ADHD
Condition Summary: A neurodevelopmental difference in
attention, activity, and executive function that does not end at
eighteen — carried into work, money, time, and relationships.
Care & Treatment: Medication management per adult
guidelines — stimulant medication first-line for most, reviewed
monthly until stable and quarterly thereafter — alongside CBT for
adult ADHD, a specifically validated adult protocol, delivered in a
twelve-session course with boosters, and weekly organizational-skills
coaching.
At St. Margaret’s, we expand this with movement-rich
guild placement, body-double work companionship, task-chunking
systems, and environmental structure — and movement is never
withdrawn as a consequence.
Tourette Syndrome & Chronic Tic Disorders
Condition Summary: Motor and vocal tics persisting into
adulthood, most often traveling with OCD or ADHD — which we
screen for, always.
Care & Treatment: CBIT — Comprehensive Behavioral
Intervention for Tics, first-line at every age per the American Academy
of Neurology — delivered to protocol: one-to-one, eight sessions
over ten weeks, with boosters as needed. Medication is second-line, via
a consulting neurologist.
At St. Margaret’s, the therapy sits inside a
zero-judgment community deliberately trained to not react to tics at
all — with stress-reduction somatic supports and private
retreat with dignified return.
Dyspraxia (Developmental Coordination Disorder)
Condition Summary: A motor-coordination difference that makes
the everyday sequences of adult life — stairs, kitchens,
workbenches, buses — genuinely harder work.
Care & Treatment: Task-oriented therapy on adult-chosen
goals, on the CO-OP model, in goal-directed blocks twice weekly —
with ergonomic engineering of every workstation and a review at each
new placement.
At St. Margaret’s, weighted and adaptive tools,
joint-protective techniques, and motor practice embedded in guild
craft that means something — never drills for their own
sake.
Cerebral Palsy
Condition Summary: A group of lifelong motor conditions
affecting movement, posture, and muscle tone — and the services
cliff is notoriously brutal here: adults with CP face early
musculoskeletal aging, with pain, fatigue, and walking loss often
beginning in the twenties and thirties, precisely when pediatric
services vanish.
Care & Treatment: Lifelong physical therapy focused on
mobility preservation — strength, pain, and energy management
against early musculoskeletal aging — with spasticity management
continued at the adult standard, proactive chronic-pain care, fall
prevention, cardiometabolic screening for inactivity-driven risk, and
equipment and seating for life.
At St. Margaret’s, the Wellness Wing’s
hypermobility-safe strengthening, hydrotherapy, ergonomic audits, and
orthotics serve cerebral palsy almost verbatim — alongside
adapted guild stations, AAC maintained for life through
Cupertino’s Adult Center, and advocacy through the Guardianship
Network. Most systems retire from CP care at eighteen, exactly when
the body’s needs begin to grow. We do not.
Sensory Processing Differences
Condition Summary: Thresholds for sound, light, touch,
movement, and internal signals that differ from the world’s
assumptions — at real daily cost in overload and fatigue.
Care & Treatment: Sensory-adaptive environments
campus-wide, with individualized sensory plans drawn from standardized
adult profiling — the Adolescent/Adult Sensory Profile —
and full eight-modality assessment by occupational therapists.
At St. Margaret’s, regulation rooms, personal sensory
kits, shutdown and meltdown recovery protocols — and protected
motor rights: rocking, pacing, and humming affirmed as dignified
self-regulation.
Anxiety & Social Anxiety
Condition Summary: Among the most common companions of
neurodivergent adulthood — and often decades old by the time an
adult arrives here.
Care & Treatment: Cognitive behavioral therapy with
graduated exposure — the first-line adult treatment — in
weekly 45–60 minute sessions across 12–20 session courses,
with exposure groups of three to five; properly adapted for autistic
adults; SSRI medication where indicated and monitored.
At St. Margaret’s, the skills leave the therapy room:
graded real-world practice through St. Louise’s outings, the
animal-assisted calm of St. Bernadette’s Sanctuary, and skills
carried into cottage life.
Depression & Mood Conditions
Condition Summary: Depression and related mood conditions
— including those that hide behind “behavior” in
adults who cannot report their own suffering.
Care & Treatment: Cognitive behavioral therapy and
behavioral activation — with the fellowship program and the
guilds as the activation engine — weekly therapy, psychiatric
review per protocol, and medication held to the minimum effective
dose.
At St. Margaret’s, we screen actively against
diagnostic overshadowing in adults with intellectual disability, and
we build the ordinary architecture of a life worth waking for:
structured daily rhythm, light and movement, grief work, peer
fellowship.
