnosing developmental coordination disorder?

    <p>Motor skills deficits explained by neurological conditions</p> Signup and view all the answers

    What is a common manifestation of developmental coordination disorder in young children?

    <p>Choreiform movements of unsupported limbs</p> Signup and view all the answers

    What characteristic differentiates developmental coordination disorder from other motor skill impairments?

    <p>Significant impact on daily activities</p> Signup and view all the answers

    Which age group is most commonly assessed for developmental coordination disorder prevalence?

    <p>Children aged 5-11 years</p> Signup and view all the answers

    What role do standardized tests play in diagnosing developmental coordination disorder?

    <p>Providing culturally appropriate evaluations</p> Signup and view all the answers

    What percentage of children with developmental coordination disorder is estimated to continue having coordinated movement problems into adolescence?

    <p>50%-70%</p> Signup and view all the answers

    Which of the following activities is commonly affected by developmental coordination disorder?

    <p>Using age-appropriate utensils during meals</p> Signup and view all the answers

    What is a common misconception about the motor deficits associated with developmental coordination disorder?

    <p>They are caused by neurological abnormalities</p> Signup and view all the answers

    Which of the following best describes unspecified tic disorders?

    <p>They apply to tic symptoms that lead to significant impairment in functioning.</p> Signup and view all the answers

    What distinguishes other specified neurodevelopmental disorder from unspecified neurodevelopmental disorder?

    <p>Other specified neurodevelopmental disorder identifies the specific reason for not meeting full criteria.</p> Signup and view all the answers

    Which statement accurately reflects the potential comorbidities associated with tic disorders?

    <p>Tic disorders are associated with an increased risk for mood, anxiety, or substance use disorders.</p> Signup and view all the answers

    What is a defining feature of neurodevelopmental disorder associated with prenatal alcohol exposure?

    <p>It leads to a range of developmental disabilities following exposure to alcohol in utero.</p> Signup and view all the answers

    Under what circumstances would a clinician utilize the unspecified neurodevelopmental disorder classification?

    <p>When a clear diagnosis of a specific neurodevelopmental disorder cannot be established but functioning is impaired.</p> Signup and view all the answers

    At what age is the first onset of tics typically noted?

    <p>4 to 6 years</p> Signup and view all the answers

    Which condition is less commonly associated with tic disorders in individuals as they transition to adulthood?

    <p>Learning disabilities</p> Signup and view all the answers

    What precedes the occurrence of a tic for many individuals?

    <p>Premonitory urge</p> Signup and view all the answers

    What is the heritability percentage range estimated for tic disorders?

    <p>70%–85%</p> Signup and view all the answers

    What are typical behaviors associated with co-occurring attention-deficit/hyperactivity disorder (ADHD) in children with tic disorders?

    <p>Disruptive behavior</p> Signup and view all the answers

    Which of the following is a characteristic symptom of Tourette's disorder in children?

    <p>Sudden jerks or twitches</p> Signup and view all the answers

    Which type of involuntary movements can commonly co-occur with tic disorders?

    <p>Dystonia</p> Signup and view all the answers

    Which environmental risk factor is associated with the development of tic disorders?

    <p>Pre-perinatal events</p> Signup and view all the answers

    What term describes the repetitive, purposeful movements that characterize motor stereotypies?

    <p>Motor stereotypies</p> Signup and view all the answers

    How do tic symptoms generally change over the lifespan?

    <p>They wax and wane in severity</p> Signup and view all the answers

    Which psychological condition is most commonly associated with tic disorders during prepubertal development?

    <p>Obsessive-compulsive disorder (OCD)</p> Signup and view all the answers

    What type of movements characterize functional tic disorder?

    <p>Dystonic or choreoathetoid movements</p> Signup and view all the answers

    What is a significant impact of severe tic symptoms on daily life?

    <p>Social isolation and interpersonal conflict</p> Signup and view all the answers

    What is the typical initial sign of developmental coordination disorder in early childhood?

    <p>Difficulty holding a knife and fork</p> Signup and view all the answers

    Which aspect of developmental coordination disorder might worsen due to co-occurring conditions?

    <p>Physical fitness and activity levels</p> Signup and view all the answers

    Which statement accurately reflects the potential impact of cultural differences on developmental coordination disorder?

    <p>Cultural context can obscure the diagnosis of the disorder.</p> Signup and view all the answers

    How might stereotypic movement disorder be manifested in children?

    <p>Performing self-injurious behaviors consistently</p> Signup and view all the answers

    What is an example of a non-self-injurious stereotypic movement?

    <p>Body rocking</p> Signup and view all the answers

    What might be a common challenge for individuals with developmental coordination disorder in adulthood?

    <p>Learning driving regulations and skills</p> Signup and view all the answers

    Which neurological implication is associated with developmental coordination disorder?

    <p>Impairment in cerebral functioning</p> Signup and view all the answers

    Which term describes the condition characterized by repetitive, purposeless motor behavior?

    <p>Stereotypic movement disorder</p> Signup and view all the answers

    What distinguishes the severity of symptoms in stereotypic movement disorder?

    <p>Presence of self-injurious behaviors</p> Signup and view all the answers

    Which of the following conditions may commonly co-occur with developmental coordination disorder?

    <p>Communication disorders</p> Signup and view all the answers

    Which observation might suggest that a child's motor issues are due to developmental coordination disorder rather than distractibility?

    <p>Poor motor competence across various contexts</p> Signup and view all the answers

    How does the frequency of stereotypic movements typically change in normally developing children?

    <p>Diminishes over time</p> Signup and view all the answers

    Which factor can complicate the diagnosis of developmental coordination disorder?

    <p>Cultural practices and environmental factors</p> Signup and view all the answers

    What is a key difference between stereotypic movement disorder and autism spectrum disorder?

    <p>Stereotypic movement disorder is characterized by the absence of self-injury.</p> Signup and view all the answers

    What distinguishes tics from stereotypic movements?

    <p>Tics experience fluctuations in severity and location.</p> Signup and view all the answers

    Which of the following best describes the onset of stereotypies compared to tics?

    <p>Stereotypies have an earlier age at onset than tics.</p> Signup and view all the answers

    Which of the following is a common comorbidity in children with chronic motor stereotypies?

    <p>Anxiety</p> Signup and view all the answers

    How does the nature of repetitive behaviors differ in OCD compared to stereotypic movement disorder?

    <p>OCD behaviors involve strict adherence to rules.</p> Signup and view all the answers

    What distinguishes Tourette's disorder from other tic disorders?

    <p>It requires the coexistence of both motor and vocal tics.</p> Signup and view all the answers

    What characteristic is common in individuals with stereotypic movement disorder?

    <p>Stereotypic movements tend to be ego-syntonic.</p> Signup and view all the answers

    Which aspect is NOT a characteristic of tic disorders?

    <p>Tics are always present without any tic-free intervals.</p> Signup and view all the answers

    Which feature is essential for diagnosing Tourette's disorder?

    <p>Presence of at least one vocal tic.</p> Signup and view all the answers

    What type of movement is characterized as complex motor tics?

    <p>Simultaneous head movement and shoulder shrugging.</p> Signup and view all the answers

    Which of the following best correlates with social interaction deficits in stereotypic movement disorder?

