The communication disorders include language disorder, speech sound disorder, so- cial (pragmatic) communication disorder, and childhood-onset ﬂuency disorder (stutter- ing). The first three disorders are characterized by deficits in the development and use of language, speech, and social communication, respectively. Childhood-onset ﬂuency dis- order is characterized by disturbances of the normal fluency and motor production of speech, including repetitive sounds or syllables, prolongation of consonants or vowel sounds, broken words, blocking, or words produced with an excess of physical tension.
Like other neurodevelopmental disorders, communication disorders begin early in life and may produce lifelong functional impairments.
Autism spectrum disorder is characterized by persistent deficits in social communica- tion and social interaction across multiple contexts, including deficits in social reciprocity, nonverbal communicative behaviors used for social interaction, and skills in developing, maintaining, and understanding relationships. In addition to the social communication deficits, the diagnosis of autism spectrum disorder requires the presence of restricted, re- petitive patterns of behavior, interests, or activities. Because symptoms Change with de- velopment and may be masked by compensatory mechanisms, the diagnostic criteria may be met based on historical information, although the current presentation must cause sig- nificant impairment.
Within the diagnosis of autism spectrum disorder, individual clinical characteristics are noted through the use of specifiers (with or without accompanying intellectual impair- ment; with or without accompanying structural language impairment; associated with a known medical/genetic or environmental/acquired condition; associated with another neurodevelopmental, mental, or behavioral disorder), as well as specifiers that describe the autistic symptoms (age at first concern; with or without loss of established skills; sever- ity). These specifiers provide clinicians with an opportunity to individualize the diagnosis and communicate a richer clinical description of the affected individuals. For example, many individuals previously diagnosed with Asperger’s disorder would now receive a diagnosis of autism spectrum disorder without language or intellectual impairment.
ADHD is a neurodevelopmental disorder defined by impairing levels of inattent-ion, dis- organization, and / or hyperactivity—impulsivity. Inattention and disorganization entail inabil- ity to stay on task, seeming not to listen, and losing materials, at levels that are inconsistent with age or developmental level. Hyperactivity—impuisivity entails overactivity, fidgeting, in- ability to stay seated, intruding into other people’s activities, and inability to wait—symptoms that are excessive for age or developmental level. In childhood, ADHD frequently overlaps with disorders that are often considered to be ”externalizing disorders,” such as oppositional defiant disorder and conduct disorder. ADHD often persists into adulthood, with resultant impairments of social, academic and occupational functioning.
The neurodevelopmental motor disorders include developmental coordination disor- der, stereotypic movement disorder, and tic disorders. Developmental coordination dis- order is characterized by deficits in the acquisition and execution of coordinated motor skills and is manifested by clumsiness and slowness or inaccuracy of performance of mo- tor skills that cause interference with activities of daily living. Stereotypic movement dis- order is diagnosed when an individual has repetitive, seemingly driven, and apparently purposeless motor behaviors, such as hand ﬂapping, body rocking, head banging, self- biting, or hitting. The movements interfere with social, academic, or other activities. If the behaviors cause self—injury, this should be specified as part of the diagnostic description.