67.2 ADDRESSING PROBLEMS OF DISTRIBUTIVE JUSTICE IN THE CARE OF CHILDREN WITH INTELLECTUAL DEVELOPMENTAL DISORDERS (IDDS) WHO HAVE SUFFERED TRAUMA

Abstract

Children with intellectual development disorder (IDD) present with unique challenges when in crisis. Medical and nursing staff in emergency rooms/mental health crisis response are often less effective in understanding the needs of these children when they present relative to children of the same age without IDD. Ineffective communication can be misunderstood as defiance. The trauma response can be construed as agitation, and hence, they receive less equitable attention and care. Takahiro Soda, MD, PhD, will present a case of a patient with IDD that presented to the emergency room medically decompensated and will discuss the numerous challenges and ethical dilemmas that often arise when patients with IDD present in crisis. The practical/systematic barriers that exist in some communities that make providing optimal care for patients with IDD presenting with trauma difficult will be discussed, and the ethical duties of the child and adolescent psychiatrist in these difficult circumstances will be addressed. Practices to reduce further traumatization while in the acute medical care setting will be presented. Through this presentation, participants will gain an understanding of how to help the child with IDD and their families optimally navigate through an acute traumatic event leading to crisis and reduce further traumatization. Closely considering traumatic events as a possible cause of behavioral dysregulation will also assist in providing individuals with IDD much-needed care during crisis or after acute traumatic experiences. The psychiatrists will also be able to advocate for more equitable care. Incorporating trauma into the differential for patients with IDD with an acute medical presentation can improve the care of the child with IDD by helping providers reframe the patient’s behaviors, increase therapeutic alliance, and help us advocate for better care.