DSM-5 Neurodevelopmental Disorders

Persistent (chronic) motor or vocal tic disorder.

A patient has either motor or vocal tics, but not both

Specific learning disorder.

This may involve problems with reading, mathematics, or written expression.

Gender dysphoria in children.

A boy or girl wants to be of the other gender

Factitious disorder imposed on another.

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

Selective mutism.

A child chooses not to talk, except when alone or with select intimates. DSM-5 lists this as an anxiety disorder.

Conduct disorder.

A child persistently violates rules or the rights of others.

Language disorder

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

Disruptive mood dysregulation disorder.

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

Encopresis.

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

Enuresis.

At age 5 years or later, there is repeated voiding of urine (it can be voluntary or involuntary) into bedding or clothing.

Essential Features of Language Disorder

Beginning early in childhood, a patient's use of spoken and written language persistently lags behind age expectations. Compared to age-mates, patients will have small vocabularies, impaired use of words to form sentences, and reduced ability to employ sentences to express ideas.

Speech sound disorder

Correct speech develops slowly for the patient's age or dialect

Social (pragmatic) communication disorder.

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

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

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.

Essential Features of Autism Spectrum Disorder

From early childhood, contact with others affects to some extent nearly every aspect of how these patients function. Social relationships vary from mild impairment to almost complete lack of interaction. There may be just a reduced sharing of interests and experiences, though some patients fail utterly to initiate or respond to the approach of others. They tend to speak with few of the usual physical signals most people use—eye contact, hand gestures, smiles, and nods. Relationships with other people founder, so that SP have trouble adapting their behavior to different social situations; they may lack general interest in other people and make few, if any, friends. Repetition and narrow focus characterize their activities and interests. They resist even small changes in their routines (perhaps demanding exactly the same menu every lunchtime or endlessly repeating already-answered questions). They may be fascinated with movement (such as spinning) or small parts of objects. The reaction to stimuli (pain, loud sounds, extremes of temperature) may be either feeble or excessive. Some are unusually preoccupied with sensory experiences: They are fascinated by visual movement or particular smells, or they sometimes fear or reject certain sounds or the feel of certain fabrics. They may use peculiar speech or show stereotypies of behavior such as hand flapping, body rocking, or echolalia.

Essential Features of Social (Pragmatic) Communication Disorder

From early childhood, the patient has difficulty with each of these features: using language for social reasons, adapting communication to fit the context, following the conventions (rules) of conversation, and understanding implied communications.

Autism spectrum disorder.

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

Essential Features of Intellectual Disability

From their earliest years, people with ID are in cognitive trouble. Actually, it's trouble of two sorts. First, as assessed both clinically and with formal testing, they have difficulty with cognitive tasks such as reasoning, making plans, thinking in the abstract, making judgments, and learning from formal studies or from life's experiences. Both clinical judgment and the results of one-on-one intelligence tests are required to assess intellectual functioning. Second, their cognitive impairment leads to difficulty adapting their behavior so that they can become citizens who are independent and socially accountable. These problems occur in conceptual, social interaction, and practical living skills. To one degree or another, depending on severity, they affect the patient across multiple life areas—family, school, work, and social relations.

Attention-deficit/hyperactivity disorder.

In this common condition (usually abbreviated as ADHD), patients are hyperactive, impulsive, or inattentive, and often all three.

Individuals with intellectual disability (ID)

Most people with _________has such a deficit need special help to cope. This need defines the other major requirement for diagnosis: The patient's ability to adapt to the demands of normal life—in school, at work, at home with family—must be impaired in some important way. We can break down adaptive functioning into three areas: (1) the conceptual, which depends on language, math, reading, writing, reasoning, and memory to solve problems; (2) the social, which includes deploying such abilities as empathy, communication, awareness of the experiences of other people, social judgment, and self-regulation; and (3) the practical, which includes regulating behavior, organizing tasks, managing finances, and managing personal care and recreation. How well these adaptations succeed depends on the patient's education, job training, motivation, personality, support from significant others, and of course intelligence level.

Essential Features of Developmental Coordination Disorder

Motor skills are so much poorer than you'd expect, given a child's age, that they get in the way of progress in school, sports, or other activities. The specific motor behaviors involved include general awkwardness; problems with balance; delayed developmental milestones; and slow achievement of basic skills such as jumping, throwing or catching a ball, and handwriting.

Oppositional defiant disorder.

Multiple examples of negativistic behavior persist for at least 6 months

Tourette's disorder.

Multiple vocal and motor tics occur frequently throughout the day in these patients

Stereotypic movement disorder

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

Speech Sound Disorder

Substituting one sound for another or omitting certain sounds completely is the sort of error made by patients with speech sound disorder (SSD), formerly called phonological disorder. The difficulty can arise from inadequate knowledge of speech sounds or from motor problems that interfere with speech production. Consonants are affected most often, as in lisping. Other examples include errors in the order of sounds ("gaspetti" for spaghetti). The errors of speech found in those who learn English as a second language are not considered examples of SSD. When SSD is mild, the effects may appear quaint or even cute, but the disorder renders more severely affected individuals hard to understand, sometimes unintelligible

Essential Features of Attention-Deficit/Hyperactivity Disorder

Teachers often notice and refer for evaluation these children, who are forever in motion, disrupting class by their restlessness or fidgeting, jumping out of their seats, talking endlessly, interrupting others, seeming unable to take turns or to play quietly. In fact, hyperactivity is only half the story. These children also have difficulty paying attention and maintaining focus on their work or play—the inattentive part of the story. Readily distracted (and therefore disliking and avoiding sustained mental effort such as homework), they neglect details and therefore make careless errors. Their poor organization skills result in lost assignments or other materials and an inability to follow through with chores or appointments. These behaviors invade many aspects of their lives, including school, family relations, and social life away from home. Although the behaviors may be somewhat modified with increasing age, they may accompany these individuals through the teen years and beyond.

