YOUR SPECIAL CHILD
Depression and Disability
What parents and caregivers
need to know
BY ERICA RIMLINGER
According to the
Journal of Pediatrics,
3.2 percent of children
between the ages of
3 and 17 have
been diagnosed
with depression.

Is having a disability a risk
factor for depression?
Not all disabilities are the same and we
can’t generalize the risks of mental health
comorbidities. There are not many studies
specifically investigating the mental health
of individuals with intellectual disabilities
beyond prevalence reporting. We are see-
ing more studies coming out on autism,
but we lack the lifelong trajectory data on
individuals with mental health problems.

The National Institute of Mental Health
estimated in 2017 that approximately 19
percent of all adults over 18 in the U.S. live
with mental illness. They do not separate
disability from that number.

42 Washington FAMILY MARCH 2020
Are children with autism at greater
risk for depression? There have
been conflicting studies on this.

Yes, the results are conflicting because it
depends on the population’s language and
cognitive function. It reflects the difference
between those who are able to communicate
their depressive symptoms and the ones who
are unable to do so. Research is less inclusive
of the lower functioning individuals with
regards to mental health.

How can parents tell the
difference between the
expected mood changes of
childhood/teenage years
and a mood disorder?
We need to keep a closer eye on our adoles-
cents with disabilities as the symptomatology
might be subtle. Parents are the best advocates
for their children. They are the first to notice
a difference in mood or behavior. When that
happens, it is a priority to consult with their
primary care doctor to rule out any condition
that can be addressed that might affect behav-
ior. We often see ear or urinary infections that
present with behavioral changes. We should
never assume a situation is behavioral or
primary to the disability.

If there is a concern that seems more
severe or there is no identifiable physical
cause, the time to take action is as soon as
possible. We should not let the stigma of
a psychiatric evaluation get in the way of
seeking mental health support.

What experience or qualifications
should a parent seek in a
mental health practitioner
if their child has autism?
It depends on what you are trying to
address. It should be a psychologist who
uses evidence-based treatments that have
been studied in autism or in the specific
difficulties that are the target for treatment
ISTOCK/GETTY IMAGES PLUS/NADEZHDA1906
D epression in all children, with or
without a disability, remains preve-
lant. According to a study published
in the March 2019 issue of the Journal of
Pediatrics, 3.2 percent of children between
the ages of 3 and 17 have been diagnosed
with depression.

Adolescents with disabilities, particularly
those with autism, have a higher risk for
depression, multiple studies have found.

However, those studies vary widely on
how much higher this risk may be. Further
complicating matters, developmental dis-
abilities and autism spectrum disorders can
mask the signs and symptoms of depres-
sion—or at least the ability to report one’s
symptoms. This makes making it more
difficult to detect depression or anxiety
in a child, not just for researchers, but for
parents and families as well.

Washington FAMILY spoke with Dr.

Carmen López-Arvizu, medical director of the
Kennedy Krieger Institute’s psychiatric mental
health program, about this issue. López-Arvizu
treats individuals with psychiatric illness in
the context of developmental disabilities and
is also a faculty member in the department of
psychiatry at Johns Hopkins Hospital.