INLEIDING ............................................................................................................. 4
ONTWIKKELINGSTOORNISSEN ........................................................................... 4
GEDRAGSSTOORNISSEN .................................................................................... 5
OVERZICHT OLOD .............................................................................................. 6
INSTRUMENTEN ................................................................................................. 7
DIAGNOSTIEK MOET OP VERSCHILLENDE NIVEAUS GEBEUREN......................... 12
INTELLIGENTIE ................................................................................................. 15
AUTISMESPECTRUMSTOORNIS ............................................................................. 18
DSM- 5 CRITERIA .............................................................................................. 18
DSM IV (-TR) (1994, 2000) .................................................................................. 21
DSM-5 (2013): VAN MEER NAAR 1 EN VAN 1 NAAR MEER .................................... 22
COMORBIDITEIT ............................................................................................... 22
PREVALENTIE ................................................................................................... 23
(EEN DEEL VAN) DE GESCHIEDENIS VAN ASS .................................................... 24
VOORBIJ HET AUTISME SPECTRUM .................................................................... 29
ETIOLOGIE........................................................................................................ 30
PSYCHOLOGISCHE VERKLARINGSMODELLEN .................................................. 35
AANDACHTSDEFICIËNTIE-/HYPERACTIVITEITSSTOORNIS ...................................... 54
DSM- 5 CRITERIA .............................................................................................. 54
ADHD + COMORBIDITIET................................................................................... 57
ADHD OF? ........................................................................................................ 59
NEGATIEVE IMPACT (OOK LANGETERMIJN) OP VERSCHILLENDE DOMEINEN IN HET
LEVEN .............................................................................................................. 59
STERKE KANTEN ............................................................................................... 59
GESCHIEDENIS VAN ADHD ............................................................................... 60
PREVALENTIE ................................................................................................... 61
ETIOLOGIE........................................................................................................ 63
NEUROPSYCHOLOGISCHE VERKLARINGSMODELLEN ....................................... 68
DIAGNOSTIEK ADHD ......................................................................................... 78
GILLES DE LA TOURETTE ....................................................................................... 86
INLEIDING ........................................................................................................ 86
DSM-5: TICSTOORNISSEN ................................................................................. 86
HISTORIEK: 1STE CASUS ..................................................................................... 86
DSM- 5: STOORNIS VAN GILLES DE LA TOURETTE............................................... 87
ENKELE BEGRIPPEN ......................................................................................... 88
PREVALENTIE ................................................................................................... 89
1
, VERLOOP ......................................................................................................... 89
ETIOLOGIE........................................................................................................ 90
NEUROBIOLOGIE – NEUROPSYCHOLOGIE ........................................................ 91
COMORBIDITEIT ............................................................................................... 92
DIFFERENTIAALDIAGNOSTIEK ........................................................................... 92
BIJKOMENDE KENMERKEN ................................................................................ 93
DIAGNOSTIEK ................................................................................................... 93
COÖRDINATIEONTWIKKELINGSSTOORNISSEN (DCD) EN
COMMUNICATIESTOORNISSEN ............................................................................ 96
COÖRDINATIEONTWIKKELINGSSTOORNIS (DCD) .............................................. 96
DSM-5-TR: DCD ................................................................................................ 96
PREVALENTIE ................................................................................................... 96
COMORBITEITEN .............................................................................................. 96
IMPACT............................................................................................................. 97
ETIOLOGIE........................................................................................................ 97
DIAGNOSTIEK ................................................................................................... 98
COMMUNICATIESTOORNISSEN ............................................................................ 98
DSM- 5 ............................................................................................................. 98
TAALONTWIKKELING......................................................................................... 99
TAAL(ONTWIKKELINGS)STOORNIS .................................................................... 99
DIFFERENTIAALDIAGNOSTIEK EN COMORBIDITEIT .......................................... 102
ETIOLOGIE...................................................................................................... 102
ENKEL VEELGEBRUIKTE TESTEN ...................................................................... 102
SOCIALE (PRAGMATISCHE) COMMUNICATIESTOORNIS ................................... 102
