{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T16:23:59Z","timestamp":1790267039234,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,2,16]],"date-time":"2022-02-16T00:00:00Z","timestamp":1644969600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J intellect Disabil Res"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The World Health Organization (WHO) has approved the 11th Revision of the International Classification of Diseases (ICD\u201011). A version of the ICD\u201011 for Mental, Behavioural and Neurodevelopmental Disorders for use in clinical settings, called the Clinical Descriptions and Diagnostic Requirements (CDDR), has also been developed. The CDDR includes behavioural indicators (BIs) for assessing the severity of disorders of intellectual development (DID) as part of the section on neurodevelopmental disorders. Reliable and valid diagnostic assessment measures are needed to improve identification and treatment of individuals with DID. Although appropriately normed, standardised intellectual and adaptive behaviour assessments are considered the optimal assessment approach in this area, they are unavailable in many parts of the world. This field study tested the BIs internationally to assess the inter\u2010rater reliability, concurrent validity, and clinical utility of the BIs for the assessment of DID.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This international study recruited a total of 206 children and adolescents (5\u201318\u00a0years old) with a suspected or established diagnosis of DID from four sites across three countries [Sri\u2010Lanka (<jats:italic>n<\/jats:italic>\u00a0=\u00a057), Italy (<jats:italic>n<\/jats:italic>\u00a0=\u00a060) and two sites in India (<jats:italic>n<\/jats:italic>\u00a0=\u00a089)]. Two clinicians assessed each participant using the BIs with one conducting the clinical interview and the other observing. Diagnostic formulations using the BIs and clinical utility ratings were collected and entered independently after each assessment. At a follow\u2010up appointment, standardised measures (Leiter\u20103, Vineland Adaptive Behaviour Scales\u2010II) were used to assess intellectual and adaptive abilities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The BIs had excellent inter\u2010rater reliability (intra\u2010class correlations ranging from 0.91 to 0.97) and good to excellent concurrent validity (intra\u2010class correlations ranging from 0.66 to 0.82) across sites. Compared to standardised measures, the BIs had more diagnostic overlap between intellectual and adaptive functioning. The BIs were rated as quick and easy to use and applicable across severities; clear and understandable with adequate to too much level of detail and specificity to describe DID; and useful for treatment selection, prognosis assessments, communication with other health care professionals, and education efforts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The inclusion of newly developed BIs within the CDDR for ICD\u201011 Neurodevelopmental Disorders must be supported by information on their reliability, validity, and clinical utility prior to their widespread adoption for international use. BIs were found to have excellent inter\u2010rater reliability, good to excellent concurrent validity, and good clinical utility. This supports use of the BIs within the ICD\u201011 CDDR to assist with the accurate identification of individuals with DID, particularly in settings where specialised services are unavailable.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jir.12924","type":"journal-article","created":{"date-parts":[[2022,2,16]],"date-time":"2022-02-16T13:15:34Z","timestamp":1645017334000},"page":"376-391","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["An international field study of the ICD\u201011 behavioural indicators for disorders of intellectual development"],"prefix":"10.1111","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6772-364X","authenticated-orcid":false,"given":"K. 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T.","family":"Kishore","sequence":"additional","affiliation":[{"name":"Department of Clinical Psychology National Institute of Mental Health and Neuro Sciences  Bengaluru India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"de Jesus Mari","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Universidade Federal de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Ginige","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Peradeniya  Kandy Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Buono","sequence":"additional","affiliation":[{"name":"Department of Psychology Oasi Research Institute\u2010IRCCS  Troina Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Recupero","sequence":"additional","affiliation":[{"name":"Department of Psychology Oasi Research Institute\u2010IRCCS  Troina Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Zingale","sequence":"additional","affiliation":[{"name":"Department of Psychology Oasi Research Institute\u2010IRCCS  Troina Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Zagaria","sequence":"additional","affiliation":[{"name":"Department of Psychology Oasi Research Institute\u2010IRCCS  Troina Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Cooray","sequence":"additional","affiliation":[{"name":"Faculty of Psychiatry of Learning Disability Royal College of Psychiatrists  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Roy","sequence":"additional","affiliation":[{"name":"Coventry and Warwickshire Partnership NHS Trust  Birmingham UK"},{"name":"Centre for Educational Development, Appraisal and Research University of Warwick  Coventry UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. 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