Neurodevelopmental Disorders

Question 1

This condition usually begins in infancy; people with it have low intelligence that causes them to need special help coping with life. They have difficulty with cognitive tasks and cognitive impairment. Affected in multiple life areas.

Answer 1

Intellectual disability

Severity level: IQ
Mild: ~50-70; 85% of patients
Moderate: ~30-50; 10% of patients
Severe: ~20-30; 5% of patients
Profound: low 20s down; 2% of patients

Question 2

Indicates persons nominally ranked in the IQ range of 71-84 who do not have the coping problems associated with intellectual disability

Answer 2

Borderline intellectual functioning

Question 3

From early childhood, the patient has impaired social interactions and communication and shows stereotyped behaviors and interests.

Answer 3

Autism spectrum disorder

Specify:
{with}{without} accompanying intellectual impairment
{with}{without} accompanying language impairment
Associated with a known medical or genetic condition or environmental factor
Associated with another neurodevelopmental, mental, or behavior disorder
With catatonia

Question 4

Use when a child under the age of 5 seems to be falling behind developmentally, but you cannot reliably assess the degree

Answer 4

Global developmental delay

Question 5

Use this category when a child 5 years old or older cannot be reliably assessed, perhaps due to physical or mental impairment

Answer 5

Unspecified intellectual disability

Question 6

A child’s delay in using spoken and written language is characterized by small vocabulary, grammatically incorrect sentences, and/or trouble understanding words or sentences

Answer 6

Language disorder

Question 7

Despite adequate vocabulary and the ability to create sentences, these patients have trouble with the practical use of language; their conversational interactions tend to be inappropriate.

Answer 7

Social (pragmatic) communication disorder

Question 8

The patient has problems producing the sounds of speech, compromising communication. Correct speech develops slowly for the patients age or dialect

Answer 8

Speech sound disorder

Question 9

The normal fluency of speech is frequently disrupted

Answer 9

Childhood-onset fluency disorder (stuttering)

Question 10

A child chooses not to talk, expect when alone or with select intimates (DSM-5 classifies as anxiety disorder)

Answer 10

Selective mutism

Question 11

This may involve problems with reading, math, or written expression

Answer 11

Specific learning disorder

Question 12

Specific learning disorder with impairment in reading; math

Answer 12

dyslexia; dyscalculia

Question 13

This z-code is used when a scholastic problem (other than learning disorder) is the focus of treatment

Answer 13

Academic or educational problem

Question 14

Use for communication problems where you haven’t enough info to make a specific diagnosis.

Answer 14

Unspecified communication disorder

Question 15

The patient is slow to develop motor coordination; some also have ADHD or learning disorder

Answer 15

Developmental coordination disorder

Question 16

Begins in early childhood. Patients repeatedly rock, bang their heads, bite themselves, or pick at their own skin or body orifices.

Specificities

Answer 16

Stereotypic movement disorder

Specify:
{with}{without} self-injurious behavior

Mild. symptoms managed behaviorally
Moderate. symptoms require behavior modification and protective measures
Severe. symptoms require continuous watching to avert possible injury

Associated with a known medical or genetic condition, neurodevelopmental disorder, or environmental factor (ID or fetal alcohol syndrome)

Question 17

Multiple vocal tics (1+) and motor tics (2+) occur frequently throughout the day (longer than 1 year; begin by age 18)

Answer 17

Tourette’s disorder

Question 18

A patient has either motor OR vocal tics, but NOT both (longer than 1 year; begin by age 18)

Answer 18

Persistent (chronic) motor or vocal tic disorder

Question 19

Motor or vocal tics, or both, in any quantity occur no longer than 1 year (begin by age 18)

Answer 19

Provisional tic disorder

Question 20

Use one of these categories for tics that do not meet the criteria for any of the other tic and motor disorders

Answer 20

Other or unspecified tic disorder

Question 21

Patients are hyperactive, impulsive, or inattentive, and often all three (for 6+ months; onset before age 12)

Specificities

Answer 21

Attention-deficit/hyperactivity disorder (ADHD)

Specify (for the past 6 months):
Predominantly inattentive presentation
Predominantly hyperactive/impulsive presentation
Combined presentation

In partial remission: when the condition persists (into adulthood), enough symptoms may be lost that the full criteria are no longer met but impairment persists

Mild. few symptoms
Moderate. intermediate
Severe. many symptoms, more then required

Question 22

Use these categories for symptoms of hyperactivity, impulsivity, or inattention that do not meet full criteria for ADHD

Answer 22

Other specified or unspecified attention-deficit/hyperactivity disorder

Question 23

Multiple examples of negativistic behavior persist for at least 6 months

Answer 23

Oppositional defiant disorder (ODD)

