This diagnosis is reserved for individuals under the age of 5 when the level of clinical severity can not be reliably assessed during the first years of childhood. This category is diagnosed when a subject does not meet the developmental milestones expected in various fields of intellectual functioning, and applies to individuals in whom a systematic assessment of intellectual functioning can not be carried out, including children too small to participate in the standardized tests.

This category should be re-evaluated after a period of time.

Communication disorders include language disorder, phonological disorder and the disorder of social communication (pragmatic), characterized by deficits in the development and use of language, speech and social communication, respectively, as well as the disorder of early childhood fluidity (stuttering), characterized by changes in normal fluidity and speech production, repetition of sounds or syllables, prolongation of consonant or vowel sounds, fragmented words, blockages and words produced with excess physical tension. Also, like other alterations, the communication disorder is not specified. They all begin precociously and can cause functional deficiencies throughout their lives.

The classification of the same is:

F80.2 Language disorder (315.32)
F80.0 Phonological Disorder (315.39)
F80.81 Starting fluid disorder in childhood (stuttering) (315.35)
F80.89 Disorder of social communication (pragmatic) (315.39)
F80.9 Communication disorder not specified (307.9)

Due to its similar characteristics with regard to the TEA, it is necessary to specify the criteria for the differential diagnosis of F80.89 Social communication disorder (pragmatic) (315.39):

A. Persistent difficulties in the social use of verbal and non-verbal communication that manifests itself by all the following factors:

1. Deficiencies in the use of communication for purposes social, how to greet and share information, so
   that is appropriate to the social context.
2. Impairment of the ability to change communication in a way that suits the context or the needs of the listener, such as talking differently in a classroom or in a park, conversing differently with a child or adult, and avoiding it use of too formal language.
3. Difficulties in following the rules of conversation and narration, such as respecting the shift in conversation, expressing otherwise when it is not well understood and knowing when to use verbal and non-verbal signs to regulate the interaction.
4. Difficulties to understand what is not explicitly said (eg, making inferences) and non-literal or ambiguous meanings of language (eg, idiomatic expressions, humor, metaphors, multiple meanings that depend on the context for interpretation).

B. Deficiencies cause functional limitations in effective communication, social participation, social relationships, academic achievement or work performance, either individually or in combination.

C. Symptoms begin in the early stages of the developmental period (but deficiencies may not manifest fully until the need for social communication exceeds limited capabilities).

D. Symptoms can not be attributed to another medical or neurological condition nor to the low capacity in the domains of morphology and grammar, and are not explained better by a disorder of the spectrum of autism, intellectual disability (intellectual development disorder), delay Global development or other mental disorder.

A. Persistent pattern of inattention and / or hyperactivity-impulsivity that interferes with the operation or development, characterized by (1) and / or (2):

1. Attention: Six (or more) of the following symptoms have been maintained for at least 6 months to a degree that does not match the level of development and that directly affects social and academic / labor activities:

Note: Symptoms are not just a manifestation of opposition behavior, challenge, hostility or failure to understand tasks or instructions. For myores adolescents and adults (17 and older), a minimum of five symptoms is required.

1. Frequently, he/she fails to pay due attention to details or by neglect makes mistakes in school tasks, at work or during other activities (eg, ignore or lose details, work is not carried out with precision).
2. Frequently, he/she has difficulties in keeping the attention on tasks or recreational activities (for example, he/she has difficulty keeping up with classes, conversations or prolonged reading).
3. Frequently, it seems that he/she is not listening when it is spoken directly (for example, it seems to have the mind in other things, even in the absence of any apparent distraction).
4. Frequently, he/she do not follow the instructions and do not finish school tasks, tasks or work duties (eg, start tasks but get distracted quickly and evade easily).
5. Frequently, he/she has difficulty organizing tasks and activities (eg, difficulty managing sequential tasks, difficulty in putting materials and belongings in order, carelessness and disorganization at work, poor time management, failure to meet deadlines).
6. Frequently, he/she avoids, dislikes him/her or is shown to be unenthusiastic in initiating tasks that require a sustained mental effort (eg, homework or household chores, in older adolescents and adults, preparing reports, completing forms, reviewing long articles).
7. Frequently, he/she loses necessary things for tasks or activities (eg, school supplies, pencils, books, instruments, wallet, keys, work papers, glasses, mobile).
8. Frequently, he/she is easily distracted by external stimuli (for older adolescents and adults, it may include unrelated thoughts).
9. Frequently, he/she forget about everyday activities (eg, do the homework, do the trials, in older teens and adults, return calls, pay bills, go to appointments).

