Neurodevelopmental and Disruptive Behavior Disorders

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Lela and Carlos Enriquez have three children: Javier, Pia, and Richie. It’s been a very challenging year for the family, full of heartache; all three children have been having various difficulties at home or at school. Lela and Carlos are trying to figure out what, exactly, the problems are and what can be done about them.

The most troubling problem concerns their youngest son, Richie. He’s almost 2 years old, but he has yet to smile at his parents—or anyone else. He’s not talking, either, and although he seems to understand what people say to him, he is a bit slow to respond. Whereas most toddlers are talking in two- or three-word sentences, Richie doesn’t say even single words. Richie also seems shy in the extreme; he doesn’t even look people in the eye.

Richie’s older siblings have also been having problems. Javier is 10 years old, and he’s had both academic and social problems at school; his teacher suggested that he receive a thorough evaluation. And his 8-year-old sister, Pia, has been a bit of a puzzle. On her last report card, her teacher noted that she’s very bright but doesn’t seem to be working as hard as she could.

Like Richie, Pia, and Javier, many children achieve milestones, such as walking and talking, later than the average child or have problems socially or academically. When do such difficulties fall in the range of normal development, and when do they signal a larger problem? In this chapter we address this question by exploring two categories of DSM-5 disorders that typically arise in childhood: (1) neurodevelopmental disorders, which involve problems with the brain—the neuro part of the term—and are typically first diagnosed during infancy, childhood, or adolescence—the developmental part of the term, and (2) disruptive behavior disorders, also typically first diagnosed before adulthood. However, we must note that these are not the only disorders that can affect children; children can also be diagnosed with many of the disorders discussed in previous chapters.

We begin this chapter by examining intellectual disability—a disorder that can profoundly affect the lives of children and their families and that may require special schools or residential placements as well as other special services.