Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence Cognitive Disorders

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Disorders Usually First Diagnosed in Infancy,
Childhood, or Adolescence/ Cognitive Disorders
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Core Concepts of the Diagnostic Group

• Primarily categorized by time of onset rather
  than phenomenology.
• Predominantly disorders of abnormal development
  and maturation.
• Emphasis on inability to attain certain normal
  developmental milestones
• Common for individuals to have comorbid disorders

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Necessary Clinical Information

• Times of developmental milestones (i.e., talking,
  walking)
• Capacity to communicate with other people
• Language impairment (expressive, receptive, and
  articulation).
• Capacity for human relationships
• Quality of social interaction
• Abnormal motor movements (e.g., tics, clumsiness)
• Hyperactivity, inattention, or poor impulse
  control
• Abnormal behaviors (e.g., fire setting, animal
  cruelty)
• Enuresis or encopresis

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10 Subgroups of Diagnoses

• Mental Retardation
• Learning Disorders
• Motor Skills Disorders
• Communication Disorders
• Pervasive Developmental Disorders
• Attention-Deficit Disorders and Disruptive
  Behavior Disorders

• Feeding and Eating Disorders of Infancy and Early
  Childhood
• Tic Disorders
• Elimination Disorders
• Other Disorders of Infancy, Childhood, or
  Adolescence

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Groupings by Prominent Symptoms

• DISORDER GROUPS
• Intellectual and Cognitive Impairment
• Motor Function Impairment

• DIAGNOSES
• All Mental Retardation and Learning Disorders
• All Motor Disorders, Tic Disorder Subcategories,
  Sterotypic Movement Disorder

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Groupings by Prominent Symptoms

• All Attention-Deficit
• Disorders and Disruptive
• Behavior
• All Feeding and Eating
• Disorders of Childhood
• All Elimination Disorders
• Separation Anxiety Disorder
• Reactive Attachment
• Disorder of Childhood

• Disruptive or Self-Injurious Behavior

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Groupings by Prominent Symptoms

• Information Exchange

• All Pervasive Developmental Disorders
• All Communication Disorders
• Selective Mutism

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Mental Retardation (p.42)

• Mild Mental Retardation (IQ 50 - 70)
• Moderate Mental Retardation (IQ 35 - 55)
• Severe Mental Retardation (IQ 20 -3 5)
• Profound Mental Retardation (IQ below 20)
• Mental Retardation, Severity Unspecified
  (untestable by standard tests)
• Adaptive behavior
• Listed on Axis II (all other childhood Axis I)

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Learning Disorders

• Reading Disorder
• Mathematics Disorder
• Disorder of Written Expression
• Learning Disorder NOS
• Below expectations in academic areas
• Not due to sensory problems
• Video 10

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Motor Function Disorders

• Characterized by problems in motor coordination,
  abnormal involuntary movement, and stereotypic
  movements that interfere with the patients usual
  activities.

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Major Function Disorders

• Developmental Coordination Disorder (impairment
  in motor coordination)
• Tourettes Disorder (multiple motor and vocal
  tics)
• Chronic Motor or Vocal Tic Disorder (either motor
  or vocal tics but not both)
• Transient Tic Disorder (at least 4 weeks less
  than 12 months)
• Tic Disorder NOS

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Disruptive and Self-Injurious Behavior Disorders
(ADHD, CD, ODD)

• Characterized by behaviors that are socially
  unacceptable or potentially harmful to the
  individual. These include hyperactive,
  impulsive, inattentive, oppositional, defiant,
  and disruptive behavior as well as
  abnormalities of eating and elimination.

