Discussion: Applying Differential Diagnosis
- Read the case provided by your instructor for this week’s Discussion and identify relevant symptoms and factors. You may want to make a simple list of the symptoms and facts of the case to help you focus on patterns.
- Read the Morrison (2014) selection. Focus on Figure 1.1, “The Roadmap for Diagnosis,” to guide your decision making.
- Provide a full DSM-5 diagnosis of the client. Remember, a full diagnosis should include the name of the disorder, ICD-10-CM code, specifiers, severity, and the Z codes (other conditions that may be a focus of clinical attention). Keep in mind a diagnosis covers the most recent 12 months
With the information provided, Emmanual is diagnosed with intellectual disability, ICD-11, an intellectual developmental disorder. This information about Emmanual is as recent as of September 2019. The specifiers in Emmanual’s case include problem-solving abilities, academic level, learning, communication, and attentive abilities. With the multiple levels of severity, they are defined based on adaptive functioning and not through IQ scores because adaptive functioning determines the level of support that is required (American Psychiatric Association., 2013j). The severity of Emmanual’s case is moderate (318.0 (F71)). The Z Code in relation to Emmanual’s case is a parent-child relational problem (Z62.820). Parent-child relational problems are used to test the quality of the parent-child relationship and when it is affecting the course, prognosis, or treatment of the mental or medical disorder (American Psychiatric Association., 2013l). Emmanual’s parents used their own treatment for his conditions by using natural and cultural treatments. This prolonged his condition and was not getting the appropriate treatment. It is important to note that this was done based on religion.
Explain the diagnosis by matching the symptoms identified in the case to the specific criteria for the diagnosis
Emmanual displays challenges with his schoolwork, such as direct guidance needed, not retaining information, and challenges with his grades. Additionally, he experiences social cues from his peers, struggles with friendships, behavioral challenges, and lacks of communication skills. Emmanual’s diagnosis matches that on a moderate level. Moderate intellectual disability symptoms include an individual’s conceptual skills lagging behind those of peers, differences in social and communicative behaviors, social cue differences, an extended period of teaching and time is needed for the individual, and friendships affected by communication or social limitations (American Psychiatric Association., 2013).
Identify which four diagnoses you initially considered in the case of the client, using the DSM-5 diagnostic criteria to explain why you selected these four items. In one or two sentences each, explain why three of these diagnoses were excluded.
When diagnosing Emmanual, the four diagnoses I considered for his condition included specific learning disorder, autism spectrum disorder, communication disorder, and intellectual disability. I considered a specific learning disorder for Emmanual because of his inability to process information efficiently. Specific learning disorder was excluded because it implies select deficits in an individual’s inability to process information. Autism spectrum disorder was considered because of the deficits in social communication and social interaction across multiple contexts (American Psychiatric Association., 2013j). Additionally, with the autism spectrum, there are deficits in understanding relationships, nonverbal communicative behaviors within social interaction (American Psychiatric Association., 2013j). Autism spectrum was excluded because Emmanual did not display restricted or repetitive patterns of behaviors and did not have additional specifiers that matched this diagnosis. Lastly, communication disorder was considered because of his communication disorder. Communication disorder was excluded because Emmanual was not experiencing specifically a speech sound disorder such as stuttering and disturbances in speech.
Explain any obvious eliminations that could be made from within the neurodevelopmental spectrum.
An obvious elimination within the neurodevelopmental spectrum includes ADHD. ADHD is defined as disorganization and or hyperactivity-impulsivity behavior (American Psychiatric Association., 2013j). Emmanual did not present with this diagnosis.
Describe in detail how the client’s symptoms match up with the specific diagnostic criteria for the primary disorder that you finally selected for him. Note two other relevant DSM-5 criteria for that illness from the sections on “diagnostic features” and “development and course” that fit this case.