The ICD-11, is the International Classification of Diseases for Mortality and Morbidity Statistics – Eleventh Revision. Catchy, eh? It is compiled by The World Health Organisation and it is relevant for neurodivergent people because it is used, alongside the United States’ DSM-5-TR, as the basis for all of the diagnostic tools for neurodivergencies, including ASD and ADHD.

When I did my Psychology degree the ICD-10 (the previous revision) had already been in use for seven years, and it remained in use until 2022. That’s 28 years without any change in definitions and diagnostic criteria, despite the huge advances in research, knowledge and attitudes that have taken place in that time. So, an update was long overdue.

The ICD is relevant here because many of us are seeking diagnoses, and the ICD-11 is used by 35 countries around the world as a diagnostic tool. That’s quite some power it has.

A positive change between the ICD-10 and the ICD-11 is that the updated version acknowledges, for the first time, that autistic people often have hyposensitivity and/or hypersensitivity to particular sensory stimuli.

Another improvement in the current ICD is that ‘delayed language’ is no longer used as an essential element of diagnosis. Nor is there any requirement to demonstrate autistic behaviours were present before primary school age. This is an explicit acknowledgement that it is the very act of going to school – a highly stressful environment for most autistic children – that is directly responsible for increasing the anxiety and the social expectations on autistic children. At the same time we are losing the safety and security of everything that has been familiar to us.

It is also now acknowledged that autistic traits may only become evident in teenagers or as adults – at each stage the external pressures on us are greater. I see this as a major breakthrough in acknowledging the impact our environment has on our ability to cope. Cynically, it could also be a way of justifying why so many of us weren’t identified as autistic sooner.

A really key change in the updated version is that Asperger’s and autism are no longer seen as two separately diagnosed conditions. They have been combined as Autism Spectrum Disorder (ASD).

For ADHDers, this updated version is even more of a change. The diagnosis of ADHD didn’t appear at all in the ICD-10. It was classed as Hyperkinetic Disorder (HKD). The onset of ADHD has also been updated to include a broader age range.

For those of you who really want to deep dive into the diagnostic criteria for autism, as stated by the ICD-11:

Click here for the ICD-11 entry for Autism Spectrum Disorder

and Click here for the ICD-11 entry for ADHD