NEURODEVELOPMENTAL DISORDERS

Overview

Most disorders have their origins in childhood, but problems may not appear fully until much later. The
term ``childhood disorder'' can be misleading because disorders that appear early in life often persist
into old age. All the developmental disorders in this group are believed to be neurological in origin, so
the DSM-5 classifies them as neurodevelopmental disorders (American Psychiatric Association, 2013).

Clinical Descriptions

Attention-Deficit Hyperactivity Disorder (ADHD)

Individuals with this disorder have a great deal of difficulty sustaining their attention on a task or
activity (e.g. unfinished task, seem to not be listening when someone talks to them); display motor
hyperactivity (e.g. fidgety, unable to sit still); impulsivity-acting apparently without thinking.

There are two categories of symptoms of ADHD:

 Problems of inattention - People may appear not to listen to others; they may lose
necessary school assignments, books, or tools; and they may not pay enough attention to
details, making careless mistakes.
 Hyperactivity and impulsivity - Hyperactivity includes fidgeting, having trouble sitting for
any length of time, and always on the go. Impulsivity includes blurting out answers before
questions have been completed and having trouble waiting turns.

Either the first (inattention) or the second and third (hyperactivity and impulsivity) set of symptoms
must be present for someone to be diagnosed with ADHD. These different presentations are called
subtypes including inattentive subtype, hyperactive/impulsive subtype, and combined subtype
(individuals meet criteria for both inattention and hyperactivity/ impulsivity).

Specific Learning Disorder

A significant discrepancy between a person’s academic achievement and what would be expected
for someone of the same age—referred to by some as “unexpected underachievement.” The
person perform academically at a level significantly below that of a typical person of the same age,
cognitive ability (as measured on an IQ test), and educational background; the person’s disability
not be caused by a sensory difficulty, such as trouble with sight or hearing, and should not be the
result of poor or absent instruction – are criteria’s to be diagnosed with SLD.

DSM-IV-TR listed specific disorders in reading, mathematics, and written expression as separate
disorders, but they are now combined to assist clinicians in taking a broader view of the
individual’s learning styles. Clinicians can use the specifiers for disorders of reading, written
expression, or mathematics to highlight specific problems for remediation. As with other disorders,
clinicians rate the disorder on levels of severity.

Autism Spectrum Disorder

Autism spectrum disorder (ASD) is a neurodevelopmental disorder that, at its core, affects how
one perceives and socializes with others. There are two major characteristics of ASD expressed in
DSM-5 –- 1) impairments in social communication and social interaction, and 2) restricted,
repetitive patterns of behavior, interests, or activities.
To accommodate the range of difficulties in the two symptom clusters (social/communication
interaction and restricted, repetitive patterns of behavior, interests, or activities), DSM-5 introduced
three levels of severity: Level 1— “Requiring support,” Level 2— “Requiring substantial support,”
and “Level 3— “Requiring very substantial support.
Intellectual Disability (Intellectual Developmental Disorder)
Intellectual disability (ID) is a disorder evident in childhood as significantly below-average
intellectual and adaptive functioning. People with ID experience difficulties with day-to-day
activities to an extent that reflects both the severity of their cognitive deficits and the type and
amount of assistance they receive. DSM-5 identifies difficulties in three domains: conceptual (e.g.,
skill deficits in areas such as language, reasoning, knowledge, and memory), social (e.g.,
problems with social judgment and the ability to make and retain friendships), and practical (e.g.,
difficulties managing personal care or job responsibilities).

People with ID display a broad range of abilities and personalities. To be diagnosed with ID, a
person must have significantly subaverage intellectual functioning, a determination made with one
of several IQ tests with a cutoff score set by DSM-5 of approximately 70. The second criterion calls
for concurrent deficits or impairments in adaptive functioning. In other words, scoring
“approximately 70 or below” on an IQ test is not sufficient for a diagnosis of ID; a person must also
have significant difficulty in areas such as communication, self-care, home living, social and
interpersonal skills, use of community resources, self-direction, functional academic skills, work,
leisure, health, and safety. The final criterion for ID is the age of onset. The characteristic below-
average intellectual and adaptive abilities must be evident before the person is 18.

People with ID differ significantly in their degree of disability. Traditionally, classification systems
have identified four levels of ID: mild, which is identified by an IQ score between 50–55 and 70;
moderate, with a range of 35–40 to 50–55; severe, ranging from 20–25 to 35–40; and profound,
which includes people with IQ scores below 20–25.

Epidemiology

ADHD
More prevalent in boys than girls
SLD

ASD
Symptoms often develop before 36 months of age
ID