Exam 2: Neurodevelopmental Disorders

Cultural background should always be taken into account in order to fully understand a child's symptoms of mental illness.

It wasn't until Jeremy went to school that his problems became evident to his parents. They just thought Jeremy needed a lot of extra love. According to his mother, "We always thought he would grow out of his odd little habits but it doesn't look like that's happening." Jeremy talked early but walked late, and he always seemed clumsy. Starting as early as the day he began pre kindergarten, Jeremy had no friends. Very early on, Jeremy was interested in computers. His teacher found he would go into great length describing different computer applications and yet Jeremy was unaware of how others would get bored by his "conversations." Jeremy's diagnosis would be:

One of the most well-recognized childhood developmental disorders characterized by inattention, hyperactivity and impulsiveness is

Behaviors resulting in self-inflicted bodily injury that requires medical treatment is not a criterion for the DSM-5 diagnosis of stereotypic movement disorder.

The neurodevelopmental disorders are a group of conditions characterized by all of the following except:

Christina is now 6 years old. Her mother reports that Christina's developmental milestones were unremarkable but adds, "She achieved them in her own time and in her own way." Christina was talking by the time she was 2 and using complex sentences by the time she was 4 years old. Her school work is average but she often seems distracted because she is preoccupied with learning the multiplication tables. Her classmates see her as "different" and leave her alone. Christina is content to be by herself and practices intricate multiplications. Her diagnosis is:

Mrs. Matthews contacted the Children's Center for her daughter, Diane, who is now 5 years old. As soon as Diane was born, her mother thought her daughter was "different." Mrs. Matthews reported that the pediatrician found Diane to be in good health and predicted she would eventually outgrow her odd behaviors. Unfortunately, that does not seem to be the case. Diane does not make eye contact when she speaks and grunts if anyone tries to get too close to her. Diane has certain routines. For example, she has to line up all her dolls in a certain way before leaving the house. If a routine is interrupted, Diane becomes extremely upset and aggressive; that is, kicking and punching anyone who tries to comfort her. Diane's diagnosis is:

The failure to meet criteria for the communication disorders is a DSM-5 criterion for unspecified communication disorder.

A child who shows repeated rhythmic, purposeless movements such as nail biting, head banging or body rocking would be diagnosed with:

Symptom onset for speech sound disorder is in the child's early developmental period.

Attention-deficit/hyperactivity disorder

Mary Lynn Dodson knew as soon as her son, Lou, was born that he was somehow "different." She remembered that Lou never liked to be held. "If I tried to cuddle him, he would cry something awful and arch his back. It was so hard to keep him close to me," she added. Lou seemed to be in his own world and rarely even looked at his mother. He often rocked himself back and forth in his crib. Aside from grunting noises, Lou did not talk. As Lou grew older, Ms. Dodson observed that he would get upset if there was even the smallest change in his routine. His favorite toy was his train set. His mother reported that Lou was fascinated with the wheels and would spin them over and over. Lou's diagnosis is:

Inborn characteristics, such as genetic makeup, do not play a role in the neurodevelopmental disorders in children.

Children with the neurodevelopmental disorders are typically seen very early, often before the child enters grade school.

A mother on your caseload describes her 7 year-old son as pervasively and chronically restless, impulsive, and inattentive. She notes, "He just can't seem to pay attention, makes careless mistakes, doesn't seem to listen when I talk to him, constantly loses things, is easily distracted, and is just so disorganized." Further, she adds that her son often talks excessively, blurts things out, cannot wait his turn, constantly interrupts, fidgets, and simply cannot play quietly. Which diagnosis best fits this clinical picture?

Little Sammie, a nickname since childhood, is a 23 year-old single man who lives at home with his parents, Joe and Isabelle Carhart. He is an only child. Sammie attended special education classes and since graduation has been working in a sheltered workshop. Joe comments, "My son is a hard worker and gets along really well on the job." However, Joe and his wife are becoming increasingly concerned about how Sammie will manage if something happens to them. "My son is such a good boy but he's so gullible. It's easy to take advantage of him," said Isabelle. She adds, "He simply cannot manage on his own." Which of the following diagnoses best apply to Sammie?

When it is clear that one of the neurological disorders ought to be diagnosed, but the practitioner does not have enough information about the child's difficulties, this diagnosis is assigned with the understanding that as more information becomes available, a more specific diagnosis can be made. The diagnosis considered is:

Matt Bradley is now 7 years old. He is in second grade and it has become increasingly apparent to his teachers that he struggles to reason, has difficulties solving problems, and learning from his experiences. Further, Matt has been slow to develop his reading skills, his writing is illegible, and he is poor in math. On the playground, Matt does not play in an age-appropriate manner with his peers. His parents report that their son has always made slow progress throughout his development although they do see some improvements. However, they concede that Matt requires assistance with everyday skills - dressing, feeding, bathing, doing homework - on a daily basis. What would be the appropriate severity rating for Matt's current presentation?

Which of the following is not a criterion for the diagnosis of attention-deficit/hyperactivity disorder ADHD) in the DSM-5?