Posted by vms on July 21, 1999, at 22:15:49
In reply to Predatory aggression, posted by Robin Dickson, M.A., Behavior Specialist on June 30, 1999, at 18:59:02
>Have you tried teaching him some rudimentary sign? I have experience with deaf with organic brain syndrome, and the communication is a real pain. It's easy to jump to the wrong conclusions and retaliate if you don't understand what's going on. Try a few functional signs like bathroom, eat, with reinforcers. Build from there. You can't be sure if it's random if you don't know what he is thinking. Also try and find a way to include him with other people. If he feels isolated or ignored, he may be acting out from envy and frustration. Does your state have a deaf expert in their state department of mental health? They could be invaluable for helping you decide which are mental health problems, deafness probs, cognitive.
Also try to warn him of changes in routine and transitions. Does he have a laminated schedule or a calendar? Make him a little book of routine items..dinner, bedtime...and flip to the one it will be....Or prewarn with a timer...vibrating, if possible if he can no longer hear the bell.
Did you exhaust all the mood stabilizers like Neurontin, Lamactil, Topamax? I have heard that for the extremely unresponsive, Clozaril is still the best antipsychotic. But would he tolerate the weekly lab work....?
Good luck...
I am interested in finding out about medications/treatments for predatory aggression (aggression without anger/rage or warning). The patient is a man in his 30's with progressive hearing loss and severe mental retardation. He does not communicate very well and so cannot explain why he attacks others--mostly his peers. He grabs, bites and kicks others, and seems to look for opportunities for aggression(transitions, decreased staffing, for ex.). The patient normally is slow moving and lethargic, but attacks with extreme quickness and ferocity. He has had extensive treatment with mood stabilizers (not lithium), some SSRI's, and antipsychotics (except clozapine). A 24 hour EEG was normal. He grew up in his family home without trauma/neglect, with the onset of his attacks in adolescence. Thanks to all who reply.
poster:vms
thread:8065
URL: http://www.dr-bob.org/babble/19990628/msgs/9053.html