George, age 17, sometimes suffers from severe depression, but not for the reasons that you might think. He’s not sad because he’s not liked by friends, and he’s not depressed because he’s not doing well in school. He’s depressed because he is different than his peers in ability, cognition, and development.
When George was 5 years old he suffered a traumatic brain injury which affected his life significantly. As he got older, he had seizures. He wasn’t able to articulate his words clearly, and there were some things he didn’t understand. As he grew, his thinking capacity did not. Although he was progressing into his early teens and adolescence, his body and mind remained developmentally younger. Furthermore, George couldn’t walk or talk as well as his peers.
Despite this, his parents feel that George is able to understand much more than most people give him credit for. They believe that even when George is quiet, he’s thinking. Or even when George is perseverating on numbers, like he does often, that he’s also using that time to reflect and contemplate. In other words, his parents believe that George is much brighter than he comes across.
And they feel that this is precisely what is contributing to George’s depression. George isn’t able to express himself, to use skills of the mind that he used to once have. Although George experienced a brain injury when he was young, there are parts of him that yearn for expression, such as his intelligence, feelings, and spirit. Today, George has improved immensely because of different forms of therapy he has attended, the support of his family and friends, and his willingness to not let his condition get him down.
Having a developmental disability, which is what George has, means an individual has a disability that impairs his or her general intellectual functioning and/or adaptive behavior. A developmental disability is one that manifests before the age of 22 and typically means a substantial impairment for a teen. Some examples of developmental disabilities include cerebral palsy, mental retardation, epilepsy, autism or other neurological conditions.
There are various forms of treatment for those with developmental disabilities, such as those described below. These therapeutic modalities not only support the daily living skills of a teen with a developmental disability, but they can also provide the structure that’s necessary so that depression and/or anxiety is not as difficult.
Applied Behavioral Analysis (ABA)
This form of therapy has been used to treat children and teens who are either autistic or have a developmental disability since the 1960’s. It addresses the communication, social, academic, and behavioral impairments that are common among those diagnosed with autism, and other disorders. This form of therapy is derived from the work of B.F. Skinner, a Behavioral Psychologist who developed what is known as operant conditioning. It uses the basics of conditioning – an antecedent, the resulting behavior, and consequence – in order shape a teen’s unwanted behavior so that it is socially acceptable.
Pivotal Response Treatment (PRT)
Because ABA has been so successful, variations of this therapy have emerged. One of these is PRT, developed in the 1970’s. It uses the methods of ABA, but focuses on pivotal behaviors that have a strong influence on a teen’s overall conduct. By focusing on these core behaviors, an overall change in behavior can be made. Its teaching focus is on language skills, decreasing disruptive and self-stimulating behaviors, and enhancing social and communication skills. One difference in PRT is that it is child-directed. This is achieved by uncovering the teen’s intrinsic desires to change. Depending on how a teen responds to sessions determines the next steps in therapy. Each session is tailored to meet the goals and needs of a teen as well as fit into the family’s routine at home.
Verbal Behavior (VB)
This form of therapy is also a variation of ABA. Its focus is on language and how language can be used to shape behavior. B.F. Skinner also developed the idea that language can be grouped into various forms of operants, each serving different behavioral functions. Using these operants appropriately can help to shape the behavior of an autistic or developmentally challenged teen.
These forms of treatment can be useful for those teens who find that their developmental or intellectual impairment affecting their mental health.