Health assessment instruments for people with intellectual disabilities-A systematic review.
Add the CHAP or SWH-HRA form to your intake for adult clients with ID to spot hidden health issues early.
01Research in Context
What this study did
The team hunted for every health-screening form made for adults with intellectual disability.
They read 20 tools and graded how well each was built and tested.
No new data were collected; they just scored the forms already out there.
What they found
Most tools lacked strong proof that they work.
Two forms stood out: the CHAP and the SWH-HRA.
Clinicians liked using them and they cover the main health spots often missed.
How this fits with other research
DiStefano et al. (2020) zooms in on people with severe-profound ID and warns that many tests floor-out.
Their tip to adapt language and motor tasks extends this review: even the top-rated CHAP may need tweaks for this subgroup.
Katz et al. (2003) built a full informant battery years earlier.
That battery overlaps several domains the CHAP now covers, but the older set never got the same psychometric check-up, so the newer CHAP essentially supersedes those rougher sheets.
Schmidt et al. (2010) showed that proxies often rate quality of life lower than adults with ID themselves.
Because the CHAP relies on caregiver report for parts, you should double-check any red-flag item directly with the client when possible.
Why it matters
Many adults with ID visit the doctor only when crisis hits.
Slipping the one-page CHAP or SWH-HRA into your intake packet catches missed diagnoses like thyroid problems or side-effects before they explode.
It takes five extra minutes and gives the physician a ready roadmap, saving you future behavior calls tied to untreated pain or poly-pharmacy.
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Print the free CHAP, include it in your next adult assessment packet, and review flagged items with the client’s nurse.
02At a glance
03Original abstract
BACKGROUND: People with intellectual disabilities (ID) experience health disparities and are less likely to undergo recommended age- and gender-specific screening and health promotion. New diagnoses are frequently missed. Assessments with the aid of health assessment instruments are a way to address these problems. AIM: The aim of this review is to find the available health assessment instruments for people with ID used in primary care and evaluate their quality. METHODS: We conducted an electronic literature search of papers published between January 2000 and May 2016. After a two-phase selection process (kappa: 0.81 and 0.77) we collected data from the 29 included peer-reviewed articles on the following four domains; development, clinimetric properties (i.e. validity, reliability, feasibility, acceptability), content (i.e. ID-related health problems, prevention and health promotion topics) and effectiveness of the instruments. RESULTS/CONCLUSIONS: We distinguished 20 different health assessment instruments. Limited information was found on the development of the instruments as well as on their clinimetric properties. The content of the instruments was rather diverse. The included papers agreed that health assessment instruments are effective. However, only three instruments evaluated effectiveness in a randomised controlled trial. Patients with ID, carers and general practitioners (GPs) generally appreciated the health assessment instruments. IMPLICATION: Two instruments, "Stay well and healthy -Health risk appraisal (SWH-HRA)"and the "Comprehensive Health Assessment Programme (CHAP)", appeared to have the highest quality. These instruments can be used to construct a health assessment instrument for people with ID that meets scientific standards.
Research in developmental disabilities, 2017 · doi:10.1016/j.ridd.2017.03.002