A Scoping Review of the Healthcare and Hygiene Literature for Individuals with Intellectual and Developmental Disabilities.
Graduated exposure plus DRA works for healthcare and hygiene skills in people with ID, but we still don’t know which part matters most.
01Research in Context
What this study did
The team read every single-case study on healthcare and hygiene for people with intellectual or developmental disabilities.
They found 52 small experiments that tested ways to help clients brush teeth, take medicine, or sit through a doctor visit.
Most studies used several tricks at once, like slowly getting used to the dentist chair plus earning a reward for staying calm.
What they found
Almost every study said the package worked.
Gradual exposure and earning rewards (DRA) showed up again and again.
But hardly anyone ran a functional analysis or asked clients or parents if the change really mattered to them.
How this fits with other research
Johnson et al. (1994) first sketched what good health care should track, yet gave no data. ASutton et al. (2022) now fills that gap with real experiments.
Hsieh et al. (2015) showed adults with ID gain weight when they lack community activity. ASutton et al. (2022) adds that we can teach hygiene skills, but we still need to check if those skills lower BMI or boost activity.
Wilson et al. (2023) proved teens with ID can reliably tell us how they feel. ASutton et al. (2022) shows we rarely ask them about hygiene or doctor visits—so we may be fixing problems clients don’t see as problems.
Why it matters
You can feel safe using graduated exposure plus DRA to help clients with ID tolerate tooth-brushing, blood draws, or haircuts.
Next step: pick one skill, run a quick functional analysis, and add a five-question social validity check at the end.
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02At a glance
03Original abstract
<h4>Objectives</h4>Previous reviews highlight the similarities in teaching healthcare and hygiene routines to individuals with and without intellectual and developmental disabilities. Additionally, similar interventions are used when interfering behaviors occur. Although these routines are topographically distinct, there are enough similarities to suggest effective procedures for one routine may be used to inform another. This scooping review aims to identify effective teaching and intervention procedures for healthcare and hygiene routines specifically for individuals with intellectual and developmental disabilities. We also evaluated the extent to which functional analyses were conducted; a dimension not included in previous reviews.<h4>Methods</h4>Eligible articles targeted compliance or tolerance within the context of a defined healthcare or hygiene routine as a dependent variable and used an experimental design with a demonstration of experimental control. Articles were identified through PsycINFO, PubMed, and Academic Search Premier databases. Additionally, a hand search of five related journals was conducted. Data were collected on dependent variables, functional analyses, baseline contingencies, teaching procedures, and additional experimental components.<h4>Results</h4>A total of 52 articles met inclusion criteria. Most experiments produced positive outcomes. The findings show all experiments involved a treatment package with multiple components. The most common teaching procedures were graduated exposure and DRA. A lack of functional analyses and social validity was noted.<h4>Conclusions</h4>Component analyses are needed to identify the most effective and efficient procedures. Pyramidal training to teach medical professionals how to provide preventative pyramidal training should be explored.<h4>Supplementary information</h4>The online version contains supplementary material available at 10.1007/s41252-022-00249-7.
, 2022 · doi:10.1007/s41252-022-00249-7