Physical Roots of Behavior

There is a principle in  medicine and psychology that is important to know. It can affect people with disabilities in a profound manner. It is called Diagnostic Overshadowing.

“It is the idea that once a person is given a diagnosis there is a tendency to see that as the reason for everything that occurs for that individual,” Ashley Burghardt, a Wildwood behaviorist, says. “That type of overgeneralizing can cause teachers, professionals and families to form the wrong conclusions, especially around behavior.”

Assuming that the behavior of an individual is solely  because of their disability often results in missing the true causes of their symptoms. It is important to examine a person as completely as possible, especially when it comes to behavior. Physical issues are some of  the most common causes of behavior that may cause an individual difficulty.  Many developmental disabilities also have common medical components.

Gastrointestinal issues are unpleasant to experience for anyone. Over 50% of people with autism experience regular constipation. It should come as no shock to anyone that this can lead to increased irritability, hyperactivity and even defiance. Gastroesophageal Reflux Disease is two to three times more common in people with autism. This will affect an individual’s appetite and sleep and may result in maladaptive self-injurious responses like slapping of the chest. A condition called Bladder Bowel Dysfunction can occur when a person’s sensory preferences may lead them to hold their urine or stool.  This can have long term effects keeping them from having regular digestive processes which can lead to discomfort and behavioral issues.

Epilepsy is a group of neurological disorders that are categorized by recurrent seizures. As many as 25% of people with autism have some type of epilepsy.

“Epilepsy can get in the way of communication skills, it can have effects on mood and cause heightened anxiety. In people with autism it might be the case that these characteristics may have more to do with the epilepsy than autism,”  Ashley says.

Sleep issues occur twice as often in people with developmental disabilities as they do in the general population. Almost all of us experience problems falling or staying asleep sometimes and you know that on those days you are likely to feel more anxious, agitated and restless. Things bother you more the day following a bout of insomnia.

“People with autism often experience sleep disturbances and this can exacerbate attention deficit disorder, sensory sensitivities, anxiety and depression,” Ashley says.

Urinary tract infections are painful and often difficult to treat. For people who have difficulty expressing themselves verbally this can be difficult to describe. In addition to the pain, discomfort and burning it can also mean frustration and anger when a person doesn’t feel understood. They may express themselves by reaching for the affected area, by spending additional time in the bathroom or by pointing. UTI’s can cause serious health problems if not addressed.

Medications may be used to address medical, mood or psychological issues that people with disabilities face.

“Just about every medication has side effects that can cause they’re own issues from weight gain, to fatigue to appetite increase. It is important to realize that some side effects can be predicted and that the individual is reacting to the medication and that their behavior or mood is not part of their disability,” Ashley says.

Everyone is unique and every person with a disability is unique. It is important to remember that when understanding each person. A disability doesn’t explain every behavior or mood. People are simply too complex to be reduced to a single classification.

“When we evaluate an individual’s behavior and we see something that is new for that person and that isn’t serving their needs we always think first about a medical explanation. We all react differently when our bodies are affected,” Ashley says. “When people have difficulty communicating it can definitely lead to misunderstanding. It is really important to think of medicine first.”

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