Primary Care of Adults With Intellectual and Developmental Disabilities: 2018 Canadian Consensus Guidelines
Canadian Family Physician
Sullivan, W. F., Diepstra, H., et al. (2018).
Canadian Family Physician, 64(4), 254-279.
This guideline from a 2016 Canadian colloquium of primary care providers provides recommendations on health issues specific to adults with intellectual and developmental disabilities. This summary highlights recommendations within the scope of speech-language pathology (e.g., interprofessional practice, swallowing disorders).
Ontario Ministry of Community and Social Services; the Ontario Ministry of Health and Long-Term Care
For adults with intellectual and developmental disabilities, "refer to a speech and language pathologist to assess swallowing function when signs and symptoms of swallowing difficulty are detected" (Strongly Recommend; p. 263).
For adults with intellectual and developmental disabilities (IDD), clinicians should "engage in or support developing an integrated health care team of professionals, preferably ones who are familiar with adults with IDD (e.g., medical specialists, pharmacists, audiologists, speech and language pathologists, dentists, dietitians, occupational therapists, physiotherapists, psychologists, behaviour therapists, and those providing community supports)" (Strongly Recommend; p. 260). During times of transition, all members of the care team, including the individual and their caregivers, should collaborate to develop a transition plan (Strongly Recommend).
For adults with intellectual and developmental disabilities, effective communication from healthcare providers is essential and should include addressing the patient directly, engaging the patient, using the patient's preferred method of communication, slowing communication, involving caregivers and family members, and allowing time for the patient to independently share questions and concerns (Strongly Recommend). To support the patient's decision-making capacity and engage in shared decision making, information should be adapted to the patient's communication needs (Strongly Recommend).
For adults with intellectual and developmental disabilities, therapeutic interventions may include environmental modifications or communication aids (Strongly Recommend).
For adults with intellectual and developmental disabilities, "refer for audiology assessments based on screening and for age-related hearing loss every 5 y[ears] after age 45" (Strongly Recommend; p. 262). "Screen for cerumen impaction every 6 mo[nths] and address (e.g., by advising periodic use of mineral oil drops)" (Recommend; p. 262).
For adults with intellectual and developmental disabilities, "assess annually for overt or silent aspiration and signs of swallowing difficulty (e.g., throat clearing after swallowing, coughing, choking, drooling, long meal times, aversion to food, weight loss, and frequent chest infections or asthma) or when these signs are detected" (Strongly Recommend; p. 263).
For adults with intellectual and developmental disabilities (IDD), communication disorders should be assessed by speech-language pathologists with expertise in IDD (Strongly Recommend).
