DSM 5 PDF

Neurodevelopmental disorders are conditions that begin early in a child's life, usually before they start school. These disorders happen because of differences or delays in how the brain develops, which can lead to challenges in **personal**, **social**, **academic**, and occupational functioning....

Neurodevelopmental disorders are conditions that begin early in a child's life, usually before they start school. These disorders happen because of differences or delays in how the brain develops, which can lead to challenges in **personal**, **social**, **academic**, and occupational functioning. Some of these challenges might be very specific, like difficulty focusing or learning certain skills. Others might be broader, like having trouble with social skills or thinking abilities. **Specifiers for diagnosis** **Severity**: For some disorders (like intellectual developmental disorder, autism spectrum disorder, ADHD, specific learning disorder, and stereotypic movement disorder), severity levels are noted. These indicate how much the symptoms affect daily life and how much support is needed. **Current Symptoms**: For conditions like ADHD, specific learning disorder, and persistent motor or vocal tic disorder, specifiers are used to describe the current symptoms a person is experienceing. This helps track how the disorder is presenting at the moment. **Associated Medical or Environmental Factors**: For autism spectrum disorder and stereotypic movement disorder, a specifier notes whether the disorder is linked to a genetic condition, medical issue, or environmental factor (e.g., brain injury, prenatal exposure to toxins). This helps clinicians understand potential causes and how these factors might influence the course of the disorder or its treatment. **Intellectual Developmental Disorder (Intellectual Disability):** Intellectual developmental disorder (intellectual disability) is a disorder with onset During the developmental period that includes both **intellectual** Skills like reasoning, problem-solving, and learning. and **adaptive Functioning** Everyday life skills, such as communication, independence, and social participation. The diagnosis of intellectual Developmental disorder is based on both clinical assessment and standardized testing of Intellectual functions, standardized neuropsychological tests, and standardized tests of adaptive Functioning. Deficits in conceptual, social, and practical domains. The following three Criteria must be met: A. **Deficit in intellectual functioning** Difficulty with skills like: Reasoning and problem-solving. Planning and making judgments.Learning in school or from everyday experiences. B. **Problems with Adaptive Functioning** The person struggles with independence and social responsibilities, which affects: Communication (e.g., expressing needs clearly). Social participation (e.g., making friends or working with others). Independent living (e.g., managing money, cooking, or self-care). These challenges happen in multiple settings, like at home, school, work, or in the community. C. **Starts During the Developmental Period** The intellectual and adaptive deficits must begin during childhood or adolescence, not later in life. **Conceptual domain (Thinking and Learning)** **MILD** Learning difficulties are noticeable, but individuals can achieve academic skills up to approximately a 6^th^-grade level. They may need some support in complex tasks like managing money, planning, or understanding abstract concepts. Adults can live fairly independently with minimal guidance. **Moderate** Academic skills typically remain at an elementary level, and progress in reading, writing, math, and understanding time/money is very limited. Individuals need daily assistance to perform tasks requiring conceptual thinking. Responsibilities like managing finances or planning tasks are often handled entirely by others. **Severe** Little understanding of academic or symbolic concepts (e.g., time, money). Learning is limited to basic tasks and requires extensive caregiver support. **Profound** Extremely limited understanding of the world; focus is entirely on basic physical interactions. No capacity for academic or symbolic thinking (e.g., reading or writing). **Social domain** **MILD:** Immature compared to peers; struggles to understand social cues. Can form meaningful relationships but is at risk of being manipulated. **Moderate:** Communication is less complex; language is concrete and simplified. Can form friendships but struggles with social judgment and decision-making, needing assistance in these aareas. **Severe:** Language is very limited, often using single words, simple phrases, or gestures. Social interactions are limited to familiar caregivers and family, relying on emotional or gestural communication. **Profound:** Communication is nonsymbolic, relying on gestures, emotional cues, or basic physical expressions. Relationships are limited to close family or caregivers for emotional connection and care. **Practical domain** **Mild:** Mostly independent in personal care. Needs help with complex tasks like managing finances or organizing daily life. Can work in jobs that don't require advanced conceptual skills. **Moderate:** Basic personal care achieved after extended teaching but needs reminders and guidance. Support needed for household tasks and employment. Can handle routine tasks under supervision. **Severe:** Fully dependent on caregivers for personal care (eating, dressing, hygiene). Participation in household tasks or work is minimal and requires close supervision. **Profound:** Completely dependent on caregivers for all aspects of personal care and daily life. Participation in activities is passive (e.g., listening to music or being pushed on a walk). Severe physical or sensory impairments often co-occur, further limiting independence. **Global Developmental Delay (GDD)** **Who is it for?** It applies to children under 5 years old who are not meeting important developmental milestones in multiple areas like learning, problem-solving, communication, or motor skills. **Why is it used?** It's used when a child is too young or unable to complete formal tests that measure their intellectual abilities. This could be due to age or medical conditions. **What happens next?** GDD isn't a permanent label. Doctors or specialists will reassess the child later to see if they meet the criteria for a more specific diagnosis (like intellectual developmental disorder) as they grow older. **Unspecified Intellectual Developmental Disorder (F79)** **Who is it for?** It's for individuals older than 5 years who likely have intellectual developmental delays, but their level of difficulty can't be accurately assessed. **Why is it difficult to assess?** This happens when there are other factors that make testing hard, such as: Sensory impairments (e.g., blindness, deafness). Physical disabilities (e.g., difficulty moving or speaking). Severe problem behaviors or mental health issues. **Why is it used?** It's a temporary diagnosis used when professionals need more time or better tools to assess the individual's condition accurately. **What happens next?