Emergency evaluation and treatment for Pediatric Intellectual Disability ?
Evaluation and treatment of psychiatric emergencies in individuals who are intellectually developmentally disabled pose additional challenges. The goal of crisis intervention is the same as in the general population (ie, to reduce the risk of harm to self/others and to accomplish this objective in the least restrictive setting). For optimum results, the assessment and treatment of patients who are intellectually disabled should include the input of the primary caregivers. Psychiatrists who are unaccustomed to the usual presentation of ID may be nonplussed by the clinical manifestations of psychiatric emergencies in these patients. Limitations in cognition and verbal expression make it difficult for patients to describe abstract concepts such as mood, guilt, and ideas of reference.
@tasmeen To reduce distraction or overstimulation, evaluations of the patient are best performed in a safe quiet area, away from the prying eyes and ears of other staff and patients. Care providers should be included in the assessment process because they can be a calming influence on the patient and they can provide valuable information. Taking a biopsychosocial approach to problem solving should lead to interventions that address biological, psychological, and social factors that caused the crisis situation. While resolving every aspect of the crisis is not necessary, identifying and addressing the main concerns of the caregivers is important. Once the immediate crisis is resolved, the remaining problems can be referred to community or state agencies.