medical guidelines
Primary Care of Adults with Intellectual and Developmental Disabilities: 2018 Canadian Consensus Guidelines
The 2018 published guidelines (updated from the previous 2011 clinical practice guidelines) address the Canadian best practices for the primary care of adults with intellectual disabilities. The information presented in this report was based on a consensus of primary care providers who ranked the importance of certain topics and aspects of care, as well as on empirical data and population-level data. These efforts resulted in a series of comprehensive recommendations for family physicians and
other health care professionals on various topics of care for adults with intellectual disabilities. The guidelines also contain a table that maps out and helps disseminate information on approaches to care, assessments and considerations, physical health, and mental health.
Co-occurring Medical Conditions in Adults with Down Syndrome: A Systematic Review Toward the Development of Health Care Guidelines
This 2017 literature review by Capone and others, conducted for the Down Syndrome Medical Interest Group (DSMIC-USA) Adult Health Care Workgroup, was presented as a two-part series of articles. The review aims to address the clinical knowledge gaps on various comorbid or co-occurring medical problems in adults with Down syndrome by researching a large database of review articles that discussed these co-occurring conditions. The goals outlined by this group of clinical researchers are: (1) determine
the frequency of co-occurring medical conditions, (2) discuss the prevalence, severity, and methodologies for screening, (3) determine the quality of evidence from these review articles, (4) identify critical knowledge gaps in the clinical decision making and management, and (5) discuss these findings in the context of developing practice guidelines.
Health Check A Comprehensive Health Assessment of Adults with Intellectual and Developmental Disabilities (Surrey Place – Developmental Disability Primary Care Program)
This 2019 version of a series of published screening tools was created by the Developmental Disabilities Primary Care initiative in collaboration with the Medication Use Management Services (MUMS). These tools are published and presented on the Surrey Place website. If you wish to explore further, please click on this link: (https://ddprimarycare.surreyplace.ca/tools-2/). We have included a fillable PDF form
of the Health Check screening tool which provides a guided or step-by-step approach to gathering information from patients with IDD and aids in the clinical management of these patients. This is a very broad tool containing information on various medical conditions, as well as practice tips, tools, and resources that are Canadian specific.
Clinical Report — Health Supervision for Children With Down Syndrome (American Academy of Pediatrics)
This is a link to the 2011 published guidelines on the topic of Health Supervision and Down syndrome care for children and young adults from the American Association of Pediatrics. This is a comprehensive report that gives a chronologically structured review of health concerns that present and persist at different stages of development,
as well as the frequency and timeline at which these health concerns need to be addressed and monitored. All of these concerns can be discussed with the family during their clinic visits, and suggestions are given in regards to which specialists can be involved in their care for a given medical diagnosis.
Health Watch Table (Canadian Guidelines)
This is also a link to a Canadian 2011 publication by Foster‐Gibson and Berg regarding their Health Watch Table for Down syndrome. They have listed on this form information regarding health considerations in DS, their frequencies, and subsequent recommendations for both children and adults with DS. It is subsequently organized
as a checklist, with each of these three previously mentioned features discussed under headers of major physiological systems. It is comprehensive in its structure and compliments the AAP Guideline link above in terms of its content and percentage prevalence of the conditions described.
NTG-EDSD (National Task Group Early Detection Screen for Dementia) Screening Tool
These documents outline one of the goals of the NTG (National Task Group on Intellectual Disabilities and Dementia Practices), to raise awareness on the issue of dementia and intellectual disabilities and to disseminate knowledge on what is clinically known about this association to date. With this goal the NTG wishes to improve the quality of health and community services for people with intellectual disabilities and their families. To accomplish this, they have created (1) an
informational brochure on dementia that covers many key topics – chief among these being the warning signs to look for in persons with intellectual disabilities, and (2) the NTG Early Detection Screen for Dementia – an administrative screen for early detection of cognitive impairment, which can be used by staff and family caregivers to categorically record functional decline and other health problems.
Pre-Assessment Screening Guide for a Psychiatric or Psychology Consultation (for care-givers and Physicians)
This screening guide has been developed by the Vancouver Island Health Authority Developmental Disability Mental Health Team for care-givers and patients to consider prior to a visit with a Developmental Disability Mental Health Team (DDMHT). Patients
are recommended to book an appointment with their doctor to review this screening guide with the purpose of ruling out possible underlying medical conditions that may be manifesting as a dementia process or behavioural challenge.