Seven Hills

• Provides community‐based supports for individuals with a broad spectrum of disabilities

• Staffs and runs over 120 group residential homes in Massachusetts and Rhode Island for adults with IDD

• Offers education and day programs along with an employment program to help individuals work in the community

Cardinal Cushing

• Oversees shared living arrangements along with family care• Staffs 9 homes in the community which each house 4‐5 adults with IDD• Two locations (Braintree and Hanover) offer Day Habilitation Programs 

where adults with IDD have access to nursing, PT, OT, Speech, communication and music therapies along with many planned activities and community involvement

CDDER  Center for Developmental Disabilities Evaluation and Research

• Research on vulnerable patient populations to improve the services and supports provided to adults with IDD

• Provides evaluation and training to service agencies to help them better support and serve adults with IDD

MassMATCHREquipment Center 

• Promotes the use of assistive technology services to empower people with disabilities to live more independent lives

• Recycling center for assistive mobility devices, such as wheelchairs

Population Health Clerkship: Caring for Adults with Intellectual DisabilitiesAshley Bradylyons, Alexander Buslov, Kevin Liang

Faculty: Emily Lauer, MPH, Alexandra Bonardi, MA, MS

Background Information Advocating for Adults with IDD

Acknowledgements

References

Community Resources

Advice for Clinicians

What is an intellectual  and developmental disability?

“Intellectual disability is a disability characterized by significantlimitations both in intellectual functioning (reasoning, learning,problem solving) and in adaptive behavior, which coverages arange of everyday social and practical skills. This disabilityoriginates before the age of 18.”

‐ American Association on Intellectual and Developmental Disabilities

We would like to take this opportunity to thank all thepeople that have taken the time to share their vast wealth ofknowledge regarding the adults with IDD community.Specifically, we would like to thank our clerkship groupleaders, Emily Lauer and Alixe Bonardi. We are also gratefulto Dr. Baldor, Dr. Mitra, Sharon Goldberg and Seven Hills,Cardinal Cushing Center, Dr. Moran, MassMATCH, and NancyAlterio of the DPPC.

Service Learning Project

Acknowledgements

Service Learning ProjectEvery two years, CCDER collaborates with the Department ofDevelopmental Services (DDS) to update the preventative healthscreening recommendations for adults with IDD

These guidelines are crucial for this population because of theimmense hurdles faced by adults with IDD in navigating anincreasingly complex healthcare system. At least 30% of adults withIDD have unique health issues requiring additional screening

For our service project, we conducted a literature review of newscreening recommendations since 2014 and compiled the updates forCDDER and DDS to review as part of the 2016 update. Notableupdates included changes to mammography and PSA screening

Figure 3: Massachusetts DDS Health Screening Recommendations, Updated Oct. 2014

• Racial Disparities in Median Age at Death of Persons With Down Syndrome ‐‐‐ United States, 1968—1997, MMWR, June 08, 2001 / 50(22); 463‐5   

• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3093586/pdf/0570541.pdf• http://www.mhqp.org/products_and_tools/?content_item_id=169#C• http://psychologyshistory.umwblogs.org/evolution‐of‐institutions/• Eunice Kennedy Shriver Center, UMass Medical School• Tyler, C.V. (1999) Medical Issues for Adults with Mental Retardation. High Tide Press, 

Homewood, Illinois.• http://shriver.umassmed.edu/sites/shriver.umassmed.edu/files/MA%20DDS%20health_scr

eening_brochure_2014.pdf• Erickson, W., Lee, C., & von Schrader, S. (2016). 2014 Disability Status Report: United States. 

Ithaca, NY: Cornell University Yang Tan Institute on Employment and Disability(YTI).

The Disabled Persons Protection Commission (DPPC)

• Hospital personnel (doctors, interns, nurses, psychologists, etc.) and many others in the medical field are mandated reporters for suspicions of abuse. Any suspected crimes should be directly reported to the police and for adults with disabilities aged 22‐59, any suspected abuse should also be reported to the DPPC.

• When providers have the “mere suspicion” of neglect or abuse against a person with a disability they should call the 24‐hour hotline at 1‐800‐426‐9009. 

• Focus on the PERSON, not the disability• Communicate directly with the patient even if they are nonverbal

• Commonly under‐recognized health problems in this population: GI: dysphagia, constipation, GERD Vision: cataracts, glaucoma, retinal detachment MSK: osteoporosis, degenerative joint disease Neuro: compressive neuropathies from contractures or 

long‐term use of assistive devices for mobility  Down syndrome: screen specifically for hearing and 

ocular problems, hypothyroidism, seizure disorders

• Up until the movement to deinstitutionalize adults with IDD in the1970's and 1980's, many individuals spent their entire lives ininstitutions, interacting minimally with the general population

• Developmental disability is a broader term that encompassesdisabilities with onset before age 22 that may be purely physical innature, such as cerebral palsy

• Intellectual and developmental disability (IDD) is now the preferredmedical term for the group of disabilities previously diagnosed asmental retardation

Medical Education Tips • After concluding this clerkship, we believe our medical education is 

lacking in its inclusion of adults with disability in the curriculum• We think it would be beneficial to 1st year medical students to have a 

discussion about adults with IDD during DCS1 

Figure 1: Prevalence of Disability Among All Ages in the USA, 2014

Figure 2: Primary Residence of Adult Population Served by Massachusetts DDS

Common Causes of Intellectual Disability