Adhd axis code
| Disorder Class: Disorders Usually Diagnosed in Infancy, Childhood, and Adolescence | Disorder Class: Neurodevelopmental Disorders |
| A. Either (1) or (2): | A. A persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development, as characterized by (1) and/or (2): |
| 1. Six (or more) of the following symptoms of inattention have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level: | 1. Inattention: Six (or more) of the following symptoms have persisted for at least 6 months to a degree that is inconsistent with developmental level and that negatively impacts directly on social and academic/occupational activities: |
| Note: The symptoms are not solely a manifestation of oppositional behavior, defiance, hostility, or failure to understand tasks or instructions. For older adolescents and adults (age 17 or older), at least five symptoms are required. | |
| Inattention | |
| a. often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities | a. Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or during other activities (e.g., overlooks or misses details, work is inaccurate). |
| b. often has difficulty sustaining attention in tasks or play activity | b. Often has difficulty sustaining attention in tasks or play activities (e.g., has difficulty remaining focused during lectures, conversations, or lengthy reading). |
| c. often does not seem to listen when spoken to directly | c. Often does not seem to listen when spoken to directly (e.g., mind seems elsewhere, even in the absence of any obvious distraction). |
| d. often does not follow through on instructions and fails to finish schoolwork, chores or duties in the workplace (not due to oppositional behavior or failure to understand instructions) | d. Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., starts tasks but quickly loses focus and is easily sidetracked). |
| e. often has difficulty organizing tasks and activities | e. Often has difficulty organizing tasks and activities (e.g., difficulty managing sequential tasks; difficulty keeping materials and belongings in order; messy, disorganized work; has poor time management; fails to meet deadlines). |
| f. often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework) | f. Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (e. g., schoolwork or homework; for older adolescents and adults, preparing reports, completing forms, reviewing lengthy papers). |
| g. often loses things necessary for tasks or activities (e.g., toys, school assignments, pencils, books or tools) | g. Often loses things necessary for tasks or activities (e.g., school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones). |
| h. is often easily distracted by extraneous stimuli | h. Is often easily distracted by extraneous stimuli (for older adolescents and adults, may include unrelated thoughts). |
i. is often forgetful in daily activities | i. Is often forgetful in daily activities (e.g., doing chores, running errands; for older adolescents and adults, returning calls, paying bills, keeping appointments). |
| 2. Six (or more) of the following symptoms of hyperactivity-impulsivity have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level: | 2. Hyperactivity and impulsivity: Six (or more) of the following symptoms have persisted for at least 6 months to a degree that is inconsistent with developmental level and that negatively impacts directly on social and academic/occupational activities: |
Note: The symptoms are not solely a manifestation of oppositional behavior, defiance, hostility, or a failure to understand tasks or instructions. For older adolescents and adults (age 17 or older), at least five symptoms are required. | |
| Hyperactivity | |
| a. Often fidgets with hands or feet or squirms in seat | a. Often fidgets with or taps hands or feet or squirms in seat. |
| b. Often leaves seat in classroom or in other situations in which remaining seated is expected | b. Often leaves seat in situations when remaining seated is expected (e.g., leaves his or her place in the classroom, in the office or other workplace, or in other situations that require remaining in place). |
| c. Often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to subjective feelings of restlessness) | c. Often runs about or climbs in situations where it is inappropriate. (Note: In adolescents or adults, may be limited to feeling restless). |
| d. Often has difficulty playing or engaging in leisure activities quietly | d. Often unable to play or take part in leisure activities quietly. |
| e. Is often “on the go” or often acts as if “driven by a motor” | e. Is often “on the go” acting as if “driven by a motor” (e.g., is unable to be or uncomfortable being still for extended time, as in restaurants, meetings; may be experienced by others as being restless or difficult to keep up with). |
| f. Often talks excessively | f. Often talks excessively. |
| Impulsivity | |
| g. Often blurts out answers before questions have been completed | g. Often blurts out an answer before a question has been completed (e.g., completes people’s sentences; cannot wait for turn in conversation). |
| h. Often has difficulty awaiting turn | h. Often has trouble waiting his/her turn (e.g., while waiting in line). |
| i. Often interrupts or intrudes on others (e.g., butts into conversations or games) | i. Often interrupts or intrudes on others (e.g., butts into conversations, games, or activities; may start using other people’s things without asking or receiving permission; for adolescents and adults, may intrude into or take over what others are doing). |
| B. Some hyperactive-impulsive or inattentive symptoms must have been present before age 7 years. | B. Several inattentive or hyperactive-impulsive symptoms were present before age 12 years. |
| C. Some impairment from the symptoms is present in at least two settings (e.g., at school [or work] and at home). | C. Several inattentive or hyperactive-impulsive symptoms are present in two or more settings, (e.g., at home, school or work; with friends or relatives; in other activities). |
| D. There must be clear evidence of clinically significant impairment in social, academic or occupational functioning. | D. There is clear evidence that the symptoms interfere with, or reduce the quality of, social, school, or work functioning. |
E. The symptoms do not occur exclusively during the course of a pervasive developmental disorder, schizophrenia, or other psychotic disorders and is not better accounted for by another mental disorder (e.g., mood disorder, anxiety disorder, dissociative disorder, or a personality disorder). | E. The symptoms do not occur exclusively during the course of schizophrenia or another psychotic disorder and are not better explained by another mental disorder (e.g., mood disorder, anxiety disorder, dissociative disorder, personality disorder, substance intoxication or withdrawal). |
Code based on type:
| Specify whether:
|
01 Attention-Deficit/Hyperactivity Disorder, Predominantly Hyperactive-Impulsive Type: if Criterion A2 is met but Criterion A1 is not met for the past 6 months
ADHD Diagnosis | ADHD institute
How is ADHD diagnosed?
