Psychiatric assessment of severe presentations in autism spectrum disorders and intellectual disability.
Children with autism spectrum and related disorders and intellectual disability are not protected from the experience of psychiatric illnesses. Many factors can contribute to exacerbation of existing behavioral symptoms or to the emergence of new psychiatric problems. The psychiatric assessment must thus take into account a range of possible etiologic or contributory factors. The approach outlined in this article highlights the value of assessing 4 broad domains, including diagnostic (genetic) factors, medical considerations, developmental influences, and environmental factors. Examples of how the consideration of each of these domains may inform the diagnostic formulation are highlighted.
Department of Psychiatry and Behavioral Medicine, Seattle Children's Autism Center, Seattle Children's Hospital, Seattle, WA, USA; Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA. Electronic address: bhking@u.washington.edu.
Bryan H
BH
King
Nina
N
de Lacy
Matthew
M
Siegel
D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology; D002648:Child; D002659:Child Development Disorders, Pervasive / Q000453:epidemiology* / Q000235:genetics / Q000523:psychology; D005260:Female; D006760:Hospitalization; D006801:Humans; D008607:Intellectual Disability / Q000453:epidemiology* / Q000235:genetics / Q000523:psychology; D007406:Interview, Psychological / Q000379:methods; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012307:Risk Factors; D012931:Social Environment; D063189:Symptom Assessment / Q000379:methods
Aggression; Autism; Hyperactivity; Intellectual disability; Psychiatric evaluation; Self-injury