Part 2 of 5

1. 8/20/15
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+
+ Neurodevelopmental Disorders
(pg 31-86)
! What are the Neurodevelopmental Disorders?
! *THESE ARE THE DISORDERS FIRST DIAGNOSED IN INFANCY,
CHILDHOOD, OR ADOLESCENCE from DSM-IV-TR
! Occur early in the development period ~ often before the child
enters school.
! They are characterized by deficits in development that cause
problems in personal, social, academic (occupational) functioning.
! The neurodevelopmental disorders often co-occur; when there is one
look for other disorders.

2. 8/20/15
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+What are the Neurodevelopmental
Disorders?
! Categories:
! Intellectual Disorders
! Communication Disorders
! Autism Spectrum Disorder
! Attention-Deficit/Hyperactivity
Disorder
! Specific Learning Disorder
! Motor Disorders
+ Neurodevelopmental Disorders
! Intellectual Disability (pg 33-41)(pg xiii for list of disorders under this
category )
! Term Mental Retardation is no longer the term used
! Determined by a deficit in cognitive capacity and adaptive
functioning
! Specifiers are used to determine the level of severity (see tables pgs
34-36)
! Communication Disorders (pg 41-49) (pg xiii for list of disorders under
this category)
! This category includes the disorders associated with language, speech,
sound, social communication, and fluency in speech.
! Changes: combined Expressive Language and Mixed Receptive-
Expressive Language disorders into Language Disorder; Speech
Sound Disorder (new name for Phonological Disorder); Childhood-
onset Fluency Disorder (used to be Stuttering).
! Added Social (Pragmatic) Communication Disorder; used when there are
persistent difficulties in social uses of verbal and non-verbal
communication – do not confuse with Autistic Disorders….

3. 8/20/15
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+ Autism Spectrum Disorder
Autism Spectrum Disorder was a BIG change in the DSM-5~lots of controversy!
DSM-5 Autism Spectrum Disorder Fact Sheet
! Autism Spectrum Disorder (pg 50-59)
! One Diagnosis with Specifiers 299.00 (F84.0)
! Persistent deficits in social communication and social interactions across multiple areas
! Deficits in social reciprocity, nonverbal communicative behaviors used in social interaction,
and skills in developing, maintaining, and understanding social relationships
! REQUIRES the presence of restrictive, repetitive, patterns of behavior, interests, or activities
! The severity of the disorder is determined using the chart on pg 52; specify on criterion A and
B
! Individual characteristics are noted through the use of the specifiers
! Intellectual impairment
! Language impairment
! Medial or genetic conditions
! Other neurodevelopment, mental, or behavioral disorder

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Attention-Deficit/Hyperactivity Disorder (pg. 59-66)
! Defined by impairing levels of inattention, disorganization, and/or
hyperactivity-impulsivity
! Same 18 symptoms/criteria as in DSM-IV-TR; still divided into two
symptom domains; Inattention and Hyperactivity/Impulsivity; at
least 6 symptoms have to be in one domain.
! Onset criteria has changed~~ Several symptoms must have been
present before the age of 12 (use to be 7)
! Criteria have been strengthened to include a lifespan perspective
(ie adult ADHD)
! Subtypes have been replaced with specifiers:
! Must specify:
! With combined presentation, predominantly inattentive, or
predominantly hyperactive/impulsive
! Remission status
! Severity
+ Neurodevelopmental Disorders
! Specific Learning Disorder (pg 66-74)(pg xiv for list of disorders under this
category)
! Specific deficits in the ability to perceive or process information effectively;
characterized by difficulty in learning foundational academic skills
! All the specific learning disorders have been combined with specifiers
indicating the particular deficit (ie reading, mathematics, etc)
! Motor Disorder (pg 74-85)(pg xiv-xv for list of disorders under this category)
! Includes the disorders where deficits in motor activity occur; can be too much
motor activity or slowed motor activity; must cause impairment in functioning;
social, educational, occupational areas.
! Includes Tourette’s Disorder ; tic criteria has been standardized across the
disorders for consistency
! Other Neurodevelopmental Disorders (pg 86)
! 315.8 (F88) Other Specified Neurodevelopmental Disorder
! 315.9 (F89) Unspecified Neurodevelopment Disorder

5. 8/20/15
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Assessment / Screenings
! Autism Spectrum Disorder
! CARS: Childhood Autism Rating Scale
! ASRS: Autism Spectrum Rating Scale
! GARS-3: Gilliam Autism Rating Scale 3rd Edition $$
! ADHD
! Vanderbilt ADHD Assessment Scale
! CHADD Children and Adults with ADHD
+ Treatment Basics
ADHD Treatment:
! Medication- Stimulants
! Exercise
! Cognitive Behavioral Therapy
! Behavioral therapy aims to help a child change his or her behavior. It might
involve practical assistance, such as help organizing tasks or completing
schoolwork, or working through emotionally difficult events. Behavioral
therapy also teaches a child how to monitor his or her own behavior.
Learning to give oneself praise or rewards for acting in a desired way, such
as controlling anger or thinking before acting, is another goal of behavioral
therapy. Parents and teachers also can give positive or negative feedback for
certain behaviors. In addition, clear rules, chore lists, and other structured
routines can help a child control his or her behavior.
! Therapists may teach children social skills, such as how to wait their turn,
share toys, ask for help, or respond to teasing. Learning to read facial
expressions and the tone of voice in others, and how to respond
appropriately can also be part of social skills training.
! Need to work with parents to help them with parenting skills and how to set
up behavior plans.

6. 8/20/15
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+
Gender Dysphoria
DSM-5
Dr. Christine Chasek LIMHP, LADC, NCC
! The Journey from Gender Identity Disorder to Gender Dysphoria
! DSM-IV-TR : Gender Identity Disorder
! DSM-5 : Gender Dysphoria

7. 8/20/15
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+
A Pictorial of Gender Dysphoria
+
DSM-IV-TR
! Gender Identity Disorder
! This disorder was taken out in the DSM-5
! Very controversial!
! It was also moved from the sexual disorders section, as it is
now accepted that gender dysphoria is not related to a
person’s sexual attractions or sexual orientation.
! What Issues are related to the controversy?

8. 8/20/15
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Cultural Defined Definitions
Merriam Webster Dictionary
! Gender: The state of being male or
female.
! Dysphoria: A state of feeling unwell or
unhappy.
+ DSM-5 Definitions
! Sex: Biological indicators of male and female understood in the
capacity of reproduction such as sex chromosomes, gonads, sex
hormones, and non-ambiguous internal and external genitalia
! Gender: the public and largely recognized lived role as a boy
or girl, man or woman; biological factors are seen as
contributing and interacting with social and psychological
factors to gender development
! Gender Assignment: the initial assignment as female or male;
usually occurs at birth and is referred to as “Natal Gender”
! Gender Reassignment: An official, usually legal, change of
gender

9. 8/20/15
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+ DSM-5 Dysphoria
Definitions
! Gender Identity: a category of social identity; refers to an
individual’s identification as male, female or some other
category
! Transgender: refers to the broad spectrum of individuals who
identify with a gender that is different than their natal gender
! Transsexual: refers to individuals who seek or have
undergone a social transition from the natal gender to the
new gender, usually involving a somatic transition by cross-
sex hormone treatment and genital surgery
! Gender Dysphoria: a term used to indicate an individual’s
affective/cognitive discontent with the assigned gender by it
used more specifically defined when used as a diagnostic
category
+ Gender Dysphoria
! Gender Dysphoria refers to the distress that may accompany the
incongruence between one’s experienced or expressed gender
and one’s assigned gender.
! The focus is on the dysphoria NOT the identity.
! DSM-5 Criteria
Separate set of developmentally appropriate criteria
children/adolescents and adults
302.6 (F64.2) Gender Dysphoria in Children
302.6 (F64.2) Gender Dysphoria in Adolescents and Adults
Ruby's Room Adult Gender Dysphoria
Gender Dysphoria in Children

10. 8/20/15
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Gender Dysphoria “Other”
! 302.6 (F64.8)
Other Specified
Gender
Dysphoria
! When you want to
specify a reason
the full criteria is
not met
! 302.6 (F64.9)
Unspecified
Gender
Dysphoria
! When you do not
want to specify
the reason
+ Risks and Symptoms
! Isolation
! Relationship issues
! Negative Self-concept
! Increased risk of other mental health
disorders
! Depression
! Anxiety
! Substance Use Disorders
! Increased risk of suicidal ideation, suicide
attempts, and completed attempts

11. 8/20/15
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Differential Diagnosis
! Transvestic Disorder
! Body Dysmorphic Disorder
! Schizophrenia and Other Psychotic
Disorders
+ Treatment
! This is not a commonly seen disorder (prevalence rate of .005%
to .014%)
! As a result typically the disorder or the treatment are not
generally covered in traditional courses or continuing
education conferences
! Affirmative Therapy
! An approach to therapy that embraces a positive view of
transgender identities and relationships and that addresses the
negative influences of discrimination and stigmatization
! To be an affirmative therapy involves:
! Self-reflection
! Getting involved in social justice
! Creating an affirmative setting
! Be open about your commitment to providing affirmative therapy
with your clients
! Act as an advocate with challenging discrimination and
stigmatization