Childhood disintegrative disorder

Childhood disintegrative disorder
Other namesHeller syndrome,
disintegrative psychosis,
dementia infantilis
SpecialtyPsychiatry, pediatrics
Usual onset3-4 years of age
Differential diagnosisregressive autism, Rett syndrome, lead poisoning, mercury poisoning, HIV infection, brain tumor, certain seizure disorders (e.g. Landau-Kleffner syndrome), and some neurodegenerative diseases (e.g.variant Creutzfeldt-Jakob disease)[1][2]

Childhood disintegrative disorder (CDD), also known as Heller's syndrome and disintegrative psychosis, is a rare condition characterized by late onset of developmental delays—or severe and sudden reversals—in language (receptive and expressive), social engagement, bowel and bladder, play and motor skills.[3][4] Researchers have not been successful in finding a cause for the disorder.[3][4] CDD has some similarities to autism and is sometimes considered a low-functioning form of it.[5][6][4] In May 2013, CDD, along with other sub-types of PDD (Asperger's syndrome, Classic autism, and PDD-NOS), was fused into a single diagnostic term called "autism spectrum disorder" under the new DSM-5 manual.[7]

CDD was originally described by Austrian educator Theodor Heller (1869–1938) in 1908, 35 years before Leo Kanner and Hans Asperger described autism. Heller had previously used the name dementia infantilis for the syndrome.[8]

An apparent period of fairly normal development is often noted before a regression in skills or a series of regressions in skills.[9][4] The age at which this regression can occur varies;[10] after three years of normal development is typical.[11] The regression, known as a prodrome, can be so dramatic that the child may be aware of it, and may in its beginning even ask, vocally, what is happening to them.[4][12] Some children describe or appear to be reacting to hallucinations, but the most obvious symptom is that skills apparently attained are lost.[4]

Many children are already somewhat delayed when the disorder becomes apparent, but these delays are not always obvious in young children.[4] This has been described by many writers as a devastating condition, affecting both the family and the individual's future.[4] As is the case with all pervasive developmental disorder categories, there is considerable controversy about the right treatment for CDD.[4]

  1. ^ Dr.Mary Lowthe (25 January 2021). "Childhood Disintegrative Disorder".
  2. ^ Hiroshi Kurita (2011). Textbook of Autism Spectrum Disorders. American Psychiatric Pub. p. 102. ISBN 9781585623419.
  3. ^ a b Charan, Sri Hari (January–April 2012). "Childhood disintegrative disorder". Journal of Pediatric Neurosciences. 7 (1): 55–57. doi:10.4103/1817-1745.97627. PMC 3401658. PMID 22837782. Childhood disintegrative disorder (CDD), also known as Heller's syndrome and disintegrative psychosis, is a rare condition characterized by late onset (>3 years of age) of developmental delays in language, social function, and motor skills. [...] The cause of childhood disintegrative disorder is unknown.
  4. ^ a b c d e f g h i "Definitions for childhood disintegrative disorder". Definitions.net. STANDS4. Archived from the original on 25 September 2022. Retrieved 25 September 2022. Childhood disintegrative disorder, also known as Heller's syndrome and disintegrative psychosis, is a rare condition characterized by late onset of developmental delays in language, social function, and motor skills. Researchers have not been successful in finding a cause for the disorder. CDD has some similarity to autism, and is sometimes considered a low-functioning form of it, but an apparent period of fairly normal development is often noted before a regression in skills or a series of regressions in skills. Many children are already somewhat delayed when the disorder becomes apparent, but these delays are not always obvious in young children. [...] The regression can be so dramatic, that the child may be aware of it, and in its beginning he may even ask, vocally, what is happening to him. Some children describe or appear to be reacting to hallucinations, but the most obvious symptom is that skills apparently attained are lost. This has been described by many writers as a devastating condition, affecting both the family and the individual's future. As is the case with all pervasive developmental disorder categories, there is considerable controversy about the right treatment for CDD.
  5. ^ McPartland, James; Volkmar, Fred R. (2012). "Autism and Related Disorders". Neurobiology of Psychiatric Disorders. Handbook of Clinical Neurology. Vol. 106. pp. 407–18. doi:10.1016/B978-0-444-52002-9.00023-1. ISBN 978-0-444-52002-9. ISSN 0072-9752. PMC 3848246. PMID 22608634.
  6. ^ Venkat A, Jauch E, Russell WS, Crist CR, Farrell R (August 2012). "Care of the patient with an autism by the general physician". Postgrad Med J. 88 (1042): 472–81. doi:10.1136/postgradmedj-2011-130727. PMID 22427366. S2CID 12331005.
  7. ^ "Childhood Disintegrative Disorder (Heller's Syndrome)". 25 January 2021.
  8. ^ Mouridsen SE (June 2003). "Childhood disintegrative disorder". Brain Dev. 25 (4): 225–8. doi:10.1016/s0387-7604(02)00228-0. PMID 12767450. S2CID 25420772.
  9. ^ Rogers SJ (2004). "Developmental regression in autism spectrum disorders". Ment Retard Dev Disabil Res Rev. 10 (2): 139–43. doi:10.1002/mrdd.20027. PMID 15362172.
  10. ^ Hendry CN (January 2000). "Childhood disintegrative disorder: should it be considered a distinct diagnosis?". Clin Psychol Rev. 20 (1): 77–90. doi:10.1016/S0272-7358(98)00094-4. PMID 10660829.
  11. ^ Malhotra S, Gupta N (December 1999). "Childhood disintegrative disorder". J Autism Dev Disord. 29 (6): 491–8. doi:10.1023/A:1022247903401. PMID 10638461. S2CID 189899310.
  12. ^ Dobbs, David (6 July 2016). "The most terrifying childhood condition you've never heard of". Spectrum. Simons Foundation Autism Research Initiative. Archived from the original on 25 September 2022. Retrieved 25 September 2022. During this anxiety-ridden prologue, known as a 'prodrome,' a child will often seem keenly aware that something is wrong.