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The Skills System is a user-friendly set of emotion regulation skills, designed to help people of various ages and abilities, manage emotions. Learning how to regulate emotions enables us to be present in the moment and be more effective–even in stressful situations. Over- and under-reacting can cause more stress and problems. The Skills System helps us be aware of our current moment, think through the situation, and take goal-directed actions that align with our values.
The Vital Role of Specialized Approaches: Persons with Intellectual and Developmental Disabilities in the Mental Health System is training material used to describe the co-occurrence of mental health and developmental disabilities, current trends, resources, policy recommendations, and much more.
Training for professionals providing services to people with co-occurring mental health and disabilities.
Toolkit for Educators: Educating Students with Autism Spectrum Disorder & Mental Health Challenges is for educators that want to learn more about working with Autistic students who also experience mental health concerns.
Plain Language Summary: Transition & Collaboration
Transition is when a student moves from high school to adult life. For students with disabilities, the law requires students with disabilities prepare for life after high school by having a plan (called a transition IEP) when a student is turns 16. The transition IEP must have goals for getting a job, college or training, and daily living. These goals match the student’s strengths, interests, wants, and support needs. The student’s education, related services (like therapy) and community activities also help reach their goals
The school has provided students their education, job training, job supports, and therapies. However, after graduating from high school, those services end. There is no single agency that will provide the full range of services given by the school. To receive help, transition-age youth must be eligible. Each agency has an application and eligibility process. For many students and families, this is a confusing process and requires help from the school and agency staff. Because the adult agencies’ process can take months, students need to apply before leaving school. To work together, each person should know each other’s role and responsibilities.
Roles and Responsibilities
Students should always be included in meetings about their education, healthcare, and services. Students should lead a person-centered planning (PCP) process to find their strengths, interests, wants and needs. The school can help the students decide their goals for work, school, and living. In most states when a youth with a disability reaches 18, they are legally responsible for making their own decisions. As an adult, they must agree to parents/guardians joining their meetings and appointments.
A parent/guardian’s role should be to advocate for a child’s quality of life. They know their child’s strengths, interests, wants, and needs. When the youth is under 18, parents have to apply for needed resources in their child’s name such as Supplemental Security Income (SSI), Medicaid Insurance, Medicaid Waivers, and Vocational Rehabilitation Services. Parents may also help their child by getting training at a Center for Independent Living, purchasing a bus pass, and getting a state identification card.
The VRC’s role is to provide career counseling and information about work. The VRC may help the student figure out what they want to do after high school. The VRC may offer Pre-employment transition services (Pre-ETS). Any student with a disability may get Pre-ETS to explore careers and get ready for working.
If a student receives a Medicaid Waiver, they will choose a case manager. The case manager will develop a plan with the transition-age youth to access community-based services and have the supports they needed for a meaningful quality of life. Based on the budget, the services may include in-home supports, daily living skills, long-term job supports, volunteer work, and others.
For more information and to see a table of Transition-Related Agencies with resource links, please read the full Transition and Collaboration Fact Sheet.
Resumen en lenguaje sencillo: Trastorno por déficit de atención y hiperactividad (TDAH) y su bajo tratamiento en jóvenes hispanos/latinx
El trastorno por déficit de atención con hiperactividad (TDAH) es una discapacidad del desarrollo neurológico que es una discapacidad que afecta la forma en que el cerebro de una persona crece y se desarrolla. Más de 3 de cada 4 niños con TDAH presentan síntomas graves cuando son adultos. Cuando el TDAH no se trata, puede causar problemas en el trabajo, la escuela, el hogar y la vida social de una persona. Obtener un diagnóstico temprano puede ser ventajoso. Con un diagnóstico temprano, una persona puede aprender a manejar tempranamente el TDAH, y de una manera que funcione para ellos. Desafortunadamente, no todas las personas con TDAH reciben un diagnóstico temprano o incluso nunca. Se cree que el TDAH afecta por igual a personas de todos los grupos étnicos. Sin embargo, los niños hispanos/latinx (H/L) son menos diagnosticados y tratados.
