Chapter V
Mental and behavioural disorders
(F00-F99)

Disorders of psychological development
(F80-F89)

Definition

The disorders included in this block have in common: (a) onset invariably during infancy or childhood; (b) impairment or delay in development of functions that are strongly related to biological maturation of the central nervous system; and (c) a steady course without remissions and relapses. In most cases, the functions affected include language, visuo-spatial skills, and motor coordination. Usually, the delay or impairment has been present from as early as it could be detected reliably and will diminish progressively as the child grows older, although milder deficits often remain in adult life.

F80 Specific developmental disorders of speech and language

Definition

Disorders in which normal patterns of language acquisition are disturbed from the early stages of development. The conditions are not directly attributable to neurological or speech mechanism abnormalities, sensory impairments, mental retardation, or environmental factors. Specific developmental disorders of speech and language are often followed by associated problems, such as difficulties in reading and spelling, abnormalities in interpersonal relationships, and emotional and behavioural disorders.

F80.0 Specific speech articulation disorder
Definition

A specific developmental disorder in which the child's use of speech sounds is below the appropriate level for its mental age, but in which there is a normal level of language skills.

Incl.:
Developmental:
  • phonological disorder
  • speech articulation disorder
Dyslalia
Functional speech articulation disorder
Lalling
Excl.:
speech articulation impairment (due to):
  • aphasia NOS (R47.0)
  • apraxia (R48.2)
  • hearing loss (H90-H91)
  • mental retardation (F70-F79)
  • with language developmental disorder:
    • —  expressive (F80.1)
    • —  receptive (F80.2)
F80.1 Expressive language disorder
Definition

A specific developmental disorder in which the child's ability to use expressive spoken language is markedly below the appropriate level for its mental age, but in which language comprehension is within normal limits. There may or may not be abnormalities in articulation.

Incl.:
Developmental dysphasia or aphasia, expressive type
Excl.:
acquired aphasia with epilepsy [Landau-Kleffner] ( F80.3)
dysphasia and aphasia:
  • NOS (R47.0)
  • developmental, receptive type (F80.2)
elective mutism ( F94.0)
mental retardation ( F70-F79)
pervasive developmental disorders ( F84.-)
F80.2 Receptive language disorder
Definition

A specific developmental disorder in which the child's understanding of language is below the appropriate level for its mental age. In virtually all cases expressive language will also be markedly affected and abnormalities in word-sound production are common.

Incl.:
Congenital auditory imperception
Developmental:
  • dysphasia or aphasia, receptive type
  • Wernicke aphasia
Word deafness
Excl.:
acquired aphasia with epilepsy [Landau-Kleffner] ( F80.3)
autism ( F84.0-F84.1)
dysphasia and aphasia:
  • NOS (R47.0)
  • developmental, expressive type (F80.1)
elective mutism ( F94.0)
language delay due to deafness ( H90-H91)
mental retardation ( F70-F79)
F80.3 Acquired aphasia with epilepsy [Landau-Kleffner]
Definition

A disorder in which the child, having previously made normal progress in language development, loses both receptive and expressive language skills but retains general intelligence; the onset of the disorder is accompanied by paroxysmal abnormalities on the EEG, and in the majority of cases also by epileptic seizures. Usually the onset is between the ages of three and seven years, with skills being lost over days or weeks. The temporal association between the onset of seizures and loss of language is variable, with one preceding the other (either way round) by a few months to two years. An inflammatory encephalitic process has been suggested as a possible cause of this disorder. About two-thirds of patients are left with a more or less severe receptive language deficit.

Excl.:
aphasia (due to):
F80.8 Other developmental disorders of speech and language
Incl.:
Lisping
F80.9 Developmental disorder of speech and language, unspecified
Incl.:
Language disorder NOS

F81 Specific developmental disorders of scholastic skills

Definition

Disorders in which the normal patterns of skill acquisition are disturbed from the early stages of development. This is not simply a consequence of a lack of opportunity to learn, it is not solely a result of mental retardation, and it is not due to any form of acquired brain trauma or disease.

