Childhood disintegration disorder: causes, symptoms and diagnosis

Childhood disintegrative disorder (IDD) is the psychiatric category which has been used until recently to talk about one of the forms that Autism Spectrum Disorder (ASD) takes in its early stages of development.

This category has undergone significant changes since the last update of textbooks used in psychiatry and psychology as a clinical guide. However, being recent changes, these are categories that are still used in some contexts, and even in combination, so it is worth revisiting them.

    What is Childhood Disintegration Disorder (IDD)?

    Before we begin to describe the disintegrative disorder of the child and the causes of the transformations that its diagnostic criteria have had, it is important to clarify how the diagnoses themselves work.

    Diagnostic and Statistical Manuals of Mental Disorders (DSM) are collections published by the American Psychiatric Association (APA), which describe and group together a collection of clinical manifestations known as mental disorders.

    These manuals have existed since the second half of the previous century in five different versions, and although initially their approach was purely descriptive and informative, today are among the most common clinical guidelines used by mental health professionals.

    Mentioning this is important in understanding what Childhood Disintegration Disorder was, what criteria remain, and what its name is today.

      DID: a generalized developmental disorder

      Childhood disintegration disorder is a psychiatric classification proposed by the DSM-IV (DSM in its fourth version) and which is part of generalized developmental disorders (TGD); which, in turn they fall under the category of onset disorders during childhood, childhood or adolescence.

      According to the DSM-IV, the general characteristic of TGDs is the presence of severe and widespread disruption of various areas of early development, Which, being serious, is considered unsuitable for the child’s developmental level and mental age.

      It manifests itself in the following areas: skills for social interaction and communication; as well as by the presence of stereotypical interests and behaviors (stereotypes is the technical name). Also included in the TGD category were Autistic Disorder, Rett’s Disorder, Asperger’s Disorder, Unspecified Generalized Developmental Disorder, and Pediatric Disintegration Disorder.

      Main feature of the disintegrating disorder of the child

      The main feature of DID is a marked regression of multiple domains of activity after a period of at least 2 years of development which apparently corresponds to the age of the child.

      In other words, TDI manifests itself when the child is at least two years old, has acquired the skills expected for his age and, unexpectedly, regression occurs in at least two of the following areas: verbal and non-verbal communication (expressive or receptive language), social relationships and adaptive behavior, play, sphincter control, motor skills.

      It was also known as Heller’s syndrome, childhood dementia, or disintegrative psychosis.

      From TDI to TEA

      In May 2013, when the latest version of the Statistical Manuals of Mental Disorders (DSM-V) was released, disorders of infancy, childhood or adolescence ceased to be referred to as, where applicable, to become neurodevelopmental disorders.

      Childhood disintegration disorder (along with other childhood disorders that fall under the subclassification of TGD), they have become part of a unique spectrum: Autism spectrum disorders.

      DSM-IV Disorders of infancy, childhood or adolescence included mental retardation, generalized developmental disorders, attention deficit disorder and motor disturbance, tics, disorders learning, communication disorders, childhood eating disorders and eating disorders, elimination disorders and other disorders.

      In DSM 5, neurodevelopmental disorders are a group of conditions that appear in the early stages of early development, particularly characterized by ** difficulties in establishing interpersonal, socio-adaptive and academic relationships. **

      Thus, the sub-categories of DSM-IV that we explain above, transform into: intellectual disability, autism spectrum disorder, attention deficit hyperactivity disorder, motor disorders, specific learning disability, disorders of the communication, eating disorders, excretion disorders and unspecified neurodevelopment Disorders.

      What are the diagnostic criteria currently?

      TDI is currently considered one of the many forms that the early stages of TEA development take; question today it is increasingly easy to diagnose and support from the early stages.

      As such, it is not a disease, so there is no cure or treatment, but the intervention is to stimulate coping skills within the limits of the child’s abilities and limits, when they are detected and to respond to support needs.

      The ASD is defined in the DSM by mild, moderate or severe levels, and by two basic criteria: 1. the existence of a persistent difference in communication (verbal and non-verbal) and in social interaction with difficulty establishing interpersonal relationships. And to adapt to various contexts; and 2. by the presence of restrictive and repetitive patterns of behavior, for example stereotypes, monotony or very restricted rituals.

      The causes and mechanisms that generate it are not specific, Although there are suspicions about an injury to the central nervous system and its relationship to medical conditions or genetic conditions. It usually begins with significant increases in activity levels accompanied by periods of irritability and anxiety, followed by loss of speech.

      Bibliographical references:

      • Martínez, B. and Rico, D. (2014). Neurodevelopmental Disorders in DSM-5. Workshop at the AVAP conference, University of Valencia. Accessed April 27, 2018.Available at http://www.avap-cv.com/images/actividades/2014_jornadas/DSM-5_Final_2.pdf
      • APA (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V). American Psychiatric Publishing: Washington, DC; London.
      • APA (1995). Diagnostic and Statistical Manual of Mental Disorders Fourth Version (DSM-IV). Masson: Barcelona
      • Volkmar, F. and Cohen, D. (1989). Disintegrative disorder or “late onset” autism. The Journal of Child Psychology and Psychiatry. 30 (5): 717-724.

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