Diagnostic criteria for
299.10 Childhood Disintegrative Disorder
( cautionary statement )
A. Apparently normal development for at least the first 2 years after birth as manifested by the presence of age-appropriate verbal and nonverbal communication, social relationships, play, and adaptive behavior.
B. Clinically significant loss of previously acquired skills (before age 10 years) in at least two of the following areas:
(1) expressive or receptive language
(2) social skills or adaptive behavior
(3) bowel or bladder control
(4) play
(5) motor skills
C. Abnormalities of functioning in at least two of the following areas:
(1) qualitative impairment in social interaction (e.g., impairment in nonverbal behaviors, failure to develop peer relationships, lack of social or emotional reciprocity)
(2) qualitative impairments in communication (e.g., delay or lack of spoken language, inability to initiate or sustain a conversation, stereotyped and repetitive use of language, lack of varied make-believe play)
(3) restricted, repetitive, and stereotyped patterns of behavior, interests, and activities, including motor stereotypies and mannerisms
D. The disturbance is not better accounted for by another specific Pervasive Developmental Disorder or by Schizophrenia .
Associated Features:
Childhood Disintegrative Disorder is usually associated with severe mental retardation . But this may not always be present. There also appears be an increased frequency of EEG abnormalities and seizure disorder.
Differential Diagnosis:
Some disorders have similar or even the same symptoms. The clinician, therefore, in his/her diagnostic attempt has to differentiate against the following disorders which need to be ruled out to establish a precise diagnosis.
Autism
Rett's Disorder
Asperger's Disorder
Schizophrenia
Selective Mutism
Expressive Language Disorder
Mixed Receptive-Expressive Language Disorder
Mental Retardation
Stereotypic Movement Habit Disorder
Cause:
The etiology is unknown but several lines of evidence suggest that it arises as a result of some form of central nervous system pathology. More boys than girls appear to be affected. Childhood disintegrative disorder is perhaps 10 times less common than more strictly defined autism.
Treatment:
Treatment is the same for autistic disorder ( autism ) because of the similarity in the two disorders. Treatment is can be very difficult and prolonged. Parents, teachers, and therapists work together in coordinated efforts to encourage social adjustment and speech development in the child. Positive reinforcement techniques for appropriate behavior or language responses have been successful in promoting skills. Family members may also need counseling because they often feel guilty or inadequate.
Counseling and Psychotherapy:
Intensive behavior modification programmes such as; Behavior Analysis and Applied Behavior Analysis (ABA).
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