[Emotional development in individuals with intellectual disability: clinical and therapeutic perspectives]

Individuals with intellectual disabilities (ID) show not only cognitive but also emotional developmental delays, which can be associated with challenging behavior, unnecessary psychopharmacological treatment and restricted participation. The emotional development approach provides a framework for understanding behavior associated with a certain developmental level, differentiating it from mental disorders and making it usable for diagnostics, treatment and support.

The objective is to present the theoretical foundations, diagnostics and clinical relevance of emotional developmental level for behavioral problems, mental disorders and treatment or intervention planning in adults with ID.

The emotional development approach and current empirical studies on challenging behavior, mental disorders and developmentally appropriate treatment options in people with DID are presented.

In addition to intellectual development, socioemotional abilities are also impaired in people with ID, with the severity of behavioral disorders increasing in lower developmental stages. Depending on the emotional reference age, development typical behavior, so-called behavioral phenomena, can be found, knowledge of which is helpful for distinguishing them from mental illnesses. Certain clinical pictures, such as autism spectrum disorders, feeding or tic disorders occur more frequently in early developmental stages, whereas others such as dissociative disorders, social phobias or personality disorders are only observed above a developmental age of 4 years. Disorders such as depression, posttraumatic stress disorder and schizophrenia occur in all developmental stages, independent of the emotional reference age. Developmentally appropriate treatment planning reduces the use of psychotropic medication, particularly in behavioral disorders, while simultaneously improving behavior, mood and adaptive skills.

The emotional development approach enables practitioners to engage in developmentally appropriate communication and interaction, supports differential diagnostic clarification and facilitates tailored therapy and treatment planning.