- F94
- Childhood & Adolescent Disorders
Disorders of Social Functioning with Onset in Childhood (F94)
DSM-5-TR: Reactive Attachment Disorder / Disinhibited Social Engagement Disorder / Selective Mutism
ICD-10-AM and DSM-5-TR may classify conditions differently. Refer to APA and WHO for complete diagnostic criteria.
Key Facts
- ICD-10 RangeF90-F98
- Subcodes5 subcodes
- Australian PrevalenceSelective mutism affects approximately 0.7% of children. Attachment disorders are particularly relevant in Australian child protection and out-of-home care contexts.
- Global PrevalenceSelective mutism prevalence approximately 0.5-0.8%. Attachment disorder prevalence varies widely based on population studied.
- Duration RequirementSelective mutism: at least 1 month (not limited to first month of school). Attachment disorders: present from first 5 years of life.
Overview
A heterogeneous group of disorders that have in common abnormalities in social functioning that begin during the developmental period but are not primarily characterised by an apparently constitutional social incapacity or deficit that pervades all areas of functioning.
Diagnostic Criteria (ICD-10)
Core Features
- Abnormalities in social functioning beginning during the developmental period
- Not primarily characterised by constitutional social incapacity
- Selective mutism: emotionally determined selectivity in speaking
- Attachment disorders: abnormal social relationship patterns associated with environmental deprivation
Duration Selective mutism: at least 1 month (not limited to first month of school). Attachment disorders: present from first 5 years of life.
Exclusion Criteria
- Pervasive developmental disorders (use F84)
- Schizophrenia (use F20)
- Normal developmental shyness or stranger anxiety
ICD-10-AM Subcodes
| Code | Name | Description |
|---|---|---|
| F94.0 | Elective mutism (selective mutism) | Marked, emotionally determined selectivity in speaking — the child speaks in some situations but not others, often linked to social anxiety. |
| F94.1 | Reactive attachment disorder of childhood | Abnormal patterns of social relationships beginning in the first five years of life, associated with marked environmental deprivation or abuse. |
| F94.2 | Disinhibited attachment disorder of childhood | Diffuse, non-selectively focused attachment behaviour, attention-seeking, and indiscriminate friendliness, associated with institutional rearing. |
| F94.8 | Other childhood disorders of social functioning | Other specified disorders of social functioning. |
| F94.9 | Childhood disorder of social functioning, unspecified | Childhood social functioning disorder where the specific type is unspecified. |
Classification Boundaries
Includes
- Selective mutism
- Reactive attachment disorder
- Disinhibited attachment disorder
Excludes1 (coded elsewhere)
- Pervasive developmental disorders (F84)
- Schizophrenia (F20)
- Asperger syndrome (F84.5)
Australian Clinical Context
These disorders are particularly relevant in Australian child protection and out-of-home care contexts. Attachment-informed interventions are increasingly used in Australian child welfare services. The Australian Institute of Family Studies provides guidance on trauma-informed care for children in care.
Medicare (MBS) Pathways
Better Access to Mental Health Care
The primary Medicare pathway for mental health treatment in Australia. Requires a GP Mental Health Treatment Plan (MHTP) referral. Available for any clinically diagnosed mental disorder.
10 individual + 10 group sessions per calendar year
| Provider Type | MBS Items | Session Type |
|---|---|---|
| Clinical Psychologist | 80000–80025 | Psychological therapy (higher rebate) |
| Registered Psychologist | 80100–80123 | Focused psychological strategies |
| Occupational Therapist | 80125–80145 | Focused psychological strategies |
| Social Worker | 80150–80175 | Focused psychological strategies |
| Psychiatrist | 291, 296–299, 300–308 | Psychiatric consultation |
GP referral items: 2700, 2701, 2715, 2717
Eligibility: Any clinically diagnosed mental disorder as defined by WHO ICD-10 Chapter V. Requires a GP or psychiatrist referral.
Exclusions:
- Intellectual disability (use Complex Neurodevelopmental Disorder pathway or specialist referral)
- Dementia and organic mental disorders (use specialist referral pathway)
- Tobacco use disorder
Grounded Scribe suggests the right MBS item codes from your recording so you can claim accurately without re-keying.
Reference information sourced from MBS Online (mbsonline.gov.au). Item availability, rebates, and eligibility criteria may change. This is not billing advice — always verify current items before claiming. Last verified: April 2026.
Clinical Documentation Notes
DSM-5-TR separates Reactive Attachment Disorder (F94.1) and Disinhibited Social Engagement Disorder (F94.2) as distinct trauma-related diagnoses. Selective Mutism (F94.0) is classified under Anxiety Disorders in DSM-5-TR. Always document the environmental context (deprivation, abuse, institutional care) for attachment disorders.
Related Diagnostic Codes
ICD-10-AM diagnostic codes commonly associated with the Disorders of Social Functioning with Onset in Childhood (F94).
Frequently Asked Questions
How do attachment disorders differ from autism?
Attachment disorders (F94.1, F94.2) arise from inadequate caregiving environments and can improve with stable, responsive care. Autism spectrum disorders (F84) are neurodevelopmental conditions present from birth regardless of caregiving quality. Both can involve difficulties in social interaction but for different reasons.
References
- World Health Organization. ICD-10-AM.
- American Psychiatric Association. DSM-5-TR. 2022.
- Australian Institute of Family Studies. Trauma-informed care in child welfare.
This tool calculates scores based on published guidelines for professional reference. It does not provide clinical diagnoses. Scores are provided as reference information only and should be interpreted by a qualified practitioner in the context of a comprehensive assessment.
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