    <p>There are generally no deficits in social communication.</p> Signup and view all the answers

    What is an example of a painful medical condition that may lead to self-injurious behaviors in individuals?

    <p>Middle ear infections</p> Signup and view all the answers

    How does cultural attitude affect the diagnosis of stereotypic movement disorders?

    <p>Cultural variations can cause delayed recognition.</p> Signup and view all the answers

    Which age group is most likely to exhibit simple stereotypic movements?

    <p>Infants and early childhood</p> Signup and view all the answers

    What is a notable feature of complex tics as compared to simple tics?

    <p>They are longer in duration and can appear purposeful.</p> Signup and view all the answers

    Study Notes

    Neurodevelopmental Disorders

    • Neurodevelopmental disorders manifest early in childhood, often before school entry.
    • These disorders are characterized by developmental deficits or differences in brain processes that lead to impairments in personal, social, academic, or occupational functioning.
    • Diagnosis requires the presence of both symptoms and impaired function.
    • Neurodevelopmental disorders often co-occur with each other, such as autism spectrum disorder with intellectual developmental disorder, and ADHD with specific learning disorder.

    Intellectual Developmental Disorder (IDD)

    • IDD involves deficits in intellectual functions and adaptive functioning in conceptual, social, and practical domains.
    • The term "IDD" aligns with the WHO ICD-11 classification system, while "intellectual disability" remains in use.
    • Severity levels for IDD are Mild, Moderate, Severe, and Profound.

    Mild IDD

    • Individuals may display age-appropriate conceptual differences but struggle with academic skills, abstract thinking, executive function, short-term memory, and the functional use of academic skills.
    • They may have difficulty regulating emotions and behaviors, limited understanding of risk in social situations, and gullibility in personal care.
    • Support is often needed for tasks like grocery shopping, transportation, home and child-care organization, nutritious food preparation, banking, and money management.
    • Competitive employment may be possible in non-conceptual skill-intensive roles, but they require support for healthcare and legal decision-making.
    • Support is typically needed to raise a family.

    Severe IDD

    • Individuals often show marked differences in social and communicative behavior compared to their peers.
    • Spoken language is less complex than that of peers, but they form relationships with family and friends.
    • They may struggle with perceiving and interpreting social cues, and social judgment and decision-making abilities are limited.
    • They can care for personal needs like eating, dressing, elimination, and hygiene as adults, but require extensive teaching and time for independence.
    • Participation in all household tasks can be achieved by adulthood, but ongoing support is needed to manage social expectations, job complexities, and ancillary responsibilities.
    • Recreational skills can be developed, but typically require additional supports and learning opportunities.
    • Maladaptive behavior is present in a significant minority, causing social problems.

    Profound IDD

    • Individuals generally have limited understanding of written language or concepts involving numbers, quantity, time, and spoken language.

    • They require extensive support for daily living activities, including meals, dressing, bathing, and elimination.

    • Relationships with family members and familiar others are sources of pleasure and help.

    • They cannot make responsible decisions regarding their own or others' well-being.

    • Participation in tasks at home, recreation, and work requires ongoing support and assistance.

    • Co-occurring motor and sensory impairments may prevent functional use of objects, and individuals are dependent on others for daily physical care, health, and safety.

    • IDD is defined by deficits in general mental abilities (Criterion A) and impairment in everyday adaptive functioning compared to age-, gender-, and socioculturally matched peers (Criterion B).

    • Diagnosis is based on:

      • Clinical assessment and standardized testing of intellectual functions
      • Standardized neuropsychological tests
      • Standardized tests of adaptive functioning

    • Criterion A refers to intellectual functions that involve reasoning, problem-solving, planning, abstract thinking, judgment, learning from instruction and experience, and practical understanding.

    • Critical components of intellectual functions include:

      • Verbal comprehension
      • Working memory
      • Perceptual reasoning
      • Quantitative reasoning
      • Abstract thought
      • Cognitive efficacy

    Intellectual Developmental Disorder (IDD)

    • Measured by individually administered, psychometrically valid intelligence tests
    • Scores two standard deviations below the population mean, accounting for measurement error
    • Brief screening tests or group tests can provide invalid scores
    • Discrepant individual subtest scores can also make an overall IQ score invalid
    • Instruments must be normated for the individual's cultural background and language
    • Co-occurring disorders impacting communication, language, or motor/sensory function can affect test scores
    • Neuropsychological testing provides a more comprehensive understanding of intellectual abilities than a single IQ score
    • Deficits in adaptive functioning refer to how well a person meets community standards of personal independence and social responsibility
    • Adaptive functioning involves conceptual, social, and practical reasoning
    • Impairment in at least one adaptive functioning domain requires ongoing support for adequate performance across various environments
    • Onset must occur during childhood or adolescence
    • Comprehensive evaluation includes assessment of intellectual capacity, adaptive functioning, identification of etiologies, evaluation for associated medical conditions, and evaluation for co-occurring mental, emotional, and behavioral disorders
    • Components of the evaluation include pre- and perinatal medical history, family pedigree, physical examination, genetic evaluation, metabolic screening, and neuroimaging assessment
    • IDD is a complex condition with multiple causes, including difficulties with social judgment, risk assessment, self-management, and motivation
    • It can lead to increased accidental injury rates, disruptive behaviors, gullibility, exploitation, and potential victimization
    • Prevalence is approximately 10 per 1,000, varying by country and age
    • In the United States, prevalence does not significantly vary by ethnoracial groups
    • Etiology and severity determine the onset, with more severe disorders often presenting within the first two years of life
    • All criteria, including onset, must be fulfilled by history or current presentation
    • When associated with a genetic syndrome, there may be characteristic physical appearance or behavioral phenotype
    • Acquired forms can have abrupt onset following illness or head trauma during development
    • If resulting from a loss of previously acquired skills, both IDD and neurocognitive disorder diagnoses may be assigned
    • IDD is generally lifelong, although severity levels may change over time
    • Course may be influenced by underlying medical or genetic conditions and co-occurring conditions
    • Early interventions can improve adaptive functioning and in some cases, may lead to significant improvement in intellectual functioning, rendering IDD diagnosis no longer appropriate
    • Risk and prognostic factors include genetic and physiological factors, prenatal etiologies, inborn errors of metabolism, brain malformations, maternal disease, and environmental influences
    • Cultural sensitivity is crucial, considering socioeconomic, ethnic, cultural, and linguistic background and available experiences
    • Sex- and gender-related diagnostic issues influence prevalence, with males more likely to be diagnosed with both mild and severe forms
    • IDD can be associated with suicidal thoughts or behavior
    • Major neurocognitive disorder may co-occur with IDD, such as an individual with Down syndrome developing Alzheimer's disease
    • IDD is common among individuals with autism spectrum disorder, and assessment may be complicated by social-communication and behavior deficits
    • Co-occurring neurodevelopmental and other mental and medical conditions are frequent in IDD, with rates being three to four times higher than the general population
    • Prognosis and outcome of co-occurring diagnoses may be influenced by the presence of IDD
    • Assessment procedures may require modifications due to associated disorders
    • The most common co-occurring neurodevelopmental and other mental disorders are attention-deficit/hyperactivity disorder, depressive and bipolar disorders, anxiety disorders, autism spectrum disorder, stereotypic movement disorder, impulse-control disorders, and major neurocognitive disorder
    • Individuals with IDD may exhibit aggression and disruptive behaviors, including harm of others or property destruction
    • Individuals with IDD disproportionately have more health problems, including obesity, and often cannot verbalize their physical symptoms

