DSM CHAPTER 12 DEVELOPMENTAL
MILESTONES BEST EXAM solutions (Walden
University)
written by
• Milestones are recognizable skills or abilities that have an expected range
and order of appearance, such as a child taking his first step around the
time of his first birthday. Identifying any significant variations from
expected patterns, such as a child taking that first step near his second
birthday, is a key task for any practitioner. Knowing when a significant
variation in development has occurred improves diagnostic accuracy
because DSM-5 specifically requires consideration of developmental
stages
• Five different milestone skill areas should be evaluated: gross/fine motor,
visual motor problem solving, speech and language, social/emotional,
and adaptive skills
• Gross motor skills are the most obvious to recognize because they
involve crawling, walking, running, and throwing
• Visual motor problem solving describes a child’s physical interactions with
the world. Fine motor skills (using one’s hands and fingers) rely on visual
input and generally progress at a slower pace than gross motor skills. If
the development of these milestones is delayed, it may be because of
impairments in cognitive, sensory, or motor abilities.
• To be able to communicate, a person first must be able to receive input
(process what is seen and heard), understand the meaning of that input,
then generate an expression of his thoughts (translate thoughts into
words, then express fluently). Delays in expressive language milestones
DSM CHAPTER 12 DEVELOPMENTAL
MILESTONES BEST EXAM solutions (Walden
University)
, DSM CHAPTER 12 DEVELOPMENTAL
MILESTONES BEST EXAM solutions (Walden
University)
may be more apparent than receptive language delays, which may be
more subtle but when present may worsen an expressive language
impairment
• Social/emotional skills are the core elements of psychiatric functioning.
Social skill development is interactive and thus reliant on the presence of
a responsive caregiver. A child’s temperamental traits influence how he
responds to routine activities, which influences how his caregivers
respond. Developing shared joint attention with another person by
approximately age 1 year is a key social milestone. Normal social and
emotional development is most closely linked with speech and language
skills.
• When you evaluate for the presence of an intellectual disability, adaptive
milestones need to be investigated. Standardized intelligence testing is
no longer considered the sole basis for diagnosing intellectual disability.
Adaptive skills include infants learning to feed themselves or dress
themselves. For older kids, it involves self-protection and self-direction.
• A child may acquire all his skills in the usual sequence but at a slower rate
(a delay), may acquire his skills at differential rates in different areas (a
dissociation), or may achieve milestones out of the usual order of
acquisition (a deviation). Growth and development will follow
recognizable patterns, but it is not an exact script. It is our task to consider
what would constitute normal- range development.
• Table 12-2 in the book shows normal-range developmental milestones
and developmental red flags that should trigger specialized assessments
DSM CHAPTER 12 DEVELOPMENTAL
MILESTONES BEST EXAM solutions (Walden
University)
, DSM CHAPTER 12 DEVELOPMENTAL
MILESTONES BEST EXAM solutions (Walden
University)
•
*******************************************************************
**********
RUTTER’S CHILD AND ADOLESCENT PSYCHIATRY
CHAPTER 51 AUTISM SPECTRUM DISORDER
• ASD is characterized by impairments in reciprocal social communication
and a tendency to engage in repetitive stereotyped patterns of
behaviors, interests, and activities. It arises from atypical brain
development. The etiology is likely multifactorial.
• The clinical presentation can change over time, often in response to
the demands of the environment or in the presence of co-occurring
conditions.
• Many individuals with ASD have an early history of regression or a period
of lack of progress of language, of cognition more generally, or social
behavior in the early preschool period
• The clinical presentation of ASD is remarkably diverse usually with a
combination of some delayed/immature behaviors together with the
emergence of more unusual behavioral profiles. Some of the earliest social
communication symptoms represent difficulties in joint attention, eye
contact, lack of social intention to communicate with others, lack of social
imitative play and fascination with sensory stimuli. Some symptoms of
ASD are an exaggeration of delays observed in typical development (lack
of useful speech, limited symbolic, and imaginative play skills) whereas
DSM CHAPTER 12 DEVELOPMENTAL
MILESTONES BEST EXAM solutions (Walden
University)
, DSM CHAPTER 12 DEVELOPMENTAL
MILESTONES BEST EXAM solutions (Walden
University)
other symptoms are quite distinct and are rarely (or only very transiently)
observed in the development of typical children (delayed echolalia and
neologisms).
• Cognitive difficulties are very common in individuals with ASD but with
the broadening of the diagnostic criteria for ASD, the proportion of
individuals with intellectual disability has declined
• “Hyperlexia,” a remarkable ability to read but with little
comprehension of content, is sometimes observed in severely
disabled individuals
• Children with moderate to severe cognitive impairment at earlier
developmental stages in the preschool years often present with little or no
speech and poor nonverbal communication. They also tend to engage in
repetitive play with sensory stimuli and can become quite upset by stimuli
from the environment such as the texture of certain clothes, some
everyday noises, and particular foods
• With higher functioning or older individuals, speech and language are
often present, grammar and vocabulary may be age appropriate, but there
remain difficulties in the social use of communication. In addition to the
sensory interests, higher functioning children and adolescents with ASD
often develop intense circumscribed interests that are observed in typically
developing children but are pursued in a solitary, non-social, manner
• AS referred to individuals with characteristics of autism but without
clinically significant cognitive or language delay. PDDNOS referred to
individuals with characteristics of autism but not enough to qualify for a
DSM CHAPTER 12 DEVELOPMENTAL
MILESTONES BEST EXAM solutions (Walden
University)
MILESTONES BEST EXAM solutions (Walden
University)
written by
• Milestones are recognizable skills or abilities that have an expected range
and order of appearance, such as a child taking his first step around the
time of his first birthday. Identifying any significant variations from
expected patterns, such as a child taking that first step near his second
birthday, is a key task for any practitioner. Knowing when a significant
variation in development has occurred improves diagnostic accuracy
because DSM-5 specifically requires consideration of developmental
stages
• Five different milestone skill areas should be evaluated: gross/fine motor,
visual motor problem solving, speech and language, social/emotional,
and adaptive skills
• Gross motor skills are the most obvious to recognize because they
involve crawling, walking, running, and throwing
• Visual motor problem solving describes a child’s physical interactions with
the world. Fine motor skills (using one’s hands and fingers) rely on visual
input and generally progress at a slower pace than gross motor skills. If
the development of these milestones is delayed, it may be because of
impairments in cognitive, sensory, or motor abilities.
