(2.5)-WHO-国际疾病分类ICD-11第6章：精神、行为或神经发育障碍

INTERNATIONALCLASSIFICATIONOFDISEASES-ICD-11forMortalityandMorbidityStatistics

CHAPTER06

Mental,behaviouralorneurodevelopmentaldisorders

Thischapterhas162four-charactercategories.

Coderangestartswith6A00

Mental,behaviouralandneurodevelopmentaldisordersaresyndromescharacterisedbyclinicallysignificantdisturbanceinanindividual'scognition,emotionalregulation,orbehaviourthatreflectsadysfunctioninthepsychological,biological,ordevelopmentalprocessesthatunderliementalandbehaviouralfunctioning.Thesedisturbancesareusuallyassociatedwithdistressorimpairmentinpersonal,family,social,educational,occupational,orotherimportantareasoffunctioning.

Exclusions: Acutestressreaction(QE84)

Uncomplicatedbereavement(QE62)

CodedElsewhere: Sleep-wakedisorders(7A00-7B2Z)

Sexualdysfunctions(HA00-HA0Z)

Genderincongruence(HA60-HA6Z)

Thischaptercontainsthefollowingtoplevelblocks:

Neurodevelopmentaldisorders

Schizophreniaorotherprimarypsychoticdisorders

Catatonia

Mooddisorders

Anxietyorfear-relateddisorders

Obsessive-compulsiveorrelateddisorders

Disordersspecificallyassociatedwithstress

Dissociativedisorders

Feedingoreatingdisorders

Eliminationdisorders

Disordersofbodilydistressorbodilyexperience

Disordersduetosubstanceuseoraddictivebehaviours

Impulsecontroldisorders

Disruptivebehaviourordissocialdisorders

Personalitydisordersandrelatedtraits

Paraphilicdisorders

Factitiousdisorders

Neurocognitivedisorders

Mentalorbehaviouraldisordersassociatedwithpregnancy,childbirthorthepuerperium

Secondarymentalorbehaviouralsyndromesassociatedwithdisordersordiseasesclassifiedelsewhere

Neurodevelopmentaldisorders(6A00‑6A0Z)

Neurodevelopmentaldisordersarebehaviouralandcognitivedisordersthatariseduringthedevelopmentalperiodthatinvolvesignificantdifficultiesintheacquisitionandexecutionofspecificintellectual,motor,language,orsocialfunctions.Althoughbehaviouralandcognitivedeficitsarepresentinmanymentalandbehaviouraldisordersthatcanariseduringthedevelopmentalperiod(e.g.,Schizophrenia,Bipolardisorder),onlydisorderswhosecorefeaturesareneurodevelopmentalareincludedinthisgrouping.Thepresumptiveetiologyforneurodevelopmentaldisordersiscomplex,andinmanyindividualcasesisunknown.

CodedElsewhere: Primaryticsorticdisorders(8A05.0)

Secondaryneurodevelopmentalsyndrome(6E60)

6A00 Disordersofintellectualdevelopment

Disordersofintellectualdevelopmentareagroupofetiologicallydiverseconditionsoriginatingduringthedevelopmentalperiodcharacterisedbysignificantlybelowaverageintellectualfunctioningandadaptivebehaviourthatareapproximatelytwoormorestandarddeviationsbelowthemean(approximatelylessthanthe2.3rdpercentile),basedonappropriatelynormed,individuallyadministeredstandardizedtests.Whereappropriatelynormedandstandardizedtestsarenotavailable,diagnosisofdisordersofintellectualdevelopmentrequiresgreaterrelianceonclinicaljudgmentbasedonappropriateassessmentofcomparablebehaviouralindicators.

CodingNote: Useadditionalcode,ifdesired,toidentifyanyknownaetiology.

