Mkb 10 speech disorder. Disorders of psychological development (f80-f89). Basic diagnostic measures

Often the insufficiency of colloquial speech is accompanied by a delay or a violation of verbal-sound pronunciation.

The diagnosis should only be made when the severity of the delay in the development of expressive language is outside the normal variation for the child's mental age; receptive language skills are within the normal range for a child's mental age (although they can often be slightly below average). The use of non-verbal cues (such as smiles and gestures) and "inner" speech reflected in imagination or role-play is relatively intact; the ability for social communication without words is relatively intact. The child will strive to communicate, despite the speech impairment, and to compensate for the lack of speech with gestures, facial expressions, or non-verbal vocalizations. However, comorbid disturbances in peer relationships, emotional disturbances, behavioral disturbances, and/or increased activity and inattention are not uncommon. In a minority of cases, there may be associated partial (often selective) hearing loss, but it should not be so severe as to lead to speech delay. Inadequate involvement in conversation, or more general deprivation of the environment, may play an important or contributory role in the genesis of impaired development of expressive language. In this case, the environmental causative factor should be noted through the appropriate second code from Class XXI of ICD-10. The impairment of spoken language becomes apparent from infancy without any long distinct phase of normal speech use. However, it is not uncommon to find apparently normal use of a few single words at first, followed by verbal regression or lack of progress.

It should be noted:

Often such expressive speech disorders are observed in adults, they are always accompanied by a mental disorder and are organically conditioned. In this regard, in such patients, the subcategory "Other non-psychotic disorders due to damage and dysfunction of the brain or somatic disease" (F06.82x) should be used as the first code. The sixth sign is placed depending on the etiology of the disease. The structure of speech disorders is indicated by the second code R47.0.

Included:

motor alalia;

Delays speech development according to the type of general speech underdevelopment (ONR) I - III level;

Developmental dysphasia of the expressive type;

Developmental aphasia of the expressive type.

Excluded:

Developmental dysphasia, receptive type (F80.2);

Developmental aphasia, receptive type (F80.2);

Pervasive developmental disorders (F84.-);

General disorders of psychological (mental) development (F84.-);

Selective mutism (F94.0);

F80.2 Receptive speech disorder

A specific developmental disorder in which a child's understanding of speech is below the level appropriate to his mental age. In all cases, expansive speech is also noticeably impaired and a defect in verbal-sound pronunciation is not uncommon.

Diagnostic instructions:

Inability to respond to familiar names (in the absence of non-verbal cues) from the first birthday; failure to identify at least a few common objects by 18 months of age, or failure to follow simple instructions at 2 years of age should be taken as significant signs of delayed speech development. Late disturbances include: inability to understand grammatical structures (negations, questions, comparisons, etc.), inability to understand finer aspects of speech (tone of voice, gestures, etc.).

The diagnosis can only be made when the severity of the delay in the development of receptive speech is outside the normal variation for the child's mental age, and when there are no criteria for a pervasive developmental disorder. In almost all cases, the development of expressive speech is also seriously delayed and there are often violations of verbal-sound pronunciation. Of all the variants of specific speech development disorders, this variant has the highest level of concomitant socio-emotional-behavioral disorders. These disorders do not have any specific manifestations, but hyperactivity and inattention, social ineptness and isolation from peers, anxiety, sensitivity or excessive shyness are quite common. Children with more severe forms of receptive speech impairment may have a fairly pronounced delay in social development; imitative speech is possible with a lack of understanding of its meaning, and a limitation of interests may appear. However, they differ from autistic children, usually showing normal social interaction, normal role play, normal contact with parents for comfort, near-normal use of gestures, and only mild impairment of non-verbal communication. It is not uncommon to have some degree of high-pitched hearing loss, but not enough deafness to cause speech impairment.

It should be noted:

Similar speech disorders of the receptive (sensory) type are observed in adults, which are always accompanied by a mental disorder and are organically conditioned. In this regard, in such patients, the subcategory "Other non-psychotic disorders due to damage and dysfunction of the brain or somatic disease" (F06.82x) should be used as the first code. The sixth sign is placed depending on the etiology of the disease. The structure of speech disorders is indicated by the second code R47.0.

Included:

Developmental receptive dysphasia;

Developmental receptive aphasia;

incomprehension of words;

verbal deafness;

Sensory agnosia;

Sensory alalia;

Congenital auditory immunity;

Wernicke's developmental aphasia.

Excluded:

Acquired aphasia with epilepsy (Landau-Klefner syndrome) (F80.3x);

Autism (F84.0x, F84.1x);

Selective mutism (F94.0);

mental retardation (F70 - F79);

Speech delay due to deafness (H90 - H91);

Dysphasia and aphasia of the expressive type (F80.1);

Organically determined speech disorders of the expressive type in adults (F06.82x with the second code R47.0);

Organically caused speech disorders of the receptive type in adults (F06.82x with the second code R47.0);

Dysphasia and aphasia NOS (R47.0).

F80.3 Acquired aphasia with epilepsy (Landau-Klefner syndrome)

A disorder in which a child, having a previous normal development of speech, loses both receptive and expressive speech skills, general intelligence is preserved; the onset of the disorder is accompanied by paroxysmal EEG abnormalities (almost always in the temporal lobes, usually bilaterally, but often with wider disturbances) and, in most cases, epileptic seizures. Typically onset is between 3 and 7 years of age but may occur earlier or later in childhood. In a quarter of cases, loss of speech occurs gradually over several months, but more often there is a sudden loss of skills over several days or weeks. The temporal relationship between the onset of seizures and loss of speech is quite variable, one of these signs may precede the other by several months and up to 2 years. It is very characteristic that the impairment of receptive speech is quite profound, often with difficulty in auditory comprehension at the first manifestation of the condition. Some children become mute, others are limited to jargon-like sounds, although some have a milder deficit in fluency, and speech production is often accompanied by articulation disorders. In a small number of cases, voice quality is impaired with loss of normal modulations. Sometimes speech functions appear in waves in the early phases of the disorder. Behavioral and emotional disturbances are common in the first months after the onset of speech loss, but tend to improve as children acquire some means of communication.

The etiology of the condition is unknown, but clinical evidence suggests the possibility of an inflammatory encephalitic process. The course of the condition is completely different: 2/3 of the children retain a more or less serious defect in receptive speech, and about 1/3 recover completely.

Excluded:

Acquired aphasia due to brain injury, tumor or other known disease process (F06.82x);

Aphasia NOS (R47.0);

Aphasia due to disintegrative disorders of childhood (F84.2 - F84.3);

Aphasia in autism (F84.0x, F84.1x).

F80.31 Psychotic variant of the course of acquired aphasia with epilepsy (Landau-Klefner syndrome)

F80.32 Non-psychotic course of acquired aphasia with epilepsy (Landau-Klefner syndrome)

F80.39 Unspecified according to the type of course of acquired aphasia with epilepsy (Landau-Klefner syndrome)

F80.8 Other developmental speech and language disorders

Included:

lisping;

babbling speech;

F80.81 Delays in speech development due to social deprivation

It should be noted:

This group is represented by speech disorders, a delay in the formation of higher mental functions, which are caused by social deprivation or pedagogical neglect. The clinical picture is manifested in the limited vocabulary, the lack of formation of phrasal speech, etc.

Included:

Speech development delay due to pedagogical neglect;

Physiological delay in the development of speech.

F80.82 Delays in speech development associated with delay intellectual development and specific disorders of learning skills

It should be noted:

In patients of this group, speech disorders are manifested by a limited grammatical vocabulary, difficulties in utterances and the semantic design of these utterances. Intellectual deficiency or cognitive disorders are manifested in the complexities of abstract-logical thinking, low level of cognitive ability, impaired attention and memory. In these cases, it is necessary to use the second code from the headings F70.xx - F79.xx or F81.x.

F80.88 Other developmental disorders of speech and language

Included:

lisping;

Babbling speech.

F80.9 Developmental speech and language disorders, unspecified

This category should be avoided as far as possible and used only for unspecified disorders in which there is a significant impairment in speech development that cannot be explained by mental retardation or sensory or physical abnormalities directly affecting speech.

Included:

Speech disorder NOS;

Speech disorder NOS.

F81 Specific developmental disorders of learning skills

The concept of specific learning disabilities closely resembles the concept specific disorders development of speech (see F80.-), and here the same problems exist in their definition and measurement. These are disorders in which normal skill acquisition is disrupted from the early stages of development. They are not the result of a lack of opportunity for learning, or of any brain injury or illness. Rather, the disorders are thought to arise from an impairment in cognitive processing, which is largely due to biological dysfunction. As with most other developmental disorders, this condition is significantly more common in boys than in girls.

Five kinds of difficulties arise in diagnosis. First, it is the need to differentiate disorders from normal variants. schooling. The problem here is the same as for speech disorders, and the same criteria are proposed for judging the pathological condition of the condition (with the necessary modification, which is associated with the assessment not of speech, but of school achievements). Secondly, this is the need to take into account the dynamics of development. This is important for 2 reasons:

a) severity: 1 year delay in reading at 7 years old has a completely different meaning than 1 year delay at 14 years old;

b) change in the type of manifestations: usually speech delay in school years disappears in colloquial speech, but is replaced by a specific delay in reading, which, in turn, decreases in adolescence, and the main problem in adolescence is a severe spelling disorder; the state is in all respects the same, but the manifestations change as they grow older; the diagnostic criterion must take this developmental dynamic into account.

