ICD-11 Criteria for Developmental Speech or Language Disorders (6A01)

Developmental speech or language disorders arise during the developmental period and are characterised by difficulties in understanding or producing speech and language or in using language in context for the purposes of communication that are outside the limits of normal variation expected for age and level of intellectual functioning. The observed speech and language problems are not attributable to regional, social, or cultural/ethnic language variations and are not fully explained by anatomical or neurological abnormalities. The presumptive aetiology for Developmental speech or language disorders is complex, and in many individual cases, is unknown.

6A01.0       Developmental speech sound disorder

Developmental speech sound disorder is characterised by difficulties in the acquisition, production and perception of speech that result in errors of pronunciation, either in number or types of speech errors made or the overall quality of speech production, that are outside the limits of normal variation expected for age and level of intellectual functioning and result in reduced intelligibility and significantly affect communication. The errors in pronunciation arise during the early developmental period and cannot be explained by social, cultural, and other environmental variations (e.g., regional dialects). The speech errors are not fully explained by a hearing impairment or a structural or neurological abnormality.

Inclusions:             

• Functional speech articulation disorder

Exclusions:             

• Deafness not otherwise specified (AB52)
• Diseases of the nervous system (Chapter 08)
• Dysarthria (MA80.2)
• Verbal apraxia (MB4A)

6A01.1      Developmental speech fluency disorder

Developmental speech fluency disorder is characterised by frequent or pervasive disruption of the normal rhythmic flow and rate of speech characterised by repetitions and prolongations in sounds, syllables, words, and phrases, as well as blocking and word avoidance or substitutions. The speech dysfluency is persistent over time. The onset of speech dysfluency occurs during the developmental period and speech fluency is markedly below what would be expected for age. Speech dysfluency results in significant impairment in social communication, personal, family, social, educational, occupational or other important areas of functioning. The speech dysfluency is not better accounted for by a Disorder of Intellectual Development, a Disease of the Nervous System, a sensory impairment, or a structural abnormality, or other speech or voice disorder.

Exclusions:             

• Tic disorders (8A05)

6A01.2      Developmental language disorder

Developmental language disorder is characterised by persistent deficits in the acquisition, understanding, production or use of language (spoken or signed), that arise during the developmental period, typically during early childhood, and cause significant limitations in the individual’s ability to communicate. The individual’s ability to understand, produce or use language is markedly below what would be expected given the individual’s age. The language deficits are not explained by another neurodevelopmental disorder or a sensory impairment or neurological condition, including the effects of brain injury or infection.

Exclusions:             

• Autism spectrum disorder (6A02)
• Diseases of the nervous system (Chapter 08)
• Deafness not otherwise specified (AB52)
• Selective mutism (6B06)

6A01.20       Developmental language disorder with impairment of receptive and expressive language

Developmental language disorder with impairment of receptive and expressive language is characterised by persistent difficulties in the acquisition, understanding, production, and use of language that arise during the developmental period, typically during early childhood, and cause significant limitations in the individual’s ability to communicate. The ability to understand spoken or signed language (i.e., receptive language) is markedly below the expected level given the individual’s age and level of intellectual functioning, and is accompanied by persistent impairment in the ability to produce and use spoken or signed language (i.e., expressive language).

Inclusions:              

Developmental dysphasia or aphasia, receptive type

Exclusions:             

• Acquired aphasia with epilepsy [Landau-Kleffner] (8A62.2)
• Autism spectrum disorder (6A02)
• Selective mutism (6B06)
• Dysphasia NOS (MA80.1)
• Diseases of the nervous system (Chapter 08)
• Deafness not otherwise specified (AB52)

6A01.21     Developmental language disorder with impairment of mainly expressive language

Developmental language disorder with impairment of mainly expressive language is characterised by persistent difficulties in the acquisition, production, and use of language that arise during the developmental period, typically during early childhood, and cause significant limitations in the individual’s ability to communicate. The ability to produce and use spoken or signed language (i.e., expressive language) is markedly below the expected level given the individual’s age and level of intellectual functioning, but the ability to understand spoken or signed language (i.e., receptive language) is relatively intact.

Inclusions:              

• Developmental dysphasia or aphasia, expressive type

Exclusions:             

• Acquired aphasia with epilepsy [Landau-Kleffner] (8A62.2)
• Selective mutism (6B06)
• Dysphasia and aphasia: developmental, receptive type (6A01.20)
• Dysphasia NOS (MA80.1)
• Aphasia NOS (MA80.0)
• Diseases of the nervous system (Chapter 08)
• Deafness not otherwise specified (AB52)

6A01.22      Developmental language disorder with impairment of mainly pragmatic language

Developmental language disorder with impairment of mainly pragmatic language is characterised by persistent and marked difficulties with the understanding and use of language in social contexts, for example making inferences, understanding verbal humour, and resolving ambiguous meaning. These difficulties arise during the developmental period, typically during early childhood, and cause significant limitations in the individual’s ability to communicate. Pragmatic language abilities are markedly below the expected level given the individual’s age and level of intellectual functioning, but the other components of receptive and expressive language are relatively intact. This qualifier should not be used if the pragmatic language impairment is better explained by Autism Spectrum Disorder or by impairments in other components of receptive or expressive language.

Exclusions:             

• Diseases of the nervous system (Chapter 08)
• Selective mutism (6B06)

6A01.23     Developmental language disorder, with other specified language impairment

Developmental language disorder with other specified language impairment is characterised by persistent difficulties in the acquisition, understanding, production or use of language (spoken or signed), that arise during the developmental period and cause significant limitations in the individual’s ability to communicate. The pattern of specific deficits in language abilities is not adequately captured by any of the other developmental language disorder categories.

Exclusions:             

• Autism spectrum disorder (6A02)
• Diseases of the nervous system (Chapter 08)
• Disorders of intellectual development (6A00)
• Selective mutism (6B06)

6A01.Y                   Other specified developmental speech or language disorders

6A01.Z                    Developmental speech or language disorders, unspecified

REFERENCE:

International Classification of Diseases Eleventh Revision (ICD-11). Geneva: World Health Organization; 2022. License: CC BY-ND 3.0 IGO.

https://creativecommons.org/licenses/by-nc-nd/3.0/igo/