78 Neurodevelopmental Disorders
Coding note:  Use additional code to identify the associated medical or genetic
condition, or neurodevelopmental disorder.
Specify current severity:
Mild:  Symptoms are easily suppressed by sensory stimulus or distraction.
Moderate: Symptoms require explicit protective measures and behavioral modification.
Severe:  Continuous monitoring and protective m easures are required to prevent seri-
ous injury.
Recording Procedures
For stereotypic movement diso rder that is associated with a known medical or genetic
condition, neurodevelopmental disorder, or  environmental factor, record stereotypic
movement disorder associated with (name of condition, disorder, or factor) (e.g., stereo-
typic movement disorder associat ed with Lesch-Nyhan syndrome).
Specifiers
The severity of non-self-injurious stereotypi c movements ranges from  mild presentations
that are easily suppressed by a sensory stimul us or distraction to continuous movements
that markedly interfere with all activities of da ily living. Self-injurious  behaviors range in se-
verity along various dimensions, including the frequency, impact on adaptive functioning,
and severity of bodily injury (from mild bruising or erythema from hitting hand against
body, to lacerations or amputa tion of digits, to retinal detachment from head banging).
Diagnostic Features
The essential feature of stereotypic movement disorder is repetitive, seemingly driven,
and apparently purposeless motor behavior (Criterion A). These behaviors are often
rhythmical movements of the head, hands, or body without obvious adaptive function.
The movements may or may not respond to efforts to stop them. Among typically devel-
oping children, the repetitive movements may be stopped when attention is directed to
them or when the child is distracted from performing them. Among children with neuro-
developmental disorders, the behaviors are typically less responsive to such efforts. In