The third difficulty is that school skills must be taught and learned; they are not only a function of biological maturation. Inevitably, children's level of skill acquisition will depend on family circumstances and schooling, as well as on their individual character traits. Unfortunately, there is no direct and unambiguous way to differentiate school difficulties caused by the lack of adequate experience from those caused by some individual impairment. There are good reasons to believe that this distinction has a real reality and clinical validity, but the diagnosis is difficult in individual cases. Fourth, although research evidence suggests an underlying pathology of cognitive information processing, in an individual child it is not easy to differentiate what caused reading difficulties from what accompanies poor reading skills. The difficulty stems from evidence that reading impairments may stem from more than one type of cognitive pathology. Fifth, uncertainty remains about the optimal subdivision of specific developmental learning disorders.

Children learn to read, write, spell words and improve arithmetic when they are introduced to these activities at home and at school. Countries vary widely in the age at which formal schooling begins, in schooling programs and therefore in the skills expected to be acquired by children at different ages. This discrepancy is greatest during elementary or primary school years (i.e. up to age 11) and complicates the problem of developing valid definitions of school skills impairment that have transnational relevance.

However, within any educational system, it is clear that within each age group of schoolchildren there is variation in school achievement and some children are deficient in specific aspects of skills relative to their general level intellectual functioning.

Specific school skills development disorders (SDSDS) encompass groups of disorders that present with specific and significant deficiencies in learning school skills. These learning disabilities are not a direct consequence of other conditions (such as mental retardation, gross neurological defects, uncorrected visual or auditory damage, or emotional disturbances), although they may occur as comorbidities with them. ADDS often occurs in association with other clinical syndromes (such as attention deficit disorder or conduct disorder) or other developmental disorders such as specific motor developmental disorder or specific language developmental disorders.

The etiology of SSRS is unknown, but there is speculation that biological factors play a leading role, interacting with non-biological factors (such as the availability of favorable learning opportunities and the quality of learning) to cause the condition to manifest. Although these disorders are associated with biological maturation, this does not mean that children with such disorders are simply at a lower level of the normal continuum and, therefore, will “catch up” with their peers over time. In many cases, signs of these disorders may continue into adolescence and into adults. However, a necessary diagnostic feature is that the disorders appear in certain forms in the early periods of schooling. Children may lag behind in their school improvement and at a later stage of education (due to a lack of interest in learning; poor; emotional disturbances; an increase or change in the requirements of tasks, etc.), but such problems are not included in the concept of SRRShN.

Diagnostic instructions:

There are several basic requirements for the diagnosis of any of the specific developmental disorders of school skills. First, it must be a clinically significant degree of impairment in some particular school skill. This can be judged: on the basis of severity, determined by school performance, that is, such a degree of impairment that could occur in less than 3% of the population of school-age children; on previous developmental disorders, that is, a delay or deviation in development in the preschool years, most often in speech; related problems (such as inattention, hyperactivity, emotional or behavioral disturbances); by type of disorder (that is, the presence of qualitative disorders that are usually not part of normal development); and response to therapy (i.e., school difficulties do not immediately improve as support at home and/or school increases).

Secondly, the violation must be specific in the sense that it cannot be explained only by mental retardation or a less pronounced decrease in the general intellectual level. Since IQ and school achievement do not run directly in parallel, this decision can only be made on the basis of individually administered standardized tests of learning and IQ appropriate for a particular culture and educational system. Such tests should be used in conjunction with statistical tables showing the average expected level of learning at a certain IQ at a given age. This last requirement is necessary because of the importance of the statistical regression effect: a diagnosis based on subtracting school age from the child's mental age is seriously misleading. However, in normal clinical practice, these requirements will in most cases not be met. Thus, the clinical indication is simply that the child's level of schooling should be substantially lower than that expected for a child of the same mental age.

Third, the impairment must be developmental in the sense that it must be present from the early years of schooling rather than acquired later in the course of education. Information about the child's school success should confirm this.

Fourthly, there should be no external factors that can be considered as the cause of school difficulties. As stated above, in general, the diagnosis of SSRS should be based on positive evidence of a clinically significant impairment in the assimilation of school material in combination with internal factors in the development of the child. However, in order to learn effectively, children must have adequate learning opportunities. Accordingly, if it is clear that poor school achievement is directly attributable to very long absences from school without homeschooling or grossly inadequate instruction, then these impairments should not be coded here. Frequent non-attendance at school or interruptions in education due to school changes are usually not sufficient to result in school retention to the extent necessary for a diagnosis of SSRS. However, poor schooling can exacerbate the problem, in which case school factors should be encoded using the X code from Class XXI of ICD-10.

Fifth, specific impairments in the development of school skills should not be directly due to uncorrected visual or auditory disorders.

Differential Diagnosis:

It is clinically important to differentiate between SRRS, which occur in the absence of any diagnosable neurological disorder, and SRRS, secondary to certain neurological conditions such as cerebral palsy. In practice, this differentiation is often very difficult to make (due to the uncertain meaning of multiple "soft" neurological signs), and research results do not provide a clear criterion for differentiating either in the clinical picture or in the dynamics of SRSNS depending on the presence or absence of neurological dysfunction. Accordingly, although it does not constitute a diagnostic criterion, it is necessary that the presence of any comorbid disorder be coded separately in the appropriate neurological section of the classification.

Included:

Specific violation of reading skills (dyslexia);

Specific violation of writing skills;

Specific violation of arithmetic skills (dyscalculia);

Mixed disorder of school skills (learning difficulties).

F81.0 Specific reading disorder

The main feature is a specific and significant impairment in the development of reading skills that cannot be explained solely by mental age, visual acuity problems, or inadequate schooling. Reading comprehension and improvement skills on tasks that require reading may be impaired. Spelling difficulties are often associated with a specific reading disorder and often remain in adolescence, even after some progress in reading. Children with a history of specific reading disorder often have specific language developmental disorders, and a comprehensive examination of language functioning to date often reveals persistent mild impairment, in addition to lack of progress in theoretical subjects. In addition to academic failure, poor school attendance and problems in social adjustment, especially in primary or secondary school, are fairly common complications. This condition is found in all known language cultures, but it is not clear how often this impairment is due to speech or script.

Diagnostic instructions:

A child's reading performance should be well below the level expected based on the child's age, general intelligence, and school performance. Productivity is best assessed on the basis of individually administered standardized tests of reading accuracy and comprehension. The specific nature of the reading problem depends on the expected level of reading and on the language and font. However, in the early stages of learning alphabetic script, there may be difficulty reciting the alphabet or categorizing sounds (despite normal hearing). Later, there may be errors in oral reading skills, such as:

a) omissions, substitutions, distortions or additions of words or parts of words;

b) slow pace of reading;

c) attempts to start reading again, prolonged hesitation or "loss of space" in the text and inaccuracies in expressions;

d) permutation of words in a sentence or letters in words.

There may also be a lack of reading comprehension, for example:

e) inability to recall facts from what was read;

f) inability to draw a conclusion or conclusions from the essence of what is read;

g) general knowledge rather than information from a particular story is used to answer questions about the story read.

Characteristically, in later childhood and adulthood, spelling difficulties become deeper than reading insufficiency. Spelling disorders often include phonetic errors, and it appears that reading and spelling problems may in part be due to impaired phonological analysis. Little is known about the nature and frequency of spelling errors in children who are expected to read non-phonetic languages, and little is known about the types of errors in non-alphabetic text.

Specific reading disorders are usually preceded by language developmental disorders. In other cases, the child may have normal language developmental milestones for age, but may still have difficulty processing auditory information, manifested by problems in sound categorization, rhyming, and possibly defects in speech sound discrimination, auditory sequential memory, and auditory association. In some cases, there may also be visual processing problems (such as distinguishing between letters); however, they are common among children who are just beginning to learn to read, and therefore are not causally associated with poor reading. Also common are disturbances in attention, combined with increased activity and impulsivity. The specific type of preschool developmental disorder varies considerably from child to child, as does its severity, but such impairments are common (but not mandatory).

Also typical in school age are associated emotional and / or behavioral disorders. Emotional disturbances are more common in the early school years, but conduct disorders and hyperactivity syndromes are more likely in late childhood and adolescence. Low self-esteem and problems with school adaptation and relationships with peers are also often noted.

Included:

Specific delay in reading;

Optical dyslexia;

Optical agnosia;

- "retarded reading";

Specific retardation in reading;

Reading backwards;

- "mirror reading";

developmental dyslexia;

Dyslexia due to a violation of phonemic and grammatical analysis;

Spelling disorders combined with reading disorder.

Excluded:

Alexia NOS (R48.0);

Dyslexia NOS (R48.0);

Difficulties in reading of a secondary nature in persons with emotional disorders (F93.x);

Spelling disorders not associated with reading difficulties (F81.1).

F81.1 Specific spelling disorder

This is a disorder in which the main feature is a specific and significant impairment in the development of spelling skills in the absence of a previous specific reading disorder and which is not solely explained by low mental age, visual acuity problems, and inadequate schooling. Both the ability to spell words orally and to spell words correctly are impaired. Children whose problems are solely poor handwriting should not be included here; but in some cases spelling difficulties may be due to writing problems. In contrast to the characteristics commonly found in specific reading disorder, spelling errors tend to be mostly phonetically correct.

It should be noted:

Diagnostic instructions:

A child's spelling should be well below the level expected based on their age, general intelligence and academic performance. This is best assessed with individually administered standardized spelling tests. The child's reading skills (both accuracy and comprehension) should be within normal limits and there should be no history of significant reading difficulties. Difficulties in spelling should not be due primarily to grossly inadequate training or defects in visual, auditory, or neurological function. Also, they cannot be acquired due to any neurological psychiatric or other disorder.

Although it is known that a "pure" spelling disorder differentiates from reading disorders associated with spelling difficulties, little is known about the antecedents, dynamics, correlates, and outcome of specific spelling disorders.

Included:

Specific delay in mastering the skill of spelling (without reading disorder);

Optical dysgraphia;

Spelling dysgraphia;

Phonological dysgraphia;

Specific spelling delay.

