Term
317-319 Mental Retardation
Diagnostic Criteria |
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Definition
A. Significantly subaverage intellectual functioning: an IQ of approximately 70 or below on an individually administered IQ test (for infants, a clinical judgment). (See cards for Mild/Moderate/Severe/ Profound/Unspecified)
B. Concurrent deficits or impariments in present adaptive functioning in at least 2 of the following areas: communication, self-care, home living, social/interpersonal skills, use of community resources, self-direction, functional academic skills, work, leisure, health, and safety.
C. The onset is before age 18 years. |
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Term
317 Mild Mental Retardation
Diagnostic Criteria |
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Definition
A. IQ level 50-55 to approximately 70.
B. See general criteria
C. See general criteria
Approx. 85% of people with the disorder |
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Term
318 Moderate Mental Retardation
Diagnostic Criteria |
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Definition
A. IQ level 35-40 to 50-55
B. See general criteria
C. See general criteria
Approx. 10% of people with the disorder |
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Term
318.1 Severe Mental Retardation
Diagnostic Criteria |
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Definition
A. IQ level 20-25 to 35-40
B. See general criteria
C. See general criteria |
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Term
318.2 Profound Mental Retardation
Diagnostic Criteria |
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Definition
IQ level below 20 or 25
B. See general criteria
C. See general criteria |
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Term
| 319 Mental Retardation, Severity Unspecified |
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Definition
A. There is strong presumption of Mental Retardation but the person's intelligence is untestable by standard tests
B. See general criteria
C. See general criteria |
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Term
Down Syndrome
Epidemiology and Etiology |
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Definition
Accounts for approx. 10% of institutionalized mentally retarded individuals.
Usually caused by an extra 21st chromosome, hence trisomy 21.
Its risk is higher with increasing maternal age and probably paternal age.
IQ range: 0-100 Mean: 47-50
Common physical characteristics: high cheekbones, flat nasal bridge, large protruding tongue, microcephaly (an abnormally small head and underdeveloped brain) , small round ears, hypotonic muscles (having less than the normal tone), and hyperflexibility.
Very susceptible to infections, particularly respiratory.
30-50% have congenital heart defects.
Many don't survive childhood and few reach 50 years old. (Maxmen/Ward 422)
Coded on Axis III |
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Term
Fragile X syndrome
Epidemiology and Etiology |
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Definition
Mental retardation varies from severe to mild, with a few in the borderline IQ range. Tend to do badly in math and block designs and have a specific developmental language disorder. Females are the carriers and males are affected. Males are short with long ears, a long narrow face, and sunken chest. (Maxmen/Ward 422)
Coded on Axis III |
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Term
Fetal alcohol syndrome
Epidemiology and Etiology |
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Definition
Usually results in mild mental retardation with mean IQs in the 60's and a range of 25-120. 3 signs:
1) CNS (central nervous system) deficits (most often with lower IQ) and symptoms of attention-deficit/ hyperactivity disorder;
2) faces with narrow eye slits, flat cheeks, short nose, thin upper lip, and flat filtrum (the two vertical ridges btw the upper lip and nose);
3) growth retardation.
Often have adequate verbal skills and sound normal. Often mimic words well, but don't fully understand or comprehend their meaning. (Maxmen/Ward 423)
Coded on Axis III |
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Term
| Borderline Intellectual Functioning |
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Definition
IQ level of 71-84.
Difficult to differentiate from Mild Mental Retardation when IQ is 71-75. |
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Term
315 Reading Disorder
315.1 Mathematics Disorder
315.2 Disorder of Written Expression
Diagnostic Criteria |
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Definition
A) Either one or any combination of Reading achievement (315), mathematical ability (315.1), or writing skills (315.2), as measured by individually administered standardized tests, is substantially below that expected given the person's chronological age, measured intelligence, and age-appropriate education.
B) The disturbance in Criterion A significantly interferes with academic achievement or activities of daily living that require reading skills, mathematical skills, or the composition of written texts.
C) If a sensory deficit is present, the reading, mathematical, or writing difficulties are in excess of those usually associated with it.
