Audiological and Other Factors Influencing Serious Injury From Falls in Adults With Intellectual and Developmental Disabilities

Purpose Falls in adults with intellectual and developmental disabilities (IDDs) are a challenge for the organizations responsible for their management and care. This study represents the initiation of a program to identify, manage, and rehabilitate individuals at risk for falls in this population. Method A retrospective analysis of an active database was provided by the East Tennessee Regional Office of the Department of Intellectual and Developmental Disabilities. The data from 1,652 reportable falls from state-contracted support agencies over the calendar years of 2016–2018 were analyzed using chi-square and decision tree analyses for a dependent variable of serious injury and independent variables consisting of hearing deficits, impaired mobility including balance and vestibular deficits, enrollment in current physical therapy services for impaired mobility, staff instructions present for individuals at risk for falls, staff instructions followed, falls training for the supporting staff, current fall prevention plan in place, aggressive or compulsive behaviors, history of falls, medical conditions, visual deficits, familiar environments, adaptive equipment, intrinsic and extrinsic factors, medication change/side effects, obesity, and repeat falls. Results Significant factors included age, aggressive/compulsive behaviors, physical therapist (PT) services, balance deficits, and intrinsic factors. Post hoc analysis also indicated individuals receiving PT with a history of falls increased their risk of serious injury in unfamiliar environments. Individuals not receiving PT and exhibiting aggressive behaviors increased their risk of serious injury with visual deficits. For individuals not receiving PT services and not exhibiting aggressive behaviors, intrinsic factors increased the risk of serious injury. Conclusions These results describe the characteristics that can predict an increased risk for serious injury from a fall in an adult community-dwelling population with IDDs. These data can be used to implement changes to reduced injury from falls, including improved identification of undiagnosed vestibular deficits and assessment for the need for vestibular rehabilitation.

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Testicular Torsion in Patients With Intellectual and Developmental Disabilities

Global Pediatric Health ◽

10.1177/2333794x211059119 ◽

2021 ◽

Vol 8 ◽

pp. 2333794X2110591

Author(s):

Lisa B. E. Shields ◽

Michael W. Daniels ◽

Dennis S. Peppas ◽

Eran Rosenberg

Keyword(s):

At Risk ◽

Developmental Disabilities ◽

Testicular Torsion ◽

Delayed Diagnosis ◽

Signs And Symptoms ◽

Intellectual And Developmental Disabilities ◽

Scrotal Pain ◽

Duration Of Symptoms

Patients with intellectual/developmental disabilities are at risk of delayed diagnosis of testicular torsion due to their inability to effectively communicate their symptoms. We identified males ages 1 to 18 years with testicular torsion between January 1, 2015 and December 31, 2020, focusing on patients with intellectual and/or developmental disabilities. Of the 140 patients with testicular torsion, 5 (3.6%) patients exhibited intellectual/developmental disabilities with an inability to effectively verbalize testicular/groin/scrotal pain. The patients with intellectual/developmental disabilities underwent more orchiectomies (5/5, 100%, P = .009) and had a longer duration of symptoms (median = 48 hours, P = .047) compared to those without intellectual/developmental disabilities (51/135, 38% and median = 9 hours, respectively) (51/134, 38%) ( P = .038). Parents and other caregivers of males with intellectual/developmental disabilities who are unable to adequately verbalize their testicular/groin/scrotal pain should be cognizant of the signs and symptoms associated with testicular torsion, perform a genitalia examination, and seek an immediate evaluation to diagnose and treat this urgent condition.

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Efficacy of Healthy Aging Interventions for Adults With Intellectual and Developmental Disabilities: A Systematic Review

The Gerontologist ◽

10.1093/geront/gnaa192 ◽

2020 ◽

Cited By ~ 1

Author(s):

Flavia H Santos ◽

Johanna Zurek ◽

Matthew P Janicki

Keyword(s):

Systematic Review ◽

Older Adults ◽

Health Promotion ◽

Developmental Disabilities ◽

Social Inclusion ◽

Healthy Aging ◽

Small Sample ◽

Intellectual And Developmental Disabilities ◽

Intrinsic Factors ◽

The Impact

Abstract Background and Objectives There is a lack of information on intervention strategies employed for health promotion and disease prevention for older adults with intellectual and developmental disabilities (IDD), who usually experience poorer health compared to their peers without IDD. We carried out the first systematic review to scrutinize the impact of intrinsic factors (e.g., cognitive, mental, and physical health, etc.), on health status of older adults with IDD. Research Design and Methods To assess the efficacy of such interventions, we examined 23 articles including prospective ‘healthy aging’ interventions designed for adults with IDD. Searches were carried out in the databases Web of Science; Scielo; PsycINFO in April 2020. Articles were organized in thematic areas: (1) Physical activity and health nutrition (n=10); (2) Health education and health screening (n=6); (3) Social inclusion and community participation (n=3); and (4) Multi-components (n=4). Except for five RCT studies, the designs were mainly non-randomized, involving small sample sizes (Nrange = 8 to 379 participants), and lacking follow up. Results The studies included 2,398 men and women with IDD (ranging in age from 18 to 86 years [mean age: 44.3 yrs.]). Overall, intervention outcomes were mostly positive, however some negative outcomes were reported. Discussion and Implications In brief, healthy aging interventions for people with IDD remain scarce, incipient, and sporadic. We recommend that more attention needs to be given to active health promotion with people with IDD as a program practice among organizations and as a focal public policy among governments.

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On intellectual and developmental disabilities in the United States: A historical perspective

Journal of Intellectual Disabilities ◽

10.1177/1744629518767001 ◽

2018 ◽

Vol 24 (1) ◽

pp. 85-101 ◽

Cited By ~ 2

Author(s):

Jordan A Conrad

Keyword(s):

United States ◽

Developmental Disabilities ◽

The United States ◽

Capabilities Approach ◽

Intellectual And Developmental Disabilities ◽

Right To Education ◽

Legislative Action ◽

History Of ◽

Historical Trajectory ◽

Equal Right

The history of intellectual and developmental disabilities (IDD) in the United States is, in many ways, a triumphant story reflecting an increasingly progressive attitude acknowledging the equality of all persons. The law now recognizes people with IDD as citizens, possessing an equal right to education, health care, and employment—each of which represents milestone victories. However, this progression was not a linear development but rather a product of periods of growth and decline, backsliding, and hard-won battles across political, cultural, and legal domains. This article explores the vacillating historical trajectory for people with IDD in the United States from the colonial period to the present. Particular attention is paid to the conceptual understanding of disability itself across time periods as that which informs particular developments in treatment, law, and social status. The capabilities approach, as outlined by Martha Nussbaum, is then brought to bear as a heuristic framework, consonant with current developments in disability studies, and which may guide future social and legislative action.

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