Childhood Disintegrative Disorder

Childhood disintegrative disorder is a condition in which children develop normally until age 3 or 4, but then demonstrate a severe loss of social, communication and other skills.

Doctors sometimes confuse this disorder with late-onset autism. Both conditions involve normal development followed by significant loss of language, social, play and motor skills. Childhood disintegrative disorder and autism are among several disorders known as pervasive developmental disorders or autism spectrum disorders.

Autism typically occurs at an earlier age than childhood disintegrative disorder. There's also a more dramatic loss of skills with childhood disintegrative disorder and a greater likelihood of mental retardation. In addition, childhood disintegrative disorder is far less common than autism.

Treatment for childhood disintegrative disorder involves a combination of medications, behavior therapy and other approaches.
Symptoms

Children with childhood disintegrative disorder typically show the following signs and symptoms:

Normal development for at least the first two years of life
This includes normal development of age-appropriate verbal and nonverbal communication, social relationships, and motor, play and self-care skills.

Significant loss of previously acquired or learned skills
This loss occurs before age 10, in at least two of the following areas:
Ability to say words or sentences (expressive language)
Ability to understand verbal and nonverbal communication (receptive language)
Social skills and self-care skills (adaptive behavior)
Bowel and bladder control
Play skills
Motor skills (ability to voluntarily move the body in a purposeful way)

Lack of normal function or impairment
This lack or impairment occurs in at least two of the following areas:
Social interaction. This may include impairment in nonverbal behaviors, failure to develop peer relationships, and lack of social or emotional reciprocity — an inability to share, recognize, understand and respond to social cues and interactions or to feelings of others.
Communication. This may include delay or lack of spoken language, inability to initiate or sustain a conversation, stereotyped and repetitive use of language, and lack of varied imaginative or make-believe play.
Repetitive and stereotyped patterns of behavior, interests and activities. This may include hand flapping, rocking, spinning (motor stereotypes and mannerisms); development of specific routines and rituals; difficulty with transitions or changes in routine; maintaining a fixed posture or body position (catatonia); and preoccupation with certain objects or activities.

Loss of developmental milestones may occur abruptly over the course of days to weeks or gradually over an extended period of time.