TN 3 (10-99)
DI 34232.003 Mental Listings from 01/06/86 to 12/11/90
112.00 MENTAL AND EMOTIONAL DISORDERS
Introduction. This section is intended primarily to describe mental and emotional disorders of young children. The criteria describing medically determinable impairments in adults should be used where they clearly appear to be more appropriate.
Mental retardation. General. As with any other impairment, the necessary evidence consists of symptoms, signs, and laboratory findings which provide medically demonstrable evidence of impairment severity. Standardized intelligence test results are essential to the adjudication of all cases of mental retardation that are not clearly covered under the provisions of 112.05A. Developmental milestone criteria may be the sole basis for adjudication only in cases where the child's young age and/or condition preclude formal standardized testing by a psychologist or psychiatrist experienced in testing children.
Measures of intellectual functioning. Standardized intelligence tests, such as the Wechsler Preschool and Primary Scale of Intelligence (WPPSI), the Wechsler Intelligence Scale for Children—Revised (WISC-R), the Revised Stanford-Binet Scale, and the McCarthey Scales of Children's Abilities, should be used wherever possible. Key data such as subtest scores should also be included in the report. Tests should be administered by a qualified and experienced psychologist or psychiatrist, and any discrepancies between formal tests results and the child's customary behavior and daily activities should be duly noted and resolved.
Developmental milestone criteria. In the event that a child's young age and/or condition preclude formal standardized testing by a psychologist or psychiatrist experienced in testing children, a comprehensive evaluation covering the full range of developmental activities should be performed. This should consist of a detailed account of the child's daily activities together with direct observations by a professional person; the latter should include indices or manifestations of social, intellectual, adaptive, verbal, motor (posture, locomotion, manipulation), language, emotional, and self-care development for age. The above should then be related by the evaluating or treating physician to established developmental norms of the kind found in any widely used standard pediatrics text.
Profound combined mental-neurological-musculoskeletal impairments. There are children with profound and irreversible brain damage resulting in total incapacitation. Such children may meet criteria in either neurological, musculoskeletal, and/or mental sections; they should be adjudicated under the criteria most completely substantiated by the medical evidence submitted. Frequently, the most appropriate criteria will be found under the mental impairment section.
112.01 CATEGORY OF IMPAIRMENTS, MENTAL AND EMOTIONAL
112.02 Chronic brain syndrome. With arrest of developmental progression for at least six months or loss of previously acquired abilities.
112.03 Psychosis of infancy and childhood. Documented by psychiatric evaluation and supported, if necessary, by the results of appropriate standardized psychological tests and manifested by marked restriction in the performance of daily age-appropriate activities; constriction of age-appropriate interests; deficiency of age-appropriate self-care skills; and impaired ability to relate to others; together with persistence of one (or more) of the following:
Significant withdrawal or attachment; or
Impaired sense of reality; or
Bizarre behavior patterns; or
Strong need for maintenance of sameness, with intense anxiety, fear, or anger, when change is introduced; or
Panic at threat of separation from parent.
112.04 Functional nonpsychotic disorders. Documented by psychiatric evaluation and supported, if necessary, by the results of appropriate standardized psychological tests and manifested by marked restriction in the performance of daily age-appropriate activities; constriction of age-appropriate interests; deficiency of age-appropriate self-care skills; and impaired ability to relate to others; together with persistence of one (or more) of the following:
Psychophysiological disorder (e.g., diarrhea, asthma); or
Phobic, obsessive, or compulsive behavior; or
Asocial or antisocial behavior.
112.05 Mental retardation.
Achievement of only those developmental milestones generally acquired by children no more than one-half the child's chronological age; or
IQ of 59 or less; or
IQ of 60-69, inclusive, and a physical or other mental impairment imposing additional and significant restriction of function or developmental progression.