Zentrum für Entwicklungsstörungen, Dresden, Germany.
J Intellect Disabil Res. 2021 Dec;65(12):1110. doi: 10.1111/jir.12899.
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.
Case reports.
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.
精神障碍儿童由于智力残疾，在精神病院往往无法获得有效的治疗服务。他们的语言能力有限，导致诊断和治疗中的标准程序变得困难或不可能；他们将在一个环境中获得的洞察力转移到另一个环境的能力受损；他们的家人和照顾者常常因他们的需求而不堪重负。这就是为什么需要提出一种整体的视角来看待这些儿童。本文通过三个案例报告，强调了跨学科的方法、改变医院的设置以及治疗和教学之间的不断互动、对儿童及其照顾者的服务之间的互动如何有助于克服这些困难。
案例报告。
一些儿童可能会被错误地视为智力残疾而得不到治疗。例如，如果测试显示为轻度学习障碍自闭症，那么心理教育和对（特殊学校）人员的教学培训可以帮助预防学业不良，并创造一个有利于儿童发展的环境。对严重智力残疾儿童的敏感护理和适合其发展年龄的教学干预可以防止他们因行为攻击而接受镇静剂治疗。如果父母和照顾者得到他们所需的教学培训和帮助来照顾他们的孩子，他们的情绪，甚至是幸福感都会有很大的改善。可靠和结构良好的教学培训和环境可以增强并常常替代针对这一特定群体的治疗干预。对于一些严重智力和多重残疾的儿童，在家中开始进行医疗治疗可能不安全。然而，需要通过观察来监测特定精神药物的治疗效果。对于智力残疾儿童，需要一个类似他们日常生活的临床环境来获得可靠的结果。
