. The learning difficulties begin during schooI-age years but may not become fully man- itest until the demands for those affected academic skills exceed the individual’s lim- ited capacities (e.g., as in timed tests. reading or writing lengthy complex reports for a tight deadline, excessively heavy academic loads).
. The learning difficulties are not better accounted for by intellectual disabilities, uncor- rected visual or auditory acuity, other mental or neurological disorders, psychosocial adversity, lack of proficiency in the language of academic instruction, or inadequate educational instruction.
Note: The four diagnostic criteria are to be met based on a clinical synthesis of the indi- vidual’s history (developmental, medical, family, educational), school reports, and psycho- educational assessment.
Coding note: Specify all academic domains and subskills that are impaired. When more than one domain is impaired, each one should be coded individually according to the fol- lowing specifiers.
Specify if: 315.00 (F81.0) With impairment in reading:
Note: Dyslexia is an alternative term used to refer to a pattern of learning difficulties characterized by problems with accurate or fluent word recognition, poor decoding, and poor spelling abilities. lf dyslexia is used to specify this particular pattern of dif- ficulties, it is important also to specify any additional difficulties that are present, such as difficulties with reading comprehension or math reasoning.
315.2 (F81.81) With impairment in written expression:
Clarity or organization of written expression 315.1 (F81.2) With impairment in mathematics:
Memorization of arithmetic facts
Note: Dyscalculia is an alternative term used to refer to a pattern of difficulties char- acterized by problems processing numerical information, learning arithmetic facts, and performing accurate or fluent calculations. If dyscalculia is used to specify this particular pattern of mathematic difficulties, it is important also to specify any addi- tional difficulties that are present, such as difficulties with math reasoning or word rea- soning accuracy.
Specify current severity:
Miid: Some difficulties learning skills in one or two academic domains, but of mild enough severity that the individual may be able to compensate or function well when provided with appropriate accommodations or support services, especially during the school years.
Moderate: Marked difficulties learning skills in one or more academic domains, so that the individual is unlikely to become proficient without some intervals of intensive and specialized teaching during the school years. Some accommodations or supportive services at least part of the day at school, in the workplace, or at home may be needed to complete activities accurately and efficiently.
Severe: Severe difficulties learning skills, affecting several academic domains, so that the individual is unlikely to learn those skills without ongoing intensive individualized and specialized teaching for most of the school years. Even with an array of appropri- ate accommodations or services at home, at school, or in the workplace, the individual may not be able to complete all activities efficiently.
Each impaired academic domain and subskill of specific learning disorder should be re- corded. Because of ICD coding requirements, impairments in reading, impairments in writ- ten expression, and impairments in mathematics, with their corresponding impairments in subskills, must be coded separately. For example, impairments in reading and mathematics and impairments in the subskills of reading rate or ﬂuency, reading comprehension, accu- rate or ﬂuent calculation, and accurate math reasoning would be coded and recorded as 315.00 (F810) specific learning disorder with impairment in reading, with impairment in reading rate or ﬂuency and impairment in reading comprehension; 315.1 (F812) specific learning disorder with impairment in mathematics, with impairment in accurate or ﬂuent calculation and impairment in accurate math reasoning.
Specific learning disorder is a neurodevelopmental disorder with a biological origin that is the basis for abnormalities at a cognitive level that are associated with the behavioral signs of the disorder. The biological origin includes an interaction of genetic, epigenetic, and en- vironmental factors, which affect the brain’s ability to perceive or process verbal or non- verbal information efficiently and accurately.