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BACKGROUND: Although the Canadian Consensus Guidelines for Primary Care of Adults with Intellectual and Developmental Disabilities recommends conducting periodic health checks in primary care, uptake is lacking. This study seeks to understand factors influencing the conduct of periodic health checks and identify what needs to change to increase them. METHOD: Qualitative data from five stakeholder groups (adults with intellectual and developmental disabilities, primary care providers, administrative staff, family, disability support workers) was guided by the Behaviour Change Wheel and the Theoretical Domains Framework to identify barriers and 'what needs to change' to support periodic health checks. RESULTS: Stakeholders (n = 41) voiced multiple barriers. A total of 31 common and 2 unique themes were identified plus 33 items 'needing to change'. CONCLUSION: Despite barriers, stakeholders saw merit in periodic health checks as a preventative and equitable healthcare offering for adults with intellectual and developmental disabilities. Results will inform future intervention development steps.
Asunto(s)
Equidad en Salud , Discapacidad Intelectual , Adulto , Niño , Humanos , Canadá , Discapacidades del Desarrollo , Atención a la SaludRESUMEN
OBJECTIVE: To update the 2011 Canadian guidelines for primary care of adults with intellectual and developmental disabilities (IDD). METHODS: Family physicians and other health professionals experienced in the care of people with IDD reviewed and synthesized recent empirical, ecosystem, expert, and experiential knowledge. A system was developed to grade the strength of recommendations. RECOMMENDATIONS: Adults with IDD are a heterogeneous group of patients and have health conditions and factors affecting their health that can vary in kind, manifestation, severity, or complexity from those of others in the community. They require approaches to care and interventions that are adapted to their needs. These guidelines provide advice regarding standards of care. References to clinical tools and other practical resources are incorporated. The approaches to care that are outlined here can be applied to other groups of patients that have impairments in cognitive, communicative, or other adaptive functioning. CONCLUSION: As primary care providers, family physicians play a vital role in promoting the health and well-being of adults with IDD. These guidelines can aid their decision making with patients and caregivers.
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Personas con Discapacidad , Atención Primaria de Salud/normas , Nivel de Atención/organización & administración , Adulto , Canadá , Consenso , Discapacidades del Desarrollo , Humanos , Discapacidad IntelectualRESUMEN
This study investigates the oral gestures of 8-month-old infants in response to audiovisual presentation of lip and tongue smacks. Infants exhibited more lip gestures than tongue gestures following adult lip smacks and more tongue gestures than lip gestures following adult tongue smacks. The findings, which are consistent with predictions from Articulatory Phonology, imply that 8-month-old infants are capable of producing goal-directed oral gestures by matching the articulatory organ of an adult model.
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Lenguaje Infantil , Gestos , Conducta Imitativa , Conducta del Lactante , Labio/fisiología , Lengua/fisiología , Estimulación Acústica , Adulto , Femenino , Humanos , Lactante , Masculino , Estimulación Luminosa , Hábitos LingualesAsunto(s)
Personas con Discapacidad/psicología , Defensa del Paciente , Atención Primaria de Salud/métodos , Relaciones Profesional-Paciente , Adulto , Canadá , Discapacidades del Desarrollo/psicología , Discapacidades del Desarrollo/terapia , Femenino , Equidad en Salud , Humanos , Discapacidad Intelectual/psicología , Discapacidad Intelectual/terapia , MasculinoRESUMEN
OBJECTIF: Mettre à jour les Lignes directrices consensuelles canadiennes 2011 en matière de soins primaires aux adultes ayant une déficience développementale. MÉTHODES: Des médecins de famille et d'autres professionnels de la santé expérimentés dans les soins aux personnes ayant des DID ont examiné et synthétisé les récentes connaissances empiriques, d'écosystèmes, expertes et expérientielles. Un système a été conçu pour catégoriser la qualité des recommandations. RECOMMANDATIONS: Les adultes ayant des DID sont un groupe hétérogène de patients qui présentent des affections médicales et des facteurs qui influent sur leur santé, qui diffèrent de ceux qui touchent les autres membres de la communauté de par leur nature, leurs manifestations, leur gravité ou leur complexité. Ces personnes nécessitent une approche de soins et des interventions adaptées à leurs besoins. Les présentes lignes directrices offrent des conseils en matière de normes de soins. Nous avons incorporé des références à des outils cliniques et à d'autres ressources pratiques. Les approches de soins décrites ici s'appliquent aussi à d'autres groupes de patients ayant un déficit cognitif ou de la communication, ou d'autres déficits des fonctions adaptatives. CONCLUSION: À titre de fournisseurs de soins de première ligne, les médecins de famille jouent un rôle vital de promotion de la santé et de bien-être auprès des adultes ayant des DID. Ces lignes directrices peuvent les aider à prendre des décisions avec les patients et les aidants naturels.
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Individuals with autism spectrum disorder (ASD) have many health needs that place demands on the health service sector. This study used administrative data to compare health profiles in young adults 18-24 years of age with ASD to peers with and without other developmental disability. Young adults with ASD were more likely to have almost all the examined clinical health issues and health service use indicators compared to peers without developmental disability. They were more likely to have at least one psychiatric diagnosis, and visit the family physician, pediatrician, psychiatrist, and emergency department for psychiatric reasons, compared to peers with other developmental disability. Planning for the mental health care of transition age adults with ASD is an important priority for health policy.
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Trastorno del Espectro Autista/psicología , Trastorno del Espectro Autista/terapia , Conocimientos, Actitudes y Práctica en Salud , Servicios de Salud , Aceptación de la Atención de Salud/psicología , Vigilancia de la Población , Adolescente , Trastorno del Espectro Autista/epidemiología , Estudios de Cohortes , Servicio de Urgencia en Hospital/tendencias , Femenino , Servicios de Salud/tendencias , Humanos , Masculino , Ontario/epidemiología , Vigilancia de la Población/métodos , Adulto JovenRESUMEN
Productive vocabulary composition is investigated in 17-month-old children who are participating in an ongoing longitudinal dyslexia research project in the Netherlands. The project is searching for early precursors for dyslexia and follows a group of children who are genetically at risk for dyslexia and a control group during the first 10 years of their lives. Among other measures, the Dutch version of the MacArthur Communicative Development Inventory: Words and Sentences (N-CDI) is used to investigate early vocabulary development. In this article, the first N-CDI results from the 2 groups of 17-month-old children are compared with each other, with other cross-sectional, cross-linguistic studies, and with a similar Finnish longitudinal dyslexia project. The Dutch children show the same general acquisition pattern as documented for other languages, but there are significant differences between the two groups of 17-month-old children in total number of words produced and in the linguistic composition of their productive vocabulary.