May, 20, 2009

In this issue of the “Reviews and Reports”, Dr. Shobin discusses the risk/benefit analysis that should be applied to the decision of whether annual PAP and pelvic exams are appropriate for all individuals with intellectual disabilities. This is a difficult topic as contending issues of discomfort and trauma of the exam must be balanced against general population recommendations and personalized care and, frequently, an unreliable sexual history.

In this issue of the AADMD Reviews & Reports, Dr Zelenski addresses the complex problem of destructive/maladaptive impulsive behaviors, which often occur in persons with severe cognitive dysfunction. Those of us who work with this patient population are intimately familiar with the various types of aggressive, self-injurious, or ritualistic-like behaviors that at times seem to “come-on-out-of-the-blue” with no obvious reason. Since it is “behavior,” it makes sense to consult with a psychologist or psychiatrist since “behavior management” is what they do; however, as Dr.