Assessment & Research

Prevalence of reported physical health problems in people with severe or profound intellectual and motor disabilities: a cross-sectional study of medical records and care plans.

van Timmeren et al. (2016) · Journal of intellectual disability research : JIDR 2016
★ The Verdict

Adults with severe or profound ID plus motor disability carry about twelve physical health problems each—always screen for constipation, vision loss, epilepsy, spasticity, deformities, incontinence, and reflux before treating behavior.

✓ Read this if BCBAs serving adults with severe or profound ID in residential or day programs.
✗ Skip if Clinicians who work only with mild ID or outpatient verbal clients.

01Research in Context

01

What this study did

The team read every page of medical files for 99 adults who have severe or profound intellectual and motor disabilities.

They wrote down every physical health problem listed.

No extra tests were run; they used what was already recorded.

02

What they found

Each adult had, on average, twelve different physical health problems at the same time.

More than half of the group had constipation, poor vision, epilepsy, tight muscles, bone or joint deformities, incontinence, and reflux.

These seven problems showed up again and again.

03

How this fits with other research

Bao et al. (2017) pooled many studies and found 70% epilepsy in the same disability group. That number matches the "more than half" found here.

Gaynor et al. (2008) saw only 18% epilepsy in a broader ID sample. The gap looks like a contradiction, but it fades when you note they studied all ID levels, not just the most severe motor group.

Bao et al. (2017) also mapped how these conditions cluster. They showed that vision loss, constipation, epilepsy, and spasticity often travel together, backing the long list seen in this paper.

04

Why it matters

If you write behavior plans for adults with severe motor and intellectual disability, expect a dozen medical issues behind any behavior change. Build daily checks for the big seven into your data sheet. Flag sudden behavior spikes for nurse review first, not program change. This simple habit cuts trial-and-error and keeps clients comfortable.

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→ Action — try this Monday

Add a 30-second health checklist for the big seven to your session note template and review it before every program change.

02At a glance

Intervention
not applicable
Design
other
Sample size
99
Population
intellectual disability
Finding
not reported

03Original abstract

BACKGROUND: People with severe or profound intellectual and motor disabilities (SPIMD) experience numerous serious physical health problems and comorbidities. Knowledge regarding the prevalence of these problems is needed in order to detect and treat them at an early stage. Data concerning these problems in individuals with SPIMD are limited. Therefore, the aim of this study was to determine the prevalence of reported physical health problems in adults with SPIMD through a review of medical records and care plans. METHOD: We conducted a cross-sectional study employing data obtained from medical and support records. A sample of adults with SPIMD was recruited in eight residential care settings. Physical health problems that had occurred during the previous 12 months or were chronic were recorded. RESULTS: The records of 99 participants were included. A wide range of physical health problems were found with a mean of 12 problems per person. Very high prevalence rates (>50%) were found for constipation, visual impairment, epilepsy, spasticity, deformations, incontinence and reflux. CONCLUSIONS: The results suggest that people with SPIMD simultaneously experience numerous, serious physical health problems. The reliance on reported problems may cause an underestimation of the prevalence of health problems with less visible signs and symptoms such as osteoporosis and thyroid dysfunction.

Journal of intellectual disability research : JIDR, 2016 · doi:10.1111/jir.12298