F81.0 Specific reading disorder
Definition

The main feature is a specific and significant impairment in the development of reading skills that is not solely accounted for by mental age, visual acuity problems, or inadequate schooling. Reading comprehension skill, reading word recognition, oral reading skill, and performance of tasks requiring reading may all be affected. Spelling difficulties are frequently associated with specific reading disorder and often remain into adolescence even after some progress in reading has been made. Specific developmental disorders of reading are commonly preceded by a history of disorders in speech or language development. Associated emotional and behavioural disturbances are common during the school age period.

Incl.:
"Backward reading"
Developmental dyslexia
Specific reading retardation
Excl.:
alexia NOS ( R48.0)
dyslexia NOS ( R48.0)
reading difficulties secondary to emotional disorders ( F93.-)
F81.1 Specific spelling disorder
Definition

The main feature is a specific and significant impairment in the development of spelling skills in the absence of a history of specific reading disorder, which is not solely accounted for by low mental age, visual acuity problems, or inadequate schooling. The ability to spell orally and to write out words correctly are both affected.

Incl.:
Specific spelling retardation (without reading disorder)
Excl.:
agraphia NOS ( R48.8)
spelling difficulties:
  • associated with a reading disorder (F81.0)
  • due to inadequate teaching (Z55.8)
F81.2 Specific disorder of arithmetical skills
Definition

Involves a specific impairment in arithmetical skills that is not solely explicable on the basis of general mental retardation or of inadequate schooling. The deficit concerns mastery of basic computational skills of addition, subtraction, multiplication, and division rather than of the more abstract mathematical skills involved in algebra, trigonometry, geometry, or calculus.

Incl.:
Developmental:
  • acalculia
  • arithmetical disorder
  • Gerstmann syndrome
Excl.:
acalculia NOS ( R48.8)
arithmetical difficulties:
  • associated with a reading or spelling disorder (F81.3)
  • due to inadequate teaching (Z55.8)
F81.3 Mixed disorder of scholastic skills
Definition

An ill-defined residual category of disorders in which both arithmetical and reading or spelling skills are significantly impaired, but in which the disorder is not solely explicable in terms of general mental retardation or of inadequate schooling. It should be used for disorders meeting the criteria for both F81.2 and either F81.0 or F81.1.

Excl.:
specific:
  • disorder of arithmetical skills (F81.2)
  • reading disorder (F81.0)
  • spelling disorder (F81.1)
F81.8 Other developmental disorders of scholastic skills
Incl.:
Developmental expressive writing disorder
F81.9 Developmental disorder of scholastic skills, unspecified
Incl.:
Knowledge acquisition disability NOS
Learning:
  • disability NOS
  • disorder NOS

F82 Specific developmental disorder of motor function

Definition

A disorder in which the main feature is a serious impairment in the development of motor coordination that is not solely explicable in terms of general intellectual retardation or of any specific congenital or acquired neurological disorder. Nevertheless, in most cases a careful clinical examination shows marked neurodevelopmental immaturities such as choreiform movements of unsupported limbs or mirror movements and other associated motor features, as well as signs of impaired fine and gross motor coordination.

Incl.:
Clumsy child syndrome
Developmental:
  • coordination disorder
  • dyspraxia
Excl.:
abnormalities of gait and mobility ( R26.-)
lack of coordination ( R27.-)
lack of coordination
  • secondary to mental retardation (F70-F79)

F83 Mixed specific developmental disorders

Definition

A residual category for disorders in which there is some admixture of specific developmental disorders of speech and language, of scholastic skills, and of motor function, but in which none predominates sufficiently to constitute the prime diagnosis. This mixed category should be used only when there is a major overlap between each of these specific developmental disorders. The disorders are usually, but not always, associated with some degree of general impairment of cognitive functions. Thus, the category should be used when there are dysfunctions meeting the criteria for two or more of F80.-, F81.- and F82.

F84 Pervasive developmental disorders

Definition

A group of disorders characterized by qualitative abnormalities in reciprocal social interactions and in patterns of communication, and by a restricted, stereotyped, repetitive repertoire of interests and activities. These qualitative abnormalities are a pervasive feature of the individual's functioning in all situations.

