Secondary conditions in people with developmental disability.
Expect about 11 secondary conditions per client—target communication, hygiene, and fitness first because later studies show these areas respond to simple ABA packages.
01Research in Context
What this study did
Stella et al. (2011) asked caregivers to list every extra health or daily-living problem faced by 659 people with developmental disabilities.
The team counted these ‘secondary conditions’ and ranked which ones limited life the most.
What they found
The average person had 11 extra conditions on top of the primary diagnosis.
The biggest roadblocks were trouble talking, low fitness, poor hygiene, weight problems, and memory slips.
How this fits with other research
ASutton et al. (2022) looked at 52 hygiene studies and found multi-step packages with gradual exposure and reward usually work. Stella’s list says hygiene is a top problem, AM shows you can fix it.
Lin et al. (2013) surveyed 480 adults over 45 with ID. Half stayed fully independent in daily tasks, but those with Down syndrome or severe ID needed more help. Stella counted problems; Lan-Ping shows who is most at risk.
Adams et al. (2024) asked caregivers of kids with DCD where life was hardest. School beat home and community. Stella flags memory and fitness limits; E shows these limits play out most in school settings.
Why it matters
When a new client walks in, picture 11 extra hurdles before you write the first goal. Start with the five Stella names—especially communication and hygiene—because quick wins there free up time to tackle fitness, weight, and memory later. Use AM’s package (gradual exposure plus reward) for hygiene, add fitness breaks that Lan-Ping’s low-functioning adults need, and embed memory cues where E found the biggest gap: school.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Add one hygiene goal using graduated exposure plus DRA—start with a 5-second face-wash and build up.
02At a glance
03Original abstract
The authors investigated secondary conditions in people with developmental disabilities in terms of (a) the average number of conditions experienced and overall health and independence, (b) their degree and nature, and (c) gender differences. Information was obtained by a questionnaire completed by the caregivers for 659 people with developmental disabilities. Participants experienced an average of 11.3 secondary conditions. Secondary conditions causing significant limitations were reading difficulties, communication, physical fitness-conditioning, personal hygiene-appearance, weight, dental and oral hygiene, and memory problems. Some gender differences emerged in overall health scores and limitations due to secondary conditions.
American journal on intellectual and developmental disabilities, 2011 · doi:10.1352/1944-7558-116.1.36