Los padres y maestros tienen más oportunidades de notar los síntomas del TDAH en los niños. Los valores y expectativas de una persona pueden hacer que sea más o menos probable que note los síntomas del TDAH. Por ejemplo, muchos padres H/L en un estudio dijeron que el “respeto” es importante para ellos. “Respeto” se definió como respetar y escuchar a la autoridad. Los padres que valoran el “respeto” pueden ser más propensos a notar comportamientos que parecen irrespetuosos a la autoridad. También es más probable que utilicen servicios que trabajen con estos comportamientos. Los proveedores que trabajan con familias H/L deben recordar que la población H/L es diversa y sus creencias culturales también pueden serlo.
Es importante saber que no todos los niños y adultos experimentan el TDAH de la misma manera. Mucha gente imagina al TDAH como un niño hiperactivo que no puede quedarse quieto. Aunque esto es cierto en algunos casos, no describe a todas las personas con TDAH. Los problemas de un niño con TDAH pueden pasar desapercibidos si el maestro no sabe de qué otra forma puede verse el TDAH. Por ejemplo, alguien puede tener muchos síntomas de falta de atención por el TDAH, pero pocos o ningún síntoma de hiperactividad. Algunos síntomas de falta de atención incluyen problemas en planificar y dividir su tiempo cuando tiene más de una tarea. Un niño puede ser castigado en lugar de ser ayudado cuando al TDAH se le confunde con la pereza o porque piensa que el individuo elige ser difícil.
Muchas personas con TDAH tienen problemas de salud mental. Por ejemplo, 1 de cada 3 personas con TDAH tiene ansiedad. Además, el TDAH puede afectar las relaciones de niños y adolescentes, así como también su rendimiento en la escuela. Estas son algunas de las razones por las que el TDAH puede tener un efecto negativo en la autoestima, esto es cómo una persona se ve y se siente consigo misma.
El proceso para diagnosticar el TDAH se basa principalmente en los informes de los padres sobre los comportamientos de sus hijos. Los valores culturales afectan la forma en que un padre ve e informa el comportamiento de su hijo. Se recomienda que los profesionales que diagnostican el TDAH realicen una entrevista detallada con los padres. Hacer una entrevista ayuda al profesional a conocer las creencias de los padres y cómo son los comportamientos del niño. Esto puede ser muy útil cuando los maestros y los padres tienen diferentes puntos de vista sobre el comportamiento de un niño. Los profesionales tampoco deben asumir que un padre ya sabe sobre el TDAH. El conocimiento de un padre sobre el TDAH puede afectar en cómo informan y cómo reaccionan a un diagnóstico. Los grupos de educación parental pueden brindar información y apoyo a los padres.
Para obtener más información y recursos, lea la hoja informativa completa sobre el trastorno por déficit de atención e hiperactividad y su bajo tratamiento en jóvenes hispanos/latinx.
Plain Language Summary: Attention-Deficit/Hyperactivity Disorder and Its Undertreatment in Hispanic/Latinx Youth
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disability. A neurodevelopmental disability is a disability that affects how a person’s brain grows and develops. More than 3 out of 4 children with ADHD have serious symptoms when they are adults. When ADHD is not treated, it can cause problems in a person’s work, school, home, and social life. Getting a diagnosis early can be helpful. With an early diagnosis, a person can learn how to manage ADHD sooner- in a way that works for them. Unfortunately, not everyone with ADHD is diagnosed early or at all. ADHD is believed to affect people from all ethnic groups at equal rates. Yet, Hispanic/Latinx (H/L) children are diagnosed and treated less.
Parents and teachers usually have the most opportunities to notice ADHD symptoms in children. A person’s values and expectations can make them more or less likely to notice ADHD symptoms. For example, many H/L parents in a study said “respeto” is important to them. “Respeto” was defined as respecting and listening to authority, people in charge. Parents who value “respeto” might be more likely to notice behaviors that look disrespectful to authority. They may also be more likely to use services that work with these behaviors. Providers working with H/L families should remember that the H/L population is diverse, and their cultural beliefs can be too.
It is important to know that not all children and adults experience ADHD the same way though. Many people picture ADHD as a hyperactive child who cannot sit still. Although this is true in some cases, it does not describe everyone with ADHD. A child’s struggle with ADHD might not be noticed if a teacher does not know how else ADHD can look. For example, someone can have many inattentive symptoms of ADHD and little to no symptoms of hyperactivity. Some inattentive symptoms are problems with planning and dividing your time between more than one task. A child may be punished instead of helped when ADHD is mistaken for laziness or as them choosing to be difficult.
