How different is early-onset childhood disintegrative disorder from autistic disorder with speech loss?

Hiroshi Kurita, Kanna Inoue

Department of Child Psychiatry, Nerima Welfare Center for Handicapped Persons, Tokyo, Japan.
Department of Child Psychiatry, Zenkoku Ryoiku Sodan Center, Tokyo, Japan.

DOI: 10.4236/ojpsych.2013.32A007                

Abstract

To examine the difference between early-onset (< age 3) childhood disintegrative disorder (CDD) and autistic disorder with speech loss (ADSL), 8 children with early-onset CDD (mean age = 7.6 years, SD = 3.8; 6 males) were compared with 92 age and gender-ratio comparable children with ADSL (mean age = 6.8 years, SD = 4.1; 70 males) on 24 variables not directly related to the key features of CDD (regression after normal development for at least the first 2 years after birth). Compared with the ADSL group, the early-onset CDD group had a tendency to have a higher rate of a psychosocial event before speech loss (SL) (early-onset CDD, 75.0% vs ADSL, 37.0%, p = 0.057; effect size (phi) = 0.211, p < 0.05); a significantly higher rate of fearfulness during SL (62.5% vs 4.3%, p = 0.000; phi = 0.551, p < 0.05); and a tendency to have a higher rate of epilepsy (25.0% vs 3.3%, p = 0.050; phi = 0.271, p < 0.05), a tendency to have a lower rate of the Childhood Autism Rating Scale-Tokyo Version (CARS-TV) total score ≥ 30 (75.0% vs 95.7%, p = 0.072; phi = 0.236, p < 0.05), and a significantly lower rate of CARS-TV item 2 (imitation) score ≥ 2 (50.0% vs 82.6%, p = 0.049; phi = 0.221, p < 0.05) on the first visit. The two groups did not exhibit any significant difference in the other 19 variables. The findings of no significant difference in the great majority and a significant difference in the small minority of the 24 variables between the two groups support integrating CDD into regressive autism spectrum disorder and studying CDD as its prototypical form.

Keywords

Autistic Disorder; Autism Spectrum Disorder (ASD); Childhood Disintegrative Disorder; Diagnosis; Regression

