Introduction and objective:
The transition from ICD-10 to ICD-11 reshapes the classification of paediatric neurodevelopmental disorders toward dimensional and function-oriented assessment. This review examines changes concerning Attention-Deficit/Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD), and Developmental Learning Disorders (DevLD), focusing on implementation and regional inequalities in access to care.

Review methods:
The critical narrative review examine ICD-11 revisions and their clinical, organizational, and health-system implications. Findings informed the proposed Integrated ICD-11 Neurodevelopmental Clinical Model (ICD-11-INCM), a conceptual framework requiring empirical validation.

Brief description of the state of knowledge:
ICD-11 emphasizes functional impairment, co-occurring conditions, and individualized support needs. Implementation depends on professional competencies, multidisciplinary resources, organizational readiness, and healthcare capacity. In under-resourced rural and community settings, staff shortages and inadequate referral pathways may impede access and increase pressure on primary care. Greater diagnostic flexibility may change referral patterns and increase demand for specialist assessment. Digital health and Medicine 4.0 are potential secondary supports, but as yet are unestablished solutions.

Summary:
Equitable implementation of ICD-11 requires coordinated clinical, organizational, and health-system measures that address regional inequalities and resource constraints. The proposed ICD-11-INCM model may inform implementation planning; however, the conclusions should be interpreted in light of the narrative review design, lack of empirical validation, and the heterogeneity of healthcare systems.