Excluded:

Spelling difficulties associated with reading disorder (F81.0);

Dyspraxic dysgraphia (F82);

Difficulties in spelling, mainly due to inadequate teaching (Z55.8);

Agraphia NOS (R48.8);

Acquired spelling disorder (R48.8).

F81.2 Specific disorder of arithmetic skills

This disorder involves a specific impairment of numeracy skills that cannot be explained solely by general mental underdevelopment or grossly inadequate learning. The defect concerns the basic computational skills of addition, subtraction, multiplication, and division (preferably over the more abstract math skills involved in algebra, trigonometry, geometry, or calculus).

Diagnostic instructions:

A child's performance in arithmetic should be well below the level expected in accordance with his age, general intelligence and academic performance. This is best judged on the basis of individually administered standardized numeracy tests. Reading and spelling skills should be within the normal range corresponding to his mental age, assessed by individually selected adequate standardized tests. Difficulties in arithmetic must not be due primarily to grossly inadequate learning, defects in vision, hearing or neurological function, and must not be acquired as a result of any neurological, mental or other disorder.

Calculus disorders are less well understood than reading disorders, and knowledge of antecedent disorders, dynamics, correlates, and outcome is quite limited. However, it is hypothesized that, unlike many children with reading disorders, there is a tendency for auditory and verbal skills to remain within the normal range, while visuospatial and visual-perceptual skills tend to be impaired. Some children have associated socio-emotional-behavioral problems, but little is known about their characteristics or frequency. It has been suggested that difficulties in social interaction may be particularly frequent.

The arithmetic difficulties that are noted are usually varied, but may include: a lack of understanding of the concepts underlying arithmetic operations; lack of understanding of mathematical terms or signs; non-recognition of numerical characters; the difficulty of carrying out standard arithmetic operations; difficulty in understanding which numbers related to a given arithmetic operation must be used; difficulty in mastering the ordinal alignment of numbers or in mastering decimal fractions or characters during calculations; poor spatial organization of arithmetic calculations; inability to satisfactorily learn the multiplication table.

Included:

Developmental account impairment;

Dyscalculia due to a violation of higher mental functions;

developmental specific counting disorder;

Gerstman developmental syndrome;

Acalculia of development.

Excluded:

Arithmetic difficulties associated with reading or spelling disorders (F81.3);

Arithmetic difficulties due to inadequate training (Z55.8);

Acalculia NOS (R48.8);

Acquired counting disorder (acalculia) (R48.8).

F81.3 Mixed learning disorder

This is a poorly defined, underdeveloped (but necessary) residual category of disorders in which both arithmetic skills and reading or spelling skills are significantly impaired, but in which the impairment cannot be directly explained by general mental retardation or inadequate learning. This should apply for all disorders that meet the criteria for F81.2 and either F81.0 or F81.1.

Excluded:

Specific reading disorder (F81.0);

Specific spelling disorder (F81.1);

Specific numeracy disorder (F81.2).

F81.8 Other developmental disorders of learning skills

Included:

Developmental disorder of expressive writing.

F81.9 Developmental learning disorder, unspecified

This category should be avoided as much as possible and used only for unspecified impairments in which there is a significant learning disability that cannot be directly explained by mental retardation, visual acuity problems, or inadequate learning.

Included:

Inability to acquire knowledge NOS;

learning disability NOS;

Learning disorder NOS.

F82 Specific developmental disorders of motor function

This is a disorder in which the main feature is a severe impairment in the development of motor coordination that cannot be explained by general intellectual retardation or by any specific congenital or acquired neurological disorder (other than what is assumed in coordination disorders). Typical for motor clumsiness is a combination with some degree of impaired productivity in performing visual-spatial cognitive tasks.

Diagnostic instructions:

The child's motor coordination during fine or large motor tests should be significantly lower than the level corresponding to his age and general intelligence. This is best assessed on the basis of individually administered standardized tests of fine or gross motor coordination. Difficulties in coordination must be present early in development (i.e., they must not represent acquired impairment) and must not be directly attributable to any visual or hearing impairment or any diagnosable neurological disorder.

The degree of impairment of fine or gross motor coordination varies greatly, and the specific types of motor impairment vary with age. Motor developmental milestones may be delayed, and some associated speech difficulties (especially involving articulation) may be noted. Small child may be clumsy in his usual gait, slowly learning to run, jump, climb up and down stairs. Difficulties are likely in tying shoelaces, fastening and unbuttoning buttons, throwing and catching a ball. The child may be generally clumsy in subtle and/or large movements - prone to drop things, stumble, hit obstacles and have poor handwriting. Drawing skills are usually poor, and often children with this disorder perform poorly on compound picture puzzles, construction toys, building models, ball games, and drawing (map understanding).

Disorders in which the normal pattern of acquiring language skills is already impaired in the early stages of development. These conditions do not directly correlate with neurological or language disorders, sensory impairment, mental retardation, or environmental factors.

Specific developmental speech and language disorders are often accompanied by related problems, such as difficulties in reading, spelling and pronunciation of words, impaired interpersonal relationships, emotional and behavioral disorders.

Development related:

physiological disorder

Babble [baby form of speech]

aphasia NOS (R47.0)
apraxia (R48.2)
due to:
- hearing loss (H90-H91)
- expressive type (F80.1)
- receptive type (F80.2)

Excluded:

dysphasia and aphasia:
- NOS (R47.0)
selective mutism (F94.0)

Development related:

aphasia Wernicke

Excluded:

autism (F84.0-F84.1)
dysphasia and aphasia:
- NOS (R47.0)
selective mutism (F94.0)
mental retardation (F70-F79)

Excludes: aphasia:

NOS (R47.0)
in autism (F84.0-F84.1)

Codification of speech disorders in ICD-10

Classification of speech underdevelopment in children (according to A.N. Kornev):

Principles of building a classification:

Multidimensional approach to diagnostics

A. Clinical-pathogenetic axis

1. Primary underdevelopment of speech (PNR)

a) functional dyslalia

b) articulatory dyspraxia

c) developmental dysarthria

1.2. Total Poland

Alalic variant of violation ("mixed")

a) motor alalia

b) sensory alalia

2. Secondary underdevelopment of speech (VNR)

2.1. Due to mental retardation

2.2. due to hearing loss

2.3. due to mental deprivation

3. Speech underdevelopment of mixed origin

3.1. Paraalalic variant of total speech underdevelopment (TNR)

3.2. Clinical forms with a complex type of disorder ("mixed")

B. Neuropsychological axis (syndromes and mechanisms of impairment)

1. Syndromes of the neurological level

Syndromes of central polymorphic total disturbance of sound pronunciation of organic genesis (developmental dysarthria syndromes)

2. Syndromes of the Gnostic-Practical Level

2.1. Syndrome of functional disorders of individual phonetic characteristics of speech sounds (dyslalia)

2.2. Syndromes of central polymorphic selective disorders of sound pronunciation (syndromes of articulatory dyspraxia)

Syndrome of dysphonetic articulatory dyspraxia

Syndrome of dysphonological articulatory dyspraxia

Syndrome of dynamic articulatory dyspraxia

Syndrome of delayed lexico-grammatical development

3. Language Level Syndromes

3.1. Syndrome of expressive phonological underdevelopment (as part of motor alalia)

3.2. Syndrome of impressive phonological underdevelopment (as part of sensory alalia)

3.3. Syndromes of lexical and grammatical underdevelopment

a) with a predominance of violations of paradigmatic operations (morphological dysgrammatism)

b) with a predominance of violations of syntagmatic operations (syntactic dysgrammatism)

4. Mixed Mechanism Disorders (Gnostic-Practical and Linguistic Levels)

4.1. Verbal dyspraxia syndrome

4.2. Impressive dysgrammatism syndrome

4.3. Syndrome of polymorphic expressive dysgrammatism

4.4. Syndrome of unformed phonemic representations and metalinguistic skills

B. Psychopathological axis (leading psychopathological syndrome)

1. Syndromes of mental infantilism

2. Neurosis-like syndromes

3. Psychoorganic syndrome

1. Constitutional (hereditary) form of HP

2. Somatogenic form of HP

3. Cerebro-organic form of HP

4. Form of HP of mixed genesis

5. Deprivation-psychogenic form of HP

D. Functional axis (degree of maladjustment)

1. The severity of speech disorders

I degree - mild violations

III degree - violations of moderate severity

III degree - severe violations

2. The severity of socio-psychological maladaptation

a) mild b) moderate c) severe

Guidelines on the use of the International Statistical Classification of Diseases and Problems Related to Health, the tenth revision in the diagnostic activity of centers for correctional and developmental education and rehabilitation / Ministry of Education Rep. Belarus. – Minsk, 2002.

Lopatina L.V. Guidelines for the diagnosis of speech disorders in children of preschool and school age // Logopedic diagnosis and correction of speech disorders in children: Sat. method. rec. - SPb., M.: SAGA: FORUM, 2006. - S. 4 - 36.

Lalaeva R.I. Guidelines for speech therapy diagnostics // Diagnosis of speech disorders in children and organization speech therapy work in preschool educational institution: Sat. method. recommendations / Comp. V.P. Balobanova and others - St. Petersburg: Publishing House "CHILDHOOD-PRESS", 2000. - P. 5–14.

Prishchepova I.V. Speech therapy work on the formation of the prerequisites for mastering spelling skills in junior schoolchildren with general underdevelopment of speech. Abstract dis. … cand. ped. Sciences: 13.00.03 / Russian. state ped. un-t. - L., 1993. - 16 p.

Kornev A.N. Reading and writing disorders in children: Textbook-method. allowance. - St. Petersburg: Publishing House "MiM", 1997. - 286 p.