    Global Developmental Delay (F88)

    • Used for individuals under the age of 5 when severity cannot be reliably assessed during early childhood

    Unspecified Intellectual Developmental Disorder (F79)

    • Used for individuals over the age of 5 when assessment is difficult or impossible due to associated sensory or physical impairments or severe problem behaviors

    Communication Disorders

    • Involve deficits in language, speech, and communication
    • Assessments must consider the individual's cultural and language context
    • Persistent difficulties in language acquisition and use across modalities due to deficits in comprehension or production, including reduced vocabulary, limited sentence structure, and impairments in discourse
    • Language abilities significantly below those expected for age, resulting in functional limitations
    • Onset usually occurs in the early developmental period and is not attributable to hearing or other sensory impairment, motor dysfunction, or another medical or neurological condition
    • Language disorder usually affects vocabulary and grammar, limiting the capacity for discourse
    • Children may exhibit word-finding problems, impoverished verbal definitions, or poor understanding of synonyms
    • Difficulties remembering new words and sentences are manifested by difficulties following instructions, rehearsing verbal information, and remembering sound sequences
    • Difficulties with discourse are shown by a reduced ability to provide adequate information and narrate coherently
    • Diagnosis is made based on the synthesis of the individual's history, direct clinical observation, and standardized test scores
    • Language acquisition is a complex process with language disorders emerging during the early developmental period
    • These disorders can have social consequences across the lifespan, with children at risk for peer victimization and sexual assault in adulthood
    • Children with receptive language impairments have a poorer prognosis and are more resistant to treatment
    • Bilingual children may demonstrate delays or differences in language development, and assessment across both languages is important
    • Language disorders are highly heritable, with family members more likely to have a history of language impairment
    • Differential diagnosis may be difficult before age 4 years
    • Hearing impairment needs to be excluded as the primary cause of language difficulties
    • Language impairment is often the presenting feature of intellectual developmental disorder
    • Language disorder can occur with varying degrees of intellectual ability and a discrepancy between verbal and nonverbal ability is not necessary
    • Autism spectrum disorder frequently manifests with delayed language development, often accompanied by behaviors not present in language disorder
    • Language loss may be a symptom of seizures
    • Declines in social and communication behaviors during the first two years of life are evident in most children with autism spectrum disorder
    • Language disorder may be associated with specific learning disorder, intellectual developmental disorder, attention deficit/hyperactivity disorder, autism spectrum disorder, and developmental coordination disorder

    Speech Sound Disorder

    • Characterized by persistent difficulty with speech sound production that interferes with speech comprehension or prevents verbal communication
    • Can cause limitations in effective communication, interfering with social participation, academic achievement, or occupational performance
    • Symptoms usually begin in the early developmental period and are not due 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 production involves clear articulation of phonemes, requiring both phonological knowledge and coordination of articulator movements
    • Children may experience difficulties with phonological knowledge of speech sounds, the ability to coordinate movements for speech, or both
    • Diagnosed when speech sound production is not what would be expected based on the child's age and developmental stage and when the deficits are not the result of physical, structural, neurological, or hearing impairment
    • Language disorders may co-occur with speech sound disorders, although cooccurrences are rare by age 6 years
    • A positive family history of speech or language disorders is often present
    • If rapid coordination of the articulators is difficult, there may be a history of delay or incoordination in acquiring skills that utilize the articulators, such as chewing, maintaining mouth closure, and blowing the nose
    • Other areas of motor coordination may be impaired, as in developmental coordination disorder
    • Children with speech sound disorder continue to use developmental processes for shortening words and syllables
    • Most children respond well to treatment with speech difficulties improving over time
    • When a language disorder is also present, the speech disorder has a poorer prognosis

    Childhood-Onset Fluency Disorder (Stuttering)

    • Condition characterized by abnormal speech patterns inappropriate for an individual's age and language skills
    • These disturbances include sound and syllable repetitions, sound prolongations of consonants and vowels, broken words, audible or silent blocking, circumlocutions, words produced with excess physical tension, and monosyllabic whole-word repetitions
    • The disorder can cause anxiety about speaking or limitations in effective communication, social participation, or academic or occupational performance
    • Onset of symptoms occurs during the early developmental period, and later-onset cases are diagnosed as adult-onset fluency disorder
    • The disturbance is not attributable to a speech-motor or sensory deficit, dysfluency associated with neurological insults, or another medical condition and is not better explained by another mental disorder
    • Fearful anticipation of the problem may develop, and the speaker may attempt to avoid dysfluencies through linguistic mechanisms or avoid certain speech situations
    • Stress and anxiety exacerbate dysfluency, and children with fluency disorder may also be accompanied by motor movements
    • Studies have shown both structural and functional neurological differences in children who stutter
    • Males are more likely to stutter than females
    • Causes are multifactorial, including certain genetic and neurophysiological factors
    • Childhood-onset fluency disorder occurs by age 6 for 80%-90% of affected individuals
    • The onset can be insidious or more sudden, and dysfluencies typically start gradually
    • As the disorder progresses, the dysfluencies become more frequent and interfering, occurring on the most meaningful words or phrases
    • As the child becomes aware of the speech difficulty, they may develop mechanisms for avoiding the dysfluencies and emotional responses
    • Longitudinal research shows that 65%-85% of children recover from the disorder, with severity of fluency disorder at age 8 years predicting recovery or persistence
    • Stuttering is a condition that affects first-degree biological relatives of individuals with childhood-onset fluency disorder
    • Stuttering can result from stress and anxiety, leading to impaired social functioning and negative communication attitudes
    • Differential diagnosis includes sensory deficits, normal speech dysfluencies, specific learning disorders, bilingualism, medication side effects, adult-onset dysfluencies, and Tourette's disorder
    • The disorder must be distinguished from normal dysfluencies that occur frequently in young children
    • Children who have dysfluencies when they read aloud may be diagnosed mistakenly as having a reading disorder
    • Oral reading fluency is typically measured by timed assessments, but slower reading rates may not accurately reflect the actual reading ability of children who stutter

    Childhood-Onset Fluency Disorder

    • Stuttering can be a side effect of medication, and a temporal relationship between medication exposure and the onset of stuttering may be observed.
    • Adult-onset dysfluencies can be related to neurological problems, medical conditions, and mental disorders, but are not considered a DSM-5 diagnosis.
    • It’s important to distinguish between vocal tics and repetitive sounds associated with Tourette’s disorder and those related to childhood-onset fluency disorder.
    • Childhood-onset fluency disorder can occur alongside other disorders, including ADHD, Autism Spectrum Disorder, intellectual developmental disorder, language disorder, specific learning disorder, seizure disorders, social anxiety disorder, speech sound disorder, and other developmental disorders.

