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Chapter V

Disorders of social functioning with onset specific to childhood and adolescence - F94


A somewhat heterogeneous group of disorders that have in common abnormalities in social functioning which begin during the developmental period, but which (unlike the pervasive developmental disorders) are not primarily characterized by an apparently constitutional social incapacity or deficit that pervades all areas of functioning. In many instances, serious environmental distortions or privations probably play a crucial role in etiology.
F94.0 Elective mutism
Characterized by a marked, emotionally determined selectivity in speaking, such that the child demonstrates a language competence in some situations but fails to speak in other (definable) situations. The disorder is usually associated with marked personality features involving social anxiety, withdrawal, sensitivity, or resistance.
Selective mutism
    Excludes:
  • pervasive developmental disorders ( F84.- )
  • schizophrenia ( F20.- )
  • specific developmental disorders of speech and language ( F80.- )
  • transient mutism as part of separation anxiety in young children ( F93.0 )
F94.1 Reactive attachment disorder of childhood
Starts in the first five years of life and is characterized by persistent abnormalities in the child's pattern of social relationships that are associated with emotional disturbance and are reactive to changes in environmental circumstances (e.g. fearfulness and hypervigilance, poor social interaction with peers, aggression towards self and others, misery, and growth failure in some cases). The syndrome probably occurs as a direct result of severe parental neglect, abuse, or serious mishandling.
Use additional code, if desired, to identify any associated failure to thrive or growth retardation.
    Excludes:
  • Asperger's syndrome ( F84.5 )
  • disinhibited attachment disorder of childhood ( F94.2 )
  • maltreatment syndromes ( T74.- )
  • normal variation in pattern of selective attachment
  • sexual or physical abuse in childhood, resulting in psychosocial problems ( Z61.4-Z61.6 )
F94.2 Disinhibited attachment disorder of childhood
A particular pattern of abnormal social functioning that arises during the first five years of life and that tends to persist despite marked changes in environmental circumstances, e.g. diffuse, nonselectively focused attachment behaviour, attention-seeking and indiscriminately friendly behaviour, poorly modulated peer interactions; depending on circumstances there may also be associated emotional or behavioural disturbance.
Affectionless psychopathy
Institutional syndrome
    Excludes:
  • Asperger's syndrome ( F84.5 )
  • hospitalism in children ( F43.2 )
  • hyperkinetic disorders ( F90.- )
F94.8 Other childhood disorders of social functioning
F94.9 Childhood disorder of social functioning, unspecified


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