RECTH 4300

Recreational Therapy Services

Diagnostic Protocol
Diagnostic Grouping
Cognitive and Intellectual Disabilities: A group of symptoms in functioning that originates during
the period of development (conception to age 18) that is characterized by intellectual deficits or
anomalies existing concurrently with impairment in adaptive behavior patterns where a person
ineffectively processes social requirements and personal expectations.
Etiology:
Genetics
Neurological structure and development
Environmental factors including Poverty and Neglect
Age of both parents at conception
Prenatal drug use
Complications during birth
Disease
Specific Diagnosis
Autism Spectrum Disorder (ASD): This is defined as part of the DSM-V as a neurodevelopmental
cognitive disorder that is diagnosed on behavioral and developmental characteristics rather than
medical, anatomic, or specific genetic markers. ASD is a collection of social, communication, and
behavioral impairments with a wide spectrum of functionality, the highest individuals scoring far
above average on intelligence testing and the lowest scoring far below average.
Autistic Disorder:
Problems with social interactions, communication, and imaginative play in children
younger than 3 years.
Aspergers Syndrome:
Lack of speech deficits, no problems with language. Tend to score in the average or
above-average range on intelligence tests. Same social problems and limited scope of
interests as children with autistic disorder.
Childhood Disintegrative Disorder:
Normal development for at least two years and then experience loss of some or most
of their communication and social skills. Extremely rare disorder
Pervasive Development Disorder not otherwise Specified:
Atypical Autistic behaviors that don't fit into other categories.
Severity:
Level 1, Requires Support:
Deficits in social communication cause noticeable
impairments in initiating and maintaining social
interactions. The inflexible behaviors interfere with
functioning in one or more situations.
Level 2, Requires Substantial Support:
The marked deficit in social communication skills are
apparent even when the support systems are in place.
The restricted, repetitive behaviors are significant
enough that they are obvious to a casual observer and
cause distress when change is required
Level 3, Requires very substantial support:
Severe deficits in social communication result in very
limited initiation of interactions and minimal response to
others. The restricted, repetitive behaviors are extremely
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Recreational Therapy Services
inflexible and the inability to change focus markedly
interferes with functioning in all activities.
Identified Problems (Symptoms relevant to recreational therapy)
Deficits in social communication and interaction
Social-Emotional Reciprocity
Speech deficits including non-verbal
Relationship Building
Repetitive Motor Movements
Obsessed or Fixated
Inflexible adherence to routines
Insistence on sameness
Ritualized patterns
Sensory Reactions
Resistant to change or new experiences
Abnormal intensity or focus
Cognitive Impairment or Intellectually Gifted
Visual Processors
Need High Level of structure
Difficulties in planning and organizing
Related Factors
Attention Deficits or Hyperactivity
Epilepsy (seizure disorders)
Anxiety and Depression
Aggression and Agitation
Self-Harm and/or Suicide
Sensory Over-Responsivity (Melt-downs)
Unresponsive to pain
Mixed sensory profile
Unique thinking processes
Cannot Generalize
Oblivious to social cues and nuances
Abusive
Isolation
Resources
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th
ed.). Arlington, VA: American Psychiatric Publishing.
Coco-Ripp, J., & Smith, R. L. (2015). Autism Spectrum Disorder. In H. R. Porter (Ed.), Recreational
therapy for specific diagnoses and conditions (pp. 39-50). Enumclaw, WA: Idyll Arbor.
Richards, S. B., Brady, M. P., & Taylor, R. L. (2015). Cognitive and intellectual disabilities: Historical
perspectives, current practices, and future directions (2nd ed.). New York, NY: Routledge.

Understanding Autism -- the Basics. Retrieved October 27, 2016, from

http://www.webmd.com/brain/autism/understanding-autism-basics#2
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Recreational Therapy Services
P.L. Millet TRS, CTRS