Disorders of Neurodevelopment and Brain Functioning

Abstract

Differential diagnosis of neurodevelopment and brain functioning includes the differential and comorbid diagnosis of intellectual disabilities, exceptional cognitive profiles, genetic disorders, specific learning disorders, language disorders, and attention disorders. As ASD is a diagnosis based on social communication and restricted repetitive behaviors or patterns, it is important to look at these areas in the context of other diagnoses. Intellectual disabilities include challenges in language, reasoning, knowledge, interpersonal skills, and adaptive skills. These may occur comorbid with ASD. When differentiating between giftedness and ASD, the clinician should evaluate social communication. Children who are gifted but do not have ASD will show strengths in verbal and nonverbal communication. There are numerous environmental and genetic disorders that may have ramifications for intellectual abilities and may need to be differentiated from or co-occur with ASD. These are FAS, Down syndrome, Turner syndrome, Williams syndrome, Rett syndrome, and Fragile X. Dyslexia; dysgraphia and dyscalculia are important diagnoses to consider in the assessment of ASD. A Specific Learning Disorder is performance in an academic area below what would be expected based on cognition, age, and/or grade level. A language disorder is characterized by difficulties in acquisition and use of language across modalities. These must be differentially diagnosed from ASD. While symptoms of inattention may lead to failure to read social cues and communicate effectively with others, social communication weakness is not a core deficit of AD/HD. Thus, individuals with AD/HD alone are likely to make eye contact, gesture, and exhibit ease in connecting socially with others.