Teaching Students with Autism and Mood Disorders
It’s not easy to identify a mood disorder in a typically developing child. Parents, caregivers or professionals may not understand all the signs associated with mood disorders. Or maybe unusual behavior can easily be associated with a recent environmental change, trauma or development milestone. For children with autism, diagnosing mood disorders or mental health issues are even more difficult, according to Dr. Sonal Moratsche. Dr. Moratsche is board certified in child, adolescent and adult psychiatry, and recently hosted a webinar presented by edWeb.net, Autism and Mood Disorders: Assessment & Intervention. Like typically developing children, mood disorders can occur in children and young adults with Autism Spectrum Disorder (ASD). In addition to her private practice, Dr. Moratsche works with students enrolled in the Monarch Center for Autism, based in Shaker Heights, OH. But identifying and treating symptoms of mental health can often be really challenging because mood disorders may present differently when a child or teen also has autism. Even more frustrating for individuals, parents, caretakers, and professionals working with children with ASD is that research or evidence regarding mood disorders and autism is severely limited. In specifically looking at individuals with autism, studies suggest that the prevalence of major depressive disorder ranges from 1.4 percent to 38 percent. Similarly, studies have found that the prevalence of bipolar disorder in individuals with autism to range from 1.4 percent to 30 percent. “With such wide margins in the ranges amongst findings, it can be said that the current research is largely inconclusive,” said Dr. Moratsche. So what do you do if a child with autism displays signs of a mood disorder? According to Dr. Moratsche, it is best to facilitate assessments with various medical and psychiatric professionals. Assessments will be successful if you consult a variety of sources for data or opinion. Additionally, if a mood disorder is suspected, caretakers and parents should start documenting onset behavioral differences by recording changes in patterns of sleep, eating or aggression. With about 10 percent of the general population diagnosed with some form of mood disorder, there is a strong inclination to prescribe medication to manage mental health amongst doctors and psychiatrists. However, children with ASD are more sensitive to side effects the commonly prescribed medications for treating mood disorders. And, just like in the general population, an individual with autism taking a psychiatric medication should also be engaging in non-pharmacological approaches, such as behavioral and sensory interventions and therapy. As educators, teachers and support staff of students with autism and mood difficulties, there are a few approaches to help in managing their learning and environmental needs. Educators can support students by understanding how they can or prefer to communicate their emotional needs. Additionally, educating students on how to identify different moods can be extremely helpful in supporting individual needs. According to Dr. Moratsche, you can help the student communicate and express emotions by teaching the 5-Point Scale and the Zones of Regulation. Additionally, common communication tactics for nonverbal students, like worksheets or laminated cards displaying different emotions and feelings, can be really helpful in identifying triggers or practice techniques to manage distress. Finally, if supports or interventions prove ineffective, Dr. Moratsche suggests taking the following steps:
- Stop and reassess.
- Gather opinions from multiple sources/informants.
- Ask questions!
- Have honest, open dialogue with parents.
- Call for reinforcements.