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Article
Publication date: 7 May 2019

Arvid Nikolai Kildahl, Maria Hagen Engebretsen and Sissel Berge Helverschou

Autism spectrum disorder (ASD) is an exclusion criterion for one of the two attachment disorders in the DSM 5. However, previous findings indicate that ASD and attachment…

Abstract

Purpose

Autism spectrum disorder (ASD) is an exclusion criterion for one of the two attachment disorders in the DSM 5. However, previous findings indicate that ASD and attachment disorder are unrelated conditions and may co-occur. The purpose of this paper is to explore the diagnostic assessment of an adolescent male with ASD, intellectual disability (ID), severe challenging behaviour and a suspected attachment disorder.

Design/methodology/approach

Case study methodology was chosen because of its suitability in the exploration of complex clinical phenomena where prior knowledge is sparse.

Findings

It was possible to identify symptoms of attachment disorder in a case involving ASD, ID, anxiety and severe challenging behaviour. The Disturbances of Attachment Interview was particularly useful in this assessment, as was assessment of ASD symptoms and developmental history. Differentiating the two attachment disorders proved challenging.

Research limitations/implications

There is a need for further research in ASD and attachment disorders not limited by current diagnostic categories.

Practical implications

Co-occurring symptoms of attachment disorder may be identified in individuals with ASD and ID, and exploration of these symptoms in assessments of children and adolescents with ASD/ID and challenging behaviour may be beneficial.

Originality/value

The study adds to previous findings on attachment disorder in ASD, demonstrating that identification of attachment disorder is possible even in the presence of a highly complex clinical picture involving severe challenging behaviour. It may also assist other clinicians in identifying and making more accurate assessment of attachment disorder in ASD and ID.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 13 no. 2
Type: Research Article
ISSN: 2044-1282

Keywords

Article
Publication date: 25 June 2019

Arvid Nikolai Kildahl, Maria Hagen Engebretsen, Kristin Horndalsveen, Jane Margrete Askeland Hellerud, Jorunn Ytrehorn Wiik, Gro Aasen and Sissel Berge Helverschou

Psychiatric assessment in adults with autism spectrum disorder (ASD) and intellectual disability (ID) is complex and challenging. With co-occurring congenital blindness…

Abstract

Purpose

Psychiatric assessment in adults with autism spectrum disorder (ASD) and intellectual disability (ID) is complex and challenging. With co-occurring congenital blindness, this complexity is increased. Systematic knowledge about psychiatric assessment in this combination of challenges is virtually non-existing, and there is little guidance available for clinicians faced with this task. The paper aims to discuss these issues.

Design/methodology/approach

Experiences from comprehensive psychiatric assessments in two adults with congenital blindness, ASD, and ID are explored and discussed.

Findings

Adaptation of assessment procedures usually employed for individuals with ASD and ID involved no major alteration, but co-operation between mental health and visual impairment professionals was important, as was the involvement of the families of the individuals in question. In both cases, the patient met criteria for an anxiety disorder, underlining the vulnerability and the challenges involved in living with this combination of challenges.

Research limitations/implications

There is an urgent need for research into mental health issues for this group, including case studies describing successful treatment or intervention for these issues.

Practical implications

Psychiatric assessment in individuals with this combination of challenges may be feasible, but requires involvement of professionals specializing in mental health in developmental disabilities, and professionals in visual impairment. Assessments need to be individually adapted.

Originality/value

This is the first study systematically describing psychiatric assessment in this group involving the use of checklists and assessment tools. Strategies and tools that were useful are described and discussed to aid other clinicians faced with similar challenges.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 13 no. 5
Type: Research Article
ISSN: 2044-1282

Keywords

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