What the DSM 5 Says
In the DSM 5 Autism Spectrum Disorder (ASD) is currently classified as a neurodevelopmental disorder. What does that mean exactly? Here’s what the text of the DSM 5 says,
“The neurodevelopmental disorders are a group of conditions with onset in the developmental period. The disorders typically manifest early in development, often before the child enters grade school, and are characterized by developmental deficits that produce impairments of personal, social, academic, or occupational functioning. The range of developmental deficits varies from very specific limitation of learning or control of executive functions to global impairments of social skills or intelligence. The neurodevelopmental disorders frequently co-occur; for example, individuals with autism spectrum disorder often have intellectual disability (intellectual developmental disorder), and many children with attention-deficit/hyperactivity disorder (ADHD) also have a specific learning disorder. For some disorders, the clinical presentation includes symptoms of excess as well as deficits and delays in achieving expected milestones. For example autism spectrum disorder is diagnosed only when the characteristic deficits of social communication are accompanied by excessively repetitive behaviors, restricted interests, and insistence on sameness.”
(American Psychiatric Association, 2013)
The brain works differently, to varying degrees, and everything that the brain manages will also work differently, to varying degrees. These differences show up fairly early in life.
Let’s start with the term neurodevelopmental. The “neuro” in the term neurodevelopmental points to the human brain as being the center and source of what the DSM 5 is trying to describe. The best research available to date indicates that the behaviors we recognize as indicative of neurodevelopmental disorder originate in differences in the way the human brain works.
Now for the developmental part. The definition of what exactly constitutes the developmental period in the DSM 5 was deliberately left vague in order to address concerns over the lack of evidence that there is a clear cut point at which development ends. (Wills, 2014) Legally most of us are considered to have reached full development at the age of 18. But speaking from a scientific perspective we all get there at our own pace.
There are several recognized developmental stages to the human life span. I won’t going in to too much detail here but generally they are considered to be the following:
1. Infancy and toddlerhood, 0-2
2. Early childhood, 2-6
3. Middle childhood, 7-9
4. Late childhood, 10-12
5. Early adolescence, 13-15
6. Late adolescence, 16-19
7. Early adulthood, 20-40
8. Middle adulthood, 41-65
9. Late adulthood, 65+
(Annenberg Foundation, 2015)
During each stage there are complicated changes going on in three main recognized domains.
1. Biological: the body changes, matures, and grows
2. Cognitive: the mind changes, grows, and matures. Our abilities to know, imagine, perceive, reason, and problem solve develop.
3. Psychosocial: our emotions and personality grow; our social interactions and expectations develop.
(Annenberg Foundation, 2015)
Neurodevelopmental disorders first become evident during infancy and early childhood. They continue to manifest themselves throughout the human lifespan. In terms of functioning differences are manifested in all three domains to varying degrees depending on the specific disorder. The cognitive and psychosocial domains are the most greatly impacted by neurodevelopmental disorders.
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (Fifth ed.). Arlington, VA: American Psychiatric Association. Retrieved June 17, 2015
Annenberg Foundation. (2015). Lifespan Development Domains. Retrieved June 17, 2015, from Annenberg Learner: http://www.learner.org/series/discoveringpsychology/development/domains.html
Annenberg Foundation. (2015). Lifespan Development Periods. Retrieved June 17, 2015, from Annenberg Learner: http://www.learner.org/series/discoveringpsychology/development/0_2.html
Wills, C. D. (2014, November 2). DSM-5 and Neurodevelopmental and Other Disorders of Childhood and Adolescence. The Journal of the American Academy of Psychiatry and the Law, 42, 165-72. Retrieved June 17, 2015, from http://www.jaapl.org/content/42/2/165.full.pdf