Childhood Disintegrative Disorder

Date First Published: April 2, 2007

The rarest of the autism spectrum disorders is CDD: Childhood Disintegrative Disorder. ¹   It may also be the most cruel. After an average of 3 to 4 years of normal development, complete with warm social connection and blossoming language, a child, whether slowly or abruptly, loses all that had been gained: social engagement, words and sentences, play skills, sometimes even bowel or bladder control. ² 

By the time this regression is over, the child may look very much the same as a child with autism and some degree of mental retardation. It is often the child’s history alone that can tell clinicians which diagnosis should be made. Whereas a child with autism usually will have had definite difficulties before 30 months of age, a child with CDD will have developed normally through that period and into the 3-4, and even up to 9, year range before losing skills. States one group of researchers:

“Given that the child typically has been speaking in full sentences, often quite well, the development of either total mutism or marked deterioration in verbal language is very striking and frequent in CDD… Deterioration of self-help skills, notably in toileting skills, is striking and in contrast to autism where such skills are often acquired somewhat late but are not typically dramatically lost.”  ³

Information on CDD is rather limited, for there are few cases to study. Nevertheless, official diagnostic criteria have been developed, and appear in the Diagnostic and Statistical Manual - IV ⁴ and the International Classification of Diseases -10. ⁵  Like all such criteria, these will likely change over time as we learn more about this disorder.

References

1. Fombonne, E. (2002). Prevalence of childhood disintegrative disorder. Autism, 6(2), 149-157.  Abstract
2. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., rev.). Washington DC: Author. (pg. 79).
3. Volkmar, F., Koenig, K., & State, M. (2005). Childhood disintegrative disorder. In F. Volkmar et al. (Eds.), Handbook of Autism and Pervasive Developmental Disorders (pp.70-87). Hoboken, NJ: John Wiley & Sons.
4. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., rev.). Washington DC: Author.
5. World Health Organization. (1992). International classification of diseases: Diagnostic criteria for research (10th edition). Geneva, Switzerland: Author.