GEDRAGSSTOORNISSEN: ODD EN CD ................................................................ 104
INLEIDING: GEDRAGSSTOORNISSEN .............................................................. 105
OPPOSITIONEEL OPSTANDIGE STOORNIS (ODD) ............................................. 107
NORMOVERSCHRIJDEND- GEDRAGSSTOORNIS (CD) ...................................... 109
ODD EN CD: VERLOOP, BIJKOMENDE PROBLEMEN, COMORBIDITEITEN ........... 113
DIAGNOSTIEK ................................................................................................. 113
ETIOLOGIE...................................................................................................... 116
NEUROPSYCHOLOGIE .................................................................................... 118
ODD/CD: CONCLUSIE .................................................................................... 118
NEURODIVERSITEIT ............................................................................................ 119
NEURODIVERSITEITSBEWEGING ..................................................................... 119
ETIOLOGIE...................................................................................................... 120
2
, HET GEPOLARISEERDE DEBAT ........................................................................ 122
OPLOSSING X ................................................................................................. 122
STOORNIS ALS DYNAMISCH GEGEVEN............................................................ 124
INTRIM CONCLUSIE ........................................................................................ 124
IMPLICATIES ONDERZOEK .............................................................................. 124
IMPLICATIES IN KLINISCHE PRAKTIJK ............................................................... 125
CONCLUSIE ................................................................................................... 126
DIAGNOSTIEK BIJ JONGE KINDEREN EN VOLWASSENEN ..................................... 127
BABY’S, PEUTERS EN KLEUTERS ...................................................................... 127
VOLWASSENEN .............................................................................................. 134
3
, INLEIDING
ONTWIKKELINGSTOORNISSEN
TERMEN DSM
DSM = Diagnostic and Statistical manual of Mental disorders (sinds 1952)
- Classificatiesysteem met allerlei criteria om tot bepaalde diagnose te komen
- Meest gebruikt classificatiesysteem (in België)
DSM-III-R (3)(1987)
̶ R = gereduceerde, beknopte versie (revision)
̶ Mentale retardatie
̶ pervasieve ontwikkelingsstoornissen à wordt nu autismespectrumstoornis
genoemd
̶ specifieke ontwikkelingsstoornissen
DSM-IV (1994) * DSM-IV-TR (2000)
̶ Term wordt niet meer gebruikt (“disorders usually first diagnosed in infancy,
childhood, or adolescence”)
ICD-10 (1992)
̶ F80 - F89: stoornissen in de psychologische ontwikkeling
DSM- 5 (mei 2013, NL 2014) – DSM-5-TR (2022)
̶ Neurobiologische ontwikkelingsstoornissen (Neurodevelopmental disorders)
̶ Meer overkoepelende termen (subtypes verdwenen)
̶ Meer dimensioneel
INDELING NEUROBIOLOGISCHE ONTWIKKELINGSSTOORNISSEN DSM- 5
4
ONTWIKKELINGSTOORNISSEN ........................................................................... 4
GEDRAGSSTOORNISSEN .................................................................................... 5
OVERZICHT OLOD .............................................................................................. 6
INSTRUMENTEN ................................................................................................. 7
DIAGNOSTIEK MOET OP VERSCHILLENDE NIVEAUS GEBEUREN......................... 12
INTELLIGENTIE ................................................................................................. 15
AUTISMESPECTRUMSTOORNIS ............................................................................. 18
DSM- 5 CRITERIA .............................................................................................. 18
DSM IV (-TR) (1994, 2000) .................................................................................. 21
DSM-5 (2013): VAN MEER NAAR 1 EN VAN 1 NAAR MEER .................................... 22
COMORBIDITEIT ............................................................................................... 22
PREVALENTIE ................................................................................................... 23
(EEN DEEL VAN) DE GESCHIEDENIS VAN ASS .................................................... 24
VOORBIJ HET AUTISME SPECTRUM .................................................................... 29
ETIOLOGIE........................................................................................................ 30
PSYCHOLOGISCHE VERKLARINGSMODELLEN .................................................. 35
AANDACHTSDEFICIËNTIE-/HYPERACTIVITEITSSTOORNIS ...................................... 54
DSM- 5 CRITERIA .............................................................................................. 54
ADHD + COMORBIDITIET................................................................................... 57
ADHD OF? ........................................................................................................ 59
NEGATIEVE IMPACT (OOK LANGETERMIJN) OP VERSCHILLENDE DOMEINEN IN HET
LEVEN .............................................................................................................. 59
STERKE KANTEN ............................................................................................... 59
GESCHIEDENIS VAN ADHD ............................................................................... 60
PREVALENTIE ................................................................................................... 61
ETIOLOGIE........................................................................................................ 63
NEUROPSYCHOLOGISCHE VERKLARINGSMODELLEN ....................................... 68
DIAGNOSTIEK ADHD ......................................................................................... 78
GILLES DE LA TOURETTE ....................................................................................... 86
