Childhood disintegrative disorder is a condition in which young children develop normally until age 3 or 4, but then demonstrate a severe loss of social, communication and other skills.

Doctors sometimes confuse this rare disorder with late-onset autism because both conditions involve normal development followed by significant loss of language, social, play and motor skills. However, autism typically occurs at an earlier age. There's also a more dramatic loss of skills in children with childhood disintegrative disorder and a greater likelihood of mental retardation. In addition, childhood disintegrative disorder is far less common than autism.

Childhood disintegrative disorder and autism are among several developmental disorders known as pervasive developmental disorders or autism spectrum disorders. Others in the group include Asperger's syndrome, Rett syndrome and pervasive developmental disorder not otherwise specified.

Childhood disintegrative disorder is also known as Heller's syndrome after the Viennese educator, Theodor Heller, who first described the condition. It's also called dementia infantilis, disintegrative psychosis and pervasive disintegrative disorder.

Treatment for childhood disintegrative disorder is similar to that for autism — a combination of medications for behavioral problems, behavior therapy and other approaches.

Children with childhood disintegrative disorder typically show the following signs and symptoms:

Normal development for at least the first two years of life
This includes normal development of age-appropriate verbal and nonverbal communication, social relationships, motor, play and self-care skills.

Significant loss of previously acquired or learned skills
This loss occurs before age 10, in at least two of the following areas:

• Ability to say words or sentences (expressive language)
• Ability to understand verbal and nonverbal communication (receptive language)
• Social skills and self-care skills (adaptive behavior)
• Bowel and bladder control
• Play skills
• Motor skills (ability to voluntarily move the body in a purposeful way)

Lack of normal function or impairment
This lack or impairment occurs in at least two of the following areas:

• Social interaction. This may include impairment in nonverbal behaviors, failure to develop peer relationships, and lack of social or emotional reciprocity (inability to share, recognize, understand and respond to social cues and interactions or to feelings of others).
• Communication. This may include delay or lack of spoken language, inability to initiate or sustain a conversation, stereotyped and repetitive use of language, lack of varied imaginative or make-believe play.
• Repetitive and stereotyped patterns of behavior, interests and activities. This may include hand flapping, rocking, spinning (motor stereotypes and mannerisms); development of specific routines and rituals; difficulty with transitions or changes in routine; maintaining a fixed posture or body position (catatonia); and preoccupation with certain objects or activities