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Childhood Disintegrative Disorder

Date Last Revised: 
November 14, 2013
Date Published: 
April 2, 2007

The rarest of the autism spectrum disorders, Childhood Disintegrative Disorder,1 was removed from the psychiatric diagnosis manual as a separate diagnosis in 2013. People with CDD are included under the diagnosis of autism spectrum disorder. CDD was considered to be a later-developing form of autism. 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, lost much that had been gained: social engagement, words and sentences, play skills, sometimes even bowel or bladder control.2

By the time this regression was over, the child looked very much the same as a child with autism and some degree of intellectual disability. It was often the child’s history alone that could tell clinicians which diagnosis should be made. Whereas a child with autism usually would have had definite difficulties before 30 months of age, a child with CDD would 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

The diagnostic criteria previously appeared in the Diagnostic and Statistical Manual - IV (DSM)4 and the International Classification of Diseases -105, but it was removed from the fifth edtion of the DSM published in 2013.

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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.