Skip to main content

Abstract

This chapter focuses on practical applications associated with the care of patients with intellectual and developmental disabilities in the emergency department focusing on emergency assessment, barriers to care, and understanding and utilizing the circles of supports as central to effective interdisciplinary care management. Recognition and utilization of the primary care medical home and the importance of smooth transitions and continuity of care will be the context for maximizing care quality within the emergency environment.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 389.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 499.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Lunsky Y, Gracey G. The reported experience of four women with intellectual disabilities receiving emergency psychiatric services in Canada: a qualitative study. J Intellect Disabil. 2009;13:87–98.

    Article  PubMed  Google Scholar 

  2. Kripke C. Care for adults with developmental disabilities: avoiding pitfalls, achieving success. Family and Community Medicine Grand Rounds, UCSF; 2008. Via email

    Google Scholar 

  3. Lunsky Y, Gracey C, Gelfand S. Emergency psychiatric services for individuals with intellectual disabilities: perspectives of hospital staff. Intellect Dev Disabil. 2008;46:446–55.

    Article  PubMed  Google Scholar 

  4. Weiss JA, Lunsky Y, Gracey C, Canrinus M, Morris S. Emergency psychiatric services for individuals with intellectual disabilities: caregivers’ perspectives. J Appl Res Intellect Disabil. 2009;22:354–62.

    Article  Google Scholar 

  5. Bebbington A, Glasson E, Bourke J, de Klerk N, Leonard H. Hospitalisation rates for children with intellectual disability or autism born in Western Australia 1983–1999: a population-based cohort study. BMJ Open. 2013;E:e002356. doi:10.1136/bmjopen-2012-002356.

    Article  Google Scholar 

  6. Lunsky Y, Lin E, Balogh R, Klein-Geltink J, Bennie J, Wilton A, Kurdyak P. Correspondence: are adults with developmental disabilities more likely to visit EDs? Am J Emerg Med. 2011;29:463–5.

    Google Scholar 

  7. Lunsky Y, Esralew L. Management of acute behavioral and psychiatric emergencies: part 1. American Academy of Developmental Medicine and Dentistry; 2012. URL: http://campus.educadium.com/aadmd/course/view.php?id=139&page=1440

  8. Rader R. Emergency healthcare in adults with IDD: first responders and medical emergencies. American Academy of Developmental Medicine and Dentistry; 2013. URL: http://campus.educadium.com/aadmd/course/view.php?id=142&page=1455

  9. Venkat A, Pastin RB, Hegde GG, Shea JM, Cook JT, Culig C. An analysis of ED utilization by adults with intellectual disability. Am J Emerg Med. 2011;29:401–11.

    Article  PubMed  Google Scholar 

  10. Lin JD, Yen CF, Loh CH, Hsu SW, Huang HC, Tang CC, et al. A cross-sectional study of the characteristics and determinants of emergency care utilization among people with intellectual disabilities in Taiwan. Res Dev Disabil. 2006;27:657–67.

    Article  PubMed  Google Scholar 

  11. Lunsky Y, Balogh R, Khodaverdian A, Elliott D, Jaskulski C, Morris S. A comparison of medical and psychobehavioral emergency department visits made by adults with intellectual disabilities. Emer Med Int. 2012; 427407. doi: 10.1155/2012/427407

    Google Scholar 

  12. Lunsky Y, Balogh R, Cairney J. Predictors of emergency department visits by persons with intellectual disability experiencing a psychiatric crisis. Psychiatr Serv. 2012;63:287–90.

    Article  PubMed  Google Scholar 

  13. A blind spot in the system: Health care for people with developmental disabilities. Findings from stakeholder interviews. Harder and Company Community Research; 2008. URL: http://www.specialhope.org/home/files/blind_spot%20copy.pdf

  14. Morin D, Merineau-Cote J, Oullette-Kuntz H, Tasse MJ, Kerr M. A comparison of the prevalence of chronic disease among people with and without intellectual disability. Am J Intellect Dev Disabil. 2012;117:455–63.

    Article  PubMed  Google Scholar 

  15. Barnhill J, Ailey S. Management of acute behavioral and psychiatric emergencies Part 2. American Academy of Developmental Medicine and Dentistry; 2013. URL: http://campus.educadium.com/aadmd/course/view.php?id=140&page=1445

  16. Hauser MJ. The psychiatric emergency assessment of the patient with developmental disability. In Glick RL, Berlin JS, Fishkind A, Zeller SL. Emergency psychiatry: principles and practice. 2008:345-54.

    Google Scholar 

  17. Boerlage AA, Valkenburg AJ, Scherder EJA, Steenhof G, Effing P, Tibboel D, et al. Prevalence of pain in institutionalized adults with intellectual disabilities: a cross-sectional approach. Res Dev Disabil. 2013;34:2399–406.

    Article  PubMed  Google Scholar 

  18. Evenhuis H, Henderson CM, Beange H, Lennox N, Chicoine B. Healthy ageing–adults with intellectual disabilities: physical health issues. J Appl Res Intellect Disabil. 2001;14:175–94.

    Article  Google Scholar 

  19. Calis EA, Veugelers R, Sheppard JJ, Tibboel D, Evenhuis HM, Penning C. Dysphagia in children with severe generalized cerebral palsy and intellectual disability. Dev Med Child Neurol. 2008;50:625–30.

    Article  PubMed  Google Scholar 

  20. de Winter CF, Jansen AAC, Evenhuis HM. Physical conditions and challenging behavior in people with intellectual disability: a systematic review. J Intellect Disabil Res. 2011;55:675–98.

    Google Scholar 

  21. Charlot L, Abend S, Ravin P, Mastis K, Hunt A, Deutsch C. Non-psychiatric health problems among psychiatric inpatients with intellectual disabilities. J Intellect Disabil Res. 2011;55:199–209.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Wallace RA, Schluter PJ, Forgan-Smith R, Wood R, Webb PM. Diagnosis of helicobacter pylori infection in adults with intellectual disability. J Clin Microbiol. 2003;41:4700–4.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Gnessin E, Mandeville JA, Handa SE, Lingeman JE. Changing composition of renal calculi in patients with musculoskeletal anomalies. J Endourol. 2011;25:1519–23.

    Article  PubMed  Google Scholar 

  24. Gardner B, Kluger PJ. The overall care of the spinal cord injured patient. Curr Orthop. 2004;18:33–48.

    Article  Google Scholar 

  25. Jansen DEMC, Krol B, Groothoff JW, Post D. People with an intellectual disability and their health problems: a review of comparative studies. J Intellect Disabil Res. 2004;48:93–102.

    Article  CAS  PubMed  Google Scholar 

  26. Keller S, Pokharna R. Neurologic emergencies in adults with IDD. Emergency Healthcare in IDD Webinar Series. URL: http://campus.educadium.com/aadmd/course/view.php?id=141&page=1450

  27. Powers RE. Primary care assessment and management of aggressive behavior towards others for the adult with mental retardation and developmental disabilities. DDMED; 2005. URL: http://www.ddmed.org/pdfs/2.pdf

  28. Tsiouris JA, Kim SY, Brown WT, Pettinger J, Cohen IL. Prevalence of psychotropic drug use in adults with intellectual disability: positive and negative findings from a large scale study. J Autism Dev Disord. 2013;43:719–31.

    Google Scholar 

  29. Center for Substance Abuse Treatment. Substance abuse treatment for persons with co-occurring disorders. Rockville: Substance Abuse and Mental Health Services Administration. URL: http://www.ncbi.nlm.nih.gov/books/NBK64178/

  30. Chapman SLC, Wