Of the necessary interplay of therapy and pedagogy in psychiatric hospitals for children with intellectual disability.

ABSTRACT

BACKGROUND: Mentally ill children with intellectual disabilities do not always receive the services they need for effective change at psychiatric hospitals, as their verbal limitations render standard procedures in diagnostics and therapy difficult or impossible, as their ability to transfer insights acquired in one setting to another is impaired and as their families and caretakers are often overwhelmed by their needs. This is why an integral vision for children with intellectual disabilities is presented. Drawing on three case reports, it is highlighted how an interdisciplinary approach, a changed hospital set-up and constant interplay between therapy and pedagogy, between services to the child and to its caregivers can help overcome these difficulties. METHOD: Case reports. CONCLUSIONS: Some children risk being mistakenly treated as intellectually disabled. If testing reveals, for example, autism with a mild learning disability, psychoeducation and the pedagogical training for (special school) personnel can help prevent underachievement and bring about a setting that can help the child flourish. Both sensitive care and pedagogical intervention that fit the developmental age of severely intellectually disabled children can prevent their receiving sedatives to treat aggressive behaviour. Substantial and lasting shifts in mood, even happiness can result if parents and caregivers get the pedagogical training and the assistance they need to take care of their children. Reliable and well-structured pedagogical training and environments can enhance and often substitute for unavailable therapeutic interventions for this specific group. With some profound intellectually and multiply disabled children, beginning medical treatment at home may not be safe. The (in)effectiveness of specific psychiatric medications needs to be monitored by observations however. For reliable results with intellectually disabled children, a clinical setting that resembles their everyday life is needed.