Childhood-onset fluency disorder (stuttering)

The normal fluency of speech is frequently disrupted

Separation anxiety disorder.

The patient becomes anxious when apart from parent or home.

Pica.

The patient eats material that is not food.

Essential Features of Specific Learning Disorder

The patient has important problems with reading, writing, or arithmetic, to wit: Reading is slow or requires inordinate effort, or the patient has marked difficulty grasping the meaning. The patient has trouble with writing content (not the mechanics): There are grammatical errors, ideas are expressed in an unclear manner or are poorly organized, or spelling is unusually "creative." The patient experiences unusual difficulty with math facts, calculation, or mathematical reasoning. Whichever skill is affected, standardized tests reveal scores markedly less than expected for age.

Essential Features of Speech Sound Disorder

The patient has problems producing the sounds of speech, compromising communication

Developmental coordination disorder.

The patient is slow to develop motor coordination; some also have attention-deficit/hyperactivity disorder or learning disorders

Rumination disorder.

There is persistent regurgitation and chewing of food already eaten.

Other specified (or unspecified) neurodevelopmental disorder.

These categories serve for patients whose difficulties don't fulfill criteria for one of the above disorders

Individuals with intellectual disability (ID)

These individuals have two sorts of problems, one resulting from the other. First, there's a fundamental deficit in their ability to think. This will be some combination of problems with abstract thinking, judgment, planning, problem solving, reasoning, and general learning (whether from academic study or from experience). Their overall intelligence level, as determined by a standard individual test (not one of the group tests, which tend to be less accurate), will be markedly below average.

Essential Features of Childhood-Onset Fluency Disorder (Stuttering)

These patients have problems speaking smoothly, most notably with sounds that are drawn out or repeated; there may be pauses in the middle of words. They experience marked tension while speaking, and will repeat entire words or substitute easier words for those that are difficult to produce. The result: anxiety about the act of speaking.

Academic or educational problem

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

Intellectual disability

This condition usually begins in infancy; people with it have low intelligence that causes them to need special help in coping with life

Borderline intellectual functioning.

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

Provisional tic disorder.

Tics occur for no longer than 1 year.

Unspecified communication disorder.

Use for communication problems where you haven't enough information to make a specific diagnosis.

Other or unspecified tic disorder.

Use one of these categories for tics that do not meet the criteria for any of the preceding.

Other specified (or unspecified) attention-deficit/hyperactivity disorder.

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

F89 [315.9] Unspecified Neurodevelopmental Disorder

Use these categories for those patients who have a disorder that appears to begin before adulthood and is not better defined elsewhere. For those in the first group, specify a reason, such as, "Neurodevelopmental disorder associated with ingestion of lead." The latter category is used especially when you lack adequate information

Unspecified intellectual disability

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

Global developmental delay

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

Essential Features of Stereotypic Movement Disorder

You can't find another physical or mental cause for the patient's pointless, repeated movements, such as head banging, swaying, biting (of self), or hand flapping.

Communication disorders

___________________ disorders are among the most frequent reasons why children are referred for special evaluation. For some children, problems with communication are symptomatic of broader developmental problems, such as autism spectrum disorder and intellectual disability. Many other children, however, have stand-alone disorders of speech and language. Disorders of speech include lack of speech fluidity (for example, stuttering); inaccurately produced or appropriately used speech sounds (as in speech sound disorder); and developmental verbal dyspraxias, which result from impaired motor control and coordination of speech organs. Disorders of language comprise problems with formation of words (morphology) or sentences (syntax), language meaning (semantics), and the use of context (pragmatics). These disorders still are not well understood or (often) well recognized. While they are differentiable, they are also highly comorbid with one another

Intellectual Disability (ID)

begins during the developmental years (childhood and adolescence). Of course, in most instances the onset is at the very beginning of this period—usually in infancy, often even before birth

Autism spectrum disorder (ASD)

is a heterogeneous neurodevelopmental disorder with widely varying degrees and manifestations that has both genetic and environmental causes. Usually recognized in early childhood, it continues through to adult life, though the form may be greatly modified by experience and education. The symptoms fall into three broad categories: communication, socialization and motor behavior

Language disorder (LD)

is a new category intended to cover language-related problems including spoken and written language (and even sign language) that are manifested in receptive and expressive language ability—though these may be present to different degrees. Both vocabulary and grammar are usually affected. Patients with LD speak later and less than normal children, ultimately impairing academic progress. Later in life, occupational success may be impaired. The diagnosis should be based on history, direct observation, and standardized testing, though no actual testing results are specified in the criteria. The condition tends to persist, so that affected teens and adults will likely continue to have difficulty expressing themselves. This disorder has strong genetic underpinnings.

a tic

is a sudden vocalization or movement of the body that is repeated, rapid, and unrhythmic—so quick, in fact, that it can occur literally in (and sometimes is) the blink of an eye. Complex ____, which may include several simple _____ in quick succession, naturally take longer. ______ are common; they can occur by themselves or as symptoms of Tourette's disorder.

Essential Features of Tourette's Disorder

patients with TD are often eye blinks that appear when the children are 6 or thereabouts. They are joined by vocal tics, which may initially be grunts or throat clearings. Eventually, patients with TD have multiple motor tics and at least one vocal tic. The best-known tic of all, coprolalia—swear words and other socially unacceptable speech—is relatively uncommon.