Exclusions: Dementia(6D80‑6D8Z)

6A00.0 Disorderofintellectualdevelopment,mild

Amilddisorderofintellectualdevelopmentisaconditionoriginatingduringthedevelopmentalperiodcharacterisedbysignificantlybelowaverageintellectualfunctioningandadaptivebehaviourthatareapproximatelytwotothreestandarddeviationsbelowthemean(approximately0.1–2.3percentile),basedonappropriatelynormed,individuallyadministeredstandardizedtestsorbycomparablebehaviouralindicatorswhenstandardizedtestingisunavailable.Affectedpersonsoftenexhibitdifficultiesintheacquisitionandcomprehensionofcomplexlanguageconceptsandacademicskills.Mostmasterbasicself-care,domestic,andpracticalactivities.Personsaffectedbyamilddisorderofintellectualdevelopmentcangenerallyachieverelativelyindependentlivingandemploymentasadultsbutmayrequireappropriatesupport.

6A00.1 Disorderofintellectualdevelopment,moderate

Amoderatedisorderofintellectualdevelopmentisaconditionoriginatingduringthedevelopmentalperiodcharacterisedbysignificantlybelowaverageintellectualfunctioningandadaptivebehaviourthatareapproximatelythreetofourstandarddeviationsbelowthemean(approximately0.003–0.1percentile),basedonappropriatelynormed,individuallyadministeredstandardizedtestsorbycomparablebehaviouralindicatorswhenstandardizedtestingisunavailable.Languageandcapacityforacquisitionofacademicskillsofpersonsaffectedbyamoderatedisorderofintellectualdevelopmentvarybutaregenerallylimitedtobasicskills.Somemaymasterbasicself-care,domestic,andpracticalactivities.Mostaffectedpersonsrequireconsiderableandconsistentsupportinordertoachieveindependentlivingandemploymentasadults.

6A00.2 Disorderofintellectualdevelopment,severe

Aseveredisorderofintellectualdevelopmentisaconditionoriginatingduringthedevelopmentalperiodcharacterisedbysignificantlybelowaverageintellectualfunctioningandadaptivebehaviourthatareapproximatelyfourofmorestandarddeviationsbelowthemean(lessthanapproximatelythe0.003rdpercentile),basedonappropriatelynormed,individuallyadministeredstandardizedtestsorbycomparablebehaviouralindicatorswhenstandardizedtestingisunavailable.Affectedpersonsexhibitverylimitedlanguageandcapacityforacquisitionofacademicskills.Theymayalsohavemotorimpairmentsandtypicallyrequiredailysupportinasupervisedenvironmentforadequatecare,butmayacquirebasicself-careskillswithintensivetraining.Severeandprofounddisordersofintellectualdevelopmentaredifferentiatedexclusivelyonthebasisofadaptivebehaviourdifferencesbecauseexistingstandardizedtestsofintelligencecannotreliablyorvalidlydistinguishamongindividualswithintellectualfunctioningbelowthe0.003rdpercentile.

6A00.3 Disorderofintellectualdevelopment,profound

Aprofounddisorderofintellectualdevelopmentisaconditionoriginatingduringthedevelopmentalperiodcharacterisedbysignificantlybelowaverageintellectualfunctioningandadaptivebehaviourthatareapproximatelyfourofmorestandarddeviationsbelowthemean(approximatelylessthanthe0.003rdpercentile),basedonindividuallyadministeredappropriatelynormed,standardizedtestsorbycomparablebehaviouralindicatorswhenstandardizedtestingisunavailable.Affectedpersonspossessverylimitedcommunicationabilitiesandcapacityforacquisitionofacademicskillsisrestrictedtobasicconcreteskills.Theymayalsohaveco-occurringmotorandsensoryimpairmentsandtypicallyrequiredailysupportinasupervisedenvironmentforadequatecare.Severeandprofounddisordersofintellectualdevelopmentaredifferentiatedexclusivelyonthebasisofadaptivebehaviourdifferencesbecauseexistingstandardizedtestsofintelligencecannotreliablyorvalidlydistinguishamongindividualswithintellectualfunctioningbelowthe0.003rdpercentile.

