Neurodevelopmental Disorders Lesson 9

**[Lesson 09]** **[Neurodevelopmental Disorders II]** **[Topic: 36-41]** **[Topic 36: Specific Learning Disorder]** Specific learning disorder, often referred to as learning disorder or learning disability, is a neurodevelopmental disorder that begins during school-age, although it may not be re...

**[Lesson 09]** **[Neurodevelopmental Disorders II]** **[Topic: 36-41]** **[Topic 36: Specific Learning Disorder]** Specific learning disorder, often referred to as learning disorder or learning disability, is a neurodevelopmental disorder that begins during school-age, although it may not be recognized until adulthood. This disorder is characterized by specific deficits in an individual\'s ability to perceive or process information efficiently and accurately. Learning disabilities refer to ongoing problems in one of three areas, i.e. reading, writing, and/or math, which is foundational to one's ability to learn. This disability has to be persistent and impairing to be diagnosed with specific learning disorder.  **Diagnostic Criteria for Specific Learning Disorders: ** A. Difficulties 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: 1. 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). 2. 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). 3. Difficulties with spelling (e.g., may add, omit, or substitute vowels or consonants). 4. Difficulties with written expression (e.g., makes multiple grammatical or punctuation errors within sentences; employs poor paragraph organization; written expression of ideas lacks clarity). 5. 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). 6. Difficulties with mathematical reasoning (e.g., has severe difficulty applying mathematical concepts, facts, or procedures to solve quantitative problems). B. 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 age 17 years and older, a documented history of impairing learning difficulties may be substituted for the standardized assessment. C. 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 (e.g., as in timed tests, reading or writing lengthy complex reports for a tight deadline, excessively heavy academic loads). D. 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. Note; The four diagnostic criteria are to be met based on a clinical synthesis of the individual's history (developmental, medical, family, educational), school reports, and psycho- educational assessment. **[Topic 37: Specific Learning Disabilities]** **Diagnostic Criteria: (In continuation to the previous topic 36):** While diagnosing an individual we have to look at the specifiers and spicy if: **Reading Disability: **With impairments in reading: - Word reading accuracy - Reading rate or fluency - Reading comprehension **Writing Disability: **With impairment in the written expression: - Spelling accuracy - Grammar and punctuation accuracy - Clarity or organization of written expression **Mathematical Disability: **With impairments in mathematics - Number sense - Memorization of arithmetic facts - Accurate or fluent calculation - Accurate math reasoning We also need to specify current severity on the followings: **Mild:** Some difficulties learning skills in one or two academic domains, but of mild enough severity that the individual may be able to 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. Some accommodations or supportive services at least part of the day at school, in the workplace, or at home may be needed to complete activities accurately and efficiently. **Severe:** Severe difficulties learning skills, affecting several academic domains, so that the individual is unlikely to learn those skills without ongoing intensive individualized and specialized teaching for most of the school years. Even with an array of appropriate accommodations or services at home, at school, or in the workplace, the individual may not be able to complete all activities efficiently [**Topic 38**: **Communication Disorders**] A communication disorder is any disorder that affects an individual\'s ability to comprehend, detect, or apply language and speech to engage in discourse effectively with others. Following are types of communication disorders: - Language Disorder - Speech Sound disorders - Social communication disorder - Childhood-onset fluency disorder (stuttering & stammering) **Language Disorder** Language disorder is characterized by persistent difficulties in the acquisition and use of language due to comprehension or production. **Diagnostic Criteria:** Following is the diagnostic criteria of language disorders: A. Persistent difficulties in the acquisition and use of language across modalities (i.e., spoken, written, sign language, or other) due to deficits in comprehension or production that include the following: 1. Reduced vocabulary (word knowledge and use). 2. Limited sentence structure (ability to put words and word endings together to form sentences based on the rules of grammar and morphology). 3. Impairments in discourse (ability to use vocabulary and connect sentences to explain or describe a topic or series of events or have a conversation). 