Clinical features

Early pre- and perinatal histories are generally unremarkable in Rett's syndrome, as is very early development. Usually within the first year or two of life development begins to slow or actually regress and various motor problems—typically including unusual and characteristic hand-washing stereotypies start to develop. (56> A significant loss of developmental skills occurs and head growth decelerates.(21,) The potential for misdiagnosis of autism is greatest during this time. During school age developmental regression often stabilizes and children are more socially responsive. As individuals with Rett's syndrome approach adolescence they are frequently subject to increased spasticity, scoliosis, loss of ambulation, bruxism, hyperventilation, areophagia, apnoea, and seizures. (5Z) Although debated/58' the inclusion of Rett's syndrome in the PDD class reflects an awareness of the confusion with autism and the importance of including the condition somewhere.(59)

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