Coding note: If a general medical (e.g., neurological) condition or sensory deficit is present, code the condition on Axis III. |
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Term
315.9 Learning Disorder Not Otherwise Specified
Diagnostic Criteria |
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Definition
| Might include problems in all three areas (reading, mathematics, written expression) that together significantly interfere with academic achievement even though performance on tests measuring each individual skill is not substantially below that expected given the person's chronological age, measured intelligence, and age-appropriate education. |
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Term
315.4 Developmental Coordination Disorder
Diagnostic Criteria |
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Definition
A) Performance in daily activities that require motor coordination is substantially below that expected given the person's chronological age and measured intelligence. This may be manifested by marked delays in achieving motor milestones (walking, crawling, sitting), dropping things, "clumsiness," poor performance in sports, or poor handwriting.
B) The disturbance in Criterion A significantly interferes with academic achievement or activities of daily living.
C) The disturbance is not due to a general medical condition (cerebral palsy, hemiplegia, or muscular dystrophy) and does not meet criteria for a Pervasive Developmental Disorder.
D) If Mental Retardatioin is present, the motor difficulties are in excess of those usually associated with it.
Coding note: If a general medical (e.g., neurological) condition ior sensory deficit is present, code the condition on Axis III. |
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Term
315.31 Expressive Language Disorder
Diagnostic Criteria |
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Definition
A) The scores obtained from standardized individually administered measures of expressive language development are substantially below those obtained from standardized measures of both nonverbal intellectual capacity and receptive language development. The disturbance may be manifest clinically by symptoms that include having a markedly limited vocabulary, making errors in tense, or having difficulty recalling words or producing sentences with developmentally appropriate length or complexity.
B) The difficulties with expressive language interfere with academic or occupational achievement or with social communication.
C) Criteria are not met for Mixed Receptive-Expressive Language Disorder or a Pervasive Developmental Disorder.
D) If Mental Retardation, a speech-motor or sensory deficit, or environmental deprivation is present, the language difficulties are in excess of those usually associated with these problems.
Coding note: If a speech-motor or sensory deficit or a neurological condition is present, code the condition on Axis III. |
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Term
315.32 Mixed Receptive-Expressive Language Disorder
Diagnostic Criteria |
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Definition
A) The scores obtained from a battery of standardized individually administered measures of both receptive and expressive language development are substantially below those obtained from standardized measures of nonverbal intellectual capacity. Symptoms include those for Expressive Language Disorder as well as difficulty understanding words, sentences, or sepcific types of words, such as spatial terms.
B) The difficulties with receptive and expressive language significantly interfere with academic or occupational achievement or with social communication.
C)Criteria are not met for a Pervasive Developmental Disorder.
D) If Mental Retardation, a speech-motor or sensory deficit, or environmental deprivation is present, the language difficulties are in excess of those usually associated with these problems.
Coding note: If a speech-motor or sensory deficit or a neurological condition is present, code the condition on Axis III. |
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Term
315.39 Phonological Disorder
Diagnostic Criteria |
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Definition
A) Failure to use developmentally expected speech sounds that are appropriate for age and dialect (e.g., errors in sound production, use, representation, or organization such as, but not limited to, substitutions of one sound for another [use of /t/ for intended /k/ sound] or omissions of sounds such as final consonants).
B) The difficulties in speech sound production interfere with academic or occupational achievement or with social communication.
C) If Mental Retardation, a speech-motot or sensory deficit, or environmental deprivation is present, the speech difficulties are in excess of those usually associated with these problems.
Coding note: If a speech-motor or sensory deficit or a neurological condition is present, code the condition on Axis III. |
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Term
307.0 Stuttering
Diagnostic Criteria |
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Definition
A) Disturbance in the normal fluency and time patterning of speech (inappropriate for the individual's age), characterized by frequent occurrences of one or more of the following:
1) sound and syllable repetitions
2) sound prolongations
3) interjections
4) broken words (words w/ a pause)
5) audible or silent blocking
(filled or unfilled pauses)
6) cicumlocutions
(word substitutions)
7) words produced with an excess of
physical tension
8) monosyllabic whole-word
repetitions (I-I-I)
B) The disturbance in fluency interferes with academic or occupational achievement or with social communication.
C) If a speech-motor or sensory deficit is present, the speech difficulties are in excess of those usually associated with these problems.