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. C. Onset of symptoms is in the early developmental period. D. The difficulties are not attributable to hearing or other sensory impairment, motor dysfunction, or another medical or neurological condition and are not better explained by intellectual disability (intellectual developmental disorder) or global developmental delay. [**Topic 39**: **Speech Sound Disorders**] Speech sound disorders is an umbrella term referring to any difficulty or combination of difficulties with perception, motor production, or phonological representation of speech sounds and speech segment. **Diagnostic Criteria:** Following is the diagnostic criteria of speech sound disorders: A. Persistent difficulty with speech sound production that interferes with speech intelligibility or prevents verbal communication of messages. B. The disturbance causes limitations in effective communication that interfere with social participation, academic achievement, or occupational performance, individually or in any combination. C. Onset of symptoms is in the early developmental period. D. The difficulties are not attributable to congenital or acquired conditions, such as cerebral palsy, cleft palate, deafness or hearing loss, traumatic brain injury, or other medical or neurological conditions. **[Topic 40: Childhood-Onset Fluency Disorder (Stuttering)]** Childhood-onset fluency disorder is a communication disorder in which there is a disturbance in the flow and timing of speech. **Diagnostic Criteria:** Following is the diagnostic criteria of childhood-onset fluency disorder: A. Disturbances in the normal fluency and time patterning of speech that are inappropriate for the individual's age and language skills, persist over time, and are characterized by frequent and marked occurrences of one (or more) of the following: 1. Sound and syllable repetitions. 2. Sound prolongations of consonants as well as vowels. 3. Broken words (e.g., pauses within a word). 4. Audible or silent blocking (filled or unfilled pauses in speech). 5. Circumlocutions (word substitutions to avoid problematic words). 6. Words produced with an excess of physical tension. 7. Monosyllabic whole-word repetitions (e.g., "I-I-I-I see him"). B. The disturbance causes anxiety about speaking or limitations in effective communication, social participation, or academic or occupational performance, individually or in any combination. C. The onset of symptoms is in the early developmental period. (Note: Later-onset cases are diagnosed as 307.0 \[F98.5\] adult-onset fluency disorder.) D. The disturbance is not attributable to a speech-motor or sensory deficit, dysfluency associated with neurological insult (e.g., stroke, tumor, trauma), or another medical condition and is not better explained by another mental disorder. [**Topic 41**: **Social Communication Disorder**] The social communication disorder is characterized by difficulties with the use of verbal and nonverbal language for social purposes. Individual faces difficulties in understanding what is not explicitly stated. Individual experiences functional limitations in:  - Effective communication - Social participation - Social relationships - Academic or occupational performance **Diagnostic Criteria:** Following is the diagnostic criteria of social communication disorder: A. Persistent difficulties in the social use of verbal and nonverbal communication as manifested by all of the following: 1. Deficits in using communication for social purposes, such as greeting and sharing information, in a manner that is appropriate for the social context. 2. Impairment of the ability to change communication to match context or the needs of the listener, such as speaking differently in a classroom than on a playground, talking differently to a child than to an adult, and avoiding use of overly formal language. 3. Difficulties following rules for conversation and storytelling, such as taking turns inconversation, rephrasing when misunderstood, and knowing how to use verbal and nonverbal signals to regulate interaction. 4. Difficulties understanding what is not explicitly stated (e.g., making inferences) and nonliteral or ambiguous meanings of language (e.g., idioms, humor, metaphors, multiple meanings that depend on the context for interpretation). B. The deficits result in functional limitations in effective communication, social participation, social relationships, academic achievement, or occupational performance, individually or in combination. C. The onset of the symptoms is in the early developmental period (but deficits may not become fully manifest until social communication demands exceed limited capacities). D. The symptoms are not attributable to another medical or neurological condition or to low abilities in the domains of word structure and grammar, and are not better explained by autism spectrum disorder, intellectual disability (intellectual developmental disorder), global developmental delay, or another mental disorder.