114 Childhood Disintegrative Disorder (299.1)
Introduction
- This disorder is also known as Heller’s syndrome for the educator Theodore Heller who discovered the disorder in 1908 (Hoffman, 2009).
- However, the research on this disorder is limited and rare.
DSM-IV-TR criteria
- A. Apparently normal development for at least the first two years after birth as manifested by the presence of age- appropriate verbal and nonverbal communication, social relationship, play, and adaptive behavior.
- B. Clinically significant loss of previously acquired skills (before the age 10 years) in at least two of the following areas:
Expressive or receptive language, Social skills or adaptive behavior, Bowel or bladder control, Play, Motor skills. - C. Abnormalities of functioning in at least two of the following:
- Qualitative impairment in social interaction (e.g., impairment in nonverbal behaviors, failure to develop peer relationships, lack of social or emotional reciprocity).
- Qualitative impairments in communication (e.g., delay or lack of spoken language, inability to initiate or sustain a conversation, stereotyped and repetitive use of language, lack of varied make-believe play).
- Restricted, repetitive, and stereotyped patterns of behavior, interest and activities, including motor stereotypes and mannerisms.
- D. The disturbance is not better accounted for by another specific pervasive developmental disorder or by schizophrenia.
Associated features
A child’s development progresses around the same speed as his/her peers, but still he/she will develop their skills at their own rate. A diagnosis of CDD should be considered with either development stops or begins to decline. A parent might notice that their child is no longer toilet trained. The child may lose the ability to speak normally (expressive or receptive language) or walk. Parents may notice that their child does not play as he/she did before. With CDD, a child slowly begins to lose both previously learned skills and the ability to learn new ones. Control over bowel and bladder processes, and play skills are also known to be correlated with the development of CDD. This typically occurs after the first 2 years but prior to 10 years of age.
Children with childhood disintegrative disorder are usually linked with severe mental retardation. EEG abnormalities and seizure disorders increases with Childhood Disintegrative Disorder. CDD can also be associated with certain medical conditions such as metachromatic leukodystrophy, Schilder’s disease, tuberous sclerosis, and nuerolipidoses (Hoffman, 2009).
Symptoms of CDD are more commonly diagnosed between 3 – 5 years of age. However, symptoms can onset rapidly within days or weeks or they can onset gradually over weeks to even months (Hoffman, 2009).
This disorder is sometimes misdiagnosed as autism. Autism is by far the more common of the two and is slightly different. The symptoms of CDD occur more rapidly. The skills are lost in shorter time period. Autism