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Heller, T. (1908) über Dementia infantilis: Verblodungsprozess im Kindesalter. Zeitschrift für die Erforschung und Behandlung des Jugendlichen Schwachsinns, 2, 17-28.
[2]	American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders. 4th Edition, American Psychiatric Association, Washington DC.
[3]	World Health Organization (1993) The ICD-10 classification of mental and behavioural disorders: Diagnostic criteria for research. World Health Organization, Geneva.
[4]	Fombonne, E. (2009) Epidemiology of pervasive developmental disorders. Pediatric Research, 65, 591-598. doi:10.1203/PDR.0b013e31819e7203
[5]	Malhotra, S. and Gupta, N. (2002) Childhood disintegrative disorder: Re-examination of the current concept. European Child & Adolescent Psychiatry, 11, 108-114. doi:10.1007/s00787-002-0270-6
[6]	Volkmar, F.R. and Cohen, D.J. (1989) Disintegrative disorder or “late onset” autism. Journal of Child Psychology and Psychiatry, 30, 717-724. doi:10.1111/j.1469-7610.1989.tb00784.x
[7]	Volkmar, F.R. and Rutter, M. (1995) Childhood disintegrative disorder: Results of the DSM-IV autism field trial. Journal of the American Academy of Child & Adolescent Psychiatry, 34, 1092-1095. doi:10.1097/00004583-199508000-00020
[8]	Kurita, H., Osada, H. and Miyake, Y. (2004) External validity of childhood disintegrative disorder in comparison with autistic disorder. Journal of Autism and Developmental Disorders, 34, 355-362. doi:10.1023/B:JADD.0000029556.25869.71
[9]	Kurita, H., Koyama, T., Setoya, Y., Shimizu, K. and Osada, H. (2004) Validity of childhood disintegrative disorder apart from autistic disorder with speech loss. European Child & Adolescent Psychiatry, 13, 221-226. doi:10.1007/s00787-004-0397-8
[10]	American Psychiatric Association (2012) DSM-5 autism spectrum disorder news release 1-20-12. http://www.dsm5.org
[11]	Jaydeokar, S., Bal, G. and Shah, N. (1997) Childhood disintegrative disorder: A case report. Indian Journal of Psychiatry, 39, 85.
[12]	Burd, L., Ivey, M., Barth, A. and Kerbeshian, J. (1998) Two males with childhood disintegrative disorder: A prospective 14-year outcome study. Developmental Medicine & Child Neurology, 40, 702-707. doi:10.1111/j.1469-8749.1998.tb12331.x
[13]	Zwaigenbaum, L., Szatmari, P., Mahoney, W., et al. (2000) Case report: High functioning autism and childhood disintegrative disorder in half brothers. Journal of Autism and Developmental Disorders, 30, 121-126. doi:10.1023/A:1005455505211
[14]	Agarwal, V., Sitholey, P. and Mohan, I. (2005) Childhood disintegrative disorder, an atypical presentation: A case report. Journal of Autism and Developmental Disorders, 35, 873-874. doi:10.1007/s10803-005-0033-6
[15]	Volkmar, F.R., Koenig, K. and State, M. (2005) Case report. In: Volkmar, F.R., Paul, R., Klin, A. and Cohen, D. Eds., Handbook of Autism and Pervasive Developmental Disorders, 3rd Edition, John Wiley & Sons Inc., Hoboken, 83-84.
[16]	Palomo, R., Thompson, M., Colombi, C., et al. (2008) A case study of childhood disintegrative disorder using systematic analysis of family home movies. Journal of Autism and Developmental Disorders, 38, 1853-1858. doi:10.1007/s10803-008-0579-1
[17]	Mordekar, S.R., Prendergast, M., Chattopadhyay, A.K. and Baxter, P.S. (2009) Corticosteroid treatment of behaviour, language and motor regression in childhood disintegrative disorder. European Journal of Paediatric Neurology, 13, 367-369. doi:10.1016/j.ejpn.2008.06.001
[18]	Homan, K.J., Mellon, M.W., Houlihan, D. and Katusic, M.Z. (2011) Brief report: Childhood disintegrative disorder: A brief examination of eight case studies. Journal of Autism and Developmental Disorders, 41, 497-504. doi:10.1007/s10803-010-1063-2
[19]	Charan, S.H. (2012) Childhood disintegrative disorder. Journal of Pediatric Neurosciences, 7, 55-57. doi:10.4103/1817-1745.97627
[20]	Malhotra, S., Subodh, B. N., Parakh, P. and Lahariya, S. (2013) Brief report: Childhood disintegrative disorder as a likely manifestation of vitamin B12 deficiency. Journal of Autism and Developmental Disorders, Epub ahead of Print. doi:10.1007/s10803-013-1762-6
[21]	Rosman, N.P. and Bergia, B.M. (2013) Childhood disintegrative disorder: Distinction from autistic disorder and predictors of outcome. Journal of Child Neurology, Epub ahead of Print. doi:10.1177/0883073812472391
[22]	Kurita, H. (1985) Infantile autism with speech loss before the age of thirty months. Journal of the American Academy of Child Psychiatry, 24, 191-196. doi:10.1016/S0002-7138(09)60447-7
[23]	Hoshino, Y., Kaneko, M., Yashima, Y., et al. (1987) Clinical features of autistic children with setback course in their infancy. Psychiatry and Clinical Neurosciences, 41, 237-245. doi:10.1111/j.1440-1819.1987.tb00407.x
[24]	Kobayashi, R. and Murata, T. (1998) Setback phenomenon in autism and long-term prognosis. Acta Psychiatrica Scandinavica, 98, 296-303. doi:10.1111/j.1600-0447.1998.tb10087.x
[25]	Bernabei, P., Cerquiglini, A., Cortesi, F. and D’Ardia, C. (2007) Regression versus no regression in the autistic disorder: Developmental trajectories. Journal of Autism and Developmental Disorders, 37, 580-588. doi:10.1007/s10803-006-0201-3
[26]	Baird, G., Charman, T., Pickles, A., et al. (2008) Regression, developmental trajectory and associated problems in disorders in the autism spectrum: The SNAP study. Journal of Autism and Developmental Disorders, 38, 1827-1836. doi:10.1007/s10803-008-0571-9
[27]	World Health Organization (1977) International classification of diseases. 1975 Revision, Vol. 1, World Health Organization, Geneva.
[28]	American Psychiatric Association (1980) Diagnostic and statistical manual of mental disorders. 3rd Edition, American Psychiatric Association, Washington DC.
[29]	Kurita, H., Miyake, Y. and Katsuno, K. (1989) Reliability and validity of the Childhood Autism Rating Scale—Tokyo Version (CARS-TV). Journal of Autism and Developmental Disorders, 19, 389-396. doi:10.1007/BF02212937
[30]	Schopler, E., Reichler, R.J., DeVellis, R.F. and Daly, K. (1980) Toward objective classification of childhood autism: Childhood Autism Rating Scale (CARS). Journal of Autism and Developmental Disorders, 10, 91-103. doi:10.1007/BF02408436
[31]	Koyama, T., Osada, H., Tsujii, H. and Kurita, H. (2009) Utility of the Kyoto Scale of Psychological Development in cognitive assessment of children with pervasive developmental disorders. Psychiatry and Clinical Neurosciences, 63, 241-243. doi:10.1111/j.1440-1819.2009.01931.x
[32]	Kurita, H., Osada, H., Shimizu, K. and Tachimori, H. (2003) Validity of DQ as an estimate of IQ in children with autistic disorder. Psychiatry and Clinical Neurosciences, 57, 231-233. doi:10.1046/j.1440-1819. 2003.01106.x
[33]	Kurita, H. (1988) The concept and nosology of Heller’s syndrome: Review of articles and report of two cases. Psychiatry and Clinical Neurosciences, 42, 785-793. doi:10.1111/j.1440-1819. 1988.tb01167.x
[34]	Evans-Jones, L.G. and Rosenbloom, L. (1978) Disintegrative psychosis in childhood. Developmental Medicine & Child Neurology, 20, 462-470. doi:10.1111/j.1469-8749.1978.tb15247.x
[35]	Kurita, H., Kita, M. and Miyake, Y. (1992) A comparative study of development and symptoms among disintegrative psychosis and infantile autism with and without speech loss. Journal of Autism and Developmental Disorders, 22, 175-188. doi:10.1007/BF01058149
[36]	Westphal, A., Schelinski, S., Volkmar, F. and Pelphrey, K. (2013) Revisiting regression in autism: Heller’s Dementia infantilis: Includes a translation of über Dementia Infantilis. Journal of Autism and Developmental Disorders, 43, 265-271. doi:10.1007/s10803-012-1559-z
[37]	Mouridsen, S.E., Rich, B. and Isager, T. (1998) Validity of childhood disintegrative psychosis: General findings of a long-term follow-up study. British Journal of Psychiatry, 172, 263-267. doi:10.1192/bjp.172.3.263