Classification, prevalence and integrated care for neurodevelopmental and child mental health disorders: A brief overview for paediatricians

Table 1 The reported prevalence rates and some definition of neurodevelopmental, emotional, behavioural, and intellectual disorders conditions commonly seen in Community Child Health settings

Categories/diagnosis	Characteristics	Reported prevalence	Ref.
All NDEBIDs	Four broad categories: emotional (8.1%), behavioural (4.6%), hyperactivity and other less common disorders	12.8% to 18%	[11,30,85]
Behaviour difficulties/disorders	Externalising disorders; Disruptive behavioural disorders (including ADHD, CD and ODD)	7.5 to 10%	[11,32]
Attention deficit/hyperactive disorder	Pervasive symptoms, onset before age of 12, causing significant impairment and categorised into: (1) Predominantly inattentive; (2) Predominantly hyperactive-impulsive; or (3) Combined type	1% to 9%	[51,86-88]
Autism spectrum disorder	Early onset, pervasive and persistent deficits in: (1) Social communication and social interaction across multiple contexts; and (2) Restricted, repetitive patterns of behaviour, interests or activities	0.76% to 3.5 %	[51,89-91]
Emotional disorders	Internalising disorders; Including anxiety, depression and mood disorders	8.1%	[11]
Attachment difficulties/disorders	Attachment difficulties include insecure attachment patterns and disorganised attachments, which can often evolve into coercive or compulsive caregiving patterns; Attachment disorders in DSM5: Reactive attachment disorder and disinhibited social engagement disorder; ICD-10 classification: Reactive attachment disorder and disinhibited attachment disorder	0.005% to 1.4%1	[7,85,92]
Substance abuse	Someone who has ever taken drugs; Someone who has taken drugs in the last year; Someone who has taken drugs in the last month	7% to 37%: 11-15 yr; 20%: 16-24 yr	[93]
Self harm	A range of behaviours when someone hurts themselves on purpose	6.4% to 22%	[94-96]
All neurodisabilities	A group of congenital or acquired long-term conditions that are attributed to impairment of the brain and/or neuromuscular system and create functional limitations	3% to 15%	[41,51,97,98]
Visual impairments	Any cause of visual acuity to a level of 0·5 logMAR (6/18 Snellen) in each eye; Any specific visual processing, or eye movement problems e.g., nystagmus	5.19 per 10000 (0.05%) to 5.7%1	[99-101]
Developmental coordination disorder	Early onset of coordinated motor skills is far below expected level for age; Motor skill difficulties significantly interfere with daily activities, academic/school productivity, prevocational and vocational activities, leisure and play; Not better explained by intellectual delay, visual impairment, or other neurological conditions that affect movement	0.8% to 6%	[31,91,102,103]
Hearing impairments	Any hearing loss greater than 30 (or 35) dB in the better ear, including to glue ear (otitis media); Hearing loss: Reduced ability to hear sounds in the same way as other people at 20 dB or better; Hearing loss that adversely affects a child's educational performance	0.05 to 0.3%	[10,51,71,104]
Sensory processing disorder	A condition in which the brain and nervous system have trouble processing or integrating stimulus with 3 possible components: Sensory modulation disorder is a problem with turning sensory messages into controlled behaviours that match the nature and intensity of the sensory information; Sensory-based motor disorder is a problem with stabilising, moving or planning a series of movements in response to sensory demands; Sensory discrimination disorder is a problem with sensing similarities and differences between sensations; Not currently recognised as a distinct medical diagnosis	3.2% to 16%	[105-108]
Epilepsy	A disease characterized by an enduring predisposition to generate epileptic seizures and typical neurobiological, cognitive, psychological, and social consequences, fulfilling any of the following: (1) At least two unprovoked (or reflex) seizures occurring greater than 24 h apart; (2) One unprovoked (or reflex) seizure and a probability of further seizures similar to the general recurrence risk (at least 60%) after two unprovoked seizures, occurring over the next 10 yr; (3) Diagnosis of an epilepsy syndrome	0.05% to 0.7%	[51,109,110]
Cerebral palsy	A neurological disorder of body movement and muscle coordination caused by a non-progressive brain injury or malformation that occurs while the child’s brain is under development. Cerebral palsy primarily affects, with related intellectual disability, seizures; problems with vision, hearing, or speech; changes in the spine (such as scoliosis); or joint problems	0.1% to 0.4%	[51,111]
Sleep difficulties/disorders	Parent report of difficulty falling and/or staying asleep; Repeated difficulty with sleep initiation, duration, consolidation, or quality that occurs despite age-appropriate time and opportunity for sleep and results in daytime functional impairment for the child and/or family	3% to 36%2	[112,113]
Foetal alcohol spectrum disorders	Group of disorders due to permanent brain damage in individuals exposed to alcohol during pregnancy resulting in a spectrum of physical, emotional, memory, language, behavioural and neurological impairments	0.77% to 6%	[114-117]
All developmental delays	Also called developmental disabilities or disorders; Group of conditions due to impairment in physical, learning, language, or behaviour areas beginning during the developmental period and may impact day-to-day functioning, and usually last throughout a person’s lifetime; Any delay in developmental milestones	10% to 17% (5.7% to 7% in infancy)	[28,29,118,119]
Speech and language disorder/delay	Also called Specific language impairment; A communication disorder that interferes with the development of language skills in children who have no hearing loss or intellectual disabilities. It can affect a child’s speaking, listening, reading, and writing	1.7% to 7%	[51,120]
Intellectual (learning) disability	3 core criteria of reduced ability to understand new or complex information, impaired social independence, starting in childhood; Intelligence quotient of less than 70	2.1% to 3.6%	[121,122]
Specific intellectual (learning) disability/disorder	Experience of any problems in a traditional classroom setting, including dyslexia, dyscalculia and generalized intellectual disability	1%	[51]
Global developmental delays	Delay in two or more developmental domains of gross/fine motor, speech/language, cognition, social/personal and activities of daily living; Used in early childhood suggesting need for specific diagnosis in later in life	1 to 3% (< 5 yr) to 12% by 9 mo	[28,29,118,123]

¹More than 100 times differences.

²More than 10 times differences.

NDEBIDs: Neurodevelopmental, emotional, behavioural, and intellectual disorders; ADHD: Attention deficit hyperactivity disorder; ICD: International classification of diseases; CD: Conduct disorder; ODD: Oppositional defiant disorder.