Let's Talk About Intellectual Disabilities: Loretta Claiborne at TEDxMidAtlantic
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The ability to communicate with people whose speech is affected by a mental disability is actually a skill that can be developed over time with practice. Whether They work to ensure that anyone can access the best educational resources from the web anytime, anywhere, even if they do not have an internet connection. Not only is Special Bridge a truly special dating site for singles with disabilities, but it's also a truly special social networking site for anyone living with different mental, physical, or emotional ability levels. From finding someone special to share your life with or sharing stories with a someone who fully understands you, . As well as having all the risk factors that are relevant for the whole population, people with intellectual disabilities may have extra risk factors. These can be considered using a biological-psychological-social-developmental framework ( see Figure 1: Possible risk factors for mental disorders). Assessment The integration and.
There are several types of classifications and assessments that may be useful when working with people with intellectual disabilities. These Hookup Someone With An Intellectual Disability address the following areas:.
A person with intellectual disabilities is therefore considerably more likely to have an additional mental disorder than the average person from the general population. This is not surprising when one considers the likely causes of mental disorders.
As well as having all the risk factors that are relevant for the whole population, people with intellectual disabilities may have extra risk factors. These can be considered using a biological-psychological-social-developmental framework see Figure 1: Possible risk factors for mental disorders. Assessment The integration and interpretation of information collected during a thorough psychiatric assessment typically comprises three stages:.
Methods - the methods of assessment used with the general population are also relevant when working with people with intellectual disabilities, supplemented by some additional special considerations. This includes spending time with the person to hear their concerns and experiences and to conduct an examination; taking a collateral history from a close relative or other close person; reviewing previous medical case notes; and speaking to professionals from other disciplines, such as community nurses, psychologists and social workers, who are involved in supporting the person.
The information gathered should cover the usual psychiatric headings of full history, mental state examination, physical examination and special investigations. The findings can then be integrated and interpreted into the three-stage framework to summarize the relevant psychopathology positive and negative findingsclassify and describe likely aetiology.
Special assessment considerations Psychiatric assessment of a person with intellectual disabilities has much in common with assessments undertaken with people of average ability, but there are a number of additional special considerations see Figure just click for source Psychiatric assessment of a person with an intellectual disability.
Assessment should therefore include:. A person may have capacity to consent to or refuse some interventions e. The exact process will depend on the area of jurisdiction; for example, in Scotland the legal framework provided by the Adults With Incapacity Scotland Act should be followed see also Keywood and Flynn In some circumstances, implementation of mental health legislation may be appropriate.
The extent and type of a person's intellectual disabilities influences more info ability and needs, as can a range of additional factors, such as:.
It is important to consider all these factors in order to enhance communication.
Imagine if you were capable of making reasonable choices and decisions but someone was always making these decisions for you without your input. A disabled person I know will not stop talking and repeating himself while others are trying to do paper work. The talk she gave then resonated with the commission — so much so that when it completed its latest report, and readied it for publication last week, it asked Frieda to launch it. It might be worth reading wikiHow's info on autistic meltdowns for more tips. Body language does not relate to intelligence either.
Communicating with a person with an intellectual disability. Clinicians should remain aware of possible communication limitations; even the most able person Hookup Someone With An Intellectual Disability intellectual disabilities may have difficulties remembering and communicating the temporal sequence of past events or symptoms.
Acquiescence and suggestibility may also remain a limitation to the assessment of information. It should be remembered that a person with limited or no verbal communication skills may use other methods of communicating their feelings.
This may include a change in their usual behaviour, or even aggression if this is the only or easiest way to communicate pain, distress or fear see also Joyce Sometimes several informants are necessary.
The more severe the person's intellectual disabilities, the greater the reliance on carers for information; for people with profound intellectual disabilities and no verbal communication skills, Hookup Someone With An Intellectual Disability of the assessment information will be provided by carers.
Information from parents - parents are usually able to provide detailed information from the past. This helps to provide an understanding of how the person developed through their childhood, the adverse experiences they encountered, their achievements and relationships that shaped the person they have become as an adult. This information is also important to distinguish the usual behaviour and traits of the person from behaviours that are new i.
Important background information may also include:. Information from others - if the person no longer lives with their parents, the parents will not be able to provide detailed information on daily aspects of life.
The level of detail and accuracy of information from support workers may depend on various factors, such as:. If a person's support package has only recently been established, the support workers may be able to provide limited information only. Understandably, support workers may volunteer information on needs that present the greatest challenge to care e.
It is important, therefore, that a thorough assessment is always conducted of all possible psychopathology, using a semi-structured approach, after the person and their support worker have given the history in their own words. Where necessary, additional potential informants, such as employers, day centre officers or support workers from previous placements, should be approached, and limitations and gaps in the gathered information should be recognized.
Pathoplastic effect of developmental level on Hookup Someone With An Intellectual Disability This pathoplastic effect is greater the more severe the person's intellectual disabilities. Understanding of link complex concepts such as guilt requires a developmental age of about 7 years.
Similarly, psychopathology such as hopelessness, worthlessness, suicidal ideation, delusional perception, and distorted body image do not present at more severe levels of intellectual disabilities.
Additionally, some psychopathology e. Some symptoms that occur during mental ill-health in adults with intellectual disabilities are rare in adults of average ability.
Examples include loss of skills, impairment of communication, and onset of or exacerbation of pre-existing problem behaviours. Irritability is often the core mood symptom presenting in depressive episodes. Developmental level can also have an impact on the content of abnormal phenomena.