2. Hyperactivity and impulsivity: Six (or more) of the following symptoms have been maintained for at least 6 months to a degree that does not match the level of development and that directly affects social and academic / labor activities:

Note: Symptoms are not just a manifestation of opposition behavior, challenge, hostility or failure to understand tasks or instructions. For older teens and adults (after age 17), a minimum of five symptoms is required.

1. Frequently, he/she  plays with or hit hands or feet or twists in the seat.
2. Frequently, he/she gets up in situations where he/she is expected to remain seated (for example, he/she gets up in class, in the office or in another workplace, or in other situations that need to stay in place).
3. Frequently, he/she run or climb in situations where it is not appropriate. (Note: In teens or adults, he/she may just be restless).
4. Frequently, he/she is unable to play or to take care of himself/herself in recreational activities.
5. Frequently, he/she is "busy," acting as if "driving a motor" (eg, he/she is unable to be or feels uncomfortable staying quiet for a long time, as in restaurants, meetings, the others may think he/she is uneasy or that it is difficult to follow them).
6. Frequently, he/she speaks excessively.
7. Frequently, he/she responds unexpectedly or before a question has been concluded (eg, he/sheends the sentences of others; he/shedoes not respect the conversation shift).
8. Frequently, it is difficult for him/her to wait for his/her turn (eg, while waiting in a queue).
9. Frequently, he/she interrupts or interferes with others (for example, he/she gets into conversations, games or activities; he/she can start using other people's things without waiting or receiving permission, in adolescents and adults, he/ can interfere or advance to what others do).

B. Some symptoms of inattention or hyperactive-impulsive were present before 12 years.

C. Several symptoms of inattention or hyperactive-impulsive are present in two or more contexts (eg, at home, at school or at work, with friends or relatives, in other activities).

D. There is clear evidence that the symptoms interfere with social, academic or occupational functioning, or reduce the quality of them.

Symptoms do not occur exclusively during the course of schizophrenia or another psychotic disorder and are not explained better by another mental disorder (eg, mood disorder, anxiety disorder, dissociative disorder, personality disorder, poisoning or abstinence of substances).

Specify if:

314.01 (F90.2) Combined presentation: If Criterion A1 (inattention) and Criterion A2 (hyperactivity-impulsivity) are met during the last 6 months.

314.00 (F90.0) Predominant presentation with lack of attention: If Criterion A1 is met (inattention) but Criterion A2 (hyperactivity-impulsivity) is not met during the last 6 months.

314.01 (F90.1) Hyperactive / impulsive predominant presentation: If Criterion A2 (hyperactivity-impulsivity) is met and Criterion A1 (inattention) is not met during the
last 6 months

Specify if:

In partial remission: When all the criteria were previously met, not all criteria have been met during the last 6 months, and the symptoms continue to deteriorate the functioning
social, academic or labor.

Specify the current gravity:

Mild: Few or no symptoms are present more than those necessary for the diagnosis, and the symptoms only produce minimal deterioration of social or labor performance.

Moderate: Symptoms or functional impairments present between "mild" and "severe".

Serious: Presence of many symptoms other than those necessary for the diagnosis or of several particularly serious symptoms, or the symptoms produce marked deterioration of social or occupational functioning.

A. Difficulty in learning and in the use of academic skills, evidenced by the presence of at least one of the following symptoms that have persisted for at least 6 months, despite interventions aimed at these difficulties:

1. Reading inaccurate or slow words and with effort (eg, read loose words out loud incorrectly or with slowness and hesitation, often guess words, difficulty to express the words well).
2. Difficulty understanding the meaning of what he reads (eg, he can read a text accurately but does not understand prayer, relationships, inferences or the deep sense of what he reads).
3. Spelling difficulties (for example, you can add, omit or replace vowels or consonants).
4. Difficulties with the written expression (eg, it makes multiple grammatical or punctuation errors in a sentence; it organizes the paragraph wrongly; the written expression of ideas is not clear).
5. Difficulties in mastering the numerical meaning, numerical data or calculation (eg, it misunderstood the numbers, their magnitude and their relationships; it counts with the fingers to add numbers of a single digit instead of remembering the mathematical operation as they do its equal; it is lost in the arithmetic calculation and can exchange the procedures).
6. Difficulties with mathematical reasoning (eg, it has great difficulty in applying concepts, facts or mathematical operations to solve quantitative problems).

B. The affected academic abilities are substantially measurable and measurable below what is expected for the chronological age of the individual, and significantly interfere with academic or work performance, or with activities of daily life, which are confirmed by standardized measures (tests) administered individually and an integral clinical evaluation. In individuals aged 17 or older, the documented history of learning difficulties can be replaced by standardized assessment.

