Choosing to medicate a child with a developmental disability is a decision best made after research and consultation with their doctor and other treatment resources.
For most of us, taking a medication to alleviate a symptom or illness is simple: your doctor prescribes a medication, you take it, and your symptoms improve. For children, teens, and adults with developmental disabilities, prescribing the right medication is much more difficult and may create trying periods in your lives before the right dosage and the right medication are settled.
Medicating a child with a developmental disability is a complex process, and each child will react differently. For some children, psychiatric medication does not help as much as habilitative therapies do. As a parent, you should weigh all factors involved and make sure that any prescribed medication’s benefits outweigh its risks.
Medications for Children with Developmental Disabilities
Prescription medications are commonly prescribed for children with an IDD for a variety of reasons. When they work, they can give your child the ability to focus and achieve their highest potential. Getting to this therapeutic state can be problematic, though, as children with additional physical disabilities may already take a variety of medications. Special care needs to be taken to avoid dangerous interactions.
With any child, the benefits of a medication should outweigh its risks and side effects. A neurotypical child or teen will be able to relay whether they feel better, worse, or the same and also tell you about any uncomfortable side effects. Children with developmental disabilities that include communication problems are much less likely to convey their thoughts or feelings about a new medication, even if it is making them feel worse. You will have to watch and wait for signs of troubling changes in your child.
A child on the autism spectrum may not be able to relay the physical complaints that are often the first sign of a medication mismatch. If you are the parent of an autistic child, you already know how closely you have to watch for signs of worsening or improvement when you make a change to their diet, medication, or routine.
Since children with developmental disabilities also have different reactions to painful sensations, they may not even realize there is a problem with a new medication until an uncomfortable or dangerous side effect has progressed. The inability to communicate clearly or at all can make it difficult to tell if a new medication is working.
Even though your child may not be able to clearly articulate her discomfort, or tell you how a new medication is making her feel, the physical side effects will still impact them. Some medications, like those used for anxiety, depression, and other psychiatric disorders can have severe effects on teens and young adults. This has led to the FDA’s “black box” warnings about the risk of suicidal behavior when taking these medications. Communicate with your child’s prescribing physician if this is a concern of yours.
Side Effects and Other Considerations
Since many of the medications designed to improve mental health and outlook are intended to be used in conjunction with therapy, then consider how a therapy setting is working for your child before committing to a new medication. If your child is already receiving behavioral therapy, you, the prescribing physician, and their therapist should be clear about the goals of the medication, the type of behavioral support that will be needed, and the potential outcomes.
With recent advances in genetic testing, medication specific testing will soon be available on even more drugs. These tests will tell a family if a child is a good candidate for a certain medication and if so, if that child is likely a hyper- or hypo-metabolizer. This will assist the prescribing physician in getting that child into a therapeutic range of the medication with much less trial and error in the dosing process. The cost remains high for the currently available tests at anywhere from $300 – $600 per test, but recent advances have brought the costs down by several thousands of dollars per test in the last 10 years.
According to child psychiatrist Ken Talen, medication should begin at a very low dose to avoid “zombie-like” side effects. Focus on one symptom at a time and build up to a therapeutic dosage slowly. Medication can be a life-changer if your child has a developmental disability, but only when used in the right way and closely monitored by the child’s entire care team.
If you have a child with a developmental disability, you do not have to manage their care alone. The goal of Integrity, Inc. is to support families by providing therapeutic resources you need to help your child thrive. Contact Integrity, Inc. to set up a consultation and see how our services can benefit your child at 501-406-0442.