When evaluating individuals for attention-deficit hyperactivity disorder (ADHD), or hyperkinetic disorder (HKD), it is typical to use multiple stages of assessment prior to formal diagnosis, including1-5:
- Clinical assessments
- Assessment tools and rating scales
- Clinical interviews with the individuals and parents/teachers for children and adolescents or partners for adults with ADHD.
The National Institute for Health and Care Excellence (NICE) guidelines state that a diagnosis of ADHD should only be made by a specialist psychiatrist, paediatrician or other appropriately qualified healthcare professional with training and expertise in the diagnosis of ADHD. Diagnosis of ADHD should also be based upon a full clinical and psychosocial assessment, a full developmental and psychiatric history, and observer reports of the individual’s mental state. According to the NICE guidelines, for a diagnosis of ADHD, symptoms of hyperactivity-impulsivity and/or inattention should meet the diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders – 5th Edition (DSM-5TM) for ADHD and the International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) for HKD.1 Note that in 2018, the ICD-10 was updated to the International Classification of Diseases 11th Revision (ICD-11), where HKD is now referred to as ADHD.
6
Regardless of which medical classification system is used, the features of ADHD described are similar, with both sets of diagnostic criteria describing ADHD as a pattern of inattention and/or hyperactivity-impulsivity (combined, predominantly inattentive or predominantly hyperactive-impulsive presentations).6,7 Nevertheless, these medical classification systems should be used in conjunction with a range of rating scales, which often measure the impact of ADHD upon more specific areas of functioning or quality of life.1-4
How do the two classification systems define ADHD?
The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders – 5th Edition (DSM-5
TM)The DSM-5TM medical classification system for ADHD is published by the American Psychiatric Association, and is used in the US and the rest of the world. This classification system defines ADHD as “a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development”.
7 The DSM-5TM includes ADHD among neurodevelopmental disorders, which comprise conditions associated with factors affecting brain development, and gives examples of how ADHD symptoms are expressed across the lifespan. The DSM-5TM states that at least five symptoms must be present prior to age 12 years, and that there should be clear evidence that symptoms interfere with or reduce the level of social, academic and occupational functioning for a diagnosis of ADHD.5
The DSM-5TM replaced the previous version (DSM-IV) in 2013.7,8 The NICE guidelines1 and other clinical guidelines2-5 refer to the DSM-5TM; however, some clinical trials initiated before the new edition also refer to the DSM-IV.
International Classification of Diseases 11th Revision (ICD-11)
Published in 2018, the ICD-11 characterises ADHD as a “persistent pattern (at least 6 months) of inattention and/or hyperactivity-impulsivity that has a direct negative impact on academic, occupational or social functioning.
”6
The ICD-11 further states that the onset of these symptoms occurs prior to age 12 years, typically by early- to mid-childhood. The degree of inattention and hyperactivity-impulsivity is also outside the limits of normal variation expected for age and level of intellectual functioning, and has a direct negative impact on academic, occupational or social functioning.6
According to the ICD-11, ADHD can present as6:
- Predominantly inattentive
- Some hyperactive-impulsive symptoms may also be present, but these are not clinically significant in relation to the inattentive symptoms.
- Predominantly hyperactive-impulsive
- Some inattentive symptoms may also be present, but these are not clinically significant in relation to the hyperactive-impulsive symptoms.
- Combined
- Both inattentive and hyperactive-impulsive symptoms are clinically significant, with neither predominating in the clinical presentation.
- Both inattentive and hyperactive-impulsive symptoms are clinically significant, with neither predominating in the clinical presentation.
The ICD-11 indicates that since the balance and specific manifestations of ADHD may vary across individuals, and may change over the course of development, the symptoms must be observable in more than one setting in order for a diagnosis of ADHD to be made.6
- NICE guideline 2018. Attention deficit hyperactivity disorder: diagnosis and management. Available at: https://www.nice.org.uk/guidance/ng87. Accessed January 2021.