6A00.4 Disorderofintellectualdevelopment,provisional

Disorderofintellectualdevelopment,provisionalisassignedwhenthereisevidenceofadisorderofintellectualdevelopmentbuttheindividualisaninfantorchildundertheageoffouroritisnotpossibletoconductavalidassessmentofintellectualfunctioningandadaptivebehaviourbecauseofsensoryorphysicalimpairments(e.g.,blindness,pre-lingualdeafness),motororcommunicationimpairments,severeproblembehavioursorco-occurringmentalandbehaviouraldisorders.

6A00.Z Disordersofintellectualdevelopment,unspecified

CodingNote: Useadditionalcode,ifdesired,toidentifyanyknownaetiology.

6A01 Developmentalspeechorlanguagedisorders

Developmentalspeechorlanguagedisordersariseduringthedevelopmentalperiodandarecharacterisedbydifficultiesinunderstandingorproducingspeechandlanguageorinusinglanguageincontextforthepurposesofcommunicationthatareoutsidethelimitsofnormalvariationexpectedforageandlevelofintellectualfunctioning.Theobservedspeechandlanguageproblemsarenotattributabletoregional,social,orcultural/ethniclanguagevariationsandarenotfullyexplainedbyanatomicalorneurologicalabnormalities.ThepresumptiveaetiologyforDevelopmentalspeechorlanguagedisordersiscomplex,andinmanyindividualcases,isunknown.

6A01.0 Developmentalspeechsounddisorder

Developmentalspeechsounddisorderischaracterisedbydifficultiesintheacquisition,productionandperceptionofspeechthatresultinerrorsofpronunciation,eitherinnumberortypesofspeecherrorsmadeortheoverallqualityofspeechproduction,thatareoutsidethelimitsofnormalvariationexpectedforageandlevelofintellectualfunctioningandresultinreducedintelligibilityandsignificantlyaffectcommunication.Theerrorsinpronunciationariseduringtheearlydevelopmentalperiodandcannotbeexplainedbysocial,cultural,andotherenvironmentalvariations(e.g.,regionaldialects).Thespeecherrorsarenotfullyexplainedbyahearingimpairmentorastructuralorneurologicalabnormality.

Inclusions: Functionalspeecharticulationdisorder

Exclusions: Deafnessnototherwisespecified(AB52)

Diseasesofthenervoussystem(Chapter08)

Dysarthria(MA80.2)

Verbalapraxia(MB4A)

6A01.1 Developmentalspeechfluencydisorder

Developmentalspeechfluencydisorderischaracterisedbyfrequentorpervasivedisruptionofthenormalrhythmicflowandrateofspeechcharacterisedbyrepetitionsandprolongationsinsounds,syllables,words,andphrases,aswellasblockingandwordavoidanceorsubstitutions.Thespeechdysfluencyispersistentovertime.Theonsetofspeechdysfluencyoccursduringthedevelopmentalperiodandspeechfluencyismarkedlybelowwhatwouldbeexpectedforage.Speechdysfluencyresultsinsignificantimpairmentinsocialcommunication,personal,family,social,educational,occupationalorotherimportantareasoffunctioning.ThespeechdysfluencyisnotbetteraccountedforbyaDisorderofIntellectualDevelopment,aDiseaseoftheNervousSystem,asensoryimpairment,orastructuralabnormality,orotherspeechorvoicedisorder.

Exclusions: Ticdisorders(8A05)

6A01.2 Developmentallanguagedisorder

Developmentallanguagedisorderischaracterisedbypersistentdeficitsintheacquisition,understanding,productionoruseoflanguage(spokenorsigned),thatariseduringthedevelopmentalperiod,typicallyduringearlychildhood,andcausesignificantlimitationsintheindividual’sabilitytocommunicate.Theindividual’sabilitytounderstand,produceoruselanguageismarkedlybelowwhatwouldbeexpectedgiventheindividual’sage.Thelanguagedeficitsarenotexplainedbyanotherneurodevelopmentaldisorderorasensoryimpairmentorneurologicalcondition,includingtheeffectsofbraininjuryorinfection.

