A Simple Guide to the ICD and Autism: Understanding ICD-11

Lexicon [Measures] - DSM & ICD

PlainSpeak. In Plain Language for the Lay Audience

While the USA uses the DSM, most of the world uses another tool called the ICD. The ICD, or International Classification of Diseases, is a guide created by the World Health Organization (WHO) to help doctors all over the world diagnose and understand diseases and health conditions. 

The Early Years: ICD-6 to ICD-9

• ICD-6 (1948): The sixth edition of the ICD was the first to include mental disorders, but it didn’t mention autism. Autism wasn’t recognized as its own condition back then.
• ICD-7 (1955) and ICD-8 (1965): These editions added more mental disorders but still didn’t have specific criteria for autism. Autism was often mixed up with other psychiatric conditions.
• ICD-9 (1979): This edition started to recognize autism under a broader category called "Pervasive Developmental Disorders" (PDD), showing that people were beginning to understand autism better.

Defining Autism: ICD-10

• ICD-10 (1992): This edition made a big change by giving more detailed classifications for autism. Autism was listed under "Pervasive Developmental Disorders" (F84). It included:
  • Childhood Autism: Kids with problems in social interaction, communication, and repetitive behaviors.
  • Atypical Autism: Similar to childhood autism but with unusual age of onset or different symptoms.
  • Asperger's Syndrome: Problems in social interaction and repetitive behaviors, but no significant delays in language or thinking.
  • Other PDDs: Including Rett's Syndrome and Childhood Disintegrative Disorder.

The Modern Era: ICD-11

• ICD-11 (2018): The latest edition made important changes to how autism is diagnosed, similar to the DSM-5 used in the USA. Key updates include:
  • Autism Spectrum Disorder (6A02): The ICD-11 combined all previous types of autism into one category: Autism Spectrum Disorder (ASD). This shows that autism is a spectrum with different levels of severity and symptoms.
  • Two Core Domains:
    • Deficits in Social Communication and Social Interaction: Ongoing difficulties in social communication and interaction.
    • Restricted, Repetitive Patterns of Behavior, Interests, or Activities: Repetitive movements, strict routines, very focused interests, and unusual responses to sensory experiences.
  • Severity Specifiers: These help to indicate how severe the condition is and how much support a person might need in daily life.
  • Associated Features: This allows for noting extra features like intellectual development disorders and language impairments to give a fuller picture of each person’s unique situation.

Impact of ICD-11 on Autism Diagnosis

The changes in ICD-11 help make autism diagnoses more accurate and consistent worldwide. By recognizing autism as a spectrum disorder, the ICD-11 understands that people with autism can have a wide range of symptoms and levels of severity. This approach supports more personalized and appropriate treatments, tailored to what each individual needs.

As our knowledge about autism grows, the ICD will keep evolving to make sure people with autism get the right diagnosis and support. This evolution helps ensure that everyone with autism can live a fulfilling life.

A Brief History of the ICD

Lexicon [Measures] - ICD

While the USA follows the DSM, most of the world uses ICD. The International Classification of Diseases (ICD) is a globally used diagnostic tool maintained by the World Health Organization (WHO) to classify and code diseases and health conditions.

The latest edition (ICD-11) combined the previously separate diagnoses into a single category: Autism Spectrum Disorder (ASD). This change reflects the understanding that autism is a spectrum with varying degrees of severity and manifestations.

• ICD-11 (2018):  The latest edition combined the previously separate diagnoses into a single category: Autism Spectrum Disorder (ASD). This change reflects the understanding that autism is a spectrum with varying degrees of severity and manifestations.
• Two Domains: The criteria for ASD are based on two core domains:
• Deficits in Social Communication and Social Interaction: Persistent difficulties in social communication and interaction across multiple contexts.
• Restricted, Repetitive Patterns of Behavior, Interests, or Activities: This includes stereotyped movements, insistence on sameness, restricted interests, and sensory anomalies.
• Severity Specifiers: The ICD-11 includes specifiers to indicate the severity of the condition and the level of support needed in daily life.
• Associated Features: The classification allows for the inclusion of additional features such as intellectual development disorders and language impairments, providing a comprehensive understanding of each individual’s unique presentation.

• ICD-10 (1992): This edition marked a significant shift by introducing more detailed classifications for autism. Autism was listed under "Pervasive Developmental Disorders" (F84), which included:
• Childhood Autism: Defined by impairments in social interaction, communication, and restricted, repetitive behaviors.
• Atypical Autism: Similar to childhood autism but with an atypical age of onset or atypical symptomatology.
• Asperger's Syndrome: Characterized by impairments in social interaction and restricted, repetitive behaviors, without significant delays in language or cognitive development.
• Other PDDs: Including Rett's Syndrome and Childhood Disintegrative Disorder.

• ICD-9 (1979): The ninth edition began to recognize autism under the broader category of "Pervasive Developmental Disorders" (PDD), reflecting growing awareness of the condition.
• Defining Autism: ICD-10
• ICD-7 (1955) and ICD-8 (1965): These editions continued to expand the classification of mental disorders but did not provide specific criteria for diagnosing autism. Autism was still often misclassified under other psychiatric conditions.
• ICD-6 (1948): The sixth edition of the ICD was the first to include a section on mental disorders, but it did not specifically mention autism. At this time, autism was not widely recognized as a distinct condition.

Related Posts: [DSM], [ICD], [RDoc], [Diagnosis],[Measures]

DSM vs ICD

Lexicon [Measures]-DSM & ICD

The DSM (Diagnostic and Statistical Manual of Mental Disorders) and ICD (International Classification of Diseases) are two different systems used to classify mental disabilities. 

• The DSM is used in the US and the ICD is used internationally. 
• The latest version of the DSM is the DSM-5-TR, which was published in March 2022 (revision of the 2013 DSM-5). The latest version of the ICD is ICD-11. It was adopted by the World Health Assembly in 2019 and came into effect on January 1, 2022.
• The DSM is more focused on clinical dx, while the ICD is more focused on public health.

• Both systems use a multiaxial approach, which means that they assess mental disabilities on multiple dimensions, such as symptoms, severity, and functional impairment.
• Both systems are updated periodically to reflect new research and understanding of mental disorders. The DSM is more detailed and specific and updated more frequently than ICD. 

Related Posts: [DSM], [ICD], [RDoc], [Diagnosis],[Measures]

ICD - International Classification of Diseases

Lexicon [Measures] - ICD

The ICD (International Classification of Diseases), an international diagnostic tool by the WHO, classifies autism as a neurodevelopmental disorder characterized by deficits in social interaction and communication, and repetitive behaviors or interests. The USA primarily uses the DSM (Diagnostic and Statistical Manual of Mental Disorders) system for diagnosis.

PlainSpeak: The ICD (International Classification of Diseases), a global guide used by doctors, defines autism as a condition with social interaction and communication challenges, and repetitive behaviors or interests. In the USA, doctors mainly use the DSM (Diagnostic and Statistical Manual of Mental Disorders) system for diagnosis.

Related Posts: [DSM], [ICD], [RDoc], [Diagnosis],[Measures]