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Autism Spectrum Disorders and Mental Health Issues: What Educators need to knowJacqueline Beith, Laurie O’Donnell, and Scott Bark “The estimated prevalence rate of Canadian children and adults living with developmental disabilities is between 1-3% (up to 1 million Canadians).1 This figure includes individuals with conditions such as Down Syndrome, Autism Spectrum Disorders, Fetal Alcohol Syndrome and brain injury (prior to age 18). Individuals with developmental disabilities also have higher rates of mental and physical illnesses than the average Canadian. At any time, approximately a third of our citizens with intellectual disabilities experience psychiatric difficulties (up to 380, 000 Canadians).”2 As greater awareness of children’s mental health grows and the social stigma of mental illness fades, understanding of the impacts of mental illness on children with an Autism Spectrum Disorder is beginning to emerge. With the recent publication of prevalence rates of ASD as high as 1 in 110 individuals (www.cdc.gov), awareness and vigilance of the signs and symptoms of mental health issues become paramount for families, caregivers, educators, and service providers of children with an ASD. As an Autism Spectrum Disorder is a lifelong disability featuring impairments in social and communication skills as well as the presence of repetitive behaviours, these characteristics may either mimic or mask symptoms of a mental illness, making early awareness of these signs and impacts a key to early identification of mental illnesses and obtaining the appropriate treatment and supports. Key considerations include: 1) Signs and symptoms of some mental health issues (such as attention deficit/hyperactivity disorder, obsessive compulsive disorder, and depression) may appear similar to the communicative, social, and behavioural impairments characteristic of an ASD. These may include, but are not limited to: Therefore, in order to ascertain whether the above are symptomatic of a mental illness, we must examine whether the appearance of any of these are a change from the child’s usual behavior (increase or decrease) and whether they persist over time. “People with a dual diagnosis experience the “double jeopardy” effect of stigma which occurs when two disabilities (developmental and mental health needs) are present in the same person, further marginalizing and disadvantaging them. The result is often “diagnostic overshadowing,”3 meaning that the mental health problems are ignored and untreated because the symptoms are judged to be “just” part of the developmental disability.”4 2) Behaviourally based treatments (such as Applied Behaviour Analysis and Intensive Behavioural intervention) that are effective for improving communication, behavior, and social skills for a child with an ASD may need to be supplemented with additional psychiatric, counseling, and/or pharmacological interventions in order to improve the overall well being of the child when a mental health issue is present 3) In order to identify and obtain appropriate supports and treatment of metal health issues in a child with an ASD, the family, caregivers, educators, and other professionals should work together for the well being of the child. It is important for educators and other professionals to note the presence of any symptoms and to track these over time. As many children with an ASD will have communication challenges that may limit their ability to self-report feelings of sadness, anxiety, or despair, we must be vigilant for indicators of these in their everyday behavior. Sometimes, it can be helpful to write these down. Different ways of tracking these include: The chart below shows samples of how changes may be noted across the four measures: Table 1 - Samples of changes across Frequency, Intensity, Duration, Topography
What you can do if you begin to observe a change in the child’s behavior: Above all, don’t ignore the symptoms of a childhood mental illness. The child with an ASD may need your help to help themselves. Possible strategies for educators to support the student with a mental health issue
For additional resources and information: References: |
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