68 Neurodevelopmental Disorders
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.
Recording Procedures
Each impaired academic domain and subskill of specific learning disorder should be re-
corded. Because of ICD coding requirements, im pairments in reading, impairments in writ-
ten expression, and impairments in mathematics, with their corresponding impairments in
subskills, must be coded sepa rately. 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 (F81.0) specific learning disorder with impairment in reading, with impairment in
reading rate or fluency and impairment in reading comprehension; 315.1 (F81.2) specific
learning disorder with impairment in mathemat ics, with impairment in accurate or fluent
calculation and impairment in  accurate math reasoning.
Diagnostic Features
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