Sheppard Pratt, Maryland’s leading provider of behavioral health treatment services, has developed a specialized inpatient unit for the psychiatric evaluation, stabilization and treatment of adolescent patients with co-existing developmental disabilities or significant neurological impairments.
Under the direction of Desmond Kaplan, M.D., service chief, the program offers a behavioral approach to care for these dually diagnosed adolescents. It is the only one of its kind in Maryland. The cheerfully appointed, specially designed 11 bed inpatient unit is located on Sheppard Pratt’s Towson campus. Patients most appropriate for the program are adolescents, ages 10 to 18, whose intensity and/or frequency of maladaptive behaviors make them unsafe to self or others and who have sub-normal IQ’s or diagnoses of neurological illness or syndromes such as cerebral palsy, spina bifida, autism, pervasive developmental disorder, Asperger syndrome, Rett’s disorder, fragile X syndrome, Down syndrome, Prader-Willi Syndrome, Turner’s Syndrome, Lesch-Nyham Syndrome, and tuberous sclerosis complex.
Criteria for admission include: IQ of between 70 and 35 or diagnosis of neurological illness or syndrome with severe impairment; Vineland Adaptive score of less than 70 (if available); and symptoms or behaviors that interfere with functioning at home, in school or in the community with a frequency or intensity that is unsafe to self or others
The goal of the program is to provide care safely, in the least restrictive environment, stressing documentable clinical effectiveness, multi-disciplinary teamwork with the patient and family, and minimization of the cost per episode of care. A priority is to encourage positive change in the young patient’s life, focusing on the development of increased independence and self help skills, thereby effectively and efficiently reintegrating the developmentally disabled child or adolescent into his or her home community.
The Adolescent Neuropsychiatry unit has a multi-disciplinary staff and higher staff-to-patient ratios than would be found on a traditional inpatient unit. Staff with experience and training in the developmental disabilities includes a child and adolescent psychiatrist with a fellowship in developmental disabilities; a psychologist with extensive training in developmental disabilities and applied behavior analysis; psychiatric nurses; social workers; occupational therapists; special education teachers and behaviorally trained mental health workers. There are regular consultations by a pediatrician and a neuropsychiatrist.
An individualized behavioral plan is developed for each patient and family as well as a transitional education plan to assure that the treatment goals can be sustained upon discharge. Each patient undergoes a systematic behavioral assessment to identify problem behavior including a functional assessment to determine whether behaviors are motivated by need for attention, escape, tangible conditions or automatic/internal triggers.
The treatment day includes a community meeting of patients and staff, two hours of educational services and at least one hour of occupational therapy, as well as therapeutic and recreational groups. The Adolescent Neuropsychiatry Program is geared to an average length of stay of three weeks. The higher staffing ratio, behavioral treatment philosophy, caregiver training and longer length of stay are all designed to result in extended periods of stability and an interruption in the cycle of repeated psychiatric hospitalizations for this population. In addition to the inpatient unit, specialized outpatient services for this patient population are available on the Sheppard Pratt Towson campus at Dulaney Station’s Family and Children’s Center (410-939-3899). Admissions to the unit are handled through the Sheppard Pratt Admissions Office at: 410-938-3800.