CDD: Symptoms, Tests and Diagnosis

CDD is a severe condition which could change the very course of your life. Coming to terms with your child’s CDD is not easy; it would require you to tap into all your physical and emotional reserves. The first step, however, begins with understanding the condition thoroughly, so that you can make the right choices for your child.

Criteria for CDD

Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association has outlined the below criteria for a child to be diagnosed with CDD:

1. Normal Development: The child develops normally for the first two years of his life. This includes age appropriate verbal and non verbal communication skills, motor skills, social and emotional skills.

2. After two years of normal development, the child experiences rapid and significant loss of skills in at least two of the below areas:

• Ability to talk in sentences/form words
• Ability to grasp or receive ideas
• Self care skills
• Bowel movements
• Bladder Control
• Playing games
• Motor skills

3. The child experiences loss of normal functions in at least two of the below areas:

• Social Interactions: The child no longer recognizes his peers, friends nor does he show any interest in playing. He faces acute difficulty in responding to social cues, sharing and experiences a wide range of problems with social connectedness.

• Communication: The child might start using the same words over and over again and is no longer able to hold conversations.

4. The child flaps his hands in rock or spin motions; becomes attached to specific routines and rituals; faces difficulty with changes in routine. Many children with this disorder develop a fixed posture (catatonia) and may become preoccupied with certain objects or activities.

In the initial visits, your child’s paediatrician might look out for signs of developmental delays or sudden, significant regression. Once he suspects your child to be suffering from CDD, he might refer him to a team comprising of a child psychologist, a child psychiatrist, an occupational therapist, a neurologist, a paediatrician specializing in behavioral therapy, an audiologist, a speech therapist and a physical therapist.

Further Tests to Confirm CDD

The above team will perform the following tests for further confirmation:

1. Medical History

The team conducts an extensive interview with parents emphasizing particularly on when developmental milestones were reached, and the age at which the child started losing previously learned skills. Baby books, family photo albums and videotapes prove helpful to remember when your child reached specific developmental milestones.

2. Neurological Exam

The neurologist physically examines your child for any abnormalities in your child’s brain and nervous system. He/she may order imaging tests of the brain and tests that measure the brain’s electrical activity.

3. Genetic Tests

These tests usually involve a study of your child’s chromosomes through blood tests to determine if there’s an inherited family condition or disease.

4. Communication and Language Tests

The therapists conduct in-depth tests to measure how your child communicates verbally and non verbally, (facial expressions, posture, rhythm of speech, gestures) and how your child behaves with others (understanding words, body language, social cues, tone of voice).

5. Lead Screening

A blood test is performed to rule out lead poisoning. Lead exposure in children causes damage to the nervous system, developmental delays, hearing loss and behavior problems.

6. Hearing (audiology) Test

This is an exam to check for hearing loss or hearing-related problems.

7. Vision Test

This exam checks for vision loss or vision-related problems.

8. Behavior Inventory:

Doctors use formal rating scales to document and record the occurrence of specific behaviors in the child such as repetitive movements, oversensitive or under sensitive responses to normal sights, sounds and touch sensations in the environment, as well as social interactions and play skills.

Prognosis and Changes that Come with CDD

A child suffering from CDD would be given the following prognosis:

1.  Loss of skills often reaches a plateau by around age 10. Limited improvement, however, is seen in a minority of cases.

2.  In the long run, children with CDD exhibit similarities to a child with severe (Kanner’s) autism with long-term impairment of behavioral and cognitive functioning.

3. There are profound effects on intellectual function, self-sufficiency and adaptive skills, with most cases regressing to severe intellectual disability.

4.  As the condition progresses, medical co-morbidities such as epilepsy commonly develop.

5. Those with moderate-to-severe mental intellectual disability tend to do worse than those who are left with a higher IQ and some verbal communication.

6. Children will require lifelong support.

7.  Risk of seizures increases throughout childhood, peaking at adolescence, and seizure threshold may, however, be lowered by selective serotonin reuptake SSRIs and neuroleptics.

8. Life expectancy has previously been reported as normal. However, more recent studies suggest that mortality of people diagnosed with this condition is twice than that of the general population, mainly due to complications of epilepsy.

Treatment and Medication

Treatment consists of a mix of the below mentioned points:

1. Behavioral therapy which aims to teach your child to re-learn communication skills
2. Sensory enrichment
3. Other antipsychotics, stimulants and selective serotonin reuptake inhibitors (SSRIs)

Finally, even as you steer your child through the tough, challenging times, cherish every moment that you spend with him, filling his life with joy and compassion.