Information for Patients
As children grow older, they develop in several different ways. Child development includes physical, intellectual, social, and emotional changes.
Children grow and mature at very different rates. It's hard to say what "normal" is. There can be big differences in height, weight, and build among healthy children. Diet, exercise and genes are all factors. Some children begin puberty or are close to it before they are teenagers.
Children start to become more independent from their parents. They may rebel. They also look outward - to their friends, who are usually of the same sex. Peer approval becomes very important. Your child may try new behaviors to be part of "the group." This can also be the time that parents or teachers recognize learning disabilities or behavioral problems in children. These problems can get worse as time goes on, so it is important to get help early.
What is a learning disability?
Learning disabilities are conditions that affect the ability to learn. They can cause problems with:
- Understanding what people are saying
- Doing math
- Paying attention
Often, children have more than one kind of learning disability. They may also have another condition, such as attention deficit hyperactivity disorder (ADHD), which can make learning even more of a challenge.
What causes learning disabilities?
Learning disabilities don't have anything to do with intelligence. They are caused by differences in the brain, and they affect the way the brain processes information. These differences are usually present at birth. But there are certain factors that can play a role in the development of a learning disability, including:
- Environmental exposures (such as lead)
- Problems during pregnancy (such as the mother's drug use)
How do I know if my child has a learning disability?
The earlier you can find and treat a learning disability, the better. Unfortunately, learning disabilities are usually not recognized until a child is in school. If you notice that your child is struggling, talk to your child's teacher or health care provider about an evaluation for a learning disability. The evaluation may include a medical exam, a discussion of family history, and intellectual and school performance testing.
What are the treatments for learning disabilities?
The most common treatment for learning disabilities is special education. A teacher or other learning specialist can help your child learn skills by building on strengths and finding ways to make up for weaknesses. Educators may try special teaching methods, make changes to the classroom, or use technologies that can assist your child's learning needs. Some children also get help from tutors or speech or language therapists.
A child with a learning disability may struggle with low self-esteem, frustration, and other problems. Mental health professionals can help your child understand these feelings, develop coping tools, and build healthy relationships.
If your child has another condition such as ADHD, he or she will need treatment for that condition as well.
NIH: National Institute of Child Health and Human Development
General Equivalence Map Definitions
The ICD-9 and ICD-10 GEMs are used to facilitate linking between the diagnosis codes in ICD-9-CM and the new ICD-10-CM code set. The GEMs are the raw material from which providers, health information vendors and payers can derive specific applied mappings to meet their needs.
- Approximate Flag - The approximate flag is on, indicating that the relationship between the code in the source system and the code in the target system is an approximate equivalent.
- No Map Flag - The no map flag indicates that a code in the source system is not linked to any code in the target system.
- Combination Flag - The combination flag indicates that more than one code in the target system is required to satisfy the full equivalent meaning of a code in the source system.
Index of Diseases and Injuries Definitions
- And - The word "and" should be interpreted to mean either "and" or "or" when it appears in a title.
- Code also note - A "code also" note instructs that two codes may be required to fully describe a condition, but this note does not provide sequencing direction.
- Code first - Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions, the ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. Wherever such a combination exists, there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation.
- Type 1 Excludes Notes - A type 1 Excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
- Type 2 Excludes Notes - A type 2 Excludes note represents "Not included here". An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.
- Includes Notes - This note appears immediately under a three character code title to further define, or give examples of, the content of the category.
- Inclusion terms - List of terms is included under some codes. These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
- NEC "Not elsewhere classifiable" - This abbreviation in the Alphabetic Index represents "other specified". When a specific code is not available for a condition, the Alphabetic Index directs the coder to the "other specified” code in the Tabular List.
- NOS "Not otherwise specified" - This abbreviation is the equivalent of unspecified.
- See - The "see" instruction following a main term in the Alphabetic Index indicates that another term should be referenced. It is necessary to go to the main term referenced with the "see" note to locate the correct code.
- See Also - A "see also" instruction following a main term in the Alphabetic Index instructs that there is another main term that may also be referenced that may provide additional Alphabetic Index entries that may be useful. It is not necessary to follow the "see also" note when the original main term provides the necessary code.
- 7th Characters - Certain ICD-10-CM categories have applicable 7th characters. The applicable 7th character is required for all codes within the category, or as the notes in the Tabular List instruct. The 7th character must always be the 7th character in the data field. If a code that requires a 7th character is not 6 characters, a placeholder X must be used to fill in the empty characters.
- With - The word "with" should be interpreted to mean "associated with" or "due to" when it appears in a code title, the Alphabetic Index, or an instructional note in the Tabular List. The word "with" in the Alphabetic Index is sequenced immediately following the main term, not in alphabetical order.