Lalaeva R.I. Guidelines for speech therapy diagnostics // Diagnosis of speech disorders in children and the organization of speech therapy work in a preschool educational institution: Sat. method. recommendations / Comp. V.P. Balobanova and others - St. Petersburg: Publishing House "CHILDHOOD-PRESS", 2000. - P. 5–14.

Lalaeva R.I. Problems of speech therapy diagnostics // Speech therapy today. - 2007. - No. 3. - S. 37 - 43.

A.N. Kornev Fundamentals of childhood speech pathology: clinical and psychological aspects. SPb., 2006.

Specific developmental disorders of speech and language

Disorders in which the normal pattern of acquiring language skills is already impaired in the early stages of development. These conditions do not directly correlate with disorders of neurological or speech mechanisms, sensory impairment, mental retardation, or environmental factors. Specific developmental speech and language disorders are often accompanied by related problems, such as difficulties in reading, spelling and pronunciation of words, disturbances in interpersonal relationships, emotional and behavioral disorders.

Specific speech articulation disorder

A specific developmental disorder in which a child's use of speech sounds is at a level lower than appropriate for his age, but at which the level of language skills is normal.

Development related:

physiological disorder
disorder speech articulation

Functional speech articulation disorder

Babble [baby form of speech]

Excludes: insufficiency of speech articulation:

aphasia NOS (R47.0)
apraxia (R48.2)
due to:
- hearing loss (H90-H91)
- mental retardation (F70-F79)
in combination with a developmental language disorder:
- expressive type (F80.1)
- receptive type (F80.2)

Expressive speech disorder

A specific developmental disorder in which the child's ability to use spoken language is at a level significantly lower than appropriate for their age, but in which language comprehension is within the normal range for their age; anomalies of articulation in this case may not always be.

Developmental dysphasia or aphasia of the expressive type

Excluded:

acquired aphasia with epilepsy [Landau-Klefner] (F80.3)
dysphasia and aphasia:
- NOS (R47.0)
- developmental receptive type (F80.2)
selective mutism (F94.0)
mental retardation (F70-F79)
pervasive developmental disorders (F84.-)

Receptive speech disorder

A developmental specific disorder in which a child's understanding of language is at a level that is less than appropriate for their age. At the same time, all aspects of the use of the language suffer noticeably and there are deviations in the pronunciation of sounds.

Congenital inability of auditory perception

Development related:

dysphasia or aphasia of the receptive type
aphasia Wernicke

Excluded:

acquired aphasia in epilepsy [Landau-Klefner] (F80.3)
autism (F84.0-F84.1)
dysphasia and aphasia:
- NOS (R47.0)
- developmental expressive type (F80.1)
selective mutism (F94.0)
language delay due to deafness (H90-H91)
mental retardation (F70-F79)

Acquired aphasia with epilepsy [Landau-Klefner]

A disorder in which a child who previously had a normal course of speech development loses receptive and expressive language skills but retains general intelligence. The onset of the disorder is accompanied by paroxysmal EEG changes and, in most cases, epileptic seizures. The onset of the disorder usually falls between three and seven years of age, with loss of skills occurring after a few days or weeks. The temporal relationship between the onset of seizures and the loss of language skills is variable, with one preceding the other (or cycling) from a few months to two years. An inflammatory process in the brain is suggested as a possible cause of this disorder. Approximately two-thirds of cases are characterized by the persistence of more or less severe deficiencies in language perception.

Excludes: aphasia:

NOS (R47.0)
in autism (F84.0-F84.1)
due to disintegrative disorders of childhood (F84.2-F84.3)

Mkb 10 dyslalia

Disorders of psychological (mental) development

The disorders included in F80 to F89 have the following characteristics:

a) the onset is necessarily in infancy or childhood;

b) damage or delay in the development of functions closely related to the biological maturation of the central nervous system;

c) a constant course, without remissions or relapses, characteristic of many mental disorders.

In most cases, the functions affected include speech, visuospatial skills, and/or motor coordination. A characteristic feature of the damage is that it tends to decrease progressively as children get older (although milder failure often persists into adulthood). Typically, developmental delay or damage appears as early as it can be detected, with no preceding period of normal development. Most of these conditions are observed in boys several times more often than in girls.

Developmental disorders are characterized by a hereditary burden of similar or related disorders, and there is evidence suggesting an important role of genetic factors in the etiology of many (but not all) cases. Environmental factors often influence impaired developmental functions, but in most cases they are not of paramount importance. However, although there is usually no significant divergence in the general conceptualization of the disorders in this section, in most cases the etiology is unknown, and uncertainty remains about the boundaries and specific subgroups of developmental disorders. Moreover, there are two types of states included in this section, which do not fully meet the broad conceptual definition given above. Firstly, these are disorders in which there was an undoubted phase of previous normal development, such as disintegrative disorder of childhood, Landau-Klef syndrome.

no, some cases of autism. These states are included here because

that although their beginning is different, yet their characteristic features and course

have many similarities with the group of developmental disorders; moreover, it is not known whether they differ etiologically. Secondly, there are disorders primarily defined as abnormalities rather than delays in the development of functions; this is especially applicable to autism. Autistic disorders are included in this section because, although defined as abnormalities, some degree of developmental delay is almost always found. In addition, there is overlap with other developmental disorders both in terms of characteristic features individual cases, as well as in similar groups.

/F80/ Specific developmental disorders of speech and language

These are disorders in which normal speech development is disrupted in the early stages. The conditions cannot be explained by a neurological or speech mechanism of pathology, sensory damage, mental retardation, or environmental factors. The child may be more able to communicate or understand in certain well-known situations than others, but language ability is always impaired.

As with other developmental disorders, the first difficulty in diagnosis relates to differentiation from normal developmental variants. Normal children vary considerably in the age at which they first acquire spoken language and in the rate at which language skills are acquired firmly. Such normal variations in the timing of language acquisition are of little or no clinical significance, as most "late speakers" continue to develop quite normally. Children with specific disorders in the development of speech and language differ sharply from them, although most of them eventually reach a normal level of development of speech skills. They have many associated problems. Delayed speech development is often accompanied by difficulties in reading and writing, impaired interpersonal communication, emotional and behavioral disorders. Therefore, early and thorough diagnosis of specific developmental disorders of speech

very important. There is no sharply defined demarcation from the extreme

variants of the norm, but for the judgment of a clinically significant disorder

four main criteria are used: severity; flow; type; and related problems.

As a general rule, speech delay can be considered pathological when it is severe enough to be delayed by two standard deviations. In most cases of this level of severity, there are associated problems. However, in older children, the level of severity in statistical terms has less diagnostic value, since there is a natural tendency for steady improvement. In this situation, current is a useful indicator. If the current level of impairment is relatively mild, but nonetheless has a history of severe impairment, then it is more likely that current functioning is a consequence of a major disorder rather than a normal variant. It is necessary to pay attention to the type of speech functioning; if the type of disorder is pathological (i.e., abnormal, not just a variant corresponding to an earlier developmental phase) or if the child's speech contains qualitatively pathological features, then a clinically significant disorder is likely. Moreover, if a delay in some specific aspect of language development is accompanied by a lack of school skills (such as a specific delay in reading and writing), disturbances in interpersonal relationships and / or emotional or behavioral disorders, then this is unlikely to be a variant of the norm.

The second difficulty in diagnosis relates to differentiation from mental retardation or general developmental delay. Since intellectual development includes verbal skills, it is likely that if the IQ of a child is significantly below average, then his speech development will also be below average. The diagnosis of a specific developmental disorder suggests that the specific delay is in significant disparity with the general level of cognitive functioning. Accordingly, when speech delay is part of general mental retardation or general developmental delay, then this condition cannot be coded as F80.-. The mental retardation coding F70 - F79 should be used. However, mental retardation is characterized by a combination with uneven

intellectual productivity, especially with such a speech impairment, which is usually more serious than the delay in non-verbal skills. When this discrepancy is so prominent that it becomes apparent in the child's daily functioning, then the specific language developmental disorder should be coded in addition to the mental retardation (F70 -

A third difficulty concerns differentiation from secondary disorders due to severe deafness or some specific neurological or other anatomical disorder. Severe deafness in early childhood in fact always leads to a marked delay and distortion of speech development; such conditions should not be included here as they are a direct consequence of hearing loss. However, often more severe disturbances in the development of perceptive speech are accompanied by partial selective hearing damage (especially high-pitched frequencies). These disorders should be excluded from F80-F89 if the severity of the hearing impairment significantly explains the speech delay, but included if partial hearing loss is only a complicating factor and not a direct cause.

However, a strictly defined distinction cannot be made. A similar principle applies to neurological pathology and anatomical defects. Thus, pathology of articulation due to cleft palate or dysarthria due to cerebral palsy should be excluded from this section. On the other hand, the presence of mild neurological symptoms that would not cause speech delay is not grounds for exclusion.

F80.0 Specific speech articulation disorder

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

The age at which a child acquires speech sounds and the order in which they develop are subject to considerable individual variation.

Normal development. At the age of 4 years, errors in pronouncing speech sounds are common, but the child can be easily understood by strangers. Most speech sounds are acquired by the age of 6-7 years. Although difficulties may remain in certain sound combinations, they do not lead to communication problems. By age, almost all speech sounds should be acquired.

pathological development. Occurs when a child's acquisition of speech sounds is delayed and/or diverted, resulting in: disarticulation with consequent difficulty for others in understanding his speech; omissions, distortions or replacements of speech sounds; a change in the pronunciation of sounds depending on their combination (that is, in some words the child can pronounce phonemes correctly, but not in others).

