Children with Both Developmental Disabilities and Mental Health Needs

National Policy Initiative

The Georgetown National TA Center's discussions with parents and providers and survey of state directors of mental health and developmental disabilities have highlighted common policy challenges for children with children who are dually diagnosed.

Risk and Prevalence

A greatly elevated risk for emotional difficulties is found among children and adolescents with developmental disabilities.  The rate of co-occurrence varies greatly, depending on the disability involved. As many as 30 % of children with intellectual disability may also have a pervasive developmental disorder such as autism (Dykens, 2000).   Developmental difficulties (such as intellectual disability, serious learning disability, autism spectrum disorders) are not uncommon among children with serious emotional disorders (SED).   (Click here for Pevalence Data)

Challenges to Service Access

Children with both developmental and emotional disorders often have              

• Poor access to appropriate care, sometimes because they are excluded from services because of the developmental disability or their mental health status; and
• Increased risk of out-of-home placement and involvement with the juvenile justice or child welfare system.

Parents may be required to relinquish custody in order to finance expensive care in many communities.

Communities often lack adequate services for children with complex developmental, social-emotional and medical needs.  Common structural issues include

• Inadequate access to appropriate services,
• Categorical funding,
• Inadequate numbers of cross-trained professionals,
• Eligibility barriers, and 
• Glaring gaps in available services.

State Recognition

Staes have recognized the importance of addressing policy issues for this group of children because the need for services is so great and care for some individuals can be exorbitant if adequate community resources are not in place.

Federal Effort

The National TA Center helped organize and staff two federal Interdepartmental Meetings in February and April 2004, hosted by the Office on Disability in HHS and co-sponsored by the Center for Mental Health Services at SAMHSA.  The meetings:

• Were an outgrowth of a Roundtable on Children with Co-occurring Developmental Disabilities and Mental Health Needs at Georgetown in August 2003, and 
• Highlighted federal policy barriers that impede care for this target population and  focused on engaging collaboration across federal departments. 

Identifying Exemplary Programs

The National TA Center is very interested in learning and sharing information about successful statewide efforts and exemplary local programs for this population of children and their families.  Individuals with special interest in this topic or information about exemplary state or local programs are invited to contact:

Diane Jacobstein, PhD at jacobstd@georgetown.edu.