Exclusions: Autismspectrumdisorder(6A02)

Diseasesofthenervoussystem(Chapter08)

Deafnessnototherwisespecified(AB52)

Selectivemutism(6B06)

6A01.20 Developmentallanguagedisorderwithimpairmentofreceptiveandexpressivelanguage

Developmentallanguagedisorderwithimpairmentofreceptiveandexpressivelanguageischaracterisedbypersistentdifficultiesintheacquisition,understanding,production,anduseoflanguagethatariseduringthedevelopmentalperiod,typicallyduringearlychildhood,andcausesignificantlimitationsintheindividual’sabilitytocommunicate.Theabilitytounderstandspokenorsignedlanguage(i.e.,receptivelanguage)ismarkedlybelowtheexpectedlevelgiventheindividual’sageandlevelofintellectualfunctioning,andisaccompaniedbypersistentimpairmentintheabilitytoproduceandusespokenorsignedlanguage(i.e.,expressivelanguage).

Inclusions: developmentaldysphasiaoraphasia,receptivetype

Exclusions: acquiredaphasiawithepilepsy[Landau-Kleffner](8A62.2)

Autismspectrumdisorder(6A02)

Selectivemutism(6B06)

dysphasiaNOS(MA80.1)

Diseasesofthenervoussystem(Chapter08)

Deafnessnototherwisespecified(AB52)

6A01.21 Developmentallanguagedisorderwithimpairmentofmainlyexpressivelanguage

Developmentallanguagedisorderwithimpairmentofmainlyexpressivelanguageischaracterisedbypersistentdifficultiesintheacquisition,production,anduseoflanguagethatariseduringthedevelopmentalperiod,typicallyduringearlychildhood,andcausesignificantlimitationsintheindividual’sabilitytocommunicate.Theabilitytoproduceandusespokenorsignedlanguage(i.e.,expressivelanguage)ismarkedlybelowtheexpectedlevelgiventheindividual’sageandlevelofintellectualfunctioning,buttheabilitytounderstandspokenorsignedlanguage(i.e.,receptivelanguage)isrelativelyintact.

Inclusions: Developmentaldysphasiaoraphasia,expressivetype

Exclusions: acquiredaphasiawithepilepsy[Landau-Kleffner](8A62.2)

Selectivemutism(6B06)

dysphasiaandaphasia:developmental,receptivetype(6A01.20)

dysphasiaNOS(MA80.1)

aphasiaNOS(MA80.0)

Diseasesofthenervoussystem(Chapter08)

Deafnessnototherwisespecified(AB52)

6A01.22 Developmentallanguagedisorderwithimpairmentofmainlypragmaticlanguage

Developmentallanguagedisorderwithimpairmentofmainlypragmaticlanguageischaracterisedbypersistentandmarkeddifficultieswiththeunderstandinganduseoflanguageinsocialcontexts,forexamplemakinginferences,understandingverbalhumour,andresolvingambiguousmeaning.Thesedifficultiesariseduringthedevelopmentalperiod,typicallyduringearlychildhood,andcausesignificantlimitationsintheindividual’sabilitytocommunicate.Pragmaticlanguageabilitiesaremarkedlybelowtheexpectedlevelgiventheindividual’sageandlevelofintellectualfunctioning,buttheothercomponentsofreceptiveandexpressivelanguagearerelativelyintact.ThisqualifiershouldnotbeusedifthepragmaticlanguageimpairmentisbetterexplainedbyAutismSpectrumDisorderorbyimpairmentsinothercomponentsofreceptiveorexpressivelanguage.

Exclusions: Diseasesofthenervoussystem(Chapter08)

Selectivemutism(6B06)

6A01.23 Developmentallanguagedisorder,withotherspecifiedlanguageimpairment

Developmentallanguagedisorderwithotherspecifiedlanguageimpairmentischaracterisedbypersistentdifficultiesintheacquisition,understanding,productionoruseoflanguage(spokenorsigned),thatariseduringthedevelopmentalperiodandcausesignificantlimitationsintheindividual’sabilitytocommunicate.Thepatternofspecificdeficitsinlanguageabilitiesisnotadequatelycapturedbyanyoftheotherdevelopmentallanguagedisordercategories.

