TABLE 2.

Clinical approach to a behaviour disorder in a child with an intellectual disability

Properly identify the behaviour disorder in the history. Consider an organic cause to explain the behaviour disorder. Find a possible chronological link between the symptoms and the use of medication. Consider a psychiatric illness that can explain the behaviour disorder. Propose the following steps for treatment: Usually start with a behavioural approach or modify the environment. Behavioural approach alone does not suffice and ADHD symptoms are present: treat ADHD. Behavioural approach alone does not suffice and no indicators for an underlying psychiatric illness or ADHD exist: use pharmacological approach based on symptoms. Initial assessment indicates a psychiatric illness: refer to a child psychiatrist. If the physician is comfortable with his/her assessment, he /she may start the treatment.

ADHD Attention-deficit hyperactivity disorder