For example, delusions may have a 'childlike' content, reflecting the intellectual capacity and life experiences of the person. Regarding misery, for example, the assessor may be able to cheer up Hookup Someone With An Intellectual Disability person to the point of smiling or laughing during the interview.
Characteristically, the person is unable to sustain the cheerful mood state, and returns to misery when not being talked out of it.
Delusions may not be 'unshakeable' - i. This area is covered in O'Brien Compared with epilepsy among the general population, people with intellectual disabilities often have mixed seizure types and seizure frequency that is difficult to control. This is of direct relevance to psychiatric assessment, and often requires differential diagnosis between seizures particularly complex partial seizuresmental ill-health such as panic attacks, problem behaviours and depressive episodes and drug side-effects e.
As mental disorders and epilepsy are both common in this population, they often co-exist. People who have epilepsy may also have a higher rate of mental disorders than those who do not. They may have psychological sequelae of the epilepsy itself, and a proportion additionally experience pseudo-seizures.
Psychiatric assessment should include an assessment of epilepsy in order to address these issues, and therefore requires a knowledge of epilepsy, its associations and treatments, in addition to its interface with psychiatric disorders. Assessment of epilepsy is also required to inform the development of treatment plans in view of the effects of psychotropic drugs on seizure threshold, and drug interactions between anti-epileptic drugs and other psychotropic drugs.
There may be psychiatric sequelae to some of these physical health needs, and side-effects of drugs and drug combinations. Assessment of physical health and drug histories therefore assumes a more important component of psychiatric assessment than it might for a person of average ability. Classification Classification of mental disorders is undertaken for a variety of reasons.
In the midth century it was recognized that there was considerable international variation in psychiatric practice, and the introduction of operationalized diagnostic criteria focused attention on improved, more see more psychiatric assessments and diagnostic procedures.
It could be contended that while such issues are no longer contemporary in general psychiatry, they remain relevant for psychiatric practice with people with click disabilities. Classification can therefore improve clinical practice and so benefit individuals.
Classification systems also provide a tool to use in the description of whole population needs and in service planning. Classification also has an essential role in research.
Inclusion criteria must be clearly described in order to:. All of the above requires the use of operationalized diagnostic criteria as described in a classificatory system. However, while these systems may be appropriate for people with mild learning [intellectual] disabilities, they lack validity and utility for people with more severe learning [intellectual] disabilities or with ASD or ADHD in addition to mild learning [intellectual] disabilities.
DC-LD Diagnostic Criteria for Psychiatric Disorders for Use with Adults with Learning Disabilities ; Royal College of Psychiatrists, provides more appropriate operationalized diagnostic criteria within a classification system Hookup Someone With An Intellectual Disability designed for use with adults with learning [intellectual] disabilities, and is complementary to ICD see Figure 4: The development of DC-LD addressed the following issues:. DC-LD introduces a hierarchical approach to improve clinical practice and reduce the risks of diagnostic overshadowing.
It provides further information on assessment and classification of mental disorders in adults with learning [intellectual] disabilities.
The text of DC-LD provides additional information on psychiatric assessment of adults with learning [intellectual] disabilities. Psychiatric disorders amongst adults with learning disabilities - prevalence and relationship to ability level. Ir J Psychol Med ; Some Levers to Changing Practice. A series of purpose-designed publications presenting pictorial information to facilitate work with people with intellectual disabilities.
FERGUS FINLAY: Consensual sex between adults is illegal if they have an intellectual disability
They cover a range of topics and are published by Gaskell. Royal College of Psychiatrists.
Adapting Activities for people with Intellectual Disability
A new classificatory system designed specifically for use with adults with intellectual disabilities; it is complementary to ICD As well as presenting operationalized diagnostic criteria, the text discusses issues relevant to psychiatric assessment with this population.
Classification and Assessment of Psychiatric Disorders in Adults with Intellectual Disabilities There are several types of classifications and assessments that may be useful when working with people with intellectual disabilities. Sally-Ann Cooper UK There are several types of classifications and assessments that may be useful when working with people with intellectual disabilities.
These may address the following areas: Assessment The integration and interpretation of information collected during a thorough psychiatric assessment typically comprises three stages: Read more should therefore include: The extent and type of a person's intellectual disabilities influences communication ability and needs, as can a range of additional factors, such as: Important background information may also include: The level of detail and accuracy of information from support workers may depend on various factors, such as: Measurement of developmental level enables appropriate interpretation of psychopathology in the context of the pathoplastic effect of intellectual disabilities on psychopathology.
Determining the usual pattern of behaviours and skills for the person is essential to distinguish symptoms of mental ill-health from long-standing traits e. Diagnosis of autistic spectrum disorders Hookup Someone With An Intellectual Disability and attention deficit hyperactivity disorder ADHD requires knowledge of developmental history in addition to present information see also Howlin ; pp.
If they speak using basic words, then it's probably best to use the smallest words you know. These can be considered using a biological-psychological-social-developmental framework see Figure 1: Not Helpful 0 Helpful 6. Delusions may not be 'unshakeable' - i.
A good understanding of development reduces the likelihood of 'diagnostic overshadowing' the tendency to attribute all problems to the person's intellectual disabilities - e.
For some individuals, developmental models may be relevant in understanding the aetiology of problem behaviours: For an adult with a similar level of mental capacity, developmental models may help explain aetiology, with behaviour development arrested at certain stages such that it is a problem for the person.
Determining the underlying cause of a person's intellectual disabilities identifies genetic causes. For example, hypothyroidism is common in Down's syndrome, as are sensory impairments and cardiac anomalies, all of which can be screened for. Inclusion criteria must be clearly described in order to:
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