Commentary: Old Perceptions Were Too Limited.
Medical schools still skip IDD health training—behavior analysts can supply the missing content.
01Research in Context
What this study did
The author wrote a short tribute to Dr. Allen Crocker. He used the tribute to spotlight a gap. Most medical schools still do not require any course work on intellectual or developmental disabilities (IDD).
The piece is a call-to-action, not a data study. It urges medical educators to add mandatory IDD health training.
What they found
No new data are presented. The commentary simply states that old views were "too limited." Doctors continue to graduate without basic skills for treating patients with Down syndrome, autism, or other delays.
How this fits with other research
Mulder et al. (2020) extends the same argument to teacher prep programs. Both papers show a pattern: universities rarely require behavior-focused coursework, so new professionals enter the field unprepared.
Friedman (2016) supplies a concrete example of the neglect. Years after Rosa’s Law banned the term "mental retardation," most Medicaid waiver documents still used it. The language lag proves the system moves slowly unless pushed.
Hall et al. (2007) and Matson et al. (2013) supply the historical backdrop. They trace how professional groups already replaced stigmatizing labels. Esbensen (2016) leans on that shift to argue the next step: put the new language and concepts into medical school curricula.
Why it matters
If you serve adults with IDD, you likely field calls from physicians who have never been trained. Use this commentary as evidence when you lobby local medical schools or residency programs. Offer to guest-lecture on behavioral health, epilepsy, or dysphagia protocols. One hour of your expertise can seed a permanent course requirement.
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02At a glance
03Original abstract
Throughout history, health care professionals (especially doctors) have often acted in ways that are now clearly seen as being against the best interests of individuals with intellectual and developmental disabilities (IDD). In part, because of this history, there have been movements away from the medical model that included movements away from health care professionals (especially doctors); these movements were most prominent in the latter half of the 20th century. These movements have not only been led by individuals with IDD and their families, but also by other advocates and professionals and have led to a paucity of health care professionals (especially doctors) who self-identify as specialists in the care of individuals with IDD. These movements away from organized health care (especially doctors) have been one of the factors that contributed to the relative historical scarcity of research into the health of individuals with IDD, especially in the latter half of the 21st century.This special issue of IDD has been created in large part because of the lasting legacy of Dr. Allen Crocker, who lived through those movements away from doctors. Due to the combination of his personal wit and ability to generate general good will, people did not move away from him. He was a pioneer in the area of improving the health of individuals with IDD, especially those with inherited metabolic disorders and Down syndrome. Throughout his career, he worked tirelessly as a clinician, researcher, policy advocate, teacher, and generally good man to all. He was a mentor to generations of individuals, many who are now the leaders of this field. His work was grounded on his vision that past outcomes, especially related to health, did not need to be a predictor of the future for individuals with IDD, either individually or as a population.This special issue of IDD, like Dr. Crocker's work, spans methodologies, disciplines, and points of focus: from investigations into the impact of health care reform and Medicaid managed care for the healthcare of people with IDD, to predictors of institutionalization, to new techniques for patient-oriented research in IDD, to issues related to the aging of individuals with IDD (a relatively new phenomenon, and partly due to the successful work to improve health by prior generations of professionals), to issues of disparity in the health of individuals with IDD, and to legal aspects of dealing with increasing information related to prenatal testing. This special issue of IDD also points to the changes that are occurring in the 21st century, changes that Dr. Crocker advocated: namely, an increase in both the number and activity of researchers and clinicians who dedicate themselves to the work of improving the health of individuals with IDD. To the delight of the editorial team, the call for papers resulted in more submissions than could be included in this single issue. Therefore, subsequent issues of IDD will likely be sprinkled with more work in this field.There are other signs of hope for researchers in the area of health and IDD: The National Institutes of Health has now created specific entities to address both Fragile X and Down syndrome specifically. The Centers for Disease Control and Prevention has a great group that is focused on issues of IDD. Private funders are also stepping up to support several different initiatives related specifically to health and IDD.This special issue of IDD also highlights another area that was near to Dr. Crocker's heart: The education of all health care professionals (especially doctors) needs to include these types of articles. Frankly, medical education lags considerably in the inclusion of curricular materials related to the health of individuals with IDD (as compared to education or other professional training programs). None of the organizations that oversee medical education have mandates related to the education of future doctors about individuals with IDD. This must change. Health care systems disproportionally (versus most other systems in society) interact with individuals with IDD, yet these systems have almost no leadership who have been trained in the needs of individuals with IDD, either as individuals or as a group. Therefore, the next step for the field of professionals in IDD is to take these findings and help to ensure that they are included in the training of the next generation of health care professionals. That would certainly be what Dr. Crocker would do.
Intellectual and developmental disabilities, 2016 · doi:10.1352/1934-9556-54.2.81