The diagnosis can only be made when the severity of the articulation disorder is outside the limits of normal variation corresponding to the mental age of the child; non-verbal intellectual level within the normal range; expressive and receptive speech skills within the normal range; articulation pathology cannot be explained by a sensory, anatomical, or neurotic abnormality; mispronunciation is undoubtedly abnormal, based on the characteristics of the use of speech in the subcultural conditions in which the child is located.

developmental physiological disorder;

Disorder of development of articulation;

Functional articulation disorder;

Baptism (children's form of speech);

Phonological development disorder.

Aphasia NOS (R47.0);

Disorders of articulation, combined with developmental disorder of expressive speech (F80.1);

Disturbance of articulation, combined with a developmental disorder of receptive speech (F80.2);

Cleft palate and other anatomical anomalies of oral structures involved in speech functioning (Q35 - Q38);

Disorder of articulation due to hearing loss (H90 - H91);

Disorder of articulation due to mental retardation (F70 - F79).

F80.1 Expressive language disorder

A specific developmental disorder in which the child's ability to use expressive spoken language is markedly below the level appropriate for his mental age, although speech comprehension is within the normal range. In this case, there may or may not be articulation disorders.

Although there is considerable individual variation in normal speech development, the absence of single words or related speech formations by 2 years of age, or simple expressions or two-word phrases by 3 years, should be regarded as significant signs of delay. Late impairments include: limited vocabulary development; overuse of a small set common words; difficulties in choosing suitable words and substitute words; abbreviated pronunciation; immature sentence structure; syntactical errors, especially omissions of word endings or prefixes; incorrect use or absence of grammatical features such as prepositions, pronouns, and conjugations or declensions of verbs and nouns. There may be overgeneralized use of rules,

as well as lack of fluidity of proposals and difficulty in establishing

sequence in retelling the events of the past.

Often the insufficiency of colloquial speech is accompanied by a delay or a violation of verbal-sound pronunciation.

brain or somatic disease" (F06.82x). The sixth character is placed in

depending on the etiology of the disease. Structure of speech disorders

indicated by the second code R47.0.

Delays in speech development according to the type of general underdevelopment of speech (OHP) I - III level;

Developmental dysphasia of the expressive type;

Developmental aphasia of the expressive type.

Developmental dysphasia, receptive type (F80.2);

Developmental aphasia, receptive type (F80.2);

Pervasive developmental disorders (F84.-);

General disorders of psychological (mental) development (F84.-);

Selective mutism (F94.0);

F80.2 Receptive speech disorder

Inability to respond to familiar names (in the absence of non-verbal cues) from the first birthday; inability to identify

have at least a few common items by 18 months, or

inability to follow simple instructions at 2 years of age

should be taken as significant signs of a delay in speech

development. Late disturbances include: inability to understand

grammatical structures (negations, questions, comparisons, etc.), incomprehension of more subtle aspects of speech (tone of voice, gestures, etc.).

The diagnosis can only be made when the severity of the delay in the development of receptive language is outside the normal variation for the child's mental age and when there are no criteria for a general developmental disorder. In almost all cases, the development of expressive speech is also seriously delayed and there are often violations of verbal-sound pronunciation. Of all the variants of specific speech development disorders, this variant has the highest level of concomitant socio-emotional-behavioral disorders. These disorders do not have any specific manifestations, but hyperactivity and inattention, social ineptness and isolation from peers, anxiety, sensitivity or excessive shyness are quite common. Children with more severe forms of receptive speech impairment may have a fairly pronounced delay in social development; imitative speech is possible with a lack of understanding of its meaning, and a limitation of interests may appear. However, they differ from autistic children, usually showing normal social interaction, normal role play, normal contact with parents for comfort, near-normal use of gestures, and only mild impairment of non-verbal communication. It is not uncommon to have some degree of high-pitched hearing loss, but not enough deafness to cause speech impairment.

Developmental receptive dysphasia;

Developmental receptive aphasia;

Congenital auditory immunity;

Wernicke's developmental aphasia.

Acquired aphasia with epilepsy (Landau-Klefner syndrome) (F80.3x);

Autism (F84.0x, F84.1x);

Selective mutism (F94.0);

mental retardation (F70 - F79);

Speech delay due to deafness (H90 - H91);

Dysphasia and aphasia of the expressive type (F80.1);

Organically determined speech disorders of the expressive type in adults (F06.82x with the second code R47.0);

Organically caused speech disorders of the receptive type in adults (F06.82x with the second code R47.0);

Dysphasia and aphasia NOS (R47.0).

/F80.3/ Acquired aphasia with epilepsy

vykov within a few days or weeks. Relationship in time between

the onset of epileptic seizures and loss of speech is quite variable, one of

these signs may precede another by several months and

up to 2 years. It is very characteristic that the violation of receptive speech is quite

deep, often with difficulty in auditory comprehension at the first manifestation of the condition. Some children become mute, others are limited to jargon-like sounds, although some have a milder deficit in fluency, and speech production is often accompanied by articulation disorders. In a small number of cases, voice quality is impaired with loss of normal modulations. Sometimes speech functions appear in waves in the early phases of the disorder. Behavioral and emotional disturbances are common in the first months after the onset of speech loss, but tend to improve as children acquire some means of communication.

The etiology of the condition is unknown, but clinical evidence suggests the possibility of an inflammatory encephalitic process. The course of the state is quite different; 2/3 of the children retain a more or less severe defect in receptive speech, and about 1/3 recover completely.

Acquired aphasia due to brain injury, tumor or other known disease process (F06.82x);

Aphasia NOS (R47.0);

Aphasia due to disintegrative disorders of childhood (F84.2 - F84.3);

Aphasia in autism (F84.0x, F84.1x).

F80.31 Psychotic variant of the course of acquired aphasia with epilepsy (Landau-Klefner syndrome)

F80.32 Non-psychotic course of acquired aphasia with epilepsy (Landau-Klefner syndrome)

F80.39 Unspecified according to the type of course of acquired aphasia with epilepsy (Landau-Klefner syndrome)

/F80.8/ Other developmental disorders of speech and language

F80.81 Delays in speech development due to social deprivation

Speech development delay due to pedagogical neglect;

Physiological delay in the development of speech.

F80.82 Delays in speech development, combined

with intellectual retardation and specific

Learning Skills Disorders

abstract-logical thinking, low level of cognitive ability, impaired attention and memory. In these cases, it is necessary to use the second code from the headings F70.xx - F79.xx or F81.x.

F80.88 Other developmental disorders of speech and language

F80.9 Developmental speech and language disorders, unspecified

This category should be avoided as far as possible and used only for unspecified disorders in which there is a significant impairment in speech development that cannot be explained by mental retardation or neurological, sensory or physical abnormalities directly affecting speech.

Speech disorder NOS;

Speech disorder NOS.

/F81/ Specific developmental disorders of learning skills

The concept of specific learning disabilities closely resembles the concept of specific language developmental disorders (see F80.-), and the same problems exist in defining and measuring them. These are disorders in which normal skill acquisition is disrupted from the early stages of development. They are not the result of a lack of opportunity for learning, or of any brain injury or illness. Rather, the disorders are thought to arise from an impairment in cognitive processing, which is largely due to biological dysfunction. As with most other developmental disorders, this

the condition is significantly more common in boys than in girls.

Five kinds of difficulties arise in diagnosis. The first is the need to differentiate disorders from normal schooling. The problem here is the same as for speech disorders, and the same criteria are proposed for judging the pathological condition of the condition (with the necessary modification, which is associated with the assessment not of speech, but of school achievements). Secondly, this is the need to take into account the dynamics of development. This is important for 2 reasons:

a) severity: 1 year delay in reading at 7 years old has a completely different meaning than 1 year delay at 14 years old;

b) change in the type of manifestations: usually speech delay in the preschool years in colloquial speech disappears, but is replaced by a specific delay in reading, which, in turn, decreases in adolescence, and the main problem in adolescence is a severe spelling disorder; the state is in all respects the same, but the manifestations change as they grow older; the diagnostic criterion must take this developmental dynamic into account.

uncertainty remains about the optimal subdivision

specific developmental disorders of school skills.

walk simply on a lower level of the normal continuum and, therefore, "catch up" with time peers. In many cases, signs of these disorders may continue into adolescence and into adults. However, a necessary diagnostic feature is that the disorders appear in certain forms in the early periods of schooling. Children may lag behind in their school improvement and at a later stage of education (due to lack of interest in learning; poor educational program; emotional disturbances; increase or changes in the requirements of tasks, etc.), however, such problems are not included in the concept of SRRShN.

There are several basic requirements for the diagnosis of any of the specific developmental disorders of school skills. First, it must be a clinically significant degree of impairment in some particular school skill. This can be judged: on the basis of severity, determined by school performance, that is, such a degree of impairment that could occur in less than 3% of the population of school-age children; on previous developmental disorders, that is, delay or deviation in development in the preschool years, most often in speech; related problems (such as inattention, hyperactivity, emotional or behavioral disturbances); by type of disorder (that is, the presence of qualitative disorders that are usually not part of normal development); and response to therapy (i.e., school difficulties do not immediately improve as support at home and/or school increases).

mental development at this age. This last requirement is necessary because of the importance of the statistical regression effect: a diagnosis based on subtracting school age from the child's mental age is seriously misleading. However, in normal clinical practice, these requirements will in most cases not be met. Thus, the clinical indication is simply that the child's level of schooling should be substantially lower than that expected for a child of the same mental age.

Fifth, specific impairments in the development of school skills should not be directly due to uncorrected visual or auditory disorders.

It is clinically important to differentiate SRRS that occur in the absence of any diagnosable neurological disorder,

and SSRS, secondary to certain neurological conditions such as

cerebral paralysis. In practice, this differentiation is often very

difficult to do (due to the uncertain meaning of multiple

"soft" neurological signs), and the research results are not

give a clear criterion for differentiation, neither in the clinical picture, nor in

dynamics of SRRSN depending on the presence or absence of neurological dysfunction. Accordingly, although it does not constitute a diagnostic criterion, it is necessary that the presence of any comorbid disorder be coded separately in the appropriate neurological section of the classification.

