IDD (intellectual developmental disorder)
Diagnostic criteria
IDD diagnostic criteria
Intellectual and adaptive functioning deficits in conceptual, social, and practical domains with the following 3 criteria being met:
- A. Deficits in intellectual functioning
- Reasoning
- Problem solving
- Planning
- Learning
- Judgement
- B. deficits in adaptive functioning that result in failure to meet developmental and social standards for personal independence and social responsibility
- communication
- social participation
- independant living
- across multiple environments (home, school, community)
- C. Onset of intellectual and adaptive deficits during the developmental period
Risk factors
- Adverse postnatal development
- Deprivation of nurturance and other stimulation
- Pregnancy and perinatal problems
- fetal malnutrition, prematurity, hypoxia, viral and other infections. trauma
- general medical conditions
- seizure disorders, infections, etc
Comorbidity
• Very common (range 10 – 70%) • Type may vary according to severity of IQ impairment • Depression, anxiety, antisocial more common in those with higher levels • Psychotic, autism spectrum disorder more likely in lower levels • Challenging behaviour common • ?reflects emotional problems • Maltreatment common (cause or outcome?) • Beware diagnostic overshadowing
ASD
Three domains of ASD
- Social
- Communication
- Repetitive and restrictive behaviour
Diagnostic criteria
- A. Persistent deficits in social communication and social interaction across multiple contexts
- Social emotional reciprocity
- nonverbal communicative behaviours
- relationships
- B. Restricted repetitive behaviours, interest or activities (at least 2)
- C. Symptoms must be present in early childhood (however may not fully manifest until social demands exceed limited capacities)
- D. Clinically significant impairment
Social communication disorder is pragmatic difficulties with communication just without restricted and repetitive behaviour
Risk Factors
• Family history • Rate of autism in siblings aprox 50 times than of general population • High concordance in monozygotic twins • Recurs in families at rate of 3 – 6% • Maternal age • Paternal age • Perinatal complications (e.g., hypoxia)
Common comorbidities
• IDD (50 – 80%) • Specific Learning Disorder • Speech Language Disorders • Anxiety • ADHD • Mood • Tic Disorder • Seizure Disorders