- Canadian ADHD Resource Alliance (CADDRA). Canadian ADHD Practice Guidelines. Edition 4.1. Toronto, ON: CADDRA, 2020.
- Banaschewski T, Hohmann S, Millenet S. Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung (ADHS) im Kindes-, Jugend- und Erwachsenenalter. DGKJP, DGPPN and DGSPJ German guidelines. 2018.
- Guías de Práctica Clínica en el SNS. Grupo de trabajo de la Guía de Práctica Clínica sobre las Intervenciones Terapéuticas en el Trastorno por Déficit de Atención con Hiperactividad (TDAH). 2017.
- Kooij JJS, Bijlenga D, Salerno L, et al. Updated European Consensus Statement on diagnosis and treatment of adult ADHD. Eur Psychiatry 2019; 56: 14-34.
- World Health Organization. ICD-11: International Classification of Diseases 11th Revision. 2018. Available at: https://icd.who.int/. Accessed January 2021.
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. 2013.
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC: American Psychiatric Association, 2004.
Date of preparation: March 2021; Job code: C-ANPROM/EUC/NBU/0003
Automation | Tigercat Manufacturing Process
- Chris McMillan, Technical Marketing Journalist
office of the company that soon became Tigercat Industries. Today, the same building is one of Tigercat's manufacturing and assembly plants for feller bunchers, mulchers and saw heads. As demand for Tigercat products has increased and manufacturing technology has evolved, processing and manufacturing equipment and processes have changed dramatically over the years. In this edition of On the Shop, we take a look at a recent acquisition, a 5-axis milling machine with a robotic pallet changer. After installation was completed in early December 2020, the new machine has increased the productivity of high-precision milling operations for the production of feller buncher and mulcher frames. nine0003 Three-axis movement refers to movement up and down, right and left, forward and backward. During milling, the tool can be positioned on any of these planes. But what if you need to drill a hole diagonally between any of these planes? This is where the other two axes are required, obtained by rotating the milling head and rotating the pallet. Five different milling axes available. The 5 axis milling machine can move the pallet in one direction and rotate it around the second axis, while the milling head moves in the third and fourth directions, rotating around the fifth axis. The machine is equipped with an automatic two-pallet changer, which allows you to set the assemblies on pallets in advance and avoid interruptions in the operation of the machine. Justin Cambi, head of planning and production, explains: “Before you go home, you can program the machine to do two tasks and it will do both tasks on its own. When you get back to work in the morning, you just need to unload the pallets.” If the program is interrupted for any reason, it will remember where it left off and can be restarted manually. The technology allows the operator to calmly step away from the running machine and work on completely different tasks, such as performing offline programming or preparing the next part to be loaded onto the machine. Complex machining processes can be programmed without multiple settings. In addition to the benefit of working between shifts, the new five-axis machine is faster and requires less set up. Older generation boring machines can do the same type of work, but they take time to set up, and a particular build may require several setup steps. On a new milling machine, all settings are made through programming, and the machine moves the part automatically without operator intervention. nine0003 Double pallet changer keeps the machine running continuously without interruption for the next assembly. Tool change is another operation that was done manually on previous generation machines. The five-axis machine has a wheel-type magazine that can accommodate 243 types of different cutters. When a tool change is required, the door at the back of the work area opens, the spindle moves into the magazine and the cutter changes automatically. The whole process takes a matter of seconds. The acquisition of this 5-axis milling machine, along with three units installed at other factories, is part of Tigercat's ongoing process improvement program. Write a review You'll get double Banggood points for a review if you're one of the first 3 to leave it! Sort by: evaluation Reviews only from your country (Germany) | Show original Part of the review is translated automatically. General 0 page Go to page Go 2.45€ RBR/C 2 pcs. Upgraded Metal Pedal Plate R506 for XIAOMI Jimmy XMYKC01CM 1/16 RC Car Car Model Parts (15) 5.35€ 1PC URUAV Aluminum Alloy 37mm 25T Steering Servo Horn RC Model Parts (93) 8. 1 pc. Handmade Plastic Keychain Personalized Tauren Keyring for Mechanical Keyboard (12) 11.16€ BUDI 11-In-1 Type-C 65W USB Multifunction Data Cable with Charging/Transfer/Bracket/Card Removal Pin/Storage (0) 
nine0003
Rotation can stop at any point from zero to 360 degrees on any of the rotating axes. The program necessary to perform all work with the assembly is set by the head of the department. The program is loaded into the milling machine and exits automatically even if the operator is not present. nine0003 
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As for the speed of the machine, its torque and speed are about four to five times higher than the boring machines used many years ago. The five-axis machine allows you to position the part closer to the milling head. This allows shorter tools to be used, increasing tool life. nine0003
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