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An International Field Study of the ICD-11 Behavioural Indicators for Disorders of Intellectual Development

Accurate diagnoses are important, especially when supporting children and adolescents with disorders of intellectual development.

Within the ICD-11 Clinical Descriptions and Diagnostic Requirements for Mental, Behavioural or Neurodevelopmental Disorders, behavioral indicators (BIs) are included as part of the section on neurodevelopmental disorders to help clinicians assess the severity of disorders of intellectual development (DID). To examine the reliability, validity, and clinical utility of BIs internationally, the study team (Lemay et al., 2022) conducted a multi-site field study with clinicians and participants (children and adolescents) in India, Italy, and Sri Lanka.

During the field study, clinicians assessed participants’ intellectual functioning and adaptive behaviours using the BIs after conducting clinical interviews and observations. At a follow up appointment, other standardized measures (Leiter-3 and Vineland Adaptive Behaviour Scale-II) were also used to assess the intellectual and adaptive abilities of the participants. The results showed that the BIs had excellent inter-rater reliability and good to excellent concurrent validity across the sites. Furthermore, the BIs were rated as quick and easy to use, applicable across severity levels, and useful for treatment selection, prognosis assessments, communication, and education efforts.

With the BIs having performed consistently well in varying cultural, linguistic, and economic settings, these results suggest that the inclusion of the BIs within the ICD-11 can facilitate the accurate diagnosis of individuals with DID across varying contexts. Importantly, the BIs are affordable and accessible tools embedded within the ICD-11, which can be useful in settings where specialized clinical services or standardized diagnostic tools may not be available or feasible.

The BIs are available within the ICD-11 CDDR for the neurodevelopmental disorders grouping, which is available for GCPN members here. The ICD-11 CDDR is also available online to the public here.

Citation: Lemay, K. R., Kogan, C.S, Rebello, T. J., Keeley, J. W., Bhargava, R., Sharan, P.,  Sharma, M., Kommu, J. V. S., Kishore, M. T. , Jesus de Mari, J., Ginige, P., Buono, S., Recupero, M., Zingale, M., Zagaria, T., Cooray, S., Roy, A., Reed, G. M. (2022). An international field study of the ICD‐11 behavioural indicators for disorders of intellectual development. Journal of Intellectual Disability Research, 66(4), 376-391. https://doi.org/10.1111/jir.12924