Developmental disabilities are defined by the Center for Disease Control and Prevention as those that cause intellectual, social, and mental incapacities inhibiting normal development in individuals. These can be diagnosed at any age from birth up to the age of 22. Such developmental disabilities may include one or more of the following, to varying levels of ability:
- Limitations in linguistic ability
- Restricted mobility
- Inhibition in learning capability
- Limited ability to live independently (requiring different levels of support and care, from occasional to full-time help)
- Limited ability to self-help (i.e. make decisions about one’s life style and life choices)
Historically such individuals may have been excluded from education and general interactions within society. Many would have lived in group care homes separate from their families, or kept within the boundaries of their home either with their families or in foster care. Modern treatment options are inclusive and aimed at helping the individual to live an independent life integrated into society. This has created previously unforeseen problems for such individuals.
The Risks Faced
The de-institutionalizing of those with developmental disabilities is accepted as a positive step in treatment and long-term care. However, with increased freedom and individual autonomy has come reduced supervision previously provided by care homes and foster care to which the majority would have been subject. People living with developmental disabilities are vulnerable to negative influence and often will need help in making informed choices about their lives. Isolation as adults, the prejudice which they will face as people with disabilities of any sort, and adaptive problems experienced when growing up mean mental health issues can also be present. The inability to communicate that may co-exist alongside the development disability exacerbates mental health issues. The cumulative effect of this leaves the person vulnerable to developing addictive problems. Statistically, those with developmental disabilities are less likely to develop addictive problems. Whereas previously accepted wisdom believed such individuals would not have addictions, we now know that a small but significant number do develop addictive problems. Cognitive impairment means informed understanding is not always possible for individuals with developmental disabilities. As children, such individuals may have been overly protected, further inhibiting the development of necessary social skills. The desire to be accepted by peers can lead to poor decision-making. The lack of understanding of specific vulnerabilities and needs of the developmentally disabled person leads to communicative and behavioral problems both on the part of the individual and their peers. Some of the therapeutic treatments individuals with behavioral developmental disabilities undergo teach compliance; for example, those diagnosed as being on the autism spectrum of disorders will be taught techniques to adapt and comply in social situations. This can leave them vulnerable to social pressures. The lack of recognition of those with developmental disabilities with regard to the risks of addiction leaves them vulnerable to developing an addiction. Specific conditions of developmental disabilities may mimic the actions of a person on alcohol or narcotics. Interaction with medications may also cover up developing addictive behaviors. This means that not only may an addiction go unnoticed by caregivers, but also that non-addicted people with certain types of developmental disability may be mistaken by law enforcement officers and the public as intoxicated. The existence of a developmental disability does not mean an inability to comprehend unfair treatment but may inhibit the ability to express oneself.
The treatment of addiction in people with developmental disabilities necessitates adaption to the specific type of disability. Understanding and acceptance of one’s addiction is essential to treatment, but if the addicted person is limited in capacity to comprehend, the treatment needs to be adapted to address these inhibiting factors. Since the 1980s the medical profession has used the term “dual diagnosis” to define those living with developmental disabilities and/or mental health issues and/or addiction. Treatments have been and are being developed. The risks of addiction and the vulnerability of those with developmental disabilities is leading to the creation of tools and methodologies enabling the individual to cope with those risks and to make healthy choices. There are people who target the vulnerable members of society; those with developmental disabilities living independently, to any degree, are vulnerable. Social responsibility towards the vulnerable in society is a neglected area of education and understanding and this aspect must be addressed. Standardized educational programs cannot serve people with developmental disabilities. Successful prevention and treatment of addiction for people with developmental disabilities requires that appropriately targeted information be available, and that caregivers be given information and access to programs appropriately aimed at their charges. Such programs are in development but there is still some way to go.