    Social Communication Disorder

    • Social (pragmatic) communication disorder is characterized by difficulties with social language use and communication, resulting in functional limitations in communication effectiveness, social inclusion, forming relationships, academic performance, and work.
    • Deficits are not attributed to low language structure skills, cognitive abilities, or Autism Spectrum Disorder.
    • The most prevalent symptom associated with social communication disorder is language impairment, evidenced by delayed language milestones and past or present language structure problems.
    • Individuals with social communication difficulties may exhibit genetic and physiological issues, such as ADHD, emotional and behavioral challenges, and specific learning disabilities.
    • Diagnosing social communication disorder in children under 4 years old is uncommon, as most children develop adequate speech and language skills by age 4 or 5.
    • Milder forms of the disorder might not become apparent until early adolescence, when communication and social interactions become more complex.
    • The outcome for individuals with social (pragmatic) communication disorder varies; some experience significant improvement over time, while others continue facing challenges into adulthood.
    • A family history of Autism Spectrum Disorder, communication disorders, or specific learning disorders raises the risk of developing social communication disorder, including siblings of children with these conditions who may display early symptoms.
    • Autism Spectrum Disorder is the primary diagnostic consideration for individuals displaying social communication difficulties.
    • Both disorders can be differentiated by the presence of restricted/repetitive patterns of behavior, interests, or activities in Autism Spectrum Disorder, which are absent in social (pragmatic) communication disorder.
    • While qualitatively similar, social communication symptoms may be milder in social (pragmatic) communication disorder compared to Autism Spectrum Disorder.
    • Primary deficits of ADHD can lead to impairments in social communication and functional limitations in communication effectiveness, social participation, or academic performance.
    • Deficient social communication skills are common among individuals with global developmental delay or intellectual developmental disorder, but a separate diagnosis is only given when social communication deficits exceed intellectual limitations.

