YOUR SPECIAL CHILD
such as anxiety, depression or poor social
skills. If the patient is not verbal and the
goal is to address challenging behaviors,
you will need a behavioral psychologist.

If you don’t know where to start, seeing a
neurologist, a developmental pediatrician
or a child psychiatrist who has experience
in treating individuals with autism can be
helpful, as they can guide you on the more
specific treatment approaches indicated for
the presenting problem.

Is there a difference in the
way depression is diagnosed
in kids with disabilities?
The criteria are the same. The difference is in
how to ask the questions that represent the
symptoms. It takes experience and tact to
do a full review of symptoms. Diagnosis and
treatment of mental health conditions in per-
sons with developmental disabilities can be
challenging and has to be adapted to the indi-
vidual. Limitations in their ability to self-report
symptoms of mental distress may mean
that healthcare needs can go unrecognized
and unmet. Healthcare professionals report
feeling unqualified and uncomfortable caring
for patients with disabilities. Disability edu- examples are the lack of adequate social
cation should be part of cultural competency interactions and feelings of exclusion and
accessibility to the world in general.

requirements in medical education.

Literature has shown individuals with cere-
Is there a difference in treatment? bral palsy and comorbid neurodevelopmental
Psychopharmacological treatment is similar. disorders have a higher risk of mental health
Much more difficult is to find clinicians who disorders. However, a diagnosis of CP or
are educated or willing to learn about this another developmental disability alone brings
population. We notice this more when psy- a higher risk for inadequate access to health
chotherapy is indicated. Trained clinicians care and health screenings, trauma from abuse,
who understand disabilities, either physical neglect or intrusive therapeutic procedures,
—for example, spina bifida or cerebral poverty related to unemployment and under-
palsy—or cognitive, like intellectual impair- employment and social isolation stemming
ment or autism, are very rare. At Kennedy from communication difficulties, transporta-
Krieger Institute, we are lucky to have them, tion barriers and limited social opportunities.

but families report this is a barrier to obtain All these factors can be treatable and modi-
fiable to avoid their contribution to primary
treatment or even an initial evaluation.

depression or anxiety.

We still have much to do. We know that
Are there preventative steps
community support, standards of living
parents of kids with disabilities
and working conditions and opportunities,
can take to forestall depression?
Yes, to a degree. We know social environ- as well as political and economic factors,
ments are increasingly being recognized affect access to care for identification and
as contributors to poor mental and physi- treatment of mental illness.

However, one determinant of positive out-
cal health. Environmental contributors are
highly relevant to the health of persons with come is family involvement and advocacy.

developmental disabilities. Well-identified They can make all the difference. ■
Parenting isn’t easy, but there
are strategies that can help.

Find support and resources
at familytreemd.org/flip
or our 24-hour Parenting
HelpLine at 800-243-7337.

WashingtonFAMILY.com 43