Exclusions: Autismspectrumdisorder(6A02)

Diseasesofthenervoussystem(Chapter08)

Disordersofintellectualdevelopment(6A00)

Selectivemutism(6B06)

6A01.Y Otherspecifieddevelopmentalspeechorlanguagedisorders

6A01.Z Developmentalspeechorlanguagedisorders,unspecified

6A02 Autismspectrumdisorder

Autismspectrumdisorderischaracterisedbypersistentdeficitsintheabilitytoinitiateandtosustainreciprocalsocialinteractionandsocialcommunication,andbyarangeofrestricted,repetitive,andinflexiblepatternsofbehaviour,interestsoractivitiesthatareclearlyatypicalorexcessivefortheindividual’sageandsocioculturalcontext.Theonsetofthedisorderoccursduringthedevelopmentalperiod,typicallyinearlychildhood,butsymptomsmaynotbecomefullymanifestuntillater,whensocialdemandsexceedlimitedcapacities.Deficitsaresufficientlyseveretocauseimpairmentinpersonal,family,social,educational,occupationalorotherimportantareasoffunctioningandareusuallyapervasivefeatureoftheindividual’sfunctioningobservableinallsettings,althoughtheymayvaryaccordingtosocial,educational,orothercontext.Individualsalongthespectrumexhibitafullrangeofintellectualfunctioningandlanguageabilities.

Inclusions: Autisticdisorder

Exclusions: Rettsyndrome(LD90.4)

6A02.0 Autismspectrumdisorderwithoutdisorderofintellectualdevelopmentandwithmildornoimpairmentoffunctionallanguage

Alldefinitionalrequirementsforautismspectrumdisorderaremet,intellectualfunctioningandadaptivebehaviourarefoundtobeatleastwithintheaveragerange(approximatelygreaterthanthe2.3rdpercentile),andthereisonlymildornoimpairmentintheindividual'scapacitytousefunctionallanguage(spokenorsigned)forinstrumentalpurposes,suchastoexpresspersonalneedsanddesires.

6A02.1 Autismspectrumdisorderwithdisorderofintellectualdevelopmentandwithmildornoimpairmentoffunctionallanguage

Alldefinitionalrequirementsforbothautismspectrumdisorderanddisorderofintellectualdevelopmentaremetandthereisonlymildornoimpairmentintheindividual'scapacitytousefunctionallanguage(spokenorsigned)forinstrumentalpurposes,suchastoexpresspersonalneedsanddesires.

6A02.2 Autismspectrumdisorderwithoutdisorderofintellectualdevelopmentandwithimpairedfunctionallanguage

Alldefinitionalrequirementsforautismspectrumdisorderaremet,intellectualfunctioningandadaptivebehaviourarefoundtobeatleastwithintheaveragerange(approximatelygreaterthanthe2.3rdpercentile),andthereismarkedimpairmentinfunctionallanguage(spokenorsigned)relativetotheindividual’sage,withtheindividualnotabletousemorethansinglewordsorsimplephrasesforinstrumentalpurposes,suchastoexpresspersonalneedsanddesires.

6A02.3 Autismspectrumdisorderwithdisorderofintellectualdevelopmentandwithimpairedfunctionallanguage

Alldefinitionalrequirementsforbothautismspectrumdisorderanddisorderofintellectualdevelopmentaremetandthereismarkedimpairmentinfunctionallanguage(spokenorsigned)relativetotheindividual’sage,withtheindividualnotabletousemorethansinglewordsorsimplephrasesforinstrumentalpurposes,suchastoexpresspersonalneedsanddesires.

