If
you wish to return to the 'Ask Dr. Dunc.' mainpage, please click
here
If
you wish to visit the 'Ask Dr. Dunc.' question archives, please
click here
Question 78: I have one student, labelled with a developmental
disability, who deeply wants to be part of the regular grade 6 scene
but has great difficulty with anyone or anything which blocks or delays
his general wish of being included. I spoke to his father at length
in December about your reference to disinhibition difficulties and
he did seem open to the idea that something like that could be going
on with his son. Is a medical workup the place to start in case medication
would help? Or is there another point of entry that you would recommend?
R.A. (special education teacher), ON, Canada.
Certainly
if you think diagnoses above and beyond the intellectual limitations
covered by the Deveopmental Disability (still formally recognized as
Mental Retardation) diagnosis may be present and the parents agree,
getting an appointment with a professional who can diagnose a disinhibition
disorder like TS, ADHD, OCD etc. would be the important first step,
yes.
-A pediatrician,
neurologist or psychiatrist (all medical doctors) can do so, and are
covered by the Ontario Health Insurance Plan (OHIP), but the wait-lists
can be formidable and usually a family doctor has to give a referral
(many parents can tell you stories of instances where their general
practitioner has been sometimes reluctant to do so).
-On the
other hand a Psychologist can also diagnose, does not need a referral,
and the wait-lists (if they exist at all) are typically shorter. The
shortcoming here is that Psychologists are not covered by OHIP (although
most work insurance policies include at least some coverage for Psychologists).
After
the diagnosis is made, if medication is warranted only a medical doctor
can prescribe in most parts in Canada (although some Psychologists in
remote northern areas of Canada are given special permission to do so).
Psychologists can recommend medications in their reports, however, and
with your permission send a copy of the report to your family doctor
or pediatrician to provide a prescription.
The best
of luck to the family! And may I take my hat off to such a diligent,
invested, and caring teacher. Thank you for doing what you do sir.
All
activities related to Life's A Twitch!® are conducted
by B. Duncan McKinlay, Ph.D., C.Psych. in a private capacity and
do not represent the Ministry of Children and Youth Services or
the Government of Ontario.
Dr.
B. Duncan McKinlay's Life's A Twitch!®
Site
on
Tourette Syndrome & Associated Disorders