Specific violation of reading skills (dyslexia);

Specific violation of writing skills;

Specific violation of arithmetic skills (dyscalculia);

Mixed disorder of school skills (learning difficulties).

F81.0 Specific reading disorder

The main feature is a specific and significant impairment in the development of reading skills that cannot be explained solely by mental age, visual acuity problems, or inadequate schooling. Reading comprehension and improvement skills on tasks that require reading may be impaired. Spelling difficulties are often associated with a specific reading disorder and often remain in adolescence, even after some progress in reading. Children with a history of specific reading disorder often have specific language developmental disorders, and comprehensive examination of language functioning to date often reveals persistent mild impairment, in addition to lack of progress in theoretical subjects. In addition to academic failure, poor school attendance and problems in social adjustment, especially in elementary or high school. This condition is found in all known language cultures, but it is not clear how often this impairment is due to speech or script.

A child's reading performance should be well below the level expected based on the child's age, general intelligence, and school performance. Productivity is best assessed on the basis of individually administered standardized tests of reading accuracy and comprehension. The specific nature of the reading problem depends on the expected level of reading and on the language and font. However, in the early stages of learning alphabetic script, there may be difficulty reciting the alphabet or categorizing sounds (despite normal hearing acuity). Later, there may be errors in oral reading skills, such as:

a) omissions, substitutions, distortions or additions of words or parts of words;

b) slow pace of reading;

c) attempts to start reading again, prolonged hesitation or "loss of space" in the text and inaccuracies in expressions;

d) permutation of words in a sentence or letters in words.

There may also be a lack of reading comprehension, for example:

e) inability to recall facts from what was read;

f) inability to draw a conclusion or conclusions from the essence of what is read;

g) general knowledge rather than information from a particular story is used to answer questions about the story read.

Also typical at school age are accompanying emotional and/or behavioral disorders. Emotional disturbances are more common in the early school years, but conduct disorders and hyperactivity syndromes are more likely in late childhood and adolescence. Low self-esteem and problems with school adaptation and relationships with peers are also often noted.

Specific delay in reading;

Specific retardation in reading;

Reading backwards;

Dyslexia due to a violation of phonemic and grammatical analysis;

Spelling disorders combined with reading disorder.

Alexia NOS (R48.0);

Dyslexia NOS (R48.0);

Difficulties in reading of a secondary nature in persons with emotional disorders (F93.x);

Spelling disorders not associated with reading difficulties

F81.1 Specific spelling disorder

grossly inadequate training or defects in visual, auditory

or neurological functions. Also, they cannot be purchased.

due to any neurological mental or other

Specific delay in mastering the skill of spelling (without reading disorder);

Specific spelling delay.

Spelling difficulties associated with reading disorder (F81.0);

Dyspraxic dysgraphia (F82);

Difficulties in spelling, mainly due to inadequate teaching (Z55.8);

Agraphia NOS (R48.8);

Acquired spelling disorder (R48.8).

F81.2 Specific disorder of arithmetic skills

into algebra, trigonometry, geometry, or calculus).

The arithmetic difficulties that are noted are usually varied, but may include: a lack of understanding of the concepts underlying arithmetic operations; lack of understanding of mathematical terms or signs; non-recognition of numerical characters; the difficulty of carrying out standard arithmetic operations; difficulty in understanding which numbers related to a given arithmetic operation must be used; difficulty in mastering the ordinal alignment of numbers or in mastering decimal fractions or signs during calculations; poor spatial organization of arithmetic calculations; inability to satisfactorily learn the multiplication table.

Developmental account impairment;

Dyscalculia due to a violation of higher mental functions;

developmental specific counting disorder;

Gerstman developmental syndrome;

Arithmetic difficulties associated with reading or spelling disorders (F81.3);

Arithmetic difficulties due to inadequate training

Acalculia NOS (R48.8);

Acquired counting disorder (acalculia) (R48.8).

F81.3 Mixed learning disorder

F81.2 and either F81.0 or F81.1.

Specific reading disorder (F81.0);

Specific spelling disorder (F81.1);

Specific numeracy disorder (F81.2).

F81.8 Other developmental disorders of learning skills

Developmental disorder of expressive writing.

F81.9 Developmental learning disorder, unspecified

Inability to acquire knowledge NOS;

learning disability NOS;

Learning disorder NOS.

F82 Specific developmental disorders of motor function

The child's motor coordination during fine or large motor tests should be significantly lower than the level corresponding to his age and general intelligence. It is better to evaluate on the basis of

new individually administered standardized tests of fine or

gross motor coordination. Difficulties in coordination must be present early in development (i.e., they must not represent acquired impairment) and must not be directly attributable to any visual or hearing impairment or any diagnosable neurological disorder.

The degree of impairment of fine or gross motor coordination varies considerably, and specific types of motor impairment vary with age. Motor developmental milestones may be delayed, and some associated speech difficulties (especially involving articulation) may be noted. A small child may be clumsy in his normal gait, slowly learning to run, jump, climb up and down stairs. Difficulties are likely in tying shoelaces, fastening and unbuttoning buttons, throwing and catching a ball. The child may be generally clumsy in subtle and/or large movements - prone to drop things, stumble, hit obstacles and have poor handwriting. Drawing skills are usually poor, and often children with this disorder perform poorly on compound picture puzzles, construction toys, building models, ball games, and drawing (map understanding).

In most cases, careful clinical examination reveals marked immaturity of neurodevelopment, particularly choreiform limb movements or mirror movements and other accompanying motor symptoms, as well as signs of poor fine or gross motor coordination (commonly described as "soft" neurological signs in young children). ).Tendon reflexes can be increased or decreased on both sides, but not asymmetrically.

Some children may have school difficulties, sometimes quite severe; in some cases, socio-emotional-behavioral problems are accompanied, but their frequency or features are little known.

There is no diagnosable neurological disorder (such as cerebral palsy or muscular dystrophy). However, in some cases, a history of perinatal

conditions, such as very low birth weight or significant

Clumsy Childhood Syndrome is often misdiagnosed as "minimal brain dysfunction", but the term is not recommended as it has so many different and conflicting meanings.

Syndrome of child clumsiness;

Developmental incoordination;

Anomalies of gait and mobility (R26.-);

incoordination (R27.-);

Impaired coordination secondary to mental retardation (F70 - F79);

Impaired coordination secondary to a diagnosable neurological disorder (G00 - G99).

F83 Mixed specific disorders of psychological (mental) development

This is an ill-defined, underdeveloped (but necessary) residual group of disorders in which there is a mixture of specific developmental language, school skills, and/or movement disorders, but there is no significant predominance of any of them to establish a primary diagnosis. Common to these specific developmental disorders is an association with some degree of general cognitive impairment, and this mixed category can only be used when there is significant overlap in specific disorders. Thus, this category should be used when there are dysfunctions that meet the criteria for two or more of F80.-, F81.x and F82.

/ F84 / General disorders of psychological

A group of disorders characterized by qualitative abnormalities in social interaction and communication and a limited, stereotyped, repetitive set of interests and activities. These qualitative disturbances are common features of individual functioning in all situations, although they may vary in degree. In most cases, development is disturbed from infancy and, with only a few exceptions, appear in the first 5 years. They usually, but not always, have some degree of cognitive impairment, but the disorders are defined behaviorally as deviant in relation to mental age (regardless of the presence or absence of mental retardation). The subdivision of this group of general developmental disorders is somewhat debatable.

In some cases, the disorders co-occur with and are suspected to be due to some medical conditions, among which the most common are infantile spasms, congenital rubella, tuberous sclerosis, cerebral lipidosis, and X-chromosome fragility. However, the disorder must be diagnosed on the basis of behavioral features, regardless of the presence or absence of concomitant medical (somatic) conditions; however, any of these associated conditions must be coded separately. In the presence of mental retardation, it is important to separately code it (F70 - F79), since it is not a mandatory feature of general developmental disorders.

/F84.0/ Childhood autism

A pervasive developmental disorder defined by the presence of abnormal and/or impaired development that begins before the age of 3 years and abnormal functioning in all three areas of social interaction, communication, and restricted, repetitive behaviour. In boys, the disorder develops 3-4 times more often than in girls.

There is usually no preceding period of undoubtedly normal development, but if there is, then anomalies are detected before the age of 3 years. Qualitative violations of social interaction are always noted. They appear in the form of an inadequate assessment of socio-emotional signals, which is noticeable by the absence of reactions to the emotions of other people and / or the absence of modulation of behavior in accordance with the social situation; poor use of social cues and little integration of social, emotional, and communicative behaviour; the absence of socio-emotional reciprocity is especially characteristic. Qualitative disturbances in communication are equally obligatory. They act in the form of a lack of social use of existing speech skills; violations in role-playing and social simulation games; low synchronicity and lack of reciprocity in communication; insufficient flexibility of speech expression and the relative lack of creativity and fantasy in thinking; lack of emotional response to verbal and non-verbal attempts by other people to enter into a conversation; impaired use of tonalities and expressiveness of the voice to modulate communication; the same absence of accompanying gestures, which have an amplifying or auxiliary value in conversational communication. This condition is also characterized by limited, repetitive and stereotyped behavior, interests and activities. This is manifested by the tendency to establish a rigid and once and for all routine in many aspects. Everyday life, usually refers to new activities as well as old habits and play activities. There may be a special attachment to unusual, often hard objects, which is most characteristic of early childhood. Children may insist on a special order for non-functional rituals; there may be a stereotypical preoccupation with dates, routes, or schedules; motor stereotypes are frequent; characterized by a special interest in the non-functional elements of objects (such as smell or tactile qualities surface); the child may resist changes to routines or details of his environment (such as decorations or home furnishings).

