Teens with Intellectual Disability Have it Harder
Trudy is 16 and attends the local high school. Her mother tells me she’s always been an affectionate, optimistic girl with a quick smile and a big heart. But lately she’s been sad more often than happy. Lately, she has neglected her appearance, refused to do chores, and insisted on staying home from school and staying in bed. She doesn’t even want to watch her favorite videos. What could be wrong? Oh – one more thing: Trudy has Down Syndrome.
First things first: When there’s a significant change in anyone’s behavior, it’s important to make sure there is nothing medically wrong. Trudy’s mother has already taken her to a doctor and been reassured that Trudy is physically fine. Her labs came back normal. She doesn’t have the flu that’s been going around. Her heart (repaired when she was only 6 weeks old) is beating strong. So that’s not it.
What we’re probably seeing, then, is the emergence of some kind of psychological distress.
Sadly, it’s common. While about 20 percent of American teenagers between the ages of 13 to 18 are affected by some type of mental disorder to an extent that they have difficulty functioning, teens with intellectual disability are more than twice as likely to develop a mental illness. Double!
The reason is a convergence of more traumatic experiences with less of the inner resources needed to handle them.
Life for teens with an intellectual disability is hard.
My colleague, Daniel Tomasulo, suggests that people with intellectual disability (ID) suffer both “big T” traumas and “little t” traumas. “Big T” includes what you’d expect: such events as car accidents, house fires, rape, bullying, and violence. But “little t” might surprise you. People with intellectual disability depend on a certain amount of predictability and stability in their lives to manage. A typical teen might be annoyed at forgetting her lunch or homework. She might welcome having a substitute teacher for art class or a change in schedule because a special speaker came to the school. But for kids with intellectual disability, such changes are scary. Without the external structure of predictability, they lose their bearings. Unless someone quickly helps them understand what’s going on, anxiety often overtakes them.
For a teen like Trudy who has mild ID, just knowing and coming to terms with the fact that she has Down Syndrome is in itself “little t” traumatizing. Having entered adolescence, she has come to understand that she isn’t like everyone else at school. She desperately wants the things that she sees her peers having: a boyfriend, a driver’s license, independence. She watches the same videos, movies, and TV shows as her contemporaries. Few of them include people like herself. When she looks around at school, she doesn’t see many people like her there either. Like every teen, she hates feeling different. She especially hates feeling alone in her difference. It’s no surprise, then, that she might go through periods of depression and anger.
One of the most important factors that helps a typical teen cope is having loyal friends. Kids like Trudy often don’t have any. Even when they have some friends among their typical classmates, they are often confused by peer behavior. The kid who befriends her in class may ignore her in the lunchroom out of fear of peer judgment. Often the Trudys in a school are the victims of teasing, even bullying. At school, then, their reliable support system often is only some adults. A couple of paraprofessionals and teachers who care isn’t the same as a circle of true friends. Life at school can be pretty lonely.