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Attention-Deficit Disorders

• ADHD
• Predominantly Inattentive Type
• Predominantly Hyperactive-Impulsive Type
• Combined Type
• Video 15, 18, 21

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Attention-Deficit Disorders

• DSM IV (p. 92)

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Disruptive Behavior Disorders

• Conduct Disorder (violating rights of others or
  societal rules and norms)
• Oppositional Defiant Disorder (negativistic,
  hostile, defiant behavior)
• Disruptive Behavior Disorder NOS

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Feeding and Eating Disorders of Infancy or Early
Childhood

• Pica (eating nonnutritive substances)
• Rumination Disorder (regurgitate and rechew food)
• Feeding Disorder of Infancy or Early Childhood
  (not eating adequately)
• Encopresis (inappropriately passing feces - gt 4
  years old)
• Enuresis (urinating in bed or clothes - gt 5 years
  old)

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Other Disorders

• Separation Anxiety Disorder (excessive anxiety
  about separation)
• Reactive Attachment Disorder
• Pathological care
• Inhibited type
• hypervigilant, or ambivalent and contradictory
  responses to social interactions
• Disinhibited type
• diffuse, indiscriminate attachments to other
  people)

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Information Exchange Disorders

• Autistic Disorder (p. 75 video)
• Retts Disorder
• Childhood Disintegrative Disorder
• Aspergers Disorder
• Pervasive Developmental Disorder NOS
• Expressive Language Disorder
• Mixed Receptive-Expressive Language Disorder
• Phonological Disorder
• Stuttering
• Communication Disorder NOS
• Selective Mutism
• Disorder of Infancy, Childhood, or Adolescence NOS

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Autistic Disorder

• Impairment in social interaction
• Language delay/impairment
• Restricted repetitive behavior and interests
• Video 330
• Aspergers differential dx by language

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Making a Diagnosis

• Is the childs predominant symptom an impairment
  of learning or intellectual functioning?
• Is the childs predominant symptom abnormal motor
  activity?
• Is the childs predominant symptom socially
  inappropriate or self-injurious behavior?
• Is the childs predominant symptom an impairment
  in the ability to communicate or exchange
  meaningful information with other people?

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• Joey is a 14-year-old boy with an IQ of __who has
  had academic difficulty in school and is
  currently reading and writing at a fifth-grade
  level. He has also had some difficulty making
  friends and fitting in with his peer group. Over
  the last 2 months Joey has become unusually
  irritable and his school work has begun to
  deteriorate. He has difficulty sleeping, has
  little appetite, and no longer enjoys playing
  ball or sharing other activities with his father.
  Recently, his younger sister started teasing him
  at the dinner table saying, "Joey's in love,
  Joey's in love." Joey exploded and began
  screaming, "You think I'm just dumb and no one
  likes me!" and ran out of the room. A few minutes
  later his mother tried to talk with him. In
  response to her repeated questions Joey replied,
  "Everyone knows. I' m dumb. None of the girls
  talk with me like they do with the other guys.
  I'm not worth .anything. I wish I was dead." His
  mother became alarmed and called Joey's
  therapist. What is Joey's diagnosis(es)?

Key symptoms other info
IQ61
DX Mild MR depressive disorder single episode
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• A 7-year-old' boy -with a mild to moderate speech
  deficit was tested and found to have an IQ of 57
  A subsequent examination demonstrated that he has
  a moderate hearing impairment. What is the best
  diagnosis for the patient?

IQ cannot be adequately determined in the
presence of a sensory deficit such as deafness
unless compensation is made.-for the' deficit
Mental Retardation cannot be made under these
circumstances
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• Steven is a 13-year-old boy who is known as a
  chronic bully in his neighborhood. He delights in
  fighting with other adolescents and hurting them.
  He continually defies his parents and refuses to
  follow school rules. Steve has been suspended
  from school twice in the past for fighting and
  hurting another student. When Steve wants
  something he can be exceedingly charming until he
  gets it. He compulsively lies to friends and
  parents. What is his diagnosis(es)?

Ho Oppositional Defiant Disorder .and 'Conduct
'Disorder
Key repeated violations of the rights of other
people
DX Conduct Disorder would take precedence over
ODD