** Like with Global Developmental Delay, the individual's condition needs reassessment later to confirm their abilities and limitations once the barriers to assessment are addressed. **Communication disorder**:A communication disorder is a condition characterized by difficulties in speech, language, or communication that significantly impair an individual's ability to express, understand, or interact effectively. These disorders can involve: **Speech**: Problems with the production of sounds, including articulation, fluency, and voice. **Articulation**: Clarity of sounds. **Fluency**: Smoothness of speech (e.g., absence of stuttering). **Voice and Resonance**: Vocal tone and quality. **Language**: Deficits in understanding or using a rule-governed system of symbols (e.g., spoken or written language). **Communication**: Challenges in verbal or nonverbal behaviors used to influence or interact with others, such as in social or pragmatic contexts. Communication disorders can arise from neurodevelopmental, cognitive, sensory, or physical impairments and are often associated with other developmental or mental health conditions. **Language Disorder** is a neurodevelopmental condition that affects a person's ability to understand, acquire, and use language effectively. It is categorized under Communication Disorders in the DSM-5 and is characterized by persistent difficulties in various aspects of language, including vocabulary, grammar, sentence structure, and discourse. These difficulties interfere with academic, social, and occupational functioning. **Deficits in Comprehension and Production**; The individual may struggle to understand spoken or written language (receptive language) or express themselves clearly (expressive language). **Reduced Vocabulary**: Limited ability to learn new words or recall the appropriate word during conversations. **Limited Sentence Structure**: Difficulty constructing grammatically correct sentences and using proper word order or verb tenses. **Impaired Discourse**: Trouble organizing thoughts, explaining ideas, or maintaining coherent conversations. B. Language abilities are substantially and quantifiably below those expected for Age, resulting in functional limitations in effective communication, social Participation, academic achievement, or occupational performance, individually Or in any combination. D. Onset of symptoms is in the early developmental period. E. The difficulties are not attributable to hearing or other sensory impairment, motor Dysfunction, or another medical or neurological condition and are not betterExplained by intellectual developmental disorder (intellectual disability) or global Developmental delay. **Speech Sound Disorder (SSD**) refers to difficulties with speech sound production that interfere with intelligibility and are not consistent with the child's age or developmental stage. **Speech Sound Production**: Involves the clear articulation of phonemes (individual speech sounds) to form spoken words. **Requires phonological knowledge** (understanding speech sounds) and motor coordination (movement of articulators like the jaw, tongue, and lips, along with breathing and vocalizing). **Phonological Knowledge Deficits:** Difficulty recognizing, learning, or using the appropriate speech sounds for a language. May result in consistent mispronunciations or substituting one sound for another (e.g., saying "wabbit" instead of "rabbit"). **Motor Coordination Challenges**: Struggles to coordinate the movements of the articulators necessary for producing speech sounds correctly. This can result in imprecise articulation or difficulty with specific sounds. **Persistent Difficulty with Speech Sound Production:** The individual has trouble articulating speech sounds, which impacts the clarity and intelligibility of their speech. These difficulties may include: Substituting one sound for another (e.g., saying "wabbit" for "rabbit"). Omitting sounds (e.g., saying "ca" instead of "cat"). Distorting sounds, making speech difficult to understand. **Impacts on Communication and Daily Life**: The speech sound production difficulties result in: **Social Limitations**: Difficulty engaging in conversations or forming relationships. **Academic Limitations**: Problems with reading, writing, or participating in class due to unclear speech. **Occupational Limitations**: In older individuals, difficulty being understood in the workplace. **Early Developmental Onset**: Symptoms begin in the early developmental period, typically as speech sounds are acquired (e.g., during infancy or early childhood). D. **Not Attributable to Other Conditions The difficulties cannot be explained by:** **Congenital Conditions**: Such as cleft palate or cerebral palsy. Hearing Loss: Speech issues caused by deafness or partial hearing loss. Neurological or Medical Conditions: Such as traumatic brain injury or other disorders affecting speech production. **Conclusion:** Speech Sound Disorder is characterized by persistent articulation difficulties that impair speech clarity and affect communication. The condition is diagnosed when symptoms emerge early in life and are not due to other medical or structural causes. Effective interventions, such as speech therapy, are crucial for improving speech intelligibility and communication abilities. **Childhood-Onset Fluency Disorder**, commonly known as stuttering, is a condition where a person has trouble with the normal flow of speech. To be diagnosed, the individual must have persistent difficulties with the flow and timing of speech, which are not appropriate for their age or language skills. These difficulties include: **Repetitions** -- Repeating sounds or syllables (e.g., "b-b-b-ball"). **Prolongations** -- Stretching out sounds (e.g., "sssssnake"). **Broken words** -- Pauses or interruptions within a word. **Blocking** -- Pausing before speaking, either with a sound (e.g., "uh... I want that") or silently. **Circumlocutions** -- Avoiding certain words by using others. **Physical tension** -- Speaking with visible effort or strain. **Whole-word repetitions** -- Repeating entire words, often monosyllabic (e.g., "I-I-I-I see him"). **B. Impact on Life**: The disorder must cause significant distress, leading to anxiety about speaking, difficulty in social situations, and problems with school or work. **C. Early Onset** Symptoms must appear in early childhood, not in adulthood. If a similar fluency disorder begins in adulthood, it is diagnosed as Adult-Onset Fluency Disorder (F98.5). **D. Not Due to Another Condition** The stuttering should not be due to neurological damage (like a stroke or brain injury). It should not be caused by a motor or sensory issue (like a hearing impairment). It should not be better explained by a mental health condition. SSD is about making sounds correctly (pronunciation problem). Stuttering is about how smoothly speech flows (fluency problem). SSD usually doesn't cause speaking anxiety, while stuttering often does. SSD errors are consistent, while stuttering varies by situation.