Bruce D. McCreary is professor emeritusin the Division of Developmental Disabilities at the Department of Psychiatry, Queen's University.

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Jessica Jones is an associate professor in the Division of Developmental Disabilities at the Department of Psychiatry, Queen's University.

CONTENTS

Foreword..................................... vii

Preface...................................... ix

How to Use This Guide........................ xi

PART 1 - KNOWLEDGE

1.1 To understand the impact of different levels of intellectual
impairment on an individual’s adaptive behaviour in
childhood and at maturity.........................................................2

1.2 To understand the contribution of genetic factors and
environmental influences to the etiology of developmental
disabilities and dual diagnosis.......................................................5

1.3 To understand the role of developmental programs, case
management, and social services in providing care and
support for persons with intellectual disabilities and dual
diagnosis, and their families.........................................................8

1.4 To understand the comorbid health problems that influence
the adjustment and quality of life of persons with
developmental disabilities........................................................... 10

1.4.1 Congenital anomalies........................................................... 11

1.4.2 Sensory impairments.......................................................... 12

1.4.3 Epilepsy....................................................................... 14

1.4.4 Cerebral palsy.................................................................... 15

1.5 To understand the comorbid mental health problems that
influence the adjustment and quality of life of persons with
developmental disabilities.............................................................. 16

1.5.1 Diagnostic and nosologic challenges................................... 17

1.5.2 Level A: Pervasive developmental disorders........................ 18

1.5.3 Level B: Psychiatric illnesses............................................... 21

1.5.4 Level C: Personality disorders............................................. 25

1.5.5 Level D: Problem behaviours.............................................. 26

1.5.6 Level E: Other disorders...................................................... 28


Part 2 - Skills

2.1 To be familiar with how to prepare treatment-management
plans for persons with developmental disabilities and dual
diagnosis....................................................................... 31

2.1.1 Collecting the history.......................................................... 32

2.1.2 Conducting clinical examinations and assessments............. 33

2.1.3 Formulating treatment-management plans........................... 35

2.2 To be familiar with the necessity of interprofessional
collaboration in providing care and support for persons
with developmental disabilities and dual diagnosis......................... 38

2.3 To be familiar with the provision of effective caregiver
support in treatment-management plans for persons with
developmental disabilities and dual diagnosis................................40

2.4 To be familiar with the provision of ambulatory
treatment-management plans for people living in
community residences............................................................ 42

2.4.1 Developmental services...................................................... 43

2.4.2 Psychosocial treatments...................................................... 45

2.4.3 Biomedical treatments........................................................48

2.5 To be familiar with the provision of residential and hospital
treatment-management plans......................................................... 50

2.5.1 Residential treatment..................................................... 51

2.5.2 Hospital treatment........................................................ 51


Part 3 - Attitudes

3.1 To develop empathetic awareness of the special needs of
persons with developmental disabilities and dual diagnosis
for respectful health and mental healthcare................................... 55

3.2 To identify with the challenges experienced by family and
agency caregivers who provide care and support for persons
with developmental disabilities and dual diagnosis......................... 58

3.3 To respect the contributions of various professional
disciplines who provide services for persons with
developmental disabilities and dual diagnosis................................60

3.4 To develop vigilance regarding the risk of neglect and abuse
observed in persons with developmental disabilities and dual
diagnosis....................................................................................... 62

3.5 To acknowledge important attitudinal variables involved in
providing optimal care and support for individuals with
reduced mental capacity to make decisions................................... 63


Appendices

A. A format for recording the clinical history..................... 67

B. A framework for treatment-management planning.............. 74

C. Self-examination questions and answers..................... 76

D. Case vignettes..............................................80

Glossary................................................................ 93

About the Authors........................................................99

Index.................................................................. 101