Behavioral Issues and Behavior Plan Considerations

Although children with CdLS can have behavior problems, this is not a foregone conclusion. Nor is it the case that behaviors always get worse over time. Problematic behaviors can occur, and both behavioral interventions and medications have been used in children with CdLS.

Your suggestions are excellent. Referring this family to a behavioralist or psychologist is critical, as they can analyze the specific behavior problems and come up with a behavioral plan. Professionals who have experience in autism are often very helpful, as the two groups of children often have shared behavioral and communication issues. Working on the communication issue is also very important. A lot of "behavior problems" can stem from the frustration of not communicating one's thoughts or needs. Consultation for an augmentative communication device would be great. As you mentioned, using picture cards and having a predictable schedule are very important as well. The picture cards facilitate communication and the schedule may do much to ease anxiety (and ensuing behavior problems that result from not knowing what will happen next).

I would suggest trying all of the strategies that you outlined to help extinguish undesirable behaviors and to promote communication. These kinds of interventions can make a huge difference in terms of behavior. Medications could be considered if behavioral interventions do not work, but there has been inconsistent response to psychotropic medications.

My suggestion would be to exhaust the non-medication interventions first (they are often effective, and would result in less risk for the patient).

EA/ TK 7-13-10