Late Diagnosis of Developmental issues and Failure to Accommodate executive Functioning challenges raises risk of institutionalization

Conjecture

CMS (the Centers for Medicare & Medicaid Services) and others have championed Physical and Mental Health Integration --- one of the other important components to that is DEVELOPMENTAL HEALTH.

We currently have a sizable number of people who are getting a LATE DIAGNOSIS of a NEURO-DEVELOPMENTAL DISORDER such as ADHD and/or AUTISM that come with significant EXECUTIVE FUNCTIONING CHALLENGES.

I would submit that LATE DIAGNOSIS of NEURO-DEVELOPMENTAL DISORDERS is INCREASING INSTITUTIONALIZATION of people with Neuro-Developmental & Psychiatric Disorders insofar as NEURO-DEVELOPMENTAL and PSYCHIATRIC DISORDERS appear to be on a CONTINUUM.

Further, CHRONIC STRESS resulting from UN-ACCOMMODATED EXECUTIVE FUNCTIONING CHALLENGES is increasing the burden on individuals, families and the communities in this country as well as other countries.

In some ways --- this may not be that new --- we just didn't recognize it. 

In the 20th Century --- SMOKING EXPLODED --- and a population that had significant Neuro-Developmental Disorders was perceived calmer and more stable in some respects --- even as large numbers of people were dying of heart disease from smoking.

Further, smoking during pregnancy multiplies the risk of ADHD in the child and that appears to go to  the 3rd Generation and maybe beyond.

We don't have the same level of smoking anymore --- but the current "Mental Health Crisis" is spiralling out of contol without better CONCEPTUALIZATIONS and TREATMENTS.

Further, this isn't just related to our "Mental Health Crisis" --- it also seems to be related to our CHRONIC DISEASE EPIDEMIC where people with ADHD and/or AUTISM seem more vulnerable to these diseases.

Additionally, our MODERN ALIENATED, INDIVIDUALIST WORLD VIEW has not always been helpful in understanding this --- if we think this is just about the "LIFESTYLE CHOICES" of the INDIVIDUAL --- IT'S NOT.

Further, it is not just about the LIFESTYLE CHOICES OF THE PARENT. 

BUT LIFESTYLE CHOICES going forward do need to "ACCOMMODATE" and/or ADDRESS these DEVELOPMENTAL DIFFERENCES.

Our current go to of a MENTAL HEALTH PROFESSION that thought its mission was to help people change is a MIXED BAG --- it is BOTH HELPING AND HURTING.

Further, when I started as a mental health advocate in 2007 --- the Mental Health Centers didn't think it was their responsibility to deal with DEVELOPMENTAL DISORDERS.

On the other hand, individuals have been "UNCONSCIOUSLY MASKING" for as long as they could and many of these "HYPER-CONNECTED BRAINS" --- had a hard time understanding why they would have EXECUTIVE FUNCTIONING CHALLENGES and so did everybody else.

You can start to see why this isn't really working. 

Now that is slowly changing, but people with these "DEVELOPMENTAL DIFFERENCES" have to be part of the process of constructing appropriate supports going forward.

The Impact of Systemic Inflammation on Neurodevelopment (2018)

Cytokines and neurodevelopment

In the past several decades, inflammation has been increasingly recognized as an important contributor to central nervous system (CNS) injury in both the developing and adult brain [1,2] (Table 1).

The brain is particularly vulnerable in utero as well as during infancy and early childhood, and insults that occur during these critical periods have the potential to cause long-term damage.

Several neurodevelopmental disorders have been linked to early life immune activation and inflammation, including autism spectrum disorders (ASD), schizophrenia, cerebral palsy, epilepsy, cognitive impairment, and depression