INLEIDING ........................................................................................................ 86
DSM-5: TICSTOORNISSEN ................................................................................. 86
HISTORIEK: 1STE CASUS ..................................................................................... 86
DSM- 5: STOORNIS VAN GILLES DE LA TOURETTE............................................... 87
ENKELE BEGRIPPEN ......................................................................................... 88
PREVALENTIE ................................................................................................... 89
1
, VERLOOP ......................................................................................................... 89
ETIOLOGIE........................................................................................................ 90
NEUROBIOLOGIE – NEUROPSYCHOLOGIE ........................................................ 91
COMORBIDITEIT ............................................................................................... 92
DIFFERENTIAALDIAGNOSTIEK ........................................................................... 92
BIJKOMENDE KENMERKEN ................................................................................ 93
DIAGNOSTIEK ................................................................................................... 93
COÖRDINATIEONTWIKKELINGSSTOORNISSEN (DCD) EN
COMMUNICATIESTOORNISSEN ............................................................................ 96
COÖRDINATIEONTWIKKELINGSSTOORNIS (DCD) .............................................. 96
DSM-5-TR: DCD ................................................................................................ 96
PREVALENTIE ................................................................................................... 96
COMORBITEITEN .............................................................................................. 96
IMPACT............................................................................................................. 97
ETIOLOGIE........................................................................................................ 97
DIAGNOSTIEK ................................................................................................... 98
COMMUNICATIESTOORNISSEN ............................................................................ 98
DSM- 5 ............................................................................................................. 98
TAALONTWIKKELING......................................................................................... 99
TAAL(ONTWIKKELINGS)STOORNIS .................................................................... 99
DIFFERENTIAALDIAGNOSTIEK EN COMORBIDITEIT .......................................... 102
ETIOLOGIE...................................................................................................... 102
ENKEL VEELGEBRUIKTE TESTEN ...................................................................... 102
SOCIALE (PRAGMATISCHE) COMMUNICATIESTOORNIS ................................... 102
GEDRAGSSTOORNISSEN: ODD EN CD ................................................................ 104
INLEIDING: GEDRAGSSTOORNISSEN .............................................................. 105
OPPOSITIONEEL OPSTANDIGE STOORNIS (ODD) ............................................. 107
NORMOVERSCHRIJDEND- GEDRAGSSTOORNIS (CD) ...................................... 109
ODD EN CD: VERLOOP, BIJKOMENDE PROBLEMEN, COMORBIDITEITEN ........... 113
DIAGNOSTIEK ................................................................................................. 113
ETIOLOGIE...................................................................................................... 116
NEUROPSYCHOLOGIE .................................................................................... 118
ODD/CD: CONCLUSIE .................................................................................... 118
NEURODIVERSITEIT ............................................................................................ 119
NEURODIVERSITEITSBEWEGING ..................................................................... 119
ETIOLOGIE...................................................................................................... 120
2
, HET GEPOLARISEERDE DEBAT ........................................................................ 122
OPLOSSING X ................................................................................................. 122
STOORNIS ALS DYNAMISCH GEGEVEN............................................................ 124
INTRIM CONCLUSIE ........................................................................................ 124
IMPLICATIES ONDERZOEK .............................................................................. 124
IMPLICATIES IN KLINISCHE PRAKTIJK ............................................................... 125
CONCLUSIE ................................................................................................... 126
DIAGNOSTIEK BIJ JONGE KINDEREN EN VOLWASSENEN ..................................... 127
BABY’S, PEUTERS EN KLEUTERS ...................................................................... 127
VOLWASSENEN .............................................................................................. 134
3
, INLEIDING
ONTWIKKELINGSTOORNISSEN
TERMEN DSM
DSM = Diagnostic and Statistical manual of Mental disorders (sinds 1952)
- Classificatiesysteem met allerlei criteria om tot bepaalde diagnose te komen
- Meest gebruikt classificatiesysteem (in België)
DSM-III-R (3)(1987)
̶ R = gereduceerde, beknopte versie (revision)
̶ Mentale retardatie
̶ pervasieve ontwikkelingsstoornissen à wordt nu autismespectrumstoornis
genoemd
̶ specifieke ontwikkelingsstoornissen
DSM-IV (1994) * DSM-IV-TR (2000)
̶ Term wordt niet meer gebruikt (“disorders usually first diagnosed in infancy,
childhood, or adolescence”)
ICD-10 (1992)
̶ F80 - F89: stoornissen in de psychologische ontwikkeling
DSM- 5 (mei 2013, NL 2014) – DSM-5-TR (2022)
̶ Neurobiologische ontwikkelingsstoornissen (Neurodevelopmental disorders)
̶ Meer overkoepelende termen (subtypes verdwenen)
̶ Meer dimensioneel
INDELING NEUROBIOLOGISCHE ONTWIKKELINGSSTOORNISSEN DSM- 5
4