Coding note: If a speech-motor or sensory deficit or a neurological condition is present, code the condition on Axis III. |
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Term
307.9 Communication Disorder
Not Otherwise Specified |
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Definition
| This category is for disorders in communication that do not meet criteria for any specific Communication Disorder; for example, a voice disorder (an abnormality of vocal pitch, loudness, quality, tone, or resonance). |
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Term
Communication Disorders
Specific types |
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Definition
Expressive Language Disorder
Mixed Receptive-Expressive Language Disorder
Phonological Disorder
Stuttering |
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Term
Pervasive Developmental Disorders
Specific types |
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Definition
All characterized by problems in social interaction
Autistic Disorder
Rett's Disorder
Childhood Disintegrative Disorder
Asperger's Disorder
Pervasive Developmental Disorder Not Otherwise Specified |
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Term
299.00 Autistic Disorder
Diagnostic Criteria |
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Definition
A) A total of six or more items from 1, 2, and 3, with at least two from 1 and one each from 2 and 3.
1) qualitative impairment in social interaction, as manifested by at least two of the following:
1a - marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction
1b - failure to develop peer relationships appropriate to developmental level
1c - a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (by a lack of showing, bringing, or pointing out objects of interest)
1d - lack of social or emotional reciprocity
2) qualitative impairments in communication as manifested by at least one of the following:
2a - delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime)
2b - in individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others
2c - stereotyped and repetitive use of language or idiosyncratic language
2d - lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level
3) restricted repetitive and stereotyped patterns of behavior, interests, and activities, as manifested by at least one of the following:
3a - encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
3b - apparently inflexible adherence to specific, nonfunctional routines or rituals
3c - stereotyped and repetitive motor mannerisms (hand or finger flapping or twisting, or complex whole- body movements)
3d - persistent preoccupation with parts of objects
B) Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years: (1) social interaction, (2) language as used in social communication, or (3) symbolic or imaginative play.
C) The disturbance is not better accounted for by Rett's Disorder or Childhood Disintegrative Disorder. |
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Term
299.80 Rett's Disorder
Diagnostic Criteria |
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Definition
A) All of the following:
1 - apparently normal prenatal and perinatal development
2 - apparently normal psychomotor development through the first 5 months after birth
3 - normal head circumference at birth
B) Onset of all of the following after the period of normal development:
1 - deceleration of head growth between ages 5 and 48 months
2 - loss of previously acquired purposeful hand skills between ages 5 and 30 months with the subsequent development of stereotyped hand movements (hand wringing or hand washing)
3 - loss of social engagement early in th ecourse (social interaction often develops later)
4 - appearance of poorly coordinated gait or trunk movements
5 - severely impaired expressive and receptive language development with severe psychomotor retardation
(has only ever been reported in females) |
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Term
299.10 Childhood Disintegrative Disorder
Diagnostic Criteria |
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Definition
A) Apparently normal development for at least the first 2 years after birth as manifested by the presence of age-appropriate verbal and nonverbal communication, social relationships, play, and adaptive behavior.
B) Clinically significant loss of previously acquired skills (before age 10 years) in at least two of the following areas:
1 - expressive or receptive language
2 - social skills or adaptive behavior
3 - bowel or bladder control
4 - play
5 - motor skills
C) Abnormalities of functioning in at least two of the following areas:
1 - qualitative impairment in social interaction (impairment in nonverbal behaviors, failure to develop peer relationships, lack of social or emotional reciprocity)
2 - qualitative impairments in communication (delay or lack of spoken language, inability to initiate or sustain a conversation, stereotyped and repetitive use of language, lack of varied make-believe play)
3 - restricted, repetitive, and stereotyped patterns of behavior, interests, and activities, including motor stereotypies and mannerisms
D) The disturbance is not better accounted for by another specific Pervasive Developmental Disorder or by Schizophrenia. |
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Term
299.80 Asperger's Disorder
Diagnostic Criteria |
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Definition
A) Qualitative impairment in social interaction, as manifested by at least two of the following:
1 - marked impairment in the use of multiple nonverbal behaviors such as eye -to-eye gaze, facial expression, body postures, and gestures to regulate social interaction
2 - failure to develop peer relationships appropriate to developmental level
3 - a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (by a lack of showing, bringing, or pointing out objects of interest to other people)
4 - lack of social or emotional reciprocity
B) Restricted repetitive and stereotyped patterns of behavior, interests, and activities, as manifested by at least one of the following:
1 - encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
2 - apparently inflexible adherence to specific, nonfunctional routines or rituals
3 - stereotyped and repetitive motor mannerisms (head or finger flapping or twisting, or complex whole-body movements)
4 - persistent preoccupation with parts of objects
C) The disturbance causes clinically significant impairment in social, occupational, or other important areas of functioning
D) There is no clinically significant general delay in language (single words used by age 2 years, communicative phrases used by age 3 years)
E) There is no clinically significant delay in cognitive development or in the development of age-appropriate self-help skills, adaptive behavior (other than in social interaction), and curiosity about the environment in childhood.
