Wanneer medicatie opstarten voor gedragsproblemen bij kinderen met een verstandelijke beperking?

Abstract

When prescribing medication for behavioral problems in children with intellectual disabilities? Factors that determine the prescription of medication for behavioural problems in children with intellectual disabilities. A quantitative research. Background: Behavioral problems are in children (<12 years) with intellectual disabilities, the most common reason for admission with a specialized doctor. The context often demands if there is a need for medication. Clear guidelines for when medication in this specific population is mandatory are lacking. Scope: In this research we explore which factors influence the decision making process of Flemish child- and adolescent psychiatrists before they consider prescribing medication. Methode: Through quantitative semi-structured interviews with Flemish child- and adolescent psychiatrist we gathered data that where analyzed using thematic analysis. Results: The themes that surfaced relate to an estimation if the resilience of the context is still apt or/and the child’s development is safeguarded. If there is no reason for urgency a diagnostic phase is prior. This phase consists of revealing underlying genetic, somatic or psychiatric problems and unachievable expectations regarding intellectual and emotional capacities of the child. These problems should be appropriately addressed if possible. If no underlying problem is identified or if the needed adjustments are unfeasible prescribing medication is taken in to account. Conclusion: We can conclude that the themes that surfaced are more or less in line with the NICE (National Institute for Health and Care Excellence) guideline. This is however a general guideline not specifically targeting children. Using the themes the participants reported we propose a flowchart that could be helpful in the decision-making process when prescribing medication is considered.