DSM-5 Flashcards
Neurodevelopmental Disorders
a group of conditions with onset in the developmental period (often before grade school)
characterized by developmental deficits that produce impairments of personal, social, academic, or occupational functioning frequently co-occur
Neurodevelopmental Disorders - Intellectual Disabilities (List)
Intellectual Disability
Global Developmental Delay
Unspecified Intellectual Disability
Neurodevelopmental Disorders - Communication Disorders (List)
Language Disorder
Speech sound Disorder
Childhood Onset Fluency Disorder (Stuttering)
Social (Pragmatic) Communication Disorder
Unspecified Communication Disorder
Neurodevelopmental Disorders - Attention Deficit Hyperactivity Disorder (List)
Attention Deficit Hyperactivity Disorder
- Combined Presentation
- Predominantly Inattentive Presentation
- Predominantly Hyperactivity/Impulsivity
Other Specified ADHD Unspecified ADHD
Neurodevelopmental Disorders - Motor Disorders (List)
Developmental Coordination Disorder
Stereotypic Movement Disorder
Tourette’s Disorder
Persistent (Chronic) Motor or Vocal Tic Disorder
Provisional Tic Disorder
Other Specified Tic Disorder
Unspecified Tic Disorder
Intellectual Disability - Diagnostic Criteria
A. Deficits in intellectual functions, such as reasoning, problem-solving, planning, abstract thinking, judgment, academic learning, and learning from experience, confirmed by both clinical assessment and individualized, standardized intelligence testing.
B. Deficits in adaptive functioning that result in failure to meet developmental and sociocultural standards for personal independence and social responsibility. Without ongoing support, the adaptive deficits limit functioning in one or more activities of daily life, such as communication, social participation, and independent living, across multiple environments, such as home, school, work, and community.
C. Onset of intellectual and adaptive deficits during the developmental period.
Intellectual Disability - Prevalence
overall general population prevalence of approximately 1% (prevalence rates vary by age)
Prevalence for severe intellectual disability is approximately 6 per 1,000.
Intellectual Disability Risk and Prognostic Factors
Genetic and physiological: Prenatal etiologies include genetic syndromes (e.g., sequence variations or copy number variants involving one or more genes; chromosomal disorders), inborn errors of metabolism, brain malformations, maternal disease (including placental disease), and environmental influences (e.g., alcohol, other drugs, toxins, teratogens).
Perinatal causes include a variety of labor and delivery-related events leading to neonatal encephalopathy. Postnatal causes include hypoxic-ischemic injury, traumatic brain injury, infections, demyelinating disorders, seizure disorders (e.g., infantile spasms), severe and chronic social deprivation, and toxic metabolic syndromes and intoxications (e.g., lead, mercury).
Intellectual Disability Culture-Related Diagnostic Factors
Intellectual disability occurs in all races and cultures. Cultural sensitivity and knowledge are needed during assessment, and the individual’s ethnic, cultural, and linguistic background, available experiences, and adaptive functioning within his or her community and cultural setting must be taken into account.
Intellectual Disability Gender-Related Diagnostic Factors
Overall, males are more likely than females to be diagnosed with both mild (average male female ratio 1.6:1) and severe (average male:female ratio 1.2:1) forms of intellectual disability. However, gender ratios vary widely in reported studies. Sex-linked genetic factors and male vulnerability to brain insult may account for some of the gender differences.
Intellectual Disability - Diagnostic Markers
A comprehensive evaluation includes an assessment of intellectual capacity and adaptive functioning; identification of genetic and nongenetic etiologies; evaluation for associated medical conditions (e.g., cerebral palsy, seizure disorder); and evaluation for co-occurring mental, emotional, and behavioral disorders.
Components of the evaluation may include basic pre- and perinatal medical history, three-generational family pedigree, physical examination, genetic evaluation (e.g., karyotype or chromosomal microarray analysis and testing for specific genetic syndromes), and metabolic screening and neuroimaging assessment.
Intellectual Disability Differential Diagnosis
A diagnosis of intellectual disability should not be assumed because of a particular genetic or medical condition. A genetic syndrome linked to intellectual disability should be noted as a concurrent diagnosis with the intellectual disability.
Major and Mild Neurocognitive Disorders
Communication Disorders and Specific Learning Disorders
Autism Spectrum Disorder
Intellectual Disability Differential Diagnosis - Autism Spectrum Disorder
ID is common among individuals with autism spectrum disorder. Assessment of intellectual ability may be complicated by social- communication and behavior deficits inherent to autism spectrum disorder, which may interfere with understanding and complying with test procedures. Appropriate assessment of intellectual functioning in autism spectrum disorder is essential, with reassessment across the developmental period, because IQ scores in autism spectrum disorder may be unstable, particularly in early childhood.
Intellectual Disability Differential Diagnosis - Communication Disorders and Specific Learning Disorder
These neurodevelopmental disorders are specific to the communication and learning domains and do not show deficits in intellectual and adaptive behavior. They may co-occur with intellectual disability. Both diagnoses are made if full criteria are met for intellectual disability and a communication disorder or specific learning disorder.
Intellectual Disability Differential Diagnosis - Major and Mild Neurocognitive Disorders
Intellectual disability is categorized as a neurodevelopmental disorder and is distinct from the neurocognitive disorders, which are characterized by a loss of cognitive functioning. Major neurocognitive disorder may cooccur with intellectual disability (e.g., an individual with Down syndrome who develops Alzheimer’s disease, or an individual with intellectual disability who loses further cognitive capacity following a head injury). In such cases, the diagnoses of intellectual disability and neurocognitive disorder may both be given.
