Intellectual disability Category

Behaviour modification. A personalized approach is recommended. The first choice of behavioural interventions is the selection of reinforcement and extinction-based strategies. Pharmacological treatment. Direct effects:The success rate of pharmacological agents varies. Risperidone or olanzapine may decrease aggression and SIB in children with ID. Some patients respond to anticonvulsants such as topiramate or valproic acid. Fluoxetine […]

1. Etiology SIB is both determined genetically and acquired. It is due to a complex interaction between neurobiological and environmental variables, and is often a means of communication for patients with poor social skills, or for those living in an environment with little or no social interaction. Pain insensitivity has been hypothesized to be a […]

If there is no specific diagnosis, treatment will target the symptoms (eg, selective serotonin reuptake inhibitors for anxiety and neuroleptics for psychotic symptoms). According to the Expert Consensus Guidelines for the Treatment of Psychiatric and Behavioural Problems in Mental Retardation, prolonged use of benzodiazepines and anticholinergics, long half-life hypnotics or high doses of antipsychotic medications […]

1. Assessment Assessment of symptoms of aggression in a patient with an ID is conducted in a manner similar to that used for the general population. The Aberrant Behaviour Checklist, a screening assessment tool for identifying psychopathology in children and adolescents with mental retardation, may also be useful. The questionnaire must be adapted to the […]

There are different types of aggression: a) toward others (eg, hitting, biting, kicking); b) destructive/disruptive behaviours (eg, breaking windows, screaming, etc); and c) toward self (eg, self-injurious behaviour including biting, self-hitting, head banging) (see below). The first two types of aggression can be further subdivided into planned and reactive aggression. In planned aggression, as in […]

3. pharmacological treatment Methylphenidate (MPH) has been the most extensively studied medication used in children with an ID and ADHD, with 20 double-blind, placebo-controlled studies conducted through 2006 . Response rates vary between 45% to 66% in the population with an ID, versus 77% in the population without an ID, with benefits including decreased impulsivity, […]

1. General approach Agitation refers to a spectrum of behaviours, during which an individual is restless and hyperactive, that lead to disruptive, uncooperative and even belligerent behaviour. If the agitation is ‘excessive’, it is important to rule out an organic or environmental cause that could trigger, or aggravate, this symptom. Moreover, the child with an […]