F) Criteria are not met for another specific Pervasive Developmental Disorder or Schizophrenia. |
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Term
| 299.80 Pervasive Developmental Disorder Not Otherwise Specified (Including Atypical Autism) |
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Definition
| This category should be used when there is a severe and pervasive impairment in either verbal or nonverbal communication skills or with the presence of stereotyped behavior, interests, and activities, but the criteria are not met for a specific Pervasive Developmental Disorder, Schizophrenia, Schizotypal Personality Disorder, or Avoidant Personality Disorder. For example, this category includes "atypical autism" - presentations that do not meet the criteria for Autistic Disorder because of late age at onset, atypical symptomatology, or subthreshold symptpomatology, or all of these. |
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Term
Attention-Deficit/Hyperactivity Disorder
Diagnostic Criteria
314.01 ADHD, Combined Type
314.00 ADHD, Predominantly Inattentive
Type
314.01 ADHD, Predominantly Hyperactive- Impulsive Type |
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Definition
A) Either 1 or 2
1 - six or more of the following symptoms of inattention have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level:
a) often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities
b) often has difficulty sustaining attention in tasks or play activities
3) often does not seem to listen when spoken to directly
d) often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand)
e) often has difficulty organizing tasks and activities
f) often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (schoolwork or homework)
g) often loses things necessary for tasks or activities
h) is often easily distracted by extraneous stimuli
i) is often forgetful in daily activities
2) six or more of the following symptoms of hyperactivity-impulsivity have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level:
Hyperactivity:
a) often fidgets with hands or feet or squirms in seat
b) often leaves seat in classroom or in other situations in which remaining seated is expected
c) often runs about or climbs excessively in situation s in which it is inappropriate (in adolescents or adults, may be limited to subjective feelings of restlessness)
d) often has difficulty playing or engaging in leisure activities quietly
e) is often "on the go" or acts as if "driven by a motor"
f) often talks excessively
Impulsivity:
g) often blurts out answers before questions ave been completed
h) often has difficulty awaiting turn
i) often interrupts or intrudes on others (often into conversations or games)
B) Some hyperactive -impulsive or inattentive symptoms that caused impairment were present before age 7 years.
C) Some impairment from the symptoms is present in two or more settings
D) There must be clear evidence of clinically significant impairment in social, academic, or occupational functioning
E) The symptoms do not occur exclusively during the course of a Pervasive Developmental Disorder, Schizophrenia, or other Psychotic Disorder and are not better accounted for by another mental disorder (Mood Disorder, Anxiety Disorder, Dissociative Disorder, or a Personality Disorder)
Code based on type:
314.01 ADHD, Combined Type:
if both criteria A1 and A2 are met for the past 6 months
314.00 ADHD, Predominantly Inattentive Type:
if Criterion A1 is met but Criterion A2 is not met for the past 6 months
314.01 ADHD< Predominantly Hyperactive- Impulsive Type:
if Criterion A2 is met but Criterion A1 is not met for the past 6 months
Coding note: For individuals (especially adolescents and adults) who currently have symptoms that no longer meet full criteria, "In Partial Remission" should be specified. |
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Term
| ADHD, Not Otherwise Specified |
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Definition
This category is for disorders with prominent symptoms of inattention or hyperactivity-impulsivity that do not meet criteria for ADHD. Examples:
1 - Individuals whose symptoms and impairment meet the criteria for ADHD, Predom. Inattentive Type, but whose age at onset is 7 years or after
2 - Individuals with clinically significant impairment who present with inattention and whose symptom pattern does not meet the full criteria for the disorder but have a behavioral pattern marked by sluggishness, daydreaming, and hypoactivity |
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Term
Conduct Disorder
Diagnostic Criteria
312.81 CD, Childhood-Onset Type
312.82 CD, Adolescent-Onset Type
312.89 CD. Unspecified Onset |
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Definition
A) A repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated, as manifested by the presence of three (or more) of the following criteria in the past 12 months, with at least one criterion present in the past 6 months:
Aggression to people and animals:
1 - often bullies, threatens, or intimidates others
2 - often initiates physical fights
3 - has used a weapon that can cause serious physical harm to others
4 - has been physically cruel to people
5 - has been physically cruel to animals
6 - has stolen while confronting a victim (mugging, etc.)
