The Carlat Psychiatry Podcast Empowering Decision-Making in Developmental Disabilities
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May 26, 2025 Joshua Feder, an expert in child psychiatry and co-author of notable texts on child medication, discusses the unique challenges faced by young adults with developmental disabilities at 18. The conversation focuses on empowering decision-making while balancing autonomy and necessary support. Key topics include assessing decision-making capacity, the role of guardianship, and the importance of clear communication. Feder highlights the significance of involving trusted advisors and listening to the voices of individuals with disabilities to foster informed choices.
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Assess Capacity Individually
- Assess decision-making capacity case-by-case for adults with developmental disabilities.
- Focus on understanding, weighing risks, communication, and consequence appreciation.
Poor Decisions Demand Intervention
- Some young adults make poor choices despite appearing capable, leading to serious issues.
- Conservatorship can prevent legal trouble by intervening before consequences escalate.
Use Limited Conservatorship Wisely
- Use limited conservatorship to support specific areas like healthcare or finances.
- Retain rights like voting while providing needed structured support.