    Autism Spectrum Disorder

    • The diagnostic criteria for Autism Spectrum Disorder include ongoing deficits in social communication and interaction across different situations, manifested by various factors.
    • These include deficits in social-emotional reciprocity, nonverbal communication used for social interaction, and challenges in forming, maintaining, and understanding relationships.
    • Restricted, repetitive patterns of behavior, interests, or activities are also present.
    • Examples include stereotypical or repetitive movements, insistence on sameness, highly restricted interests, and hyper- or hyporeactivity to sensory input, including unusual sensory interests.
    • Symptoms are present in early childhood and may become more apparent as social demands exceed limited capacities or may be masked by learned behaviors later in life.
    • Symptoms cause significant impairment in social, occupational, or other key areas of current functioning.
    • These disturbances are not better explained by intellectual developmental disorder (intellectual disability) or global developmental delay.
    • Individuals with a confirmed DSM-IV diagnosis of autistic disorder, Asperger’s disorder, or pervasive developmental disorder, should be diagnosed with Autism Spectrum Disorder.
    • Individuals with significant social communication deficits but not meeting all other Autism Spectrum Disorder criteria should be evaluated for social communication disorder.
    • The severity of symptoms for Autism Spectrum Disorder is categorized into three levels, with level 1 requiring “support”, level 2 requiring “substantial support”, and level 3 requiring “very substantial support” based on the level of impairment.
    • The recording procedures for diagnosing Autism Spectrum Disorder involve identifying the level of support needed for social communication deficits and restricted, repetitive behaviors.
    • Specifiers for “with or without accompanying intellectual impairment” or “without accompanying language impairment” and language impairment specification should also be recorded.
    • If language impairment is present, the current level of verbal functioning should be recorded.
    • For Autism Spectrum Disorder, the specifiers “associated with a known genetic or other medical condition or environmental factor” or “associated with a neurodevelopmental, mental, or behavioral problem” are appropriate.
    • These specifiers apply to presentations in which the listed condition or problem is potentially relevant to the clinical care of the individual and do not necessarily indicate that the condition or problem is causally related to the Autism Spectrum Disorder.
    • If the associated neurodevelopmental, mental, or behavioral problem meets criteria for a neurodevelopmental or other mental disorder, both Autism Spectrum Disorder and the other disorder should be diagnosed.
    • If the catatonia is present, record separately “catatonia associated with autism spectrum disorder.”
    • Understanding the intellectual profile of a child or adult with Autism Spectrum Disorder is crucial for interpreting diagnostic features.
    • Separate estimates of verbal and nonverbal skills are necessary.
    • The specifier “associated with a known genetic or other medical condition or environmental factor” can be applied when an individual has a known genetic condition, a known medical condition, or a history of environmental exposure in utero to a known teratogen or infection.
    • Additional neurodevelopmental, mental, or behavioral disorders should also be noted as separate diagnoses.
    • Catatonia can occur as a comorbid condition with Autism Spectrum Disorder, including classic symptoms of posturing, negativism, mutism, and stupor.
    • Autism Spectrum Disorder is characterized by ongoing impairment in reciprocal social communication and interaction (Criterion A) and restricted, repetitive patterns of behavior, interests, or activities (Criterion B).
    • Symptoms are present from early childhood and limit or impair everyday functioning (Criteria C and D).
    • The stage at which functional impairment becomes obvious will vary depending on the individual and their environment.
    • Core diagnostic features are evident in the developmental period, but intervention, compensation, and current supports may mask difficulties in certain situations.
    • Manifestations of the disorder also vary greatly depending on the severity of the autistic condition, developmental level, chronological age, and possibly gender.
    • Individuals without cognitive or language impairment may have more subtle manifestations of deficits than those with accompanying intellectual or language impairments and may be making great efforts to mask these deficits.
    • Criterion A deficits in social communication will be more subtle if an individual has better overall communication skills (e.g., verbally fluent, does not have intellectual impairments).
    • Criterion B deficits (i.e., restricted patterns of behavior and interests) may be less obvious if the interests are closer to age-typical norms (e.g., Ancient Egypt or trains as compared to wiggling a string).
    • Autism Spectrum Disorder includes disorders previously known as early infantile autism, childhood autism, Kanner’s autism, high-functioning autism, atypical autism, pervasive developmental disorder not otherwise specified, childhood disintegrative disorder, and Asperger’s disorder.
    • Impairments in social communication and social interaction specified in Criterion A are persistent and pervasive.
    • Diagnosis is most accurate and reliable when based on multiple sources of information, including clinician observations, caregiver history, and self-report.
    • Verbal and nonverbal deficits in social communication have varying manifestations, depending on the individual’s age, intellectual level, and language ability, as well as other factors such as treatment history and current support.
    • Deficits in social-emotional reciprocity may be shown in young children who exhibit little or no initiation in social interactions and no sharing of their emotions, as well as reduced or no imitation of others’ behavior.
    • Deficits in nonverbal communication used for social interaction are demonstrated by absent, reduced, or unusual use of eye contact, gestures, facial expressions, body orientation, or speech intonation.
    • Deficits in forming, maintaining, and understanding relationships should be judged against norms for age, gender, and culture.
    • These challenges are particularly evident in young children, who may lack shared social play and imagination and exhibit rigid rules.
    • Older individuals may struggle to understand what behavior is considered appropriate in one situation but not another and might have a clear preference for solitary activities or interacting with much younger or older people.
    • Friendships with siblings, coworkers, and caregivers are also important to consider (in terms of reciprocity).
    • Autism Spectrum Disorder is defined by restricted, repetitive patterns of behavior, interests, or activities, which show a range of manifestations according to age and ability, intervention, and current supports.
    • Stereotyped or repetitive behaviors include simple motor stereotypies, repetitive use of objects, and repetitive speech.
    • Excessive adherence to routines and restricted patterns of behavior may be manifest in resistance to change (e.g., distress at apparently small changes, insistence on adherence to rules; rigidity of thinking) or ritualized patterns of verbal or nonverbal behavior (e.g., repetitive questioning, pacing a perimeter).
    • Highly restricted, fixated interests in Autism Spectrum Disorder tend to be abnormal in intensity or focus (e.g., a toddler strongly attached to a pan or piece of string; a child preoccupied with vacuum cleaners; an adult spending hours writing out timetables).
    • Many individuals with Autism Spectrum Disorder without intellectual or language impairments learn to suppress repetitive behavior in public, serving an anxiolytic or self-soothing function.
    • Special interests may be a source of pleasure and motivation and provide avenues for education and employment later in life.
    • Diagnostic criteria may be met when restricted, repetitive patterns of behavior, interests, or activities were clearly present during childhood or at some time in the past, even if symptoms are no longer present.
    • Standardized behavioral diagnostic instruments with good psychometric properties, including caregiver interviews, questionnaires, and clinician observation measures, are available and can improve the reliability of diagnosis over time and across clinicians.
    • However, the symptoms of Autism Spectrum Disorder occur as dimensions without universally accepted cutoff scores for what would constitute a disorder.
    • Thus, the diagnosis remains a clinical one, taking all available information into account, and is not solely dictated by the score on a particular questionnaire or observation measure.
    • Autism Spectrum Disorder (ASD) affects between 1% and 2% of the US population, with similar estimates in child and adult samples.
    • Prevalence is lower among African American (1.1%) and Latinx children compared to White children (1.3%), even after considering socioeconomic resources.
    • The reported prevalence may be affected by misdiagnosis, delayed diagnosis, or underdiagnosis of individuals from certain ethnoracial backgrounds.
    • Autism Spectrum Disorder has approached 1% of the population in non-U.S. countries, with no substantial variation based on geographic region or ethnicity and across child and adult samples.
    • Globally, the male: female ratio in well-ascertained epidemiological samples appears to be 3:1, with concerns about underrecognition of Autism Spectrum Disorder in women and girls.
    • The onset of Autism Spectrum Disorder is typically associated with declines in critical social and communication behaviors in the first two years of life.
    • These declines in functioning are rare in other neurodevelopmental disorders and may be a helpful indicator of the presence of Autism Spectrum Disorder.
    • In rare cases, there is developmental regression occurring after at least two years of normal development, which is much more unusual and warrants more extensive medical investigation.
    • First symptoms of Autism Spectrum Disorder frequently involve delayed language development, lack of social interest, unusual social interactions, odd play patterns, and unusual communication patterns.
    • Deafness may be suspected but is usually ruled out.
    • During the second year, odd and repetitive behaviors and the absence of typical play become more apparent.
    • Clinical distinction is based on the type, frequency, and intensity of the behavior.
    • Autism Spectrum Disorder is not a degenerative disorder, and learning and compensation continue throughout life.
    • Symptoms are often most marked in early childhood and early school years, with developmental gains typical in later childhood in at least some areas.
    • A small proportion of individuals deteriorate behaviorally during adolescence, whereas most others improve.
    • As diagnosis of Autism Spectrum Disorder is made more frequently in those with superior language and intellectual abilities, more individuals are able to find a niche that matches their special interests and skills, thus being productively employed.
    • Access to vocational rehabilitation services significantly improves competitive employment outcomes for transition-age youth with Autism Spectrum Disorder.
    • Autism Spectrum Disorder is a condition that affects individuals with lower levels of impairment, making them better able to function independently.
    • However, these individuals may still be socially naive and vulnerable, have difficulties organizing practical demands without aid, and are prone to anxiety and depression.
    • Many adults use compensation strategies and coping mechanisms to mask their difficulties in public but suffer from the stress and effort of maintaining a socially acceptable facade.
    • Relatively little is known about old age in Autism Spectrum Disorder, but higher rates of co-occurring medical conditions have been documented in the literature.
    • Some individuals come for first diagnosis in adulthood, perhaps prompted by the diagnosis of autism in a child in the family or a breakdown of relations at work or home.
    • Obtaining detailed developmental history in such cases may be difficult, and it is important to consider self-reported difficulties.
    • If clinical observation suggests criteria are currently met, Autism Spectrum Disorder may be diagnosed, particularly if supported by a history of poor social and communication skills in childhood.
    • Manifestations of the social and communication impairments and restricted/repetitive behaviors that define Autism Spectrum Disorder are clear in the developmental period.
    • In later life, intervention or compensation, as well as current supports, may mask these difficulties in at least some contexts.
    • Overall, symptoms remain sufficient to cause current impairment in social, occupational, or other important areas of functioning.
    • The best-established prognostic factors for individual outcome within Autism Spectrum Disorder are the presence or absence of associated intellectual developmental disorder and language impairment, as well as additional mental health problems.
    • Epilepsy, as a comorbid diagnosis, is associated with greater intellectual disability and lower verbal ability.
    • Culture-related diagnostic issues exist in norms for social interaction, nonverbal communication, and relationships, but individuals with Autism Spectrum Disorder are markedly impaired against the norms for their cultural context.
    • Considerable discrepancies are found in age at diagnosis of Autism Spectrum Disorder in children from diverse ethnoracial backgrounds, most studies find delayed diagnosis among socially oppressed ethnic and racialized children. African American children are more often misdiagnosed with adjustment or conduct disorder than are White children.
    • Autism Spectrum Disorder is diagnosed three to four times more often in males than in females, and on average, age at diagnosis is later in females.
    • Females may have better reciprocal conversation, share interests, integrate verbal and nonverbal behavior, and modify their behavior by situation, despite having similar social understanding difficulties as males.
    • Rates of gender variance have been reported to be increased in Autism Spectrum Disorder, with higher variance in females compared with males.
    • Autism Spectrum Disorder (ASD) is a condition that affects young children, particularly those with social and communication abilities.
    • It can hinder learning through social interaction or in settings with peers and can lead to difficulties in eating, sleeping, and routine care.

    Autism Spectrum Disorder

    • Adaptive skills are typically below measured IQ in individuals with autism spectrum disorder (ASD).
    • Individuals with ASD often experience extreme difficulties in planning, organization, and coping with change.
    • These difficulties negatively impact academic achievement and may lead to challenges with establishing independence in adulthood.
    • Social isolation and communication problems may have consequences for health in older adulthood.
    • Co-occurring intellectual developmental disorder, epilepsy, mental disorders, and chronic medical conditions may be associated with a higher risk of premature mortality.
    • Abnormalities of attention, hyperactivity, and social communication deficits are common in individuals with ASD.
    • ADHD is a common comorbidity with ASD, and should be considered in individuals exhibiting excessive attentional difficulties or hyperactivity.
    • Intellectual developmental disorder (IDD) without ASD may be difficult to differentiate from language disorders and social (pragmatic) communication disorder.
    • ASD diagnosis in an individual with IDD is appropriate when social communication and interaction are significantly impaired relative to the individual’s nonverbal skills.
    • IDD is the appropriate diagnosis when there is no apparent discrepancy between the level of social communicative skills and other intellectual skills.
    • A diagnosis of ASD is appropriate when all diagnostic criteria are met, with careful consideration given to past or current restricted/repetitive behavior.
    • Selective mutism, stereotypic movement disorder, Rett syndrome, and anxiety disorders can be difficult to differentiate from ASD.
    • In selective mutism, early development is not typically disturbed, and the affected child usually exhibits appropriate communication skills in certain contexts and settings.
    • While motor stereotypies are diagnostic of ASD, an additional diagnosis of stereotypic movement disorder is not given when such behaviors are better explained by the presence of ASD.
    • Overlapping anxiety symptoms with core ASD symptoms can make classification challenging.
    • Social withdrawal and repetitive behaviors are core features of ASD but may also be expressions of anxiety.
    • The most common anxiety disorders in ASD are specific phobia, social anxiety, and agoraphobia.
    • Obsessive-compulsive disorder, schizophrenia, and personality disorders all share a defining feature of repetitive behavior, which is considered inappropriate or odd.
    • Hallucinations and delusions are not features of ASD.
    • Both ASD and schizophrenia can co-occur and both should be diagnosed when criteria are met.
    • ASD can be mistaken for narcissistic, schizotypal, or schizoid personality disorder in adults without significant language impairment.
    • The early developmental course of ASD helps differentiate it from personality disorders.
    • ASD is often associated with IDD, language disorder, specific learning difficulties, and developmental coordination disorder.
    • Psychiatric comorbidities are common in ASD, with 70% of individuals having one comorbid mental disorder and 40% having two or more.
    • Anxiety disorders, depression, and ADHD are common in individuals with ASD.
    • Avoidant/restrictive food intake disorder is a common presenting feature of ASD.
    • Observable signs such as changes in sleep or eating, increased challenging behavior should trigger an evaluation for anxiety or depression.

    Attention-Deficit/Hyperactivity Disorder

    • The diagnostic criteria for ADHD are based on a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development.
    • ADHD is considered a combined presentation if both inattention and hyperactivity-impulsivity are met for the past six months.
    • ADHD is considered a predominantly inattentive presentation if inattention and hyperactivity-impulsivity are not met for the past six months.
    • The current severity of ADHD symptoms is classified as mild, moderate, or severe.
    • ADHD symptoms must be present in more than one setting, such as home and school, home and work, or with family and friends.
    • ADHD begins in childhood, with symptoms required before age 12.
    • Symptoms of ADHD that first occur after age 13 are more likely to be explained by another mental disorder or the cognitive effects of substance use.
    • Prevalence of ADHD occurs worldwide in about 7.2% of children with a wide range across nations from 0.1% to 10.2%.
    • ADHD prevalence is higher in special populations such as foster children or correctional settings.
    • ADHD occurs in 2.5% of adults.
    • Risk and prognostic factors associated with ADHD include:
      • Reduced behavioral inhibition
      • Effortful control
      • Negative emotionality
      • Elevated novelty seeking
    • Low birth weight and degree of prematurity convey a greater risk for ADHD.
    • Prenatal exposure to smoking is associated with ADHD even after controlling for parental psychiatric history and socioeconomic status.
    • Neurotoxin exposure, infections, and alcohol exposure in utero have been correlated with subsequent ADHD.
    • ADHD has a heritability of approximately 74%, with genetic factors playing a significant role in its development.
    • Large-scale genomewide association studies (GWAS) have identified several loci enriched in evolutionarily constrained genomic regions and loss-of-function genes, as well as around brain-expressed regulatory regions.
    • There is no single gene for ADHD, and potential influences on symptoms include:
      • Visual and hearing impairments
      • Metabolic abnormalities
      • Nutritional deficiencies
    • ADHD is elevated in individuals with idiopathic epilepsy.
    • Family interaction patterns in early childhood are unlikely to cause ADHD but may influence its course or contribute to secondary development of conduct problems.
    • Clinical identification rates in the United States for African American and Latinx populations tend to be lower than for non-Latinx White populations.
    • ADHD is more frequent in males than in females in the general population, with a ratio of approximately 2:1 in children and 1.6:1 in adults.
    • Females are more likely than males to present primarily with inattentive features.
    • Sex differences in ADHD symptom severity may be due to differing genetic and cognitive liabilities between sexes.
    • No biological marker is diagnostic for ADHD.
    • Neuroimaging studies have shown differences in children with ADHD compared to control subjects.
    • Meta-analysis of all neuroimaging studies does not show differences between individuals with ADHD and control subjects, likely due to differences in diagnostic criteria, sample size, task used, and technical aspects of the neuroimaging technique.
    • ADHD is associated with reduced school performance and academic attainment.
    • Academic deficits, school-related problems, and peer neglect are most associated with elevated symptoms of inattention.
    • In its severe form, ADHD is markedly impairing social, familial, and scholastic/occupational adjustment.
    • Family relationships may be characterized by discord and negative interactions.
    • Children with ADHD are significantly more likely to develop conduct disorder in adolescence and antisocial personality disorder in adulthood, increasing the likelihood for substance use disorders and incarceration.
    • Individuals with ADHD are more likely to be injured, suffering trauma and developing subsequent posttraumatic stress syndrome.
    • Traffic accidents and violations are more frequent in drivers with ADHD.
    • There may also be an elevated likelihood of obesity and hypertension among individuals with ADHD.

