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Disorder Intellectual DisabilitiesIntellectual DisabilitiesIntellectual Developmental Disorder/ ICD-9-CM code is 319(F70) MildFor preschool children. Difficulties in learning academic skills in reading, writing, arithmetic, time, or money. In adults has abstract thinking, executive function (such as planning, priority setting, strategy, flexibility) and short-term memory. Socially they risk being in situations of manipulation by other due to gullibility. There is difficulty in regulating emotion and behavior which can be noted in peers of the individual(F71) ModerateMarked behind those of peers. Ongoing assistance on daily basis is needed to complete conceptual tasks. Shows social and communicative behavior differences. May not interpret social cues accurately. Social judgement and decision-making abilities are limited and must have assistance with life decisions. (F72) SevereAttainment of conceptual skills is limited. A caretaker will need to provide extensive support for problem solving throughout life.Spoken language is limited here in terms of vocabulary and grammar. Language is used more for social communication than for explication. (F73) ProfoundConceptual skills generally involve physical world rather than symbolic processes. Are more goal-directed fashion for self-care, work and recreation. May have co-occurring motor and sensory impairments that prevent functional use of objects. Limited understanding of symbolic communication in speech or gestures. (F88) Global Development Delay/ ICD-9-CM code 315.8(F79) Unspecified/ ICD-9-CM code 319OVERVIEWOnset is during the developmental period of the individual Deficits in the intellectual functions that can be prolong in the individuals lifeDeficits are apparent in adaptive functioning Can be specified as either mild, moderate, severe, profound, a global developmental delay, and unspecified.It is confirmed to be reliant on IQ rangeTreatmentThis will vary from the severity of this disorder which could involve:. Case managementSocial skills trainingApplied Behavior Analysis (ABA)I greatly used for individual treatment with those that have Autism Cognitive Behavioral Therapy (CBT)Short-term, goal-oriented psychotherapy treatment that takes a hands-on, practical approach to problem-solving. The goal is to change patterns of thinking or behavior that are behind people's difficulties. Interventions (could be visual schedules)Group modelsToken economies.AssessmentsQuick Neurological Screening Test Third Edition (QNST-3) General Practitioner Cognitive Assessment (GPCOG)(english).pdf CulturallyThis occurs in all races and culturesThere is still lack of evidence in this assessment on sensitivity in cultures due to the variety in an individual’s ethics, cultural, and linguistic background. It should be first considered if the individual is from a nationality that may not have available experiences to understanding a language. Disorder Communication Disorders(F80.9) Language Disorder/ 315.39(F80.0) Speech Sound Disorder/ 315.39(F80.81) Stuttering or Childhood-Onset Fluency Disorder/ 315.35(F80.89) Social (Pragmatic) Communication Disorder/ 315.39(F80.9) Unspecified Communication Disorder/ 307.9OVERVIEWThere are deficits in language, speech, and soundLanguage abilities are usually far below the age expectations.Causes limited communication There exists persistent difficulty that individual will face in this categoryTreatmentSpeech Therapy & Language TherapyCan help children learn new vocabulary, organize their thoughts and beliefs, and correct grammatical or word errors Augmentative and Alternative Communication or AACCan be used as a Treatment modalities Supplementing, or using in the absence of, natural speech and/or writing with aided (e.g., picture communication symbols, line drawings, Blissymbol’s, and tangible objects) and/or unaided (e.g., manual signs, gestures, and finger spelling) symbols. Aided symbols require some type of transmission device; unaided symbols require only the body to produce. Cognitive Behavioral Therapy or CBTIncreases children's use of desirable communication behaviors, decrease their unwanted problem behaviors and use of maladaptive coping strategies, and to promote their development of useful interpersonal skills. Changes occur via a program of systematic reward and reinforcement. For example, children may be encouraged to use mnemonic strategies (adaptive coping behavior) to help them remember facts relevant to their school performance. AssessmentsQuick Neurological Screening TestThird Edition (QNST-3)General Practitioner Cognitive Assessment (GPCOG)Autism Spectrum DisorderICD-9-CM code is 299.00 also (F84.0)Varies also into different Severity levelsLevel 3 – “Requiring very substantial support”Social CommunicationSevere deficits in verbal and nonverbal social communication skills that cause impairments in functioning, social interactions, and minimal response from others. Restricted/Repetitive behaviorsInflexibility of behavior, difficult in coping with change. Great distress/difficulty changing focus or actionLevel 2 – “Requiring substantial support”Social CommunicationSocial impairments apparent at this point. Limited ignition of social interactions. Abnormal responses to social overturns from others.Restricted/Repetitive behaviorsDifficulty coping with change and repetitive behaviors are frequently enough to be obvious to casual observer and interfere with functioning in a variety of contexts. Level 1 – “Requiring support”Social CommunicationWithout supports in place, defects in social communication cause noticeable impairmentsHighly difficult initiating social interaction and clear examples. Unsuccessful responses to social overtures with others. Restricted, Repetitive behaviorsCauses significant interference with functioning in one or more contexts. Difficulty switching between activities. Problems of organization and planning hamper this individual’s independence.OVERVIEWIn this category, there are persistent deficits in the individuals’ social communication and interaction habits.The deficits are in reciprocity, nonverbal