37.87.303 YOUTH MENTAL HEALTH SERVICES, SERIOUS EMOTIONAL DISTURBANCE CRITERIA
(1) "Serious emotional disturbance (SED)" means with respect to a youth from the age of six through 17 years of age that the youth meets the requirements of (1)(a) and (1)(b).
(a) The youth has been determined by a licensed mental health professional as having a mental disorder with a primary diagnosis falling within one of the following DSM-IV (or successor) classifications when applied to the youth's current presentation (current means within the past 12 calendar months unless otherwise specified in the DSM-IV) and the diagnosis has a severity specifier of moderate or severe:
(i) childhood schizophrenia (295.10, 295.20, 295.30, 295.60, 295.90);
(ii) oppositional defiant disorder (313.81);
(iii) autistic disorder (299.00);
(iv) pervasive developmental disorder not otherwise specified (299.80);
(v) Asperger's disorder (299.80);
(vi) separation anxiety disorder (309.21);
(vii) reactive attachment disorder of infancy or early childhood (313.89);
(viii) schizo affective disorder (295.70);
(ix) mood disorders (296.0x, 296.2x, 296.3x, 296.4x, 296.5x, 296.6x, 296.7, 296.80, 296.89);
(x) obsessive-compulsive disorder (300.3);
(xi) dysthymic disorder (300.4);
(xii) cyclothymic disorder (301.13);
(xiii) generalized anxiety disorder (overanxious disorder) (300.02);
(xiv) posttraumatic stress disorder (chronic) (309.81);
(xv) dissociative identity disorder (300.14);
(xvi) sexual and gender identity disorder (302.2, 302.3, 302.4, 302.6, 302.82, 302.83, 302.84, 302.85, 302.89);
(xvii) anorexia nervosa (severe) (307.1);
(xviii) bulimia nervosa (severe) (307.51);
(xix) intermittent explosive disorder (312.34); and
(xx) attention deficit/hyperactivity disorder (314.00, 314.01, 314.9) when accompanied by at least one of the diagnoses listed above.
(b) As a result of the youth's diagnosis determined in (1)(a) and for a period of at least six months, or for a predictable period over six months the youth consistently and persistently demonstrates behavioral abnormality in two or more spheres, to a significant degree, well outside normative developmental expectations, that cannot be attributed to intellectual, sensory, or health factors:
(i) has failed to establish or maintain developmentally and culturally appropriate relationships with adult care givers or authority figures;
(ii) has failed to demonstrate or maintain developmentally and culturally appropriate peer relationships;
(iii) has failed to demonstrate a developmentally appropriate range and expression of emotion or mood;
(iv) has displayed disruptive behavior sufficient to lead to isolation in or from school, home, therapeutic, or recreation settings;
(v) has displayed behavior that is seriously detrimental to the youth's growth, development, safety, or welfare, or to the safety or welfare of others; or
(vi) has displayed behavior resulting in substantial documented disruption to the family including, but not limited to, adverse impact on the ability of family members to secure or maintain gainful employment.
(c) SED with respect to a youth under six years of age means the youth exhibits a severe behavioral abnormality that cannot be attributed to intellectual, sensory, or health factors and that results in substantial impairment in functioning for a period of at least six months and obviously predictable to continue for a period of at least six months, as manifested by one or more of the following:
(i) atypical, disruptive, or dangerous behavior which is aggressive or self-injurious;
(ii) atypical emotional responses which interfere with the child's functioning, such as an inability to communicate emotional needs and to tolerate normal frustrations;
(iii) atypical thinking patterns which, considering age and developmental expectations, are bizarre, violent, or hypersexual;
(iv) lack of positive interests in adults and peers or a failure to initiate or respond to most social interaction;
(v) indiscriminate sociability (e.g., excessive familiarity with strangers) that results in a risk of personal safety of the child; or
(vi) inappropriate and extreme fearfulness or other distress which does not respond to comfort by care givers.
(d) A youth must be reassessed annually by a licensed mental health professional as to whether or not they continue to meet the criteria for having a serious emotional disturbance. For the initial or for an annual reassessment, the clinical assessment must document how the youth meets the criteria for having a serious emotional disturbance.
(2) The department adopts and incorporates by reference the ICD-9-CM diagnosis codes with meanings found in the Ingenix ICD-9-CM Code Book (2006), published by Ingenix. The department also adopts and incorporates by reference the DSM-IV diagnosis codes with meanings found in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Text Revision (2000), published by the American Psychiatric Association of Washington, D.C. These systems of coding provide the codes and meanings of the diagnostic terms commonly used by treating professionals and are incorporated in order to provide common references for purposes of the provision of services through the Mental Health Services Plan. Copies of applicable portions of the ICD-9-CM and the DSM-IV may be obtained from the Department of Public Health and Human Services, Health Resource Division, Children's Mental Health Bureau, 1400 Broadway, P.O. Box 202951, Helena, MT 59620-2951.
History: 53-2-201, 53-6-113, 53-21-703, MCA; IMP, 53-1-601, 53-1-602, 53-1-603, 53-2-201, 53-21-201, 53-21-202, 53-21-701, 53-21-702, MCA; NEW, 2008 MAR p. 1988, Eff. 9/12/08.