Understanding Behavior Through the Lens of Communication: Why Specialized Crisis Assessment Is Essential

All Behavior is Communication- NON Qualified Professionals Misinterpret This Communication

Children with disabilities — including those with Intellectual and Developmental Disabilities (IDD), Autism Spectrum Disorder (ASD), and communication impairments — often experience behavioral crises that look very different from traditional psychiatric emergencies. These children are not “in crisis” in the conventional sense; instead, they are communicating distress in the only ways available to them.

When schools and healthcare professionals fail to recognize this, the consequences can be devastating.

When Behavior Is Misunderstood

Far too often, behavioral expressions in children with disabilities are interpreted through a psychiatric or disciplinary lens rather than a developmental one. A child may cry, withdraw, or lash out — not because they are oppositional, but because they are overwhelmed, dysregulated, or unable to express what they feel.

Yet, standard crisis assessments in schools and hospitals are built for typical child and adolescent presentations. They rely on verbal self-reports, suicide screening tools like the C-SSRS, and de-escalation models meant for acute psychiatric conditions. These methods simply don’t fit children who communicate through movement, behavior, or sensory expression.

The result? Misinterpretation.

Behaviors that signal distress or sensory overload are mislabeled as “defiance,” “aggression,” or “threats,” leading to inappropriate crisis referrals or even hospitalization.

The Danger of Inadequate Training

Licensed Clinical Workers (LCWs), guidance counselors, and even some crisis responders are not always trained in neurodevelopmental or behavioral assessment. Without specialized knowledge, they may mistake disability-related behavior for psychiatric emergencies.

This is not a matter of ill intent — it’s a matter of insufficient understanding.

But the impact on families can be enormous: unnecessary psychiatric holds, trauma from forced separations, and deep mistrust in the very systems meant to support them.

Research from Vanderbilt University and the University of Kentucky highlights that children with disabilities are more likely to experience misinterpreted behavioral crises when assessed by general practitioners or school-based crisis teams lacking neurodevelopmental expertise.

What the Research Says

• Bramlett et al. (2018) found high emergency department utilization among autistic youth.

• Duszak et al. (2019) identified widespread under-detection of psychiatric comorbidity in children with IDD.

• Nicholas and Williams (2020) showed that Functional Behavioral Assessments (FBAs) reduce misdiagnoses by uncovering the intent behind behavior.

• Gomez and Singh (2021) noted that traditional crisis tools overlook nonverbal distress.

• Martin et al. (2022) emphasized trauma-informed, interdisciplinary emotional assessment as essential practice.

The message is clear: without specialized understanding, children with disabilities are at risk of being retraumatized by the very systems designed to protect them.

A Framework for Ethical Crisis Assessment

To ensure children with disabilities are treated with dignity and understanding, several changes must be prioritized:

1. Require interdisciplinary crisis response teams in schools and healthcare settings.

2. Mandate cross-training for LCWs, counselors, and psychologists in neurodevelopmental assessment.

3. Incorporate Functional Behavioral Assessments (FBA) into all evaluations involving students with disabilities.

4. Require family and caregiver input in every crisis evaluation.

5. Adopt trauma-informed, disability-specific de-escalation and evaluation protocols.

These principles are not just best practices — they are ethical imperatives.

Doing No Harm: A Call to Action

If a mental health or behavioral crisis assessment cannot be conducted with fidelity to individualized, ethical standards, then the most responsible action is to pause.

Continuing to evaluate or intervene without the necessary expertise risks further harm, retraumatization, and the perpetuation of systemic inequities for children with disabilities.

Children who experience the world differently deserve to be seen, heard, and supported — not labeled, restrained, or misunderstood.

Let’s commit to doing no harm by ensuring that every assessment honors the child’s dignity, neurodiversity, and human rights.