• To be able to communicate, a person first must be able to receive input
(process what is seen and heard), understand the meaning of that input,
then generate an expression of his thoughts (translate thoughts into
words, then express fluently). Delays in expressive language milestones
DSM CHAPTER 12 DEVELOPMENTAL
MILESTONES BEST EXAM solutions (Walden
University)
, DSM CHAPTER 12 DEVELOPMENTAL
MILESTONES BEST EXAM solutions (Walden
University)
may be more apparent than receptive language delays, which may be
more subtle but when present may worsen an expressive language
impairment
• Social/emotional skills are the core elements of psychiatric functioning.
Social skill development is interactive and thus reliant on the presence of
a responsive caregiver. A child’s temperamental traits influence how he
responds to routine activities, which influences how his caregivers
respond. Developing shared joint attention with another person by
approximately age 1 year is a key social milestone. Normal social and
emotional development is most closely linked with speech and language
skills.
• When you evaluate for the presence of an intellectual disability, adaptive
milestones need to be investigated. Standardized intelligence testing is
no longer considered the sole basis for diagnosing intellectual disability.
Adaptive skills include infants learning to feed themselves or dress
themselves. For older kids, it involves self-protection and self-direction.
• A child may acquire all his skills in the usual sequence but at a slower rate
(a delay), may acquire his skills at differential rates in different areas (a
dissociation), or may achieve milestones out of the usual order of
acquisition (a deviation). Growth and development will follow
recognizable patterns, but it is not an exact script. It is our task to consider
what would constitute normal- range development.
• Table 12-2 in the book shows normal-range developmental milestones
and developmental red flags that should trigger specialized assessments
DSM CHAPTER 12 DEVELOPMENTAL
MILESTONES BEST EXAM solutions (Walden
University)
, DSM CHAPTER 12 DEVELOPMENTAL
MILESTONES BEST EXAM solutions (Walden
University)
•
*******************************************************************
**********
RUTTER’S CHILD AND ADOLESCENT PSYCHIATRY
CHAPTER 51 AUTISM SPECTRUM DISORDER
• ASD is characterized by impairments in reciprocal social communication
and a tendency to engage in repetitive stereotyped patterns of
behaviors, interests, and activities. It arises from atypical brain
development. The etiology is likely multifactorial.
• The clinical presentation can change over time, often in response to
the demands of the environment or in the presence of co-occurring
conditions.
• Many individuals with ASD have an early history of regression or a period
of lack of progress of language, of cognition more generally, or social
behavior in the early preschool period
• The clinical presentation of ASD is remarkably diverse usually with a
combination of some delayed/immature behaviors together with the
emergence of more unusual behavioral profiles. Some of the earliest social
communication symptoms represent difficulties in joint attention, eye
contact, lack of social intention to communicate with others, lack of social
imitative play and fascination with sensory stimuli. Some symptoms of
ASD are an exaggeration of delays observed in typical development (lack
of useful speech, limited symbolic, and imaginative play skills) whereas
DSM CHAPTER 12 DEVELOPMENTAL
MILESTONES BEST EXAM solutions (Walden
University)
, DSM CHAPTER 12 DEVELOPMENTAL
MILESTONES BEST EXAM solutions (Walden
University)
other symptoms are quite distinct and are rarely (or only very transiently)
observed in the development of typical children (delayed echolalia and
neologisms).
• Cognitive difficulties are very common in individuals with ASD but with
the broadening of the diagnostic criteria for ASD, the proportion of
individuals with intellectual disability has declined
• “Hyperlexia,” a remarkable ability to read but with little
comprehension of content, is sometimes observed in severely
disabled individuals
• Children with moderate to severe cognitive impairment at earlier
developmental stages in the preschool years often present with little or no
speech and poor nonverbal communication. They also tend to engage in
repetitive play with sensory stimuli and can become quite upset by stimuli
from the environment such as the texture of certain clothes, some
everyday noises, and particular foods
• With higher functioning or older individuals, speech and language are
often present, grammar and vocabulary may be age appropriate, but there
remain difficulties in the social use of communication. In addition to the
sensory interests, higher functioning children and adolescents with ASD
often develop intense circumscribed interests that are observed in typically
developing children but are pursued in a solitary, non-social, manner
• AS referred to individuals with characteristics of autism but without
clinically significant cognitive or language delay. PDDNOS referred to
individuals with characteristics of autism but not enough to qualify for a
DSM CHAPTER 12 DEVELOPMENTAL
MILESTONES BEST EXAM solutions (Walden
University)
