Name This Mental Health Problem!

Among the many significant changes outlined in the new edition, and of particular interest here, are those in the category of Neurodevelopmental disorders. The term mental retardation has a new name: intellectual developmental disorder. According to the APA, this change addresses what the disorder is called, its impact on a person’s functioning, and criteria improvements to encourage more comprehensive patient assessment. Sounds good, yes? We hope so. Only time will tell.

Professionals from a variety of domains are debating and speculating about the impact the new nomenclature will have on how mental illness is understood, treated, and how services are provided. Parents are asking whether their loved-ones with cognitive and developmental challenges and disabilities will qualify for services under the new definitions. It is still very early to know how this will unfold; the DSM 5 was formally published in May this year and agencies and providers are trying to make sense of it. You might be interested to know that it took over 14 years to create the current revision, which is already being revised yet again, as I write this.

Besides cognitive and intellectual developmental problems, the DSM 5 also classifies communication disorders i.e., problems in communication and related areas such as oral motor function, under the diagnostic category of Neurodevelopmental Disorders. Probably the most controversial change (from our perspective at Stanfield, is the dropping of Asperger Syndrome as a distinct classification and subsuming it under the category of Autism Spectrum Disorder. Experts, teachers and parents alike, have voiced concern that eliminating the Asperger’s label will prevent mildly affected people from being evaluated for Autism and consequently lose out on available rehabilitative services and remedial education. The new criteria will look at severity of symptomatology as related to an individual’s ability for self-care and independent functioning. We ask whether, “by any other name” are the individuals who met the old criteria for Asperger’s any more functional? It is important to note that within the text, the new diagnostic criteria includes a note specifying that “individuals with a well-established DSM-IV diagnosis of autistic disorder, Asperger’s disorder or pervasive developmental disorder not otherwise specified should be given the diagnosis of autism spectrum disorder.” Again, even with this assurance, it is hard to know how things will play out in the real world of individuals and families facing neurodevelopmental disorders as they seek educational and medical services.

At Stanfield, We Think You Should Know:

We all need to care about this issue, this new shift in in the formulation of, and the understanding of how our loved ones with neurodevelopmental issues will be assessed and treated. We need to stay informed. In many cases, DSM diagnosis will be the ticket to insurance coverage, school-based special educational and behavioral services and disability benefits. It’s not to soon to reach out to teachers, counselors and case-managers to inquire how this shift will impact you and your loved one with disabilities. Further, individuals with neurodevelopmental disabilities are often dual-diagnosed with other mental health and addictive disorders. Such problems vary from 25-40% of individuals with neurodevelopmental disabilities depending upon on the population sampled and the definitions used. Unfortunately, when mental health problems presents for whatever reason, it is more likely to be attributed to their learning disability (diagnostic overshadowing) or classed as challenging behavior. Stay informed and advocate for those you care about who may have these difficulties. Share your experiences with others. Share your experiences with us!

Copyright 2013 James Stanfield Company. All Rights Reserved.

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Dr. James Stanfield, Ed.D.

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