    Differential Diagnosis of ADHD

    • Oppositional defiant disorder (ODD) is characterized by negativity, hostility, and defiance, which must be differentiated from ADHD.
    • Intermittent explosive disorder shares high levels of impulsive behavior but shows serious aggression toward others, which is not characteristic of ADHD.
    • Individuals with ADHD and intermittent explosive disorder share high levels of impulsive behavior but do not experience problems with sustaining attention as seen in ADHD.
    • The increased motoric activity in ADHD must be distinguished from the repetitive motor behavior that characterizes stereotypic movement disorder and some cases of autism spectrum disorder.
    • Tourette's disorder can be mistaken for the generalized fidgetiness of ADHD.
    • Specific learning disorder, intellectual developmental disorder, autism spectrum disorder, reactive attachment disorder, anxiety disorders, posttraumatic stress disorder, depression, and bipolar disorder are all common conditions that may be misdiagnosed as ADHD.
    • Children with specific learning disorder may appear inattentive because of frustration, lack of interest, or limited ability in neurocognitive processes.
    • Individuals with ADHD and those with autism spectrum disorder exhibit inattention, social dysfunction, and difficult-to-manage behavior.
    • Concentration difficulties associated with posttraumatic stress disorder (PTSD) may be misdiagnosed in children as ADHD.
    • Children younger than 6 years often manifest PTSD in nonspecific symptoms such as restlessness, irritability, inattention, and poor concentration, which can mimic ADHD.
    • Depressive disorders may present with inability to concentrate, but poor concentration in mood disorders becomes prominent only during a depressive episode.
    • Individuals with bipolar disorder may have increased activity, poor concentration, and increased impulsivity, but these features are episodic, unlike ADHD, in which the symptoms are persistent.
    • Disruptive mood dysregulation disorder is characterized by pervasive irritability and intolerance of frustration, but impulsiveness and disorganized attention are not essential features.
    • Differentiating ADHD from substance use disorders may be problematic.
    • ADHD is a condition that can be differentiated from other personality disorders, such as borderline, narcissistic, and other personality disorders.
    • It may take extended clinical observation, informant interview, or detailed history to distinguish impulsive, socially intrusive, or inappropriate behavior from narcissistic, aggressive, or domineering behavior.
    • Diagnosis of ADHD is not possible if the symptoms of inattention and hyperactivity occur exclusively during the course of a psychotic disorder.
    • Symptoms of inattention, hyperactivity, or impulsivity attributable to the use of medication are diagnosed as other specified or unspecified other (or unknown) substance-related disorders.
    • While impairment in complex attention may be one of the affected cognitive domains in a neurocognitive disorder, it must represent a decline from a previous level of performance to justify a diagnosis of major or mild neurocognitive disorder.
    • Comorbidity is common in individuals with ADHD, with females having higher rates of oppositional defiant disorder, autism spectrum disorder, and personality and substance use disorders.
    • Oppositional defiant disorder co-occurs with ADHD in approximately half of children with the combined presentation and about a quarter with the predominantly inattentive presentation.
    • Conduct disorder co-occurs in about a quarter of children or adolescents with the combined presentation, depending on age and setting.
    • Most children and adolescents with disruptive mood dysregulation disorder have symptoms that also meet criteria for ADHD; a lesser percentage of children with ADHD have symptoms that meet criteria for disruptive mood dysregulation disorder.
    • In adults, antisocial and other personality disorders may co-occur with ADHD.
    • ADHD may co-occur in variable symptom profiles with other neurodevelopmental disorders, including specific learning disorder, autism spectrum disorder, intellectual developmental disorder, language disorders, developmental coordination disorder, and tic disorders.
    • Comorbid sleep disorders in ADHD are associated with daytime impairments in cognition, such as inattention.
    • Individuals with ADHD have been found to have elevated rates of a number of medical conditions, particularly allergy and autoimmune disorders, as well as epilepsy.

    Specific Learning Disorder

    • The Diagnostic Criteria for Learning and Using Academic Skills (DLT) are four criteria that must be met based on an individual's history, school reports, and psychoeducational assessment.
    • These criteria include:
      • Difficulties in learning and using academic skills, as indicated by the presence of at least one of the following symptoms that have persisted for at least 6 months, despite the provision of interventions that target those difficulties.
      • Inaccurate or slow and effortful word reading (e.g., reads single words aloud incorrectly or slowly and hesitantly, frequently guesses words, has difficulty sounding out words).
      • Difficulty understanding the meaning of what is read (e.g., may read text accurately but not understand the sequence, relationships, inferences, or deeper meanings of what is read).
      • Difficulties with spelling (e.g., may add, omit, or substitute vowels or consonants).
      • Difficulties with written expression (e.g., makes multiple grammatical or punctuation errors within sentences; employs poor paragraph organization; written expression of ideas lacks clarity).
      • Difficulties mastering number sense, number facts, or calculation (e.g., has poor understanding of numbers, their magnitude, and relationships; counts on fingers to add single-digit numbers instead of recalling the math fact as peers do; gets lost in the midst of arithmetic computation and may switch procedures).
      • Difficulties with mathematical reasoning (e.g., has difficulty applying mathematical concepts to solve problems, has difficulty making connections between math and other subjects).

    Specific Learning Disorder

    • Characterized by persistent difficulties in reading, comprehension, written expression, spelling, arithmetic calculation, and mathematical reasoning
    • Diagnosed after formal education starts and can be diagnosed at any point after, provided evidence of onset during the years of formal schooling
    • Difficulties are not better explained by intellectual developmental disorders, hearing or vision disorders, or neurological or motor disorders
    • May occur in individuals identified as intellectually gifted
    • Symptoms frequently co-occur with an uneven profile of abilities
    • Individuals typically exhibit poor performance on psychological tests of cognitive processing
    • Many processing deficits are also found in other neurodevelopmental disorders
    • Affects 5%-15% of school-age children
    • Typically begins during elementary school years when children are required to learn to read, spell, write, and learn mathematics
    • Predispositions such as language delays or deficits, difficulties in rhyming or counting, or difficulties with fine motor skills required for writing commonly occur in early childhood
    • Manifestations may be behavioral (e.g., a reluctance to engage in learning; oppositional behavior)
    • Specific learning disorder is lifelong, but the course and clinical expression are variable
    • Problems with reading fluency and comprehension, spelling, written expression, and numeracy skills in everyday life typically persist into adulthood
    • Symptoms may be observed in preschoolers and kindergarten-age children
    • Children in primary grades may continue to have problems recognizing and manipulating phonemes
    • During adolescence and into adulthood, individuals with specific learning disorder may continue to make numerous spelling mistakes and read single words and connected text slowly and with much effort
    • Environmental factors, such as socioeconomic conditions and exposure to neurotoxicants, increase the risk for specific learning disorder
    • Family history of reading difficulties (dyslexia) and parental literacy skills predict literacy problems or specific learning disorder in offspring
    • Preterm delivery or very low birthweight is a risk for specific learning disorder
    • Neurofibromatosis type 1 has a high risk of specific learning disorder in individuals
    • Marked problems with inattentive, internalizing, and externalizing behaviors in preschool years are predictive of later difficulties in reading and mathematics
    • Specific learning disorder occurs across linguistic and ethnoracial backgrounds and across cultural and socioeconomic contexts
    • Risk factors for specific learning disorder in English-language learners include a family history of specific learning disorder or language delay in the native language
    • Comorbid reading difficulties may vary with different languages
    • Specific learning disorder is more common in males than females
    • Poor reading ability has been associated with suicidal thoughts and behavior in U.S.adolescents aged 15 years in public school
    • In a population-based study of adults in Canada, the prevalence of lifetime suicide attempts among those with specific learning disorder was higher than that among those without a specific learning disorder
    • Specific learning disorder can have negative functional consequences across the lifespan, including lower academic attainment, higher rates of high school dropout, lower rates of postsecondary education, high levels of psychological distress and poorer overall mental health, higher rates of unemployment and underemployment, and lower incomes
    • Specific learning disorder is distinguished from normal variations in academic attainment attributable to external factors
    • It differs from general learning difficulties associated with intellectual developmental disorder, neurological or sensory disorders, and cognitive-processing difficulties associated with schizophrenia or other psychotic disorders

    Diagnosis

    • The affected academic skills are substantially and quantifiably below those expected for the individual’s chronological age, and cause significant interference with academic or occupational performance, or with activities of daily living, as confirmed by individually administered standardized achievement measures and comprehensive clinical assessment.
    • For individuals aged 17 years and older, a documented history of impairing learning difficulties may be substituted for the standardized assessment.
    • The learning difficulties begin during school-age years but may not become fully manifest until the demands for those affected academic skills exceed the individual’s limited capacities.
    • The learning difficulties are not better accounted for by intellectual disabilities, uncorrected visual or auditory acuity, other mental or neurological disorders, psychosocial adversity, lack of proficiency in the language of academic instruction, or inadequate educational instruction.
    • The current severity of the learning difficulties is classified into three categories: Mild, moderate, and severe.
    • Mild: Some difficulties learning skills in one or two academic domains, but of mild enough severity that the individual may compensate or function well when provided with appropriate accommodations or support services, especially during the school years.
    • Moderate: Marked difficulties learning skills in one or more academic domains, so that the individual is unlikely to become proficient without some intervals of intensive and specialized teaching during the school years.
    • The recording procedures for each impaired academic domain and subskill of a specific learning disorder must be coded and recorded separately.