Question 24

A child persistently violates rules or the rights of others

Answer 24

Conduct disorder

Question 25

The patient eats material that is not food

Answer 25

Pica

Question 26

There is a persistent regurgitation and chewing of food already eaten

Answer 26

Rumination disorder

Question 27

At age 4 years or later, the patient repeatedly passes feces into clothing or onto the floor

Answer 27

Encopresis

Question 28

At age 5 or later, there is repeated voiding of urine (voluntary or involuntary) into bedding or clothing

Answer 28

Enuresis

Question 29

During the first part of the night, these patients cry out in apparent fear. Often they don’t really wake up at all. This behavior is considered pathological only in adults, not children.

Answer 29

Non-rapid eye movement sleep arousal disorder, sleep terror type

Question 30

This z-code is used when there is no mental disorder, but a child and parent have problems getting along (ex: overprotection or inconsistent discipline)

Answer 30

Parent-child relational problem

Question 31

This z-code is used for difficulties between siblings

Answer 31

Sibling relational problem

Question 32

A variety of z-codes can be used to cover difficulties that arise from neglect or from physical or sexual abuse of children

Answer 32

Problems related to abuse or neglect

Question 33

A child’s mood is persistently negative between severe temper outbursts

Answer 33

Disruptive mood dysregulation disorder

Question 34

The patient becomes anxious when apart from parent or home

Answer 34

Separation anxiety disorder

Question 35

Children repeatedly relive a severely traumatic event, such as car accidents, natural disasters, or war

Answer 35

Post-traumatic stress disorder in preschool children

Question 36

A boy or girl wants to be of the other gender

Answer 36

Gender dysphoria in children

Question 37

A caregiver induces symptoms in someone else, usually a child, with no intention of material gain

Answer 37

Factitious disorder imposed on another

Question 38

These categories serve for patients whose difficulties don’t fulfill criteria for one of the other disorders

Answer 38

Other specified or unspecified neurodevelopmental disorder

Question 39

Expected to attain 6th grade academic skills; deficiencies in judgment and problem solving; need help with paying bills, shopping, groceries, finding accommodations; many work independently, at jobs requiring little cognitive involvement; memory and language ability can be good, but become lost when confronted with abstract thinking (metaphors); IQ ~50-70; 85% of patients [specify severity of this disorder]

Answer 39

Mild Intellectual Disability

Question 40

Can learn to read, simple math, handle money. Language use is slow to develop and simple. Need help with self-care, household tasks, making decisions, work (at undemanding jobs; sheltered workshops). IQ ~high 30s to low 50s. 10% of all patients [specify severity of this disorder]

Answer 40

Moderate Intellectual Disability

Question 41

Communication skills are rudimentary (single words, some phrases); under supervision they may hold a simple job; require supervision for all activities (even self-care); IQ in ~low 20s to high 30s. 5% of all patients [specify severity of this disorder]

Answer 41

Severe Intellectual Disability

Question 42

Usually results from a serious neurological disorder with sensory or motor disabilities. Limited speech and rudimentary capacity for social interaction (mostly use gestures); need complete help for needs (daily living); may help with simple chores. IQ ~low 20s downward. 1-2% of all patients [specify severity of this disorder]

Answer 42

Profound Intellectual Disability

Question 43

From early childhood, the patient has impaired social interactions and communication and shows stereotyped behaviors and interests.

The patient has trouble starting conversations or may seem less interested in them than most people.
-OR-
Change provokes some problems in at least one area of activity

Answer 43

Autism Spectrum Disorder requiring support

social communication severity: level 1 (mild)
restricted, repetitive behaviors: level 1 (mild)

Question 44

From early childhood, the patient has impaired social interactions and communication and shows stereotyped behaviors and interests.

There are pronounced deficits in both verbal and nonverbal communication.
-OR-
Problems in coping with change are readily apparent and interfere with functioning in various areas of activity.

Answer 44

Autism Spectrum Disorder requiring substantial support

social communication severity: level 2 (moderate)
restricted, repetitive behaviors: level 2 (moderate)

Question 45

From early childhood, the patient has impaired social interactions and communication and shows stereotyped behaviors and interests.

Little response to the approach of others markedly limits functioning. Speech is limited, perhaps to just a few words.
-OR-
Change is exceptionally hard; all areas of activity are influenced by behavioral rigidity. Causes severe distress.

Answer 45

Autism spectrum disorder requiring very substantial support

social communication severity: level 3 (severe)
restricted, repetitive behaviors: level 3 (severe)