While many developmental disorders are now categorized as autism spectrum disorders, childhood disintegrative disorder (CDD) has only recently been officially recognized by the medical establishment. CDD follows a different pattern of onset from autism spectrum disorders, but it is no less detrimental to the psychological and social well-being of the children who suffer from it. In the article below, we’ll discuss the finer points of the disorder and its history in order to provide a deeper understanding of how it develops and is treated.
An Early Discovery
Doctor Theodor Heller first discovered CDD in 1908, many years before the first diagnosis of autism. Hence, it is also known as Heller Syndrome. While today it is considered a subset of an autism spectrum disorder, its delayed onset precluded its recognition for almost a century. As a rule, many autism spectrum disorders present with delayed or entirely absent developmental features—social skills, receptive language skills, play with peers, motor skills, and even bowel or bladder control may be hampered or entirely absent at the expected age when they typically develop.
Childhood disintegrative disorder is so named because those afflicted with it do develop in a normal capacity for the first several years of life. However, at age three or four, they suddenly lose the acquired skills. Dr. Heller codified the disorder after treating six children, originally calling the extreme developmental regression ‘dementia infantilis’ to describe the loss of basic skills.
In 1994, CDD was finally officially recognized and added to the DSM-IV, which is a comprehensive work compiled by the American Psychiatric Association. It is categorized as a part of the current autism spectrum because it shares a similar profile of debilitating affects, which impact the developmental faculties of children.
However, even in an unofficial capacity, physicians and psychiatrists recognized the symptom profile. Over several decades, it was called both disintegrative psychosis of childhood (DPC) or childhood-onset pervasive developmental disorder (COPDD). Rather than seeking to define the differences that characterize CDD from other types of autism, diagnosticians labeled it as late childhood onset autism.
Signs and Symptoms
Because children with this disorder tend to develop at a normal rate for the first three to four years of life, it’s important that physicians know the signs of its onset. The first indication many doctors have is when a parent brings their child to them for observation. Diagnostic criteria for CDD require that a child exhibit abnormal or regressive behavior in at least two major areas, such as:
• Ability to maintain or initiate conversations with others
• Ability to develop peer relations and demonstrate social and emotional reciprocity
• Natural motion and behaviors consonant with healthy physical/spatial awareness
Children with CDD will often be incapable of extended dialogue with others, but may exhibit a marked reticence to initiate communication, even in comfortable surroundings. They may also exhibit a regression in social skills already acquired, becoming incapable of rendering emotional response or building a social relationship. Their movements may become repetitive, including bobbing of the head or other stereotypical, repetitive motions that do not correspond to any other condition or mental disorder.
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The medical establishment is seeking to enhance and broaden its understanding of autistic disorders in order to render therapy and aid to those who suffer from them. As well, greater understanding of the physiological underpinnings and genetic seeds of such developmental disorders may one day lead to an effective treatment or preventative therapy. While it is a recognizably different type of autism spectrum disorder, childhood disintegrative disorder impacts the lives of children, parents, and caregivers in similar ways.