Agent harnesses truncate file reads around ~60k characters, so the largest dsm5 reference files (up to 132k chars) were being cut off mid-file (reported: "The neurodevelopmental file was truncated"). - Split 15 reference files over 50k chars into a small index (original filename preserved, so all existing links keep resolving) plus part files of <= ~40k chars each, organized by disorder group - Updated SKILL.md routing rows to point at indexes and read the part for the condition; added large-file handling guidance - Updated dsm5/README.md What You Get table; documented the size convention in 00-overview-and-method.md (Maintaining this library) - Verified: no reference file exceeds 50k chars (66 files), all 466 relative links resolve, validators pass, lookup.py lists all parts Co-authored-by: factory-droid[bot] <138933559+factory-droid[bot]@users.noreply.github.com>
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Neurodevelopmental Disorders — DSM-5-TR Companion Reference
Summarized and paraphrased from DSM-5-TR (American Psychiatric Association, 2022). This file is for orientation and education; verify exact criteria wording, codes, and recording procedures against the official DSM-5-TR before any formal clinical, legal, insurance, or research use.
Chapter Overview
The neurodevelopmental disorders are a group of conditions with onset in the developmental period, typically manifesting before the child enters school, caused by developmental deficits or differences in brain processes that impair personal, social, academic, or occupational functioning. Deficits range from very specific limitations of learning or executive control to global impairments of social skills or intellectual ability. Once thought to be categorical, these conditions are now understood dimensionally: severity varies along a continuum with no very clear boundary against typical development, so diagnosis requires BOTH symptoms and impaired function. The disorders frequently co-occur with one another (e.g., autism spectrum disorder with intellectual developmental disorder; ADHD with specific learning disorder) and with other mental disorders with childhood onset (e.g., communication disorders and autism spectrum disorder with anxiety; ADHD with oppositional defiant disorder; tics with obsessive-compulsive disorder). A common lay misconception is that these conditions are rare or neatly separate; in fact they are common, overlapping, life-span conditions whose presentations change with age and support.
Disorders in this chapter
| Disorder | ICD-10-CM code(s) | What it is |
|---|---|---|
| Intellectual Developmental Disorder (Intellectual Disability) | F70 mild, F71 moderate, F72 severe, F73 profound | Global intellectual and adaptive deficits with onset in the developmental period |
| Global Developmental Delay | F88 | Failure to meet expected milestones in several areas of intellectual functioning; used under age 5 when severity cannot be reliably assessed |
| Unspecified Intellectual Developmental Disorder (Intellectual Disability) | F79 | IDD that cannot be quantified (age 5+) because of sensory/physical impairments, severe behavior, or co-occurring mental disorder |
| Language Disorder | F80.2 | Persistent deficits in language comprehension and/or production (vocabulary, grammar, discourse) |
| Speech Sound Disorder | F80.0 | Persistent difficulty producing speech sounds, affecting intelligibility |
| Childhood-Onset Fluency Disorder (Stuttering) | F80.81 | Disturbances of speech fluency (repetitions, prolongations, blocking) with onset in the developmental period |
| Social (Pragmatic) Communication Disorder | F80.82 | Persistent deficits in the social use of verbal and nonverbal communication, without restricted/repetitive behavior |
| Unspecified Communication Disorder | F80.9 | Impairing communication symptoms not meeting full criteria; reason unspecified |
| Autism Spectrum Disorder | F84.0 | Social-communication deficits plus restricted, repetitive behavior, interests, or activities |
| Attention-Deficit/Hyperactivity Disorder | F90.0 inattentive, F90.1 hyperactive/impulsive, F90.2 combined | Impairing inattention and/or hyperactivity-impulsivity across settings |
| Other Specified / Unspecified ADHD | F90.8 / F90.9 | ADHD-like symptoms not meeting full criteria (specified reason / unspecified) |
| Specific Learning Disorder | F81.0 reading, F81.81 written expression, F81.2 mathematics | Persistent, impairing difficulty learning reading, writing, and/or math academic skills |
| Developmental Coordination Disorder | F82 | Motor coordination markedly below age expectation, interfering with daily activities |
| Stereotypic Movement Disorder | F98.4 | Repetitive, seemingly driven, purposeless motor behavior, with or without self-injury |
| Tourette's Disorder | F95.2 | Multiple motor and one or more vocal tics for more than 1 year |
| Persistent (Chronic) Motor or Vocal Tic Disorder | F95.1 | Motor or vocal tics (not both) for more than 1 year |
| Provisional Tic Disorder | F95.0 | Motor and/or vocal tics for less than 1 year |
| Other Specified / Unspecified Tic Disorder | F95.8 / F95.9 | Tics not meeting criteria (specified reason, e.g., onset after age 18 / unspecified) |
| Other Specified Neurodevelopmental Disorder | F88 | Neurodevelopmental symptoms not meeting full criteria with a stated reason (e.g., associated with prenatal alcohol exposure) |
| Unspecified Neurodevelopmental Disorder | F89 | Neurodevelopmental symptoms not meeting full criteria; reason not specified |
Parts of this chapter reference
| Part | Covers |
|---|---|
| Intellectual developmental disorders | Intellectual developmental disorder, global developmental delay, unspecified intellectual developmental disorder |
| Communication disorders | Language, speech sound, childhood-onset fluency (stuttering), social (pragmatic) communication, and unspecified communication disorders |
| Autism spectrum disorder | Autism spectrum disorder (full entry) |
| ADHD and learning disorders | Attention-deficit/hyperactivity disorder (including other specified and unspecified presentations), specific learning disorder |
| Motor and tic disorders | Developmental coordination disorder, stereotypic movement disorder, tic disorders, other/unspecified neurodevelopmental disorder |
Cross-Chapter Notes
- Hierarchies and cross-listing: The tic disorders are hierarchical (Tourette's > persistent [chronic] motor or vocal tic disorder > provisional tic disorder > other/unspecified); a prior higher-level diagnosis negates lower-level diagnoses. Autism spectrum disorder supersedes social (pragmatic) communication disorder when ASD criteria are met. Stereotypic movement disorder is not additionally diagnosed when stereotypies are better explained by ASD unless self-injury or treatment focus is present.
- Catatonia: When catatonia co-occurs with autism spectrum disorder, record "catatonia associated with autism spectrum disorder" (additional code F06.1), using the catatonia criteria in the schizophrenia spectrum chapter (see 11-schizophrenia-spectrum-and-other-psychotic.md).
- Adult-onset fluency disorder (F98.5): Noted in the criteria for childhood-onset fluency disorder for dysfluency beginning during or after adolescence; not a DSM-5 neurodevelopmental diagnosis.
- Cross-cutting guidance: For differentials that cut across chapters (inattention across ADHD, anxiety, trauma, and mood; repetitive behavior across ASD, OCD, tics, and stereotypies), see 40-cross-cutting-differentials.md.