In addition to these specific diagnostic features, children with autism often present with a number of other non-specific problems, such as

like fears (phobias), sleep and eating disorders, outbursts of anger and aggressiveness. Self-injury (for example, as a result of biting the wrists) is quite common, especially with concomitant severe mental retardation. Most children with autism lack spontaneity, initiative and creativity in organizing leisure activities, and when making decisions they find it difficult to use general concepts(even when the task is well within their ability). The specific manifestations of the defect characteristic of autism change as the child grows, but throughout adulthood this defect persists, manifesting itself in many respects by a similar type of problems of socialization, communication and interests. To make a diagnosis, developmental anomalies must be noted in the first 3 years of life, but the syndrome itself can be diagnosed in all age groups.

In autism, there can be any level of mental development, but in about three-quarters of cases there is a distinct mental retardation.

In addition to other variants of general developmental disorder, it is important to consider: specific developmental disorder of receptive language (F80.2) with secondary socio-emotional problems; reactive attachment disorder in childhood (F94.1) or childhood attachment disorder of the disinhibited type (F94.2); mental retardation (F70 - F79) with some associated emotional or behavioral disorders; schizophrenia (F20.-) with unusually early onset; Rett syndrome (F84.2).

autistic psychopathy (F84.5);

F84.01 Childhood autism due to organic brain disease

Autistic disorder caused by an organic brain disease.

F84.02 Childhood autism due to other causes

/F84.1/ Atypical autism

A type of pervasive developmental disorder that differs from childhood autism (F84.0x) either in age of onset or in the absence of at least one of the three diagnostic criteria. So, one or another sign of abnormal and / or disturbed development first appears only after the age of 3 years; and/or there is a lack of sufficiently distinct abnormalities in one or two of the three psychopathological domains required for a diagnosis of autism (namely, impairments in social interaction, communication, and restricted, stereotyped, repetitive behavior) in spite of characteristic abnormalities in the other domain(s). Atypical autism most commonly occurs in children with severe mental retardation, in whom very low levels of functioning provide little scope for the specific deviant behaviors required for a diagnosis of autism; it also occurs in individuals with severe specific developmental disorder of receptive language. Atypical autism is thus a condition significantly different from autism.

mental retardation with autistic features;

Atypical childhood psychosis.

F84.11 Atypical autism with mental retardation

This cipher is put in the first code, and the mental retardation code (F70.xx - F79.xx) is the second.

Mental retardation with autistic features.

F84.12 Atypical autism without mental retardation

Atypical childhood psychosis.

F84.2 Rett syndrome

A condition so far described only in girls, the cause of which is unknown, but which is distinguished on the basis of the characteristics of the onset of the course and symptomatology. In typical cases, behind an outwardly normal or almost normal early development partial or complete loss of acquired manual skills and speech follows, along with slowing of head growth, usually with onset between 7 and 24 months of age. Loss of intentional hand movements, handwriting stereotypies, and shortness of breath are especially characteristic. Social and play development is delayed in the first two or three years, but there is a tendency to maintain social interest. During middle childhood, there is a tendency to develop trunk ataxia and apraxia, accompanied by scoliosis or kyphoscoliosis, and sometimes choreoathetoid movements. In the outcome of the condition, severe mental disability constantly develops. Often there are epileptic seizures during early or middle childhood.

The onset of the disease in most cases is between 7 and 24 months of age. Most characteristic- loss of intentional hand movements and acquired fine motor manipulative skills. This is accompanied by loss, partial loss or lack of speech development; characteristic stereotypical hand movements are noted - painful wringing or "washing hands", arms bent in front of the chest or chin; stereotyped wetting of hands with saliva; lack of proper chewing of food; frequent episodes of shortness of breath; there is almost always an inability to establish control over functions Bladder and intestines; frequent excessive salivation and protrusion of the tongue; loss of involvement in social life. Typically, the child retains a semblance of a "social smile", a look "for" or "through" people, but does not interact socially with them in early childhood (although social interaction often develops later). Wide-legged posture and gait, muscles are hypotonic, trunk movements usually become poorly coordinated, and scoliosis or kyphoscoliosis usually develops. In adolescence and adulthood, about half of the cases develop special atrophies with severe motor disability. Rigid muscle spasticity may appear later, usually more pronounced in the lower extremities than in the upper ones. In most cases, epileptic seizures occur, usually involving some form of small seizures and usually beginning before the age of 8 years. In contrast to autism, both intentional self-harm and stereotyped interests or routines are rare.

Rett's syndrome is primarily differentiated on the basis of lack of purposeful rune movements, retarded head growth, ataxia, stereotypic movements, "washing hands" and lack of proper chewing. The course, which is expressed by a progressive deterioration in motor functions, confirms the diagnosis.

F84.3 Other disintegrative disorders of childhood

General developmental disorders (other than Rett syndrome), which are defined by a period of normal development prior to their onset, a distinct loss over several months of previously acquired skills in at least several areas of development, with the simultaneous appearance of characteristic anomalies in social, communicative and behavioral functioning. Often there is a prodromal period of unclear illness; the child becomes wayward, irritable, anxious and hyperactive. This is followed by impoverishment and then loss of speech, followed by disintegration.

The disorders included in this block share common features: a) onset is mandatory in infancy or childhood; b) violation or delay in the development of functions closely related to the biological maturation of the central nervous system; c) a steady course without remissions and relapses. In most cases, speech, visual-spatial skills and motor coordination are affected. Typically, a delay or impairment that occurs as early as can be reliably detected will decrease progressively as the child matures, although milder deficiency often persists into adulthood.

Disorders in which normal rates of acquisition of learning skills are impaired, beginning in the early stages of development. Such a disorder is not simply the result of a lack of learning opportunities or solely the result of mental retardation, and is not due to an injury or previous brain disease.

Specific Developmental Disorders of Motor Function

A disorder whose main feature is a marked reduction in the development of motor coordination and which cannot be explained solely by ordinary intellectual retardation or by some specific congenital or acquired neurological disorder. However, in most cases, a thorough clinical examination reveals signs of neurological immaturity, such as choree-like movements of the limbs in a free position, reflective movements, other signs associated with motor skills, as well as symptoms of fine and gross motor coordination disorders.

clumsy child syndrome

Development related:

incoordination
dyspraxia

Excluded:

gait and mobility disorders (R26.-)
incoordination (R27.-)
incoordination secondary to mental retardation (F70-F79)

Mixed specific developmental disorders

This residual heading contains disorders that are a combination of specific disorders of the development of speech and language, learning skills and motor skills, in which the defects are equally expressed, which does not allow isolating any of them as the main diagnosis. This rubric should only be used when there is a marked interweaving of these specific developmental disorders. These impairments are usually, but not always, associated with some degree of general cognitive impairment. Thus, this rubric should be used when there is a combination of dysfunctions that meet the criteria for two or more rubrics:

avoidance of society

infantilism

Distortion of articulation of sounds

Mosaic memory material

Concentration disorder

Violation of logical thinking

Writing disorders

Absence of own speech

Poor auditory development

The predominance of visually figurative memory

The child does not turn to the source of sounds

The child does not pronounce words on his own

Tendency to stereotypical behavior

Difficulties in speech recognition

Difficulty connecting words into phrases

Delayed psycho-speech development is a disease that is characterized by a violation of the pace of mental development of the child. In most cases, this disease is due to abnormalities in the development of the nervous system, in particular the brain. The latter may be due to a mass of etiological factors, not an exception and the wrong way of life of parents. According to the international classification of diseases of the tenth revision (ICD-10), this pathology was assigned the code F80. Is it possible to completely cure this disease, only a doctor can say after examining the patient. The sooner this disorder is diagnosed, the greater the chance of a child recovering.

It should be noted that a gross delay in psychoverbal development is most often diagnosed in children after 5 years of age. This is due to the fact that at this age the child begins to actively communicate with others and must adapt socially. Therefore, it is very important to pay attention to all problems in the development of the baby in a timely manner.

Etiology

Clinicians note that mental retardation is almost never an independent disease. In the predominant number of cases, this is a consequence of pathological processes of the central nervous system, in particular the brain.

In general, there are such diseases that can lead to the development of this disorder:

infectious diseases that affect the brain, nervous system (one of the most common -);
(oxygen starvation of the fetus);
congenital pathologies of the central nervous system;
leukodystrophy;
pathology of cerebral vessels and liquorodynamics;
mental illness.

Predisposing factors for the development of such a disorder in children include:

transferred infectious diseases of the mother during pregnancy;
improper lifestyle of the expectant mother during childbearing - smoking, drinking alcohol, taking drugs, nervous experiences, stress;
trauma to the child during childbirth, severe pregnancy;
severe illnesses suffered by a child at an early age (up to 2-3 years);
difficult psycho-emotional situation in the family;
severe psychological trauma;
genetic, chromosomal diseases that lead to inhibition of development;
improper upbringing of the child - excessive guardianship or, on the contrary, rough treatment, moral and physical abuse of the baby.

It should be understood that ZPRR itself is a consequence of certain pathological processes or psychiatric diseases. Therefore, initially it is necessary to eliminate the root cause factor.

Symptoms

In most cases, violations in speech and mental development are clearly visible in children aged 4–5 years. The following signs may indicate speech development disorders:

lack of response to sounds and appeals under the age of one year;
inactive attempts to repeat words or individual letters under the age of 1.5 years;
the child does not pronounce words on his own, cannot perform a simple action at the age of 2–2.5 years;
at the age of 2.5–3.5 years, the child cannot meaningfully combine words into whole phrases;
distortion of articulation of some sounds;
speech inactivity;
almost complete absence of own speech, starting from the age of three. The kid can only repeat learned phrases without meaning, which he most often hears in his environment.