6A02.5 Autismspectrumdisorderwithdisorderofintellectualdevelopmentandwithabsenceoffunctionallanguage

Alldefinitionalrequirementsforbothautismspectrumdisorderanddisorderofintellectualdevelopmentaremetandthereiscomplete,oralmostcomplete,absenceofabilityrelativetotheindividual’sagetousefunctionallanguage(spokenorsigned)forinstrumentalpurposes,suchastoexpresspersonalneedsanddesires

6A02.Y Otherspecifiedautismspectrumdisorder

6A02.Z Autismspectrumdisorder,unspecified

6A03 Developmentallearningdisorder

Developmentallearningdisorderischaracterisedbysignificantandpersistentdifficultiesinlearningacademicskills,whichmayincludereading,writing,orarithmetic.Theindividual’sperformanceintheaffectedacademicskill(s)ismarkedlybelowwhatwouldbeexpectedforchronologicalageandgenerallevelofintellectualfunctioning,andresultsinsignificantimpairmentintheindividual’sacademicoroccupationalfunctioning.Developmentallearningdisorderfirstmanifestswhenacademicskillsaretaughtduringtheearlyschoolyears.Developmentallearningdisorderisnotduetoadisorderofintellectualdevelopment,sensoryimpairment(visionorhearing),neurologicalormotordisorder,lackofavailabilityofeducation,lackofproficiencyinthelanguageofacademicinstruction,orpsychosocialadversity.

Exclusions: Symbolicdysfunctions(MB4B)

6A03.0 Developmentallearningdisorderwithimpairmentinreading

Developmentallearningdisorderwithimpairmentinreadingischaracterisedbysignificantandpersistentdifficultiesinlearningacademicskillsrelatedtoreading,suchaswordreadingaccuracy,readingfluency,andreadingcomprehension.Theindividual’sperformanceinreadingismarkedlybelowwhatwouldbeexpectedforchronologicalageandlevelofintellectualfunctioningandresultsinsignificantimpairmentintheindividual’sacademicoroccupationalfunctioning.Developmentallearningdisorderwithimpairmentinreadingisnotduetoadisorderofintellectualdevelopment,sensoryimpairment(visionorhearing),neurologicaldisorder,lackofavailabilityofeducation,lackofproficiencyinthelanguageofacademicinstruction,orpsychosocialadversity.

Exclusions: Disordersofintellectualdevelopment(6A00)

6A03.1 Developmentallearningdisorderwithimpairmentinwrittenexpression

Developmentallearningdisorderwithimpairmentinwrittenexpressionischaracterisedbysignificantandpersistentdifficultiesinlearningacademicskillsrelatedtowriting,suchasspellingaccuracy,grammarandpunctuationaccuracy,andorganisationandcoherenceofideasinwriting.Theindividual’sperformanceinwrittenexpressionismarkedlybelowwhatwouldbeexpectedforchronologicalageandlevelofintellectualfunctioningandresultsinsignificantimpairmentintheindividual’sacademicoroccupationalfunctioning.Developmentallearningdisorderwithimpairmentinwrittenexpressionisnotduetoadisorderofintellectualdevelopment,sensoryimpairment(visionorhearing),aneurologicalormotordisorder,lackofavailabilityofeducation,lackofproficiencyinthelanguageofacademicinstruction,orpsychosocialadversity.

Exclusions: Disordersofintellectualdevelopment(6A00)

6A03.2 Developmentallearningdisorderwithimpairmentinmathematics

Developmentallearningdisorderwithimpairmentinmathematicsischaracterisedbysignificantandpersistentdifficultiesinlearningacademicskillsrelatedtomathematicsorarithmetic,suchasnumbersense,memorizationofnumberfacts,accuratecalculation,fluentcalculation,andaccuratemathematicreasoning.Theindividual’sperformanceinmathematicsorarithmeticismarkedlybelowwhatwouldbeexpectedforchronologicalordevelopmentalageandlevelofintellectualfunctioningandresultsinsignificantimpairmentintheindividual’sacademicoroccupationalfunctioning.Developmentallearningdisorderwithimpairmentinmathematicsisnotduetoadisorderofintellectualdevelopment,sensoryimpairment(visionorhearing),aneurologicaldisorder,lackofavailabilityofeducation,lackofproficiencyinthelanguageofacademicinstruction,orpsychosocialadversity.