7 - has forced someone into sexual activity
Destruction of property
8 - has deliberately engaged in fire setting with the intention of causing serious damage
9 - has deliberately destroyed others' property (not through fire)
Deceitfulness or theft
10 - has broken into someone else's house, building, or car
11 - often lies to obtain goods or favors or to avoid obligations (cons)
12 - has stolen items of nontrivial value without confronting a victim (shoplifting, forgery)
Serious violations of rules
13 - often stays out at night despite parental prohibitions, beginning before age 13
14 - has run away from home overnight at least twice while living in parental or parental surrogat home (or once without returning for lengthy period)
15 - is often truant from school, beginning before age 13
B) The disturbance in behavior causes clinically significant impairment in social, academic, or occupational functioning
C) If the individual is age 18 or older, criteria are not met for Antisocial Personality Disorder.
Code based on age at onset:
312.81 Childhood-Onset Type: onset of at least one criterion prior to age 10
312.82 Adolescent-Onset Type: absence of any criteria characteristic of Conduct Disorder prior to age 10 years
312.89 Unspecified Onset - age unknown
Specify severity:
Mild: few if any conduct problems in excess of those required to make the diagnosis AND conduct problems cause only minor harm to others
Moderate: number of conduct problems and effect on others intermediate between "mild" and "severe"
Severe: many conduct problems in excess of those required to make the diagnosis OR conduct problems cause considerable harm to others |
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Term
313.81 Oppositional Defiant Disorder
Diagnostic Criteria |
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Definition
A) A pattern of negativistic, hostile, and defiant behavior lasting at least 6 months, during which four or more of the following are present:
1 - often loses temper
2 - often argues with adults
3 - often actively defies or refuses to comply with adults' requests or rules
4 - often deliberately annoys people
5 - often blames others for his or her mistakes or misbehavior
6 - is often touchy or easily annoyed
7 - is often angry and resentful
8 - is often spiteful or vindictive
Note: consider criterion met only if the behavior occurs more frequently than is typically observed in individuals of comparable age and developmental level.
B) The disturbance in behavior causes clinically significant impariment in social, academic, or occupational functioning.
C) The behaviors do not occur exclusively during the course of a Psychotic or Mood Disorder.
D) Criteria are not met for Conduct Disorder, and, if the individual is age 18 or older, criteria are not met for Antisocial Personality Disorder. |
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Term
| 312.9 Disruptive Behavior Disorder Not Otherwise Specified |
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Definition
| This category is for disorders characterized by conduct or oppostional defiant behaviors that do not meet the criteria for Conduct Disorder or Oppositional Defiant Disorder. For example, include clinical presentations that do not meet full criteria either for Oppositional Defiant Disorder or Conduct Disorder, but in which there is clinically significant impairment. |
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Term
Feeding and Eating Disorders of Infancy or Early Childhood
Specific Types |
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Definition
Characterized by persistent feeding and eating disturbances.
307.52 Pica
307.53 Rumination Disorder
307.59 Feeding Disorder of Infancy or Early Childhood |
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Term
307.53 Pica
Diagnostic Criteria |
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Definition
A) Persistent eating of nonnutritive substances for a period of at least 1 month.
B) The eating of nonnutritive substances is inappropriate to the developmental level.
C) The eating behavior is not part of a culturally sanctioned practice.