    Other

    • A more lenient threshold may be used when learning difficulties are supported by converging evidence from clinical assessment, academic history, school reports, or test scores.
    • Since standardized tests are not available in all languages, the diagnosis may be based in part on clinical judgment of scores on available test measures.
    • Persistence is defined as restricted progress in learning for at least 6 months despite the provision of extra help at home or school.
    • Evidence of persistent learning difficulties may be derived from cumulative school reports, portfolios of the child's evaluated work, curriculum-based measures, or clinical interviews.
    • Low academic achievement for age or average achievement that is sustainable only by extraordinarily high levels of effort or support is a robust clinical indicator of difficulties learning academic skills.
    • In children, low academic skills cause significant interference in school performance, while in adults, they interfere with occupational performance or everyday activities requiring those skills.
    • Low achievement scores on one or more standardized tests or subtests within an academic domain are needed for the greatest diagnostic certainty.
    • However, precise scores will vary according to the particular standardized tests used.
    • Learning difficulties are a significant issue in education, often manifesting in early school years.
    • However, some individuals may not fully develop these difficulties until later school years, as learning demands have increased and exceeded their limited capacities.
    • Specific learning disorders are considered "specific" for four reasons: they are not better explained by intellectual developmental disorders, hearing or vision disorders, or neurological or motor disorders; they cannot be attributed to more general external factors; they cannot be attributed to neurological (e.g., pediatric stroke) or motor disorders; vision or hearing disorders, which are often associated with problems learning academic skills but are distinct by presence of neurological signs; and the learning difficulty may be restricted to one academic skill or domain.
    • Comorbidity between different types of specific learning disorder and other neurodevelopmental disorders, mental disorders, or behavioral problems may make testing and differential diagnosis more difficult.
    • Clinical judgment is required to attribute such impairment to learning difficulties, and if there is an indication that another diagnosis could account for the difficulties learning keystone academic skills described in Criterion A, specific learning disorder should not be diagnosed.

    Developmental Coordination Disorder

    • A condition affecting motor skill coordination, with varying severity based on age and individual needs
    • Key Features:
      • Delayed motor skill acquisition and execution
      • Significant interference with daily activities
      • Not attributed to intellectual disability, visual impairment, or neurological conditions affecting movement
    • Diagnosis is clinical, incorporating individual history, physical assessment, and standardized testing
    • Prevalence of 5% to 8% in children ages 5-11 years, with males more affected
    • Onset in early childhood, with delayed milestones, difficulties with tasks requiring motor sequencing and coordination (e.g., dressing, eating with utensils, playing games), and challenges with handwriting
    • Complications:
      • Reduced participation in sports and play
      • Poor self-esteem
      • Emotional or behavioral problems
      • Academic difficulties
      • Poor physical fitness and obesity
      • Reduced quality of life
    • Co-occurs with:
      • Attention-deficit/hyperactivity disorder (ADHD)
      • Specific learning disabilities
      • Autism spectrum disorder
    • May be associated with prematurity, low birth weight, prenatal alcohol exposure, cerebellar dysfunction, and cultural differences in motor development

    Stereotypic Movement Disorder

    • A condition marked by repetitive, seemingly driven, and purposeless motor behavior
    • Key Features:
      • Behaviors can be rhythmic or purposeful, may or may not respond to attempts to stop them
      • May be self-injurious (e.g., head banging) or not (e.g., body rocking)
      • Often occur during intense focus, excitement, stress, fatigue, or boredom
      • Can interfere with social, academic, or other activities
    • Prevalence is common in young children, with simple movements common in infancy and complex movements less common
    • Complications:
      • Self-injury
    • Co-occurs with:
      • Moderate-to-severe intellectual developmental disorders
    • Risk Factors:
      • Social isolation
      • Environmental stress and fear
      • Lower cognitive functioning

    Tic Disorders

    • A group of motor and vocal movements or vocalizations, including Tourette's disorder, persistent (chronic) motor or vocal tic disorder, provisional tic disorder, and other specified and unspecified tic disorders

    • Key Features:

      • Sudden, rapid, recurrent, nonrhythmic movements or vocalizations
      • Can be simple (limited muscle involvement) or complex (combination of simple tics or appearing purposeful)
      • Usually begin in prepubertal period (average onset 4-6 years)
      • Often worsen during adolescence, peaking in severity around ages 10-12

    • Complications:

      • Functional consequences, including social isolation, interpersonal conflict, peer victimization, difficulty working or attending school, and lower quality of life
      • May be associated with other medical conditions, including movement disorders

    • Co-occurs with:

      • ADHD
      • OCD
      • Anxiety

    • Risk Factors:

      • Advanced paternal age
      • Pre- and perinatal adverse events
      • Genetic factors

    • Differential Diagnosis:

      • Stereotypic movements
      • Chorea
      • Dystonia
      • Paroxysmal dyskinesias
      • Functional tic disorder
      • Myoclonus### Obsessive-Compulsive Symptoms in Tic Disorders

    • Tic disorders can be accompanied by obsessive-compulsive symptoms, which often appear early in life.

    • These symptoms commonly include a need for symmetry and exactness or involve forbidden or taboo thoughts, such as aggressive, sexual, or religious obsessions and related compulsions.

    Co-occurring Disorders

    • Individuals with tic disorders may experience other movement disorders like Sydenham's chorea or stereotypic movement disorder.
    • They can also have neurodevelopmental and psychiatric conditions, including autism spectrum disorder and specific learning disorder.

    Teenagers and Adults with Tic Disorders

    • Teenagers and adults with tic disorders have a higher risk of developing mood, anxiety, or substance use disorders.

    Other Specified Tic Disorders (F95.8) and Unspecified Tic Disorders (F95.9)

    • These categories are used when tic disorder symptoms cause significant distress or impairment in social, occupational, or other essential areas of functioning but don't fully meet the criteria for a specific tic disorder.

    Other Specified Neurodevelopmental Disorder

    • This category encompasses presentations where symptoms of a neurodevelopmental disorder cause impairment in social, occupational, or other areas of functioning, but don't meet the full criteria for any specific neurodevelopmental disorder.
    • The clinician can use this category to specify the reason for not meeting the criteria for a specific disorder.
    • For example, "neurodevelopmental disorder associated with prenatal alcohol exposure" covers a range of developmental disabilities linked to prenatal alcohol exposure.

    Unspecified Neurodevelopmental Disorder (F89)

    • This category applies to presentations where neurodevelopmental symptoms don't meet the full criteria for any specific neurodevelopmental disorder.
    • It includes cases with insufficient information for a more specific diagnosis, often seen in emergency room settings.

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    Explore the characteristics and diagnostic criteria of neurodevelopmental disorders, including Intellectual Developmental Disorder (IDD). This quiz covers symptoms, severity levels, and common comorbidities of these disorders. Test your knowledge on the impacts these conditions have on functioning in various domains.

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