Principles of managing an adolescent with developmental disability

Adolescents with disability generally have the same health and social concerns as those without disability; however, as they develop, gaps in the cognitive ability and social development between adolescents with disability and their peers without disability often become wider. Developmental trajectory may not match physical growth and age, so expectations should be based on developmental and cognitive level.

As in many families, the adolescent’s need for independence and autonomy may conflict with their parents’ desire to protect and nurture them. The adolescent with disability may have additional concerns, including:

• self-consciousness about their body, particularly if they have physical differences
• anger or sadness at the barriers they face to having the same life experiences as other adolescents
• frustration if they encounter difficulties expressing their independence
• limited opportunities for a private time and place to explore their sexual feelings and relationships
• difficulty finding a boyfriend or girlfriend.

These concerns can be exacerbated by cognitive or communication difficulties; and may impact on or be shared by parents and siblings. See also Social and functional support for adolescents with developmental disability, Communicating with people with developmental disability and Support for carers and family of people with developmental disability. 

Increase in physical size during pubertal growth can complicate care and contribute to certain behaviours becoming behaviours of concern. Strategies to address behaviour that were effective during childhood may need to be revised, and a behaviour plan developed to support the adolescent, and help the family to manage behaviours of concern safely; see Challenging behaviour in people with developmental disability.