Catatonia is the term for a syndrome of psychological and motor disturbances associated with extremely abnormal changes in speech, movement, posture as well as hyperactivity and under-activity. Some individuals who are developmentally delayed develop complications characterized by catatonia. Symptoms exhibiting catatonia are present in around 1 out of 7 adolescents and in young autistic adults, thus accounting for the development of catatonia among this particular group of patients. It is extremely necessary to assess catatonia and its symptoms in individuals who have autistic spectrum disorders for the purpose of appropriate care and management and, most of all, immediate treatment.
Instructions
1. Collect information from one or both parents or any appropriate source with the help of the Diagnostic Interview for Social and Communication Disorders (DISCO). This systematic interview is used to logically ask details about the medical history of the patient especially on the onset of his atypical behavior.
2. Obtain essential information on the patient's cognitive ability by basing it on her performance before she had catatonia. Such information can be obtained from personal records as well as interviews conducted with the parents or caregivers. This is the best option in this case because it is difficult to test individuals with catatonia.
3. Classify the patient into one of the following: severe learning disability (IQ 0 to 49), mild learning disability (IQ 50 to 69) and borderline, average or high ability (IQ 70 and above) using the his cognitive ability.
4. Assess language used for expression using standardized measures if it is possible or using medical history and observation if testing is not possible. Obtain information about the patient's expressive language before the onset of the catatonia. After which, classify the patients into two groups: those with deviant or impaired language and those using normal grammatical speech with a good adequate vocabulary.
5. Assess for signs of significant and obvious deterioration in movement, pattern of activities, practical skills and self-care. Among individuals who are developmentally delayed, the onset of catatonia is shown by a number of symptoms such as increased slowness of verbal and physical responses; problems in inhibiting, initiating and completing actions; increased dependence on verbal or physical prompting by other people and a more pronounced passivity and an obvious lack of motivation. Afterward, compare these findings with the patient's previous records using a comprehensive diagnostic evaluation of medical and psychiatric symptoms.
6. Have the child undergo formal diagnosis using criteria specific for ASD (Autism Spectrum Disorders) with catatonia. Consider baseline symptoms such as stereotypy, muteness, negativism, echophenomena or various other abnormalities involving psychomotor skills.
7. Assess for other related behaviors such as Parkinsonian features that include excitement, freezing, and agitation, as well as a significant increase in the frequency of ritualistic or repetitive behavior.
8. Watch out for the deterioration of function, role and identity, as well as a gradual loss of a once normal set of behaviors or an onset of new ones.
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