C. Learning difficulties begin at school age but may not be fully manifested until the demands of the affected academic abilities outweigh the individual's limited abilities (eg, in scheduled exams, reading or writing complex and long reports for an unbearable deadline, excessively heavy academic tasks).

D. Learning difficulties are not explained better by intellectual disabilities, visual or uncorrected hearing disorders, other mental or neurological disorders, psychosocial adversity, lack of command in the language of academic instruction or inadequate educational guidelines.

Note: The four diagnostic criteria must be met based on a clinical synthesis of the individual's history (development, medical, family, educational), school reports and psychoeducational evaluation.

Coding note: Specify all the academic areas and subaptations altered. When more than one area is altered, each of them will be encoded individually according to the following specifiers.

Specify if:

315.00 (F81.0) With reading difficulties:

Accuracy in reading words
Speed ​​or fluidity of reading
Understanding of reading

Note: Dyslexia is an alternative term used to refer to a pattern of learning difficulties that is characterized by problems with the recognition of words in an accurate or fluid manner, spelling badly and little spelling ability. If dyslexia is used to specify this particular pattern of difficulties, it is also important to specify any additional difficulties present, such as reading comprehension difficulties or mathematical reasoning.

315.2 (F81.81) With difficulty in written expression:

Spell check
Grammar correction and punctuation
Clarity or organization of written expression

315.1 (F81.2) With mathematical difficulty:

Sense of numbers
Memorization of arithmetic operations
Correct or fluid calculation
Correct mathematical reasoning

Note: Discalculia is an alternative term used to refer to a pattern of difficulties that is characterized by problems in the processing of numerical information, learning of arithmetic operations and correct or fluid calculation. If discalculia is used to specify this particular pattern of mathematical difficulties, it is also important to specify any additional difficulty present, such as difficulties of mathematical reasoning or the correct reasoning of the words.

Specify the current gravity:

Mild: Some difficulties with learning abilities in one or two academic areas, but sufficiently lightweight so that the individual can compensate or work well when they receive adequate adaptation or help services, especially during school age.

Moderate: Notable difficulties with learning abilities in one or more academic areas, so that the individual is unlikely to become competent without some intensive and specialized teaching periods during school age. You may need some adaptation or help services at least during a part of the schedule at school, at the workplace or at home to perform the activities correctly and efficiently.

Serious: Serious difficulties in learning abilities that affect several academic areas, so that the individual is unlikely to learn those skills without consistent and intensive teaching individually and specialized for most school years. Even with various methods of adaptation and adequate services at home, at school or in the workplace, the individual may not be able to perform all activities effectively.

Motor disorders of neurodevelopment include:

F82 [315.4] Coordination development disorders: it presents deficits in the acquisition and execution of coordinated motor skills, manifested by the clumsiness and slowness or inaccuracy in the execution of motor skills, which interferes with the activities of everyday life.

F98.4 [307.3] Disorder of stereotypical movements: it presents repetitive, apparently guided and unobtrusive motor behaviors (eg, hands, rock the body, head bump ...).
 
Tic disorder: they are characterized by the presence of motor or vocal tics, which are sudden, fast, recurrent, non-rhythmic and stereotyped movements or vocals. Different between them in the duration, etiology and clinical presentation, existing:

F95.2 [307.23] Tourette Disorder
F95.1 [307.22] Disorder of persistent (chronic) motive or vocal tics
F95.0 [307.21] Transient tic disorder
F95.8 [307.20] Another specific disorder of tics

This category applies to presentations in which the characteristic symptoms of a tic disorder that causes clinically significant distress or deterioration in social, occupational, or other important areas of functioning but that do not meet all the criteria for a tic disorder or disorder, predominate. none of the disorders of the diagnostic category of neurodevelopmental disorders. The category of another tic disorder specified is used in situations in which the clinician chooses to communicate the specific reason why the presentation does not meet the criteria for a tic disorder or a specific neurological development disorder. This is done by recording "another tic disorder specified" and then the specific reason (eg, "start after age 18").

This category applies to presentations in which the characteristic symptoms of a tic disorder that cause clinically significant discomfort or impairment in social, occupational or other important areas of functioning but which do not meet all the criteria of a tic disorder or a disorder of tics predominate. none of the disorders of the diagnostic category of neurodevelopmental disorders. The unspecified tic disorder category is used in situations in which the clinician chooses not to specify the reason for noncompliance with the criteria for a tic disorder or a specific neurodevelopmental disorder, and includes presentations in which there is not enough information to make a more specific diagnosis.