D) If the eating behavior occurs exclusively during the course of another mental disorder, it is sufficiently severe to warrant independent clinical attention. |
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Term
307.53 Rumination Disorder
Diagnostic Criteria |
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Definition
A) Repeated regurgitation and rechewing of food for a period of at least 1 month following a period of normal functioning
B) The behavior is not due to an associate gastrointestingal or other general medical condition (esophageal reflux).
C) The behavior does not occur exclusively during the course of Anorxia Nervosa of Bulimia Nervosa If the symptoms occur exclusively during the course of Mental Retardation or a Pervasive Developmental Disorder, they are sufficiently severe to warrant independent clinical attention. |
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Term
307.59 Feeding Disorder of Infancy or Early Childhood
Diagnostic Criteria |
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Definition
A) Feeding disturbance as manifested by persistent failure to eat adequately with significant failure to gain weight or significant loss of weight over at least 1 month.
B) The disturbance is not due to an associated gastrointestinal or other general medical condition (esophageal reflux).
C) The disturbance is not better accounted for by another mental disorder (Rumination Disorder) or by lack of available food.
D) The onset is before age 6. |
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Term
307.23 Tourette's Disorder
Diagnostic Criteria |
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Definition
A) Both multiple motor and one or more vocal tics have been present at some time during the illness, although not necessarily concurrently.
B) The tics occur many times a day (usually in bouts) nearly every day or intermittently throughout a period of more than 1 year, and during this period there was never a tic-free period of more than 3 consecutive months.
C) The onset is before age 18
D) The disturbance is not due to the direct physiological effects of a substance, or a general medical condition. |
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Term
307.22 Chronic Motor or Vocal Tic Disorder
Diagnostic Criteria |
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Definition
A) Single or multiple motor or vocal tics, but not both, have been present at some time during the illness.
B) The tics occur many times a day (usually in bouts) nearly every day or intermittently throughout a period of more than 1 year, and during this period there was never a tic-free period of more than 3 consecutive months.
C) The onset is before age 18
D) The disturbance is not due to the direct physiological effects of a substance, or a general medical condition.
E) The criteria have never been met for Tourette's Disorder. |
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Term
307.21 Transient Tic Disorder
Diagnostic Criteria |
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Definition
A) Single or multiple motor and/or vocal tics
B) The tics occur many times a day, nearly every day for at least 4 weeks, but for no longer than 12 consecutive months.
C) The onset is before age 18.
D) The disturbance is not due to the direct physiological effects of a substance or a general medical condition.
E) Criteria have never been met for Tourette's Disorder or Chronic Motor or Vocal Tic Disorder.
Specify if Single Episode or Recurrent |
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Term
Encopresis
Diagnostic Criteria
787.6 With Constipation and Overflow Incontinence
307.7 Without COnstipation and Overflow Incontinence |
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Definition
A) Repeated passage of feces into inappropriate places (clothing or floor) whether involuntary or intentional
B) At least one such event a month for at least 3 months.
C) Chronological age is at least 4 years (or equivalent development level)
D) The behavior is not due exclusively to the direct physiological effects of a substance (laxitives) or a general medical condition except through a mechanism involving constipation. |
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Term
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Definition
A) Repeated voiding of urine into bed or clothes (voluntary or intentional)
B) The behavior is clinically significant as manifested by either a frequency of twice a week for at least 3 consecutive months or the presence of clinically significant distress or impairment in social, academic (occupational), or other important areas of functioning.
C) Chronological age is at least 5 years (or equiv. developmental level).
D) The behavior is not due exclusively to the direct physiological effect of a substance or a general medical condition.
Specify type:
Nocturnal Only
Diurnal Only
Nocturnal and Diurnal |
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Term
309.21 Separation Anxiety Disorder
Diagnostic Criteria |
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Definition
A) Developmentally inappropriate and excessive anxiety concerning separation from home or from those to whom the individual is attached, as evidenced by three (or more) or the following:
1 - recurrent excessive distress when separation from home or major attachment figures occurs or is anticipated
2 - persistent and excessive worry about losing, or about possible harm befalling, major attachment figures
3 - persistent and excessive worry that an untoward event will lead to separation from a major attachment figure (getting lost/kidnapped)
4 - persistent reluctance or refusal to go to school or elsewhere because of fear of separation
5 - persistently and excessively fearful or reluctant to be alone or without major attachment figures at home or without significant adults in other settings
6 - persistent reluctance or refusal to go to sleep without being near a major attachment figure or to sleep away from home
7 - repeated nightmares involving the theme of separation
8 - repeated complaints of physical symptoms (headaches, stomachaches, nausea, vomiting) when separation from major attachment figures occurs or is anticipated
B) The duration of the disturbance is at least 4 weeks.