Coding-Hint
Use additional code, if desired, to identify any associated medical condition and mental retardation.
F84.0 Childhood autism
Definition

A type of pervasive developmental disorder that is defined by: (a) the presence of abnormal or impaired development that is manifest before the age of three years, and (b) the characteristic type of abnormal functioning in all the three areas of psychopathology: reciprocal social interaction, communication, and restricted, stereotyped, repetitive behaviour. In addition to these specific diagnostic features, a range of other nonspecific problems are common, such as phobias, sleeping and eating disturbances, temper tantrums, and (self-directed) aggression.

Incl.:
Autistic disorder
Infantile:
  • autism
  • psychosis
Kanner syndrome
Excl.:
autistic psychopathy ( F84.5)
F84.1 Atypical autism
Definition

A type of pervasive developmental disorder that differs from childhood autism either in age of onset or in failing to fulfil all three sets of diagnostic criteria. This subcategory should be used when there is abnormal and impaired development that is present only after age three years, and a lack of sufficient demonstrable abnormalities in one or two of the three areas of psychopathology required for the diagnosis of autism (namely, reciprocal social interactions, communication, and restricted, stereotyped, repetitive behaviour) in spite of characteristic abnormalities in the other area(s). Atypical autism arises most often in profoundly retarded individuals and in individuals with a severe specific developmental disorder of receptive language.

Incl.:
Atypical childhood psychosis
Mental retardation with autistic features
Coding-Hint
Use additional code (F70-F79), if desired, to identify mental retardation.
F84.2 Rett syndrome
Definition

A condition, so far found only in girls, in which apparently normal early development is followed by partial or complete loss of speech and of skills in locomotion and use of hands, together with deceleration in head growth, usually with an onset between seven and 24 months of age. Loss of purposive hand movements, hand-wringing stereotypies, and hyperventilation are characteristic. Social and play development are arrested but social interest tends to be maintained. Trunk ataxia and apraxia start to develop by age four years and choreoathetoid movements frequently follow. Severe mental retardation almost invariably results.

F84.3 Other childhood disintegrative disorder
Definition

A type of pervasive developmental disorder that is defined by a period of entirely normal development before the onset of the disorder, followed by a definite loss of previously acquired skills in several areas of development over the course of a few months. Typically, this is accompanied by a general loss of interest in the environment, by stereotyped, repetitive motor mannerisms, and by autistic-like abnormalities in social interaction and communication. In some cases the disorder can be shown to be due to some associated encephalopathy but the diagnosis should be made on the behavioural features.

Incl.:
Dementia infantilis
Disintegrative psychosis
Heller syndrome
Symbiotic psychosis
Coding-Hint
Use additional code, if desired, to identify any associated neurological condition.
Excl.:
Rett syndrome ( F84.2)
F84.4 Overactive disorder associated with mental retardation and stereotyped movements
Definition

An ill-defined disorder of uncertain nosological validity. The category is designed to include a group of children with severe mental retardation (IQ below 35) who show major problems in hyperactivity and in attention, as well as stereotyped behaviours. They tend not to benefit from stimulant drugs (unlike those with an IQ in the normal range) and may exhibit a severe dysphoric reaction (sometimes with psychomotor retardation) when given stimulants. In adolescence, the overactivity tends to be replaced by underactivity (a pattern that is not usual in hyperkinetic children with normal intelligence). This syndrome is also often associated with a variety of developmental delays, either specific or global. The extent to which the behavioural pattern is a function of low IQ or of organic brain damage is not known.

F84.5 Asperger syndrome
Definition

A disorder of uncertain nosological validity, characterized by the same type of qualitative abnormalities of reciprocal social interaction that typify autism, together with a restricted, stereotyped, repetitive repertoire of interests and activities. It differs from autism primarily in the fact that there is no general delay or retardation in language or in cognitive development. This disorder is often associated with marked clumsiness. There is a strong tendency for the abnormalities to persist into adolescence and adult life. Psychotic episodes occasionally occur in early adult life.

Incl.:
Autistic psychopathy
Schizoid disorder of childhood
F84.8 Other pervasive developmental disorders
F84.9 Pervasive developmental disorder, unspecified

F88 Other disorders of psychological development

Incl.:
Developmental agnosia

F89 Unspecified disorder of psychological development

Incl.:
Developmental disorder NOS