Autistic Burnout
Condition Summary: Exhaustion, skill loss, and withdrawal
after years of masking and unsupported demands — described by
autistic adults for decades, now documented in emerging research.
Care & Treatment: Recognition first — with an
evidence base we honestly rate as emerging — then structured
demand reduction through the Sabbatical, energy-accounting and pacing
skills, and unmasking support.
At St. Margaret’s, sensory rest and reduced
obligations with preserved belonging — the adult steps back
from demands, never from the family — with re-entry at the
adult’s own pace and duration set by recovery, not by a
calendar.
Trauma & Attachment Wounds
Condition Summary: Histories of relinquishment,
institutional harm, and loss, carried into adulthood — sometimes
without the words to tell them.
Care & Treatment: Trauma-focused therapy at the adult
standard: EMDR — strongly supported for adult post-traumatic
stress — and trauma-focused CBT, individual and weekly, with
delivery adapted for communication differences through AAC-integrated
psychotherapy and somatic emotion-mapping.
At St. Margaret’s, consistent caregivers, a
predictable environment, life-story work done gently over time, and
the quiet companionship of animals — and coercive
“attachment therapies” categorically banned, without
exception.
Down Syndrome
Condition Summary: Adults with Down syndrome need adult
medicine — the surveillance the wider system too often stops
providing after childhood.
Care & Treatment: The GLOBAL Medical Care Guidelines for
Adults with Down Syndrome, run proactively on calendar: thyroid,
cardiac, hearing and vision, celiac screening, obstructive sleep apnea
evaluation, cervical-spine precautions — with an annual cognitive
baseline and dementia screening from the guideline-specified age, using
the National Task Group’s early-detection screen (NTG-EDSD).
At St. Margaret’s, dementia-capable care planning is
done early, with the adult, while their own voice can lead it —
alongside continued speech support, physical therapy woven into daily
life, and full guild, choir, and fellowship membership.
DiGeorge Syndrome (22q11.2 Deletion)
Condition Summary: A deletion syndrome with multi-system
medical needs, whose elevated psychiatric risk is realized in
adolescence and young adulthood.
Care & Treatment: Adult consensus-guideline surveillance
— endocrine (calcium, thyroid), cardiac, immune — with
psychiatric review at least twice yearly in young adulthood, and
early-intervention-for-psychosis standards where illness emerges.
At St. Margaret’s, coordinated specialist care with
dedicated hospital bedside advocacy, careful medication stewardship,
and cognitive and vocational support tuned to the profile.
Prader-Willi Syndrome
Condition Summary: Hyperphagia — the relentless hunger
of Prader-Willi — is a neurological drive, not disobedience, and
it does not retire at eighteen.
Care & Treatment: Lifelong food-secure living — the
evidence does not expire at eighteen — with endocrine management,
diabetes and obesity surveillance, and sleep-disordered-breathing
monitoring.
At St. Margaret’s, a dietitian–chef partnership
plans nutrition monthly, daily physical activity is built into the
rhythm, behavioral support comes from clinicians who understand the
syndrome — and the purpose-built food-secure cottage at
Domus
Margaretae is home for life, with feast days planned so no one
ever celebrates apart.
Williams Syndrome
Condition Summary: Warm, deeply feeling adults whose central
medical priority is the heart — and whose exceptional warmth is
one of their gifts, and a genuine vulnerability.
Care & Treatment: Lifelong cardiac surveillance —
blood pressure in both arms, a permanent anesthesia-risk flag on every
record — with calcium monitoring, hypertension screening, and
anxiety treatment weekly where needed.
At St. Margaret’s, musical vocation through choir and
liturgy, hyperacusis accommodation, and explicit financial and social
exploitation safeguards — the adult-life form of the
stranger-safety risk — built with the
Lifelong
Guardianship & Advocacy Network and reviewed annually,
without ever teaching an adult that their warmth is wrong.
Aging & Neurocognitive Change (all profiles)
Condition Summary: Every profile ages. Other systems quietly
discharge the resident whose needs grow heavy at the end. We do
not.
Care & Treatment: Baseline cognitive documentation for
every resident entering later adulthood, structured re-screening at
intervals — the NTG-EDSD for adults with intellectual disability
— dementia-capable environmental adaptation, and palliative and
end-of-life care in place, at home.
At St. Margaret’s, Track V’s gentle rhythm,
memory supports built into the cottage, family and Sisters at the
bedside — and anointing and the sacraments to the last day,
with a community that does not leave.