C) The onset is before age 18 years.
D) The disturbance causes clinically significant distress or impairment in socail, academic (occupational), or other important areas of functioning.
E) The disturbance does not occur exclusively during the course of a Pervasive Developmental Disorder, Schizophrenia, or other Psychotic Disorder and, in adolescents and adults, is not better accounted for by Panic Disorder With Agoraphobia.
Specify if:
Early Onset - if onset occurs before age 6 |
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Term
313.23 Selective Mutism
Diagnostic Criteria |
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Definition
A) Consistent failure to speak in specific social situations (w/ an expectation for speaking) despite speaking in other situations.
B) The disturbance interferes with educational or occupational achievement or with social communication.
C) The duration of the disturbance is at least 1 month (not the first month of school).
D) The failure to speak is not due to a lack of knowledge or comfort with the spoken language required in the social situation.
E) The disturbance is not better accounted for by a Communication Disorder (stuttering) and does not occur exclusively during the course of a Pervasive Developmental Disorder, Schizophrenia, or other Psychotic Disorder. |
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Term
313.89 Reactive Attachment Disorder of Infancy or Early Childhood
Diagnostic Criteria |
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Definition
A) Markedly disturbed and developmentally inappropriate social relatedness in most contexts, beginning before age 5 years, as evidenced by either (1) or (2):
1 - persistent failure to initiate or respond in a developmentally appropriate fashion to most social interactions, as manifest by excessively inhibited, hypervigilant, or hightly ambivalent and contradictory responses (the child may respond to caregivers with a mixture of approach, avoidance, and resistance to comforting, or may exhibit frozen watchfulness)
2 - diffuse attachments as manifest by indiscriminate sociability with marked inability to exhibit appropriate selective attachments (excessive familiarity with relative strangers or lack of selectivity in choice of attachment figures)
B) The disturbance in Criterion A is not accounted for solely by developmental delay (as in Mental Retardation) and does not meet criteria for a Pervasive Development Disorder.
C) Pathogenic care as evidenced by at least one of the following:
1 - persistent disregard of the child's basic emotional needs for comfort, stimulation, and affection
2 - persistent disregard of the child's basic physical needs
3 - repeated changes of primary caregiver that prevent formation of stable attachments (frequent changes in foster care)
D) There is a presumption that the care in Criterion C is responsible for the disturbed behavior in Criterion A (the disturbances in Criterion A began following the pathogenic care in Criterion C).
Specify type:
Inhibited Type: if Criterion A1 predominates in the clinical presentation
Disinhibited Type: if Criterion A2 predominates in the clinical presentation |
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Term
307.3 Stereotypic Movement Disorder
Diagnostic Criteria |
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Definition
A) Repetitive, seemingly driven, and nonfunctional motor behavior (hand shaking or waving, body rocking, head banging, mouthing of objects, self-biting, hitting own body).
B) The behavior markedly interferes with normal activities or results in self-inflicted bodily injury that requires medical treatment (or would result in an injury if preventive measures were not used).
C) If Mental Retardation is present, the stereotypic or self-injurious behavior is of sufficient severity to become a focus of treatment.
D) The behavior is not better accounted for by a compulsion (OCD), a tic, a stereotypy that is part of a Pervasive Developmental Disorder, or hair pulling (Trichotillomania).
E) The behavior is not due to the direct physiological effects of a substnace or a general medical condition.
F) The behavior persists for 4 weeks or longer.
Specify if:
With self-Injurious Behavior - if the behavior results in bodily damage that requires specific treatment (or that would result in bodily damage if protective measures were not used) |
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Term
| 313.9 Disorder of Infancy, Childhood, or Adolescence Not Otherwise Specified |
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Definition
| This category is a residual category for disorders with onset in infancy, childhood, or adolescence that do not meet criteria for any specific disorder in the Classification. |
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