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• All of the following suggest normal early development:
  Prenatal and perinatal development appear normal
  Psychomotor development appears normal at least until month 6
  Head circumference is normal at birth
  
  
• After this apparently normal beginning, all of:
  Head growth slows abnormally between 5 and 48 months.
  Between 5 and 30 months, the child loses already acquired purposeful hand movements and develops stereotyped hand movements such as handwashing or handwringing.
  Early in the course, the child loses interest in the social environment. (However, social interaction often develops later.)
  Gait or movements of trunk are poorly coordinated.
  Severe psychomotor retardation and impairment of expressive and receptive language.

Information on Rett's Disorder

Rett's syndrome is included as a Pervasive Developmental Disorder because there is some potential confusion with autism ; particularly in the preschool years. Otherwise the course and onset of this condition is very distinctive.

Rett's Disorder is a pervasive developmental disorder that follows a very specific progression. Children with this disorder seem to develop normally for the first six to eight months of life. Parents may notice excess levels of hand patting, waving, and involuntary movements of the fingers, wrists and arms. However, these signs are subtle and may go unnoticed. There is a slowing of normal development and a failure to reach developmental milestones on time.

Particular problems occur with the acquisition of skills requiring balance such as walking. Head deceleration occurs (the head fails to grow larger at the proper rate.) Children undergo a rapid deterioration in behavior including loss of acquired speech, and purposeful use of hands. A lack of interest in social relationships occurs, and stereotyped behaviors may develop. The most prominent symptom in Rett's syndrome may be "hand washing" movements which develop after the ability to move hands purposefully is lost.

At present, Rett's syndrome has been reported only in girls. These children are generally mentally retarded. Episodes of screaming or tantrums may occur. Sleep abnormalities and seizure disorder are present in over half of the children with this disorder. The lack of interest in social relationships, loss of expressive language and the development of stereotypies can cause this disorder to be confused with autism.