Post-traumatic stress disorder in young people with intellectual disability.
ABSTRACT Post-traumatic stress disorder (PTSD) is common and treatable. There is extensive research on people of average intelligence yet little on individuals with developmental disabilities.
We report two people with intellectual disability (ID) who experienced PTSD. The relevance of their developmental difficulties, social and communication profiles, attentional skills, and causes of these, to their presentations is discussed.
Both individuals have fragile X syndrome and severe ID. One has Diagnostic and Statistical Manual - 4th Edition (DSM-IV) autistic disorder; the other DSM-IV attention deficit-hyperactivity disorder. They experienced developmental and psychological regressions, new challenging behaviours and exacerbations of existing ones coincident with emotional trauma. PTSD symptoms and phenomena were identifiable despite intellectual and communicatory impairments.
Presentation of PTSD is influenced by degree and cause of ID, social circumstances, social and communicatory skills, nature and timing of traumatic experience and subsequent management. The paucity of literature suggests it is missed frequently in individuals with ID who risk having problems misattributed to other causes with potential for inappropriate interventions.
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ABSTRACT: Identifying atypical trajectories that distinguish children with differing developmental disorders from each other and from typically developing children is a potentially powerful tool for early ascertainment and treatment of syndrome specific proficiencies and deficiencies. The past decade has seen unparalleled advances in the fields of molecular genetics, pediatrics, developmental cognitive neuroscience and brain imaging. Collaboratively, these advances have facilitated our understanding of how genes can impact upon early development, through the identification of specific patterns of cognitive and behavior processing and the deficits in these domains that are typical to a specific developmental disorder. These advances have also made early diagnoses possible for many developmental disorders, including those for which genetic etiology has yet to be determined, such as is the case for most individuals with autism, or disorders such as fragile X syndrome that result from the silencing of a single gene. This early identification necessitates thorough investigation of the impact of a condition across the lifespan beginning in early childhood when interventions are most likely to have significant benefit. This is especially relevant for disorders that at first glance appear to share overlapping behavioral and clinical symptomology. In the case of autism and fragile X syndrome, commonalties in social and communication profiles are now well documented in early childhood. However, to what degree symptom overlap implies common developmental pathways or etiologies remains unclear. The focus of this review will be to critically evaluate whether so called 'commonalities' in phenotypic outcomes actually reflect very different developmental pathways that diverge over developmental time and across syndromes. More detailed knowledge of these profiles will facilitate early timing of tailored interventions that will promote optimal development resulting in significant educational, clinical, and adaptive benefits across a child's lifespan.Current Pediatric Reviews 01/2007; 3(1):61-68. DOI:10.2174/157339607779941660
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ABSTRACT: Although children and adolescents with developmental disabilities are said to have higher risks of abuse than those without, trauma and Posttraumatic Stress Disorder (PTSD) are little examined in those diagnosed with Autistic Spectrum Disorders (ASDs). Our study aims to assess trauma types, prevalence, risk factors and symptoms; and PTSD in individuals with diagnosis of ASD. Participants were 69 children and adolescents (53 males, 16 females) who were consecutively followed-up at our clinic and met DSM-IV criteria for ASD. Assessment was done using semi-structured interview forms. 18 had trauma history and 12 were diagnosed with PTSD. Witnessing or being a victim of accidents/disasters/violence was the most common type of trauma. Interestingly, the rate of sexual and/or physical abuse was less than in the general population. Trauma history and PTSD rates were higher in girls than boys. Deterioration in social and communicative abilities, increase in stereotypes, aggression, distractibility, sleep disorders, agitation, hyperactivity, self-injury, and loss of self-care skills were the most common symptoms detected following trauma. These results underscore the importance of detailed assessment of behavioral and emotional problems in this group by ruling out any trauma history at periods which might otherwise be misdiagnosed as an exacerbation of symptoms of ASD.Research in Autism Spectrum Disorders 05/2011; 5(1):539-546. DOI:10.1016/j.rasd.2010.06.020 · 2.96 Impact Factor