What are Developmental Disorders?Presented by Carol Nati, MD, MS, DFAPAMedical Director, MHMRTC

DSM-5

● DSM = The Diagnostic and Statistical Manuel of Mental Disorders.

● It’s in its 5th edition.

● Published in 2013, it has new definitions and terms that need to be explained.

What are Intellectual Disabilities?

Disorders that start when someone is developing.

Individuals must have deficits in intellectual and adaptive functioning.

3 Criteria Must be Met

1. The person must have deficits in reasoning, problem solving, planning, learning or judgment.2. The deficits must result in failure to meet standards for personal independence and social responsibility.3. This must occur during the developmental period.

Rosa’s Law

• A federal statute in the United States.

• Public Law 111-256• It replaced the term mental

retardation with Intellectual Disability (ID).

• Intellectual Developmental Disorders (IDD) are another way that these disorders are described.

Levels of Severity

• Mild• Moderate• Severe• Profound

These are defined on the basis of adaptive functioning, not IQ scores, because adaptive functioning determines the level of support needed.

Global Development Delay

• This is diagnosed in children under the age of 5 when the clinical severity cannot be reliably assessed.

• You can use this term in children who are too young to participate in standardized testing.

Unspecified Intellectual Disability

This term is used in children who are over the age of 5 when assessment of the degree of intellectual disability is difficult or impossible.• This could be due to a lack of

locally available procedures or due to physical impairments such as blindness or deafness.

• There also could be severe behavioral problems or another mental disorder present.

Social (Pragmatic) Communication Disorder

Persistent difficulties in the social use of verbal and nonverbal communication.

1. Deficits in using communication for social purposes.

2. Difficulty in changing communication to match the context of the situation.

3. Difficulties in following the rules of conversation.

4. Difficulties understanding what is not explicitly stated.

• These deficits need to result in functional limitations to communication.

• The onset of the symptoms need to be in the early developmental period.

• The symptoms cannot be due to another medical, neurological condition or mental disorder.

Social (Pragmatic) Communication Disorder

Autism Spectrum Disorders (ASD)

• These individuals have persistent deficits in social communication and social interaction.

• They also have restricted or repetitive patterns of behavior, interests or activities.

• Symptoms must be present in the early developmental period.

• The symptoms have to cause impairment in social, occupational or other important areas of functioning.

ASD Continued

These individuals have persistent deficits in social communication and social interaction.• Abnormal social approach or failure of

normal back and forth conversation• Problems with nonverbal

communication – eye contact or gestures.

• Problems with developing, maintaining and understanding relationships.

ASD Continued

They also have restricted or repetitive patterns of behavior, interests or activities.• Repetitive motor movements or

speech• Insistence on sameness• Highly restricted interests• Increased or decreased activity

with sensory input.

ASD Continued

Symptoms must be present in the early developmental period.• They may not become fully evident

until social demands limit capacities.• They also may be masked by learned

strategies in later life.Note: You can diagnose both an Intellectual Disability and Autism Spectrum Disorder in the same person.

What about Asperger’s Disorder?

Individuals who were diagnosed with Asperger’s Disorder, Autistic Disorder or Pervasive Developmental Disorder Not Otherwise Specified in DSM-IV will now all be given the diagnosis of Autism Spectrum Disorder (ASD).

Other Neurodevelopmental Disorders

Individuals with IDD also can have other disorders, including:• Attention-Deficit / Hyperactivity

Disorder (ADD/ADHD)• Specific Learning Disorders• Developmental Coordination

Disorders• Tic (movement) Disorders• Along with other possible

disorders

Questions/ Comments?

Thank you for the opportunity

to speak on this topic.

More Information

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