communication, and developing/maintaining relationshipsThere are repetitive patterns of behaviors, interests, and activitiesThe symptoms present in early developmental periodTreatmentAssessments such as:Applied Behavioral Analysis or ABAFloortime TherapyDeveloper Stanley Greenspan. Photo by Timothy Archibald, courtesy of ICDLAs its name suggests, Floortime encourages parents to engage children literally at their level – by getting on the floor to play. Families can combine it with other behavioral therapies or use it as an alternative approach. TEACCH methods(Treatment and Education of Autistic and Communication related handicapped Children) is an evidence-based service, training, and research program for individuals of all ages and skill levels with autism spectrum disorder PsychoeducationCould easily be used to help with parents of children with autism spectrum disorders. Medications or Pharmaceuticals Selective Serotonin reuptake inhibitors (SSRIs)Selective serotonin reuptake inhibitors (SSRIs) include citalopram, fluoxetine , and sertraline. These medicines may help with depression, anxiety, and obsessive behaviors. SSRIs have side effects, such as weight gain, insomnia, and increased agitation, but the side effects tend to be less serious than those of antipsychotic medicines.Antipsychotic medicinesHaloperidol, Risperidone, and Thioridazine change how the brain is effected by decreasing problem behaviors that occur with autism. Reduces tantrums, aggression, and self-harm.Clonidine and Guanfacine can treat impulsive and aggressive behaviors in children with autism. Lithium and Anticonvulsants/ Carbamazepine and valproic acid. This works with children that are occasionally aggressive may become more stable when using these medications. Although regularly scheduled blood tests are required to be monitored with these drugs in the body.These medications can be linked to this reference: AssessmentsAutism Treatment Evaluation Checklist (ATEC) This link below actually lists Both CARS and ATEC with links to what it’s discussing Childhood Autism Rating Scale (CARS-2)DisorderCodesTreatmentAssessmentsADHDCombined presentation-F90.2Predominantly inattentive presentation-F90.2Predominantly hyperactive/impulsive presentation-F90.1Other specified ADHD-F90.8CBTBehavior therapyNeurofeedbackMedications: Stimulants & NonstimulantsSchool accomodations & interventionsParent education & supportADHD Rating Scale for childrenAdult ADHD Self-Report Scale for adultsDiagnostic Interview for ADHDSpecific Learning DisorderWith impairment in reading-F81.0With impairment in written expression-F81.81With impairment in mathematics-F81.2Self-esteem buildingGroup counselingCareer counselingWechsler Intelligence Scale for Children, 3rd Ed. (WISC 111)Wechsler Adult Intelligence Scale - Revised (WAIS 111)Wechsler Memory ScalesBrigance Comprehensive Inventory of Basic Skills, selected subtests (Listening, Reading, Math, etc.)Motor DisordersDevelopment Coordination Disorder-F82Stereotypic Movement Disorder-F98.4CBTSensory integrationAquatic therapySpecific skills approach (SSA)Interviews, Questionnaires, ObservationsPeabody Development Motor Scales (PDMS) (preschool age)Movement Assessment Battery for Children (M-ABC) (4+)Tic DisordersTourette’s Disorder-F95.2Persistent Motor or Vocal Tic Disorder-F95.1Provisional Tic Disorder-F95.0Behavior therapyCBTMedications: Antidepressants, tranquillizers, benzodiazepines, antipsychoticsEEGNeuroimagingTreatments found in textbook for course (Kress & Paylo)Assessments found from additional resourcesDiagnostic Criteria (DSM-5 pages 59-87)ADHDSpecific Learning DisorderMotor DisordersTic DisordersInattention: 6 months or moreNegatively impacts social & academic/occupational activitiesHyperactivity & impulsivitySymptoms prior to age 12 yearsSymptoms present in 2 or more settingsClear evidence of reduction of quality of functioningNot better explained by other mental illness or substance use or withdrawalDifficulty learning & using academic skillsPersisted for at least 6 monthsAffected academic skills substantially & quantifiably below expected ageInterfere with academic performanceBegin during school-age yearsNot better accounted for by intellectual disabilities, other medical issues, or lack of educational instructionAcquisition & use of motor skills below age expectationPersistently interferes with daily livingOnset in early developmentNot better explained by intellectual disability or other disorderSudden, rapid, recurrent nonrhythmic motor movement or vocalizationMust have been present at some time during the illnessPersisted more than 1 year since first onset (can be on an off)Onset before age 18Not physiological effects of substance or medical conditionMedicationsADHD: Adderall, Ritalin, Concerta, Strattera (WebMD, 2017)Specific Learning Disorder: often comorbid with other neurodevelopmental and communication disorders or mental disorders, which can be treated by a variety of medicationsMotor Disorders: Botulinum Neurotoxin (AAN, 2008), Primidone, Gabapentin, Depakote, Klonopin (Swierzewski, 2015)Tic Disorders: Risperidone, Olanzapine, Clonidine (Robertson, 2017)ReferencesADHD Institute. (2017). Assessment and diagnosis. Shire. Internet. Viewed at: (2017). Tourette’s syndrome. Aetna. Internet. Viewed at: Academy of Neurology. (2008). Use of botulinum neurotoxin injections to treat movement disorders. AAN Summary of Evidence-based Guideline for Patients and their Families.American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author.Kress, V.E., & Paylo, M.J. (2014). Treating those with mental disorders: A strength-based, comprehensive approach to case conceptualization and treatment. Upper Saddle River: PearsonMcMaster University. (2017). Assessment of developmental coordination disorder. CanChild. Internet. Viewed at: , W.C. M.D. (2017). Tourette syndrome and other tic disorders treatment & management. Medscape.Swierzewski, S.J. III M.D. (2015). Movement disorders treatment. Remedy Health Media, LLC.WebMD. (2017). Attention deficit hyperactivity disorder (ADHD)-medications. Healthwise. Internet. 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