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299 Psychoses with origin specific to childhood

          This category should be used only for psychoses which always begin before
          puberty. Adult type psychoses such as schizophrenia or manic-depressive
          psychoses when occurring in childhood should be coded elsewhere under the
          appropriate heading--i.e., 295 and 296 for the examples given.

299.0 Infantile autism

          A syndrome present from birth or beginning almost invariably in the first 30
          months. Responses to auditory and sometimes to visual stimuli are abnormal
          and there are usually severe problems in the understanding of spoken language.
          Speech is delayed and, if it develops, is characterized by echolalia, the
          reversal of pronouns, immature grammatical structure and inability to use
          abstract terms. There is generally an impairment in the social use of both
          verbal and gestural language. Problems in social relationships are most
          severe before the age of five years and include an impairment in the
          development of eye-to-eye gaze, social attachments, and cooperative play.
          Ritualistic behavior is usual and may include abnormal routines, resistance to
          change, attachment to odd objects and stereotyped patterns of play. The
          capacity for abstract or symbolic thought and for imaginative play is
          diminished. Intelligence ranges from severely subnormal to normal or above.
          Performance is usually better on tasks involving rote memory or visuospatial
          skills than on those requiring symbolic or linguistic skills.
          Childhood autism Kanner's syndrome
          Infantile psychosis
          Excludes: disintegrative psychosis (299.1)
           Heller's syndrome (299.1)
           schizophrenic syndrome of childhood (299.9)

299.1 Disintegrative psychosis

          A disorder in which normal or near-normal development for the first few years
          is followed by a loss of social skills and of speech, together with a severe
          disorder of emotions, behavior and relationships. Usually this loss of speech
          and of social competence takes place over a period of a few months and is
          accompanied by the emergence of overactivity and of stereotypies. In most
          cases there is intellectual impairment, but this is not a necessary part of
          the disorder. The condition may follow overt brain disease--such as measles
          encephalitis--but it may also occur in the absence of any known organic brain
          disease or damage. Use additional code to identify any associated
          neurological disorder.
          Heller's syndrome
          Excludes: infantile autism (299.0)
           schizophrenic syndrome of childhood (299.9)

299.8 Other

          A variety of atypical infantile psychoses which may show some, but not all, of
          the features of infantile autism. Symptoms may include stereotyped repetitive
          movements, hyperkinesis, self-injury, retarded speech development, echolalia
          and impaired social relationships. Such disorders may occur in children of
          any level of intelligence but are particularly common in those with mental
          retardation.
          Atypical childhood psychosis
          Excludes: simple stereotypies without psychotic disturbance (307.3)

299.9 Unspecified

          Child psychosis NOS
          Schizophrenia, childhood type NOS
          Schizophrenic syndrome of childhood NOS
          Excludes: schizophrenia of adult type occurring in childhood (295.0-295.8)
           NEUROTIC DISORDERS, PERSONALITY DISORDERS,
           AND OTHER NONPSYCHOTIC MENTAL DISORDERS (300-316)
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