Exclusions: Disordersofintellectualdevelopment(6A00)

6A03.3 Developmentallearningdisorderwithotherspecifiedimpairmentoflearning

Developmentallearningdisorderwithotherspecifiedimpairmentoflearningischaracterisedbysignificantandpersistentdifficultiesinlearningacademicskillsotherthanreading,mathematics,andwrittenexpression.Theindividual’sperformanceintherelevantacademicskillismarkedlybelowwhatwouldbeexpectedforchronologicalageandlevelofintellectualfunctioningandresultsinsignificantimpairmentintheindividual’sacademicoroccupationalfunctioning.Developmentallearningdisorderwithotherspecifiedimpairmentoflearningisnotduetoadisorderofintellectualdevelopment,sensoryimpairment(visionorhearing),neurologicaldisorder,lackofavailabilityofeducation,lackofproficiencyinthelanguageofacademicinstruction,orpsychosocialadversity.

Exclusions: Disordersofintellectualdevelopment(6A00)

6A03.Z Developmentallearningdisorder,unspecified

6A04 Developmentalmotorcoordinationdisorder

Developmentalmotorcoordinationdisorderischaracterisedbyasignificantdelayintheacquisitionofgrossandfinemotorskillsandimpairmentintheexecutionofcoordinatedmotorskillsthatmanifestinclumsiness,slowness,orinaccuracyofmotorperformance.Coordinatedmotorskillsaremarkedlybelowthatexpectedgiventheindividual'schronologicalageandlevelofintellectualfunctioning.Onsetofcoordinatedmotorskillsdifficultiesoccursduringthedevelopmentalperiodandistypicallyapparentfromearlychildhood.Coordinatedmotorskillsdifficultiescausesignificantandpersistentlimitationsinfunctioning(e.g.inactivitiesofdailyliving,schoolwork,andvocationalandleisureactivities).DifficultieswithcoordinatedmotorskillsarenotsolelyattributabletoaDiseaseoftheNervousSystem,DiseaseoftheMusculoskeletalSystemorConnectiveTissue,sensoryimpairment,andnotbetterexplainedbyaDisorderofIntellectualDevelopment.

Exclusions: Abnormalitiesofgaitandmobility(MB44)

Diseasesofthemusculoskeletalsystemorconnectivetissue(Chapter15)

Diseasesofthenervoussystem(Chapter08)

6A05 Attentiondeficithyperactivitydisorder

Attentiondeficithyperactivitydisorderischaracterisedbyapersistentpattern(atleast6months)ofinattentionand/orhyperactivity-impulsivitythathasadirectnegativeimpactonacademic,occupational,orsocialfunctioning.Thereisevidenceofsignificantinattentionand/orhyperactivity-impulsivitysymptomspriortoage12,typicallybyearlytomid-childhood,thoughsomeindividualsmayfirstcometoclinicalattentionlater.Thedegreeofinattentionandhyperactivity-impulsivityisoutsidethelimitsofnormalvariationexpectedforageandlevelofintellectualfunctioning.Inattentionreferstosignificantdifficultyinsustainingattentiontotasksthatdonotprovideahighlevelofstimulationorfrequentrewards,distractibilityandproblemswithorganisation.Hyperactivityreferstoexcessivemotoractivityanddifficultieswithremainingstill,mostevidentinstructuredsituationsthatrequirebehaviouralself-control.Impulsivityisatendencytoactinresponsetoimmediatestimuli,withoutdeliberationorconsiderationoftherisksandconsequences.Therelativebalanceandthespecificmanifestationsofinattentiveandhyperactive-impulsivecharacteristicsvariesacrossindividualsandmaychangeoverthecourseofdevelopment.Inorderforadiagnosistobemade,manifestationsofinattentionand/orhyperactivity-impulsivitymustbeevidentacrossmultiplesituationsorsettings(e.g.,home,school,work,withfriendsorrelatives),butarelikelytovaryaccordingtothestructureanddemandsofthesetting.Symptomsarenotbetteraccountedforbyanothermental,behavioural,orneurodevelopmentaldisorderandarenotduetotheeffectofasubstanceormedication.

Inclusions: attentiondeficitdisorderwithhyperactivity

attentiondeficitsyndromewithhyperac