Many people with ADHD have mental health concerns. For example, 1 in 3 people with ADHD have anxiety. Also, ADHD can affect children and teenagers’ relationships and how they do in school. These are some reasons why ADHD can have a negative effect on self-esteem. Self-esteem is how a person sees and feels about themselves.
The process to diagnose ADHD greatly relies on parents’ reports of their child’s behaviors. Cultural values affect how a parent views and reports their child’s behavior. It is recommended that professionals, who diagnose ADHD, do a detailed interview with parents. Doing an interview helps the professional learn about parents’ beliefs and what the child’s behaviors look like. This can be very helpful when teachers and parents have different views on a child’s behavior. Professionals also should not assume that a parent already knows about ADHD. A parent’s knowledge of ADHD can affect their report and how they react to a diagnosis. Parent education groups can provide information and support for parents.
For more information and resources, please read the full Attention-Deficit/Hyperactivity Disorder and Its Undertreatment in Hispanic/Latinx Youth fact sheet.
Plain Language Summary: Trauma Focused Cognitive Behavioral Therapy (TF-CBT)
Trauma Focused Cognitive Behavioral Therapy (TF-CBT) is a therapy for children or adolescents who have experienced a traumatic or other distressing event. TF-CBT is based on CBT and has not yet been studied with populations who have developmental disabilities. TF-CBT has three stages: stabilization and skill building, trauma narration and processing, and review of what has been learned and closure of treatment.
As with any therapy relationship, you’ll spend some time getting to know your therapist and making sure they’re a good fit for you. You are always welcome to bring a trusted friend or family member if you prefer.
During these stages the therapist will work with the youth on relaxation techniques, emotion recognition, and identifying negative thoughts. They also work on something called “psychoeducation” which involves educating children and their parents about trauma and the effects it can have. The therapist and child will also work together to write a “trauma story”, this is a retelling of the upsetting event as the child experienced it. This allows the child to come to an understanding of the event. The therapist also helps the child to process the event in a healthy, safe setting. Through gradually exposing the child to memories of the event, their anxiety and stress will reduce. Finally, the therapist works with the child and their family on maintaining gains made in therapy and to help them feel safe after the therapy ends.
To learn more, read the MHDD fact sheet on Trauma Focused Cognitive Behavioral Therapy (TF-CBT).
Trauma is when a person experiences an event, series of events, or situation that causes lasting negative effects. The traumatic event or situation is viewed by the person as being physically or emotionally harmful or life-threatening. People with disabilities have a greater risk of experiencing trauma, because they are more likely to experience unfair treatment. Negative effects from trauma can include changes to a person’s mental, physical, social, emotional and/or spiritual well-being. Some effects of trauma can be depression, changes in behavior, headaches, nausea, and more.
Not everyone who experiences trauma is diagnosed with post-traumatic stress disorder (PTSD) because people experience trauma differently. PTSD is a mental health diagnosis that means the person’s day-to-day life is affected by the trauma. Trauma can have a lasting impact on a person but does not always affect daily living.
Trauma-informed care means using information about how trauma affects people to provide them better treatment. Communication is a major challenge in understanding trauma and providing trauma-informed care to people with disabilities. It can be hard to understand a person’s needs if they have trouble putting them into words. Including caregivers in treatment can help because they can say what they think the person with a disability is experiencing. It is also important to talk to the person with a disability, because they know their experience the best.
Many professionals are not given training about how to work with people with disabilities who have also had trauma. There is a limited number of mental health workers across the country. So, the number of workers with the knowledge to help people with disabilities work through their trauma is even more limited.
Efforts are being made to improve the quality of trauma-informed care. There are organizations, such as The National Child Traumatic Stress Network (www.nctsn.org), that are working to improve care for people with disabilities who have experienced trauma. Also, some states are trying to become ‘Trauma Informed States’ which are working to improve their trauma-informed services. Consider reaching out to state officials if your state is not a ‘Trauma Informed State’. You can also reach out to healthcare workers to consider people with developmental disabilities and their care.
Read the full Trauma-Informed Care for People with Developmental Disabilities fact sheet
Professional training guide to help improve behavioral health services.
The goal of this course is to raise awareness about the issues surrounding dual diagnosis, to present some typical and atypical signs of mental illnesses that may arise in this population, and to highlight how your interactions with individuals—whatever your role may be—can contribute to better supports for individuals
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