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Working with Individuals with Neurodevelopmental Disorders

February 2021

Working with Individuals with Neurodevelopmental Disorders: A Psychiatrist's Perspective

Dr. Oliver C. Joseph, MD, Chief Medical Officer, Open Sky Community Services

Neurodevelopmental disorders are a broad group of conditions that appear in early childhood and continue throughout one’s life, often affecting multiple areas of life—socially and professionally —and affect one’s functional abilities.  There are many causes of neurodevelopmental disorders, some relatively common such as fetal alcohol syndrome, and others far more rare, like Rett’s disorder.  The developmental difficulties can present as a fairly narrow issue, such as a specific learning disorder, or can be more impacting, as we see with the broader intellectual disabilities.  What’s more, people can experience multiple co-occurring developmental disorders, like in the case of an individual with an autism spectrum disorder who also has ADHD and an intellectual disability. 

Individuals with neurodevelopmental disorders can experience other co-occurring psychiatric disorders at a higher rate than those without developmental disabilities and often they do not necessarily present as one would typically expect when compared to individuals without developmental disabilities.  There are also known syndromes in the population with developmental disabilities that are rarely encountered in those who do not have a developmental disability, usually leading to delayed recognition and treatment, as can be seen with acute cycloid psychosis in Prader-Willi syndrome, for example.  Additionally, there are often common medical and neurologic conditions that can co-occur in neurodevelopmental disorders such as gastrointestinal difficulties, like gastric reflux or constipation, or even the marked seizure disorders that are central to Lennox-Gastaut Syndrome. 

I have found myself drawn to working with this population not only because it is woefully underserved and in need of focused providers, but also because there is such a rich intersection of psychiatric, neurologic, and medical care.  I encourage a team-based approach to their care, by including the individual served and meeting them at their level, as well as including their family or caretakers, as much as possible.  Involving other healthcare providers, like clinicians and behaviorists, as well as other physician specialists, like primary care and neurology is also often paramount to providing the best care.  Given the complexities of working with this population, I encourage selecting a provider who has demonstrated expertise.  Providing for these individuals can be challenging at times, but the reward of helping individuals who at times have difficulty communicating their needs more than makes up for the challenge.  I work with this population nearly exclusively and have found it has become a driving force for me. 

About the Author: 

Dr. Oliver C. Joseph, MD, has been at Open Sky Community Services since 2018. First serving as a consulting psychiatrist, and currently serving as Chief Medical Officer. He secured a $100k grant over a two-year period to help fund an Intellectual/Developmental Disability Clinic, which has shown success in reducing medication burden, as well as hospitalization and emergency room visits.

Dr. Joseph takes a person-centered approach to psychiatric care, not only delivering the strongest evidence-based care, but also looking beyond just medication management. He has special interest and expertise in serving those with neuropsychiatric conditions, including intellectual/developmental disabilities, autism spectrum disorders, acquired/traumatic brain injuries and neurodegenerative conditions. 

 He graduated magna cum laude from Boston University with his Bachelor of Arts in Biology and was inaugurated as a member of the Charter Class and received his Medical Doctorate (MD) from Virginia Tech Carilion School of Medicine. He completed his training at the University of Massachusetts with a dual Chief Residency in Consult-Liaison Psychiatry and Emergency Mental Health Services, and additionally received a Medical Student Teaching Award. He has also completed his Board Certification in Psychiatry.