"Mark spends all of his time watching TV or listening to CD’s alone in his room. He’s putting on so much weight, and doesn’t want to work at his speech therapy. His biggest goal right now is finding a girlfriend, but his dad and I want him to spend more time on his schoolwork!"

Working in a home health agency that provides case management and respite care to individuals with disabilities, you’ve heard these complaints before from parents of teens with developmental disabilities. Although Mark has Down syndrome and a history of congenital heart disease, he’s pretty much a typical adolescent when it comes to puberty issues and family relationships. At the time of life when his typically-developing peers are physically and cognitively able to separate from their parents, Mark still faces developmental delays and physical challenges that tie him to his mother and father.

Since this is your first meeting with Mark and his parents, you’ve arranged to interview them together and then separately. As you talk with Mark alone in the family room, he confides, "My mom and dad love me but they treat me like a little kid." In response to your gentle probing, Mark replies, "I want to drive a car and take a girl to the prom." When asked what he’d like to do when he turns 22, Mark promptly blurts, "Go to college and live in a dorm."

Back in the living room, you gather information from Mark and his parents to complete a nursing assessment. By the end of the session, you’ve listed a few health concerns:

• complaints of fatigue along with snoring at night,
• gum tenderness,
• dry skin, and
• a definite weight problem.

Mark and his parents agree that they need to make some decisions about social activities, and have asked you to participate in the transition meeting scheduled at his school next month. Before you leave, you outline some recommendations, and promise to make some referrals for the issues that the family is ready to address.

© RnCeus