ICD-10 recommends that multiaxial assessment be carried out for children and adolescents, while DSM-IV suggests it for all ages. In both systems Axis 1 is used for psychiatric disorders which have been discussed above. The last three axes in both systems cover general medical conditions, psychosocial problems, and level of social functioning, respectively; these topics will be alluded to below under aetiology. In the middle are two axes in ICD-10, which cover specific (Axis II) and general (Axis III) mental retardation (learning disability) respectively, and one in DSM-IV (Axis II), which covers personality disorders and general mental retardation.
It is essential to assess both specific and general mental retardation in individuals with conduct problems. Fully a third of children with conduct disorder also have specific reading retardation,(8) defined as having a reading level of two standard deviations below that predicted by the person's IQ. While this may in part be due to a lack of adequate schooling, there is good evidence that the cognitive deficits often precede the behavioural problems. General mental retardation is often missed in children with conduct disorder unless IQ testing is carried out. The rate of conduct disorder rises several-fold as IQ falls below 50. (9)
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When parents help their children learn to read, they help open the door to a new world. As a parent, you can begin an endless learning chain: You read to your children, they develop a love of stories and poems, they want to read on their own, they practice reading, and finally they read for their own information or pleasure. They become readers, and their world is forever expanded and enriched.