Building the Path to Home

Does the person have a dual diagnosis?

Important note: The following questions are intended to help you explore the possibility that someone may have a developmental disability or a mental health problem. If, after you consider the questions, you suspect that the person may have a mental health problem or a developmental disability—or both—talk to a professional about a formal assessment.

Recognizing a developmental disability

These questions will help you better understand the person's functional level and the challenges he or she faces. The person's answers will also help you start to figure out if someone who has a mental health problem may also have a developmental disability.

A formal diagnosis of developmental disability is made by a psychologist who will administer standardized tests. Diagnosis can be difficult if the person's family and friends aren't available to provide additional information about the person's level of functioning before the age of 18.

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Questions to ask about early development

• What grade did you go to in school? How old were you when you left school? (If the person was 21 years old when he or she left school, then the person may be developmentally delayed. People with a developmental disability can continue in the school system until they are 21; many have dropped out early.)
• Did you attend special education classes, behavioural classes, a special school? (This is another clue that there may have been developmental issues.) What was the name of the school?
• Did you have an assessment (special tests) as a child at school? At a hospital? What was the name of the hospital? What did they tell you about the results? (You are not likely to get this from the person. You may need the person's parents to fill in the gaps.)

Questions to ask about current functioning

• Can you tell time on an analogue watch (a watch with an hour hand and a minute hand)? (Show the person a watch and ask what time it says. A person who has a developmental disability might find this difficult.)
• Do you travel alone on buses or the subway? Did you come here by yourself today? What route did you take? (Get the person to describe it to you.) If you are going to a new place, do you need someone to show you how to get there? (People with developmental disabilities tend to learn routes by rote—with help at first—but would find it challenging to explain the route in detail.)
• Can you read the newspaper? What sections do you like the best? (Often the person can read only some parts of the paper and will say the comics are his or her favourite part.)
• What is your favourite TV show? (Often the person will choose cartoons or children's programming, because of the high visual/low verbal content.)
• Can you fill out a job application or read a menu by yourself? (This helps you assess literacy skills. You can also ask the person to read some simple text, such as a menu.)
• Do you look after your own money? Do you pay the bills? Which bills do you pay?
• How do you pay them? (The person may pay by cheque, at a bank machine or over the phone.)
• How much do a pop and a bag of potato chips cost?  How much does a car cost? How much does a house cost? (Often the person will not be able to estimate well.)
• Do you have a job? Did you ever have a job? What did you do (e.g., competitive employment, sheltered workshop, co-op program through school)?

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Cognitive indicators*

• Does the person communicate in short sentences?
• Does the person seem, on the surface, able to do things you later discover he or she really can't do?
• Does the person have trouble generalizing (applying general information to more than one specific thing)?
• Does the person seem to learn slowly?
• Does the person have trouble with abstract thinking (e.g., understanding how two things are similar)?
• Does the person do better on concrete and structured tasks (e.g., when you are very specific and break things down into steps)?
• Does the person have memory problems?
• Does the person have splinter skills, which are really actions that have been learned by rote (e.g., ability to follow bus routes, social skills)?
• Does the person have trouble solving problems?
• Does the person show poor judgment?
• Does the person have trouble understanding "why" questions?
• Is the person good at picking up non-verbal social cues?
• Is it difficult to get a true idea of what the person is capable of, what he or she takes in from a conversation?

*Adapted, with permission, from Concerned Parents of Toronto, Inc. (2002). Supports & Services Resource Handbook. Toronto: Author.

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