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

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 5

Language disorder

Question 6

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

Answer 6

Selective mutism

Question 7

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

Answer 7

Tourette’s disorder

Question 8

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

Answer 8

Persistent (chronic) motor or vocal tic disorder

Question 9

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

Specificities

Answer 9

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 10

Multiple examples of negativistic behavior persist for at least 6 months; difficulty with authority

Answer 10

Oppositional defiant disorder (ODD)

Question 11

A child persistently violates rules or the rights of others

Answer 11

Conduct disorder

Question 12

The patient eats material that is not food

Answer 12

Pica

Question 13

There is a persistent regurgitation and chewing of food already eaten

Answer 13

Rumination disorder

Question 14

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

Answer 14

Encopresis

Question 15

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

Answer 15

Enuresis

Question 16

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 16

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

Question 17

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 17

Parent-child relational problem

Question 18

This z-code is used for difficulties between siblings

Answer 18

Sibling relational problem

Question 19

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

Answer 19

Problems related to abuse or neglect

Question 20

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

Answer 20

Disruptive mood dysregulation disorder

Question 21

The patient becomes anxious when apart from parent or home

Answer 21

Separation anxiety disorder

Question 22

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

Answer 22

Post-traumatic stress disorder in preschool children

Question 23

A boy or girl wants to be of the other gender

Answer 23

Gender dysphoria in children

Question 24

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

Answer 24

Factitious disorder imposed on another

Question 25

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

Answer 25

Other specified or unspecified neurodevelopmental disorder

Question 26

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 26

Mild Intellectual Disability

Question 27

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 27

Moderate Intellectual Disability

Question 28

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 28

Severe Intellectual Disability

Question 29

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 29

Profound Intellectual Disability

Question 30

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 30

Autism Spectrum Disorder requiring support

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

Question 31

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 31

Autism Spectrum Disorder requiring substantial support

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

Question 32

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 32

Autism spectrum disorder requiring very substantial support

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

Question 33

Best Treatment Practices

Answer 33

Family Integration Therapy; in adults, Environmental Enrichment to reinstate greater levels of plasticity in adulthood. EE = environment rich in social, physical, cognitive, and inanimate stimulation