On the part of a mental disorder, the manifestation of such a general clinical picture is possible:

auditory perception is less developed than visual;
it is difficult for a child to explain what he wants, he has difficulty in forming integral images;
concentration on certain objects or situations in a child causes difficulty;
syndrome may be present;
mosaic memorization of the material;
visual-figurative memory prevails over verbal;
low mental activity;
the child cannot draw a conclusion on his own, build the simplest logical chain, explain what he said without the help of an adult;
(violation writing);
affective reactions;
infantilism;
sudden change of mood;
emotional instability;
motor awkwardness, insufficiency of coordination of movements.

Manifestations of ZPRR must be diagnosed with elements of autism. In such cases, the pathological process can be supplemented by the following autistic symptoms:

the child is prone to bouts of aggression, not only with respect to others, but also to himself. With dissatisfaction or other provoking factors, the baby can beat himself, bite, cause other physical impact;
does not enter into emotional contact with others, including loved ones. In some cases, the child may not respond positively even to the parents;
prone to stereotypical behavior - for a long time can monotonously perform the same movements or actions;
avoids the company of peers, when in an unfamiliar room can hysteria, cry;
does not know how to handle the toy, may use it for other purposes, does not show interest in new toys and entertainment;
does not understand the speech addressed to him.

If you have even 1-2 of the above symptoms, you should seek medical help from a speech therapist and a child neuropsychiatrist. It should also be understood that the presence of some of the above signs does not yet mean that the child has a ZPRR, however, this factor should not be excluded either. Timely diagnosis significantly increases the chances of a full recovery.

Diagnostics

In this case, consultation of a group of specialists is required -, children's, children's and,. It is mandatory to conduct a physical examination of the patient with the collection of not only a family history, but also an anamnesis of life and disease.

Instrumental diagnostics includes the following methods:

duplex scanning of the arteries of the head;
CT and MRI of the brain;
EchoEG;
neuropsychological testing.

Laboratory diagnostic tools, in this case, are carried out only according to indications.

It is also mandatory to undergo additional examination methods - psychodiagnostics and assessment of speech development. In this case, the following may be carried out:

diagnostic examination of speech;
Denver test of psychomotor development;
scale of psychomotor development according to Griffiths;
Bailey diagnosis;
scale of early speech development.

It should be noted that clinical manifestations in children with a delay in psychoverbal development at the age of five may be a manifestation of other diseases. Therefore, in some cases, differential diagnosis is required in order to confirm or exclude the presence of such diseases:

Down syndrome;
autism;
selective mutism;
general underdevelopment of speech 1–4 levels.

Based on the results of examinations, doctors make a diagnosis, choose the most effective treatment tactics, and give general recommendations to parents.

Treatment

How to treat this disease correctly, only a qualified medical specialist-psycho-neurologist can say. In this case, treatment should begin as early as possible and only comprehensively.

Medication intake is kept to a minimum. Depending on the current clinical picture, the doctor may prescribe the following drugs:

sedatives;
nootropic;
vitamin and mineral complex.

The basis of treatment should consist of physiotherapeutic procedures, sessions with a speech therapist and a child psychologist. The correct interaction of parents with the child is very important, therefore, consultations with a psychologist can be carried out with the relatives of the child.

As for physiotherapeutic procedures, magnetotherapy is most often prescribed - this allows you to activate the work of the cerebral cortex.

In addition, the following may be shown:

physiotherapy exercises - classes in the gym, swimming;
art therapy;
manual therapy courses.

Treatment can also take place at home - the doctor can write a set of exercises and recommendations that parents should perform with the child. This is the development of fine and gross motor skills, as well as educational games that are aimed at improving memory and attention.

It is important to understand that such classes should be held regularly and for a long time. In addition, what is very important is the psycho-emotional environment in the environment of the child. The baby should be protected from stress, psychological pressure, emotional overload, and even more so moral and physical violence.

In addition to the classes scheduled by doctors, general recommendations should be taken into account:

the child's nutrition should be complete, balanced, timely and regular;
daily walks in the fresh air are required;
active, outdoor games;
the interaction of the baby with other people, his social adaptation.

It should be understood that the sooner the therapy of this disorder is started, the higher the chances that the child will reach the desired level of development and socially adapt. At the same time, you need to understand that the treatment of this disease can last more than one year.

Forecast and prevention

The prognosis will depend on the etiology of the disease and at what stage active treatment was started. With regard to prevention, the following recommendations should be highlighted:

systematic examination by a children's speech therapist, neurologist, psychologist;
exclusion of head and central nervous system injuries;
timely and correct treatment of all diseases;
conducting healthy lifestyle life during pregnancy.

If there is a family history of genetic chromosomal diseases, it is recommended to consult a geneticist before conceiving a child.

For a correct understanding of what signs indicate a delay in speech development, it is necessary to know the main stages and conditional norms of the speech development of children early age.
The birth of a child is marked by a cry, which is the first speech reaction of the infant. The cry of the child is realized through the participation of the vocal, articulatory and respiratory sections of the speech apparatus. The time of the appearance of a cry (normal in the first minute), its volume and sound can tell a neonatologist a lot about the condition of the newborn. The first year of life is a preparatory (pre-speech) period, during which the child goes through the stages of cooing (from 1.5-2 months), babble (from 4-5 months), babbling words (from 7-8.5 months to 2 months). ), the first words (at 9-10 months in girls, 11-12 months in boys).
Normally, at 1 year old, the child's active vocabulary contains approximately 10 words, consisting of repeating words. open syllables(ma-ma, pa-pa, ba-ba, uncle-dya); in the passive dictionary - about 200 words (usually the names of everyday objects and actions). Until a certain time, the passive vocabulary (the number of words the child understands) far exceeds the active vocabulary (the number of spoken words). Approximately at 1.6 - 1.8 months. The so-called "lexical explosion" begins, when words from the child's passive vocabulary abruptly flow into the active vocabulary. In some children, the period of passive speech can be delayed up to 2 years, but in general, their speech and mental development proceeds normally. The transition to active speech in such children often occurs suddenly, and soon they not only catch up with their peers who spoke early, but also overtake them in speech development.
Researchers believe that the transition to phrasal speech is possible when there are at least 40-60 words in the child's active vocabulary. Therefore, by the age of 2, simple two-word sentences appear in the child's speech, and the active vocabulary grows to 50-100 words. By the age of 2.5, the child begins to build detailed sentences of 3-4 words. In the period from 3 to 4 years, the child learns some grammatical forms, speaks in sentences that are united in meaning (coherent speech is formed); actively uses pronouns, adjectives, adverbs; masters grammatical categories (changing words according to numbers and genders). Vocabulary increases from 500-800 words in 3 years to 1000-1500 words in 4 years.
Experts allow a deviation of the normative framework in terms of speech development for 2-3 months for girls, and for 4-5 months for boys. Correctly assess whether the delay in the timing of the appearance of active speech is a delay in speech development or individual feature, only a specialist (pediatrician, pediatric neurologist, speech therapist) who has the opportunity to observe the child in dynamics can.
T. O., signs of a delay in speech development at different stages of speech ontogenesis can be:
abnormal course of the pre-speech period (low activity of cooing and babbling, soundlessness, the same type of vocalizations).
lack of response to sound, speech in a child aged 1 year.
inactive attempts to repeat other people's words (echolalia) in a child aged 1.5 years.
impossibility in 1.5-2 years to perform a simple task (action, demonstration) by ear.
lack of independent words at the age of 2 years.
inability to combine words into simple phrases at the age of 2.5-3 years.
the complete absence of one's own speech at the age of 3 (the child uses in speech only memorized phrases from books, cartoons, etc.).
the child's predominant use of non-verbal means of communication (facial expressions, gestures), etc.

Mkb 10 speech disorder. Disorders of psychological development (f80-f89). Basic diagnostic measures

F80.2 Receptive speech disorder

F80.3 Acquired aphasia with epilepsy (Landau-Klefner syndrome)

F80.8 Other developmental speech and language disorders

F80.9 Developmental speech and language disorders, unspecified

F81 Specific developmental disorders of learning skills

F81.0 Specific reading disorder

F81.1 Specific spelling disorder

F81.2 Specific disorder of arithmetic skills

F81.3 Mixed learning disorder

F81.8 Other developmental disorders of learning skills

F81.9 Developmental learning disorder, unspecified

F82 Specific developmental disorders of motor function

Codification of speech disorders in ICD-10

Specific developmental disorders of speech and language

Specific speech articulation disorder

Expressive speech disorder

Receptive speech disorder

Acquired aphasia with epilepsy [Landau-Klefner]

Mkb 10 dyslalia

Etiology

Symptoms

Diagnostics

Treatment

Forecast and prevention

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Mkb 10 speech disorder. Disorders of psychological development (f80-f89). Basic diagnostic measures

F80.2 Receptive speech disorder

F80.3 Acquired aphasia with epilepsy (Landau-Klefner syndrome)

F80.8 Other developmental speech and language disorders

F80.9 Developmental speech and language disorders, unspecified

F81 Specific developmental disorders of learning skills

F81.0 Specific reading disorder

F81.1 Specific spelling disorder

F81.2 Specific disorder of arithmetic skills

F81.3 Mixed learning disorder

F81.8 Other developmental disorders of learning skills

F81.9 Developmental learning disorder, unspecified

F82 Specific developmental disorders of motor function

Codification of speech disorders in ICD-10

Specific developmental disorders of speech and language

Specific speech articulation disorder

Expressive speech disorder

Receptive speech disorder

Acquired aphasia with epilepsy [Landau-Klefner]

Mkb 10 dyslalia

Etiology

Symptoms

Diagnostics

Treatment

Forecast and prevention

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