Hidden barriers to healthcare for people with intellectual disabilities

Many face difficulties getting diagnoses and treatment; efforts afoot to tackle issue

- Ng Wei Kai Correspondent

When Mr Ryan Lim, 32, was born, he was so big and healthy his parents nicknamed him “Ryan the giant”.

While he continued to grow physically, at around the age of two he began to lose his speech, and was later diagnosed with autism.

Despite his impediments to speech and learning, Mr Lim remained physically healthy through his childhood and early adulthood until 2019, when he began losing control of his emotions and started lashing out more frequently.

Although these happened occasionally before, by 2021 he was having “meltdowns” more than four times a day. During these episodes, he would either freeze on the spot, unable to move, or claw at his father, leaving Mr Roland Lim with wounds on his arms.

His family, which includes his mother Rosalind Lim and younger sister Rachael, was at a loss. They did not want to send Mr Ryan Lim to the hospital as they knew from past experiences that he would have difficulty communicating with doctors and receiving treatment he once needed six people to hold him down to get stitches.

“We did not know whether it was a mental issue, we did not know whether it was a behaviour issue, but everybody was tired,” said his father.

A breakthrough came only at the end of 2021 when the family was introduced to Dr Chen Shiling, who worked with adults with intellectual disabilities.

She noticed that Mr Ryan Lim’s behaviour tended to worsen during meal times and when it was time to use the toilet.

Dr Chen later diagnosed him with irritable bowel syndrome (IBS) a condition which causes pain and discomfort in the abdomen. She also introduced him to a dentist, who removed some teeth that were rotten. His condition improved tremendously after he started treatment.

“In Ryan’s case, (his meltdowns were) because he was in pain, it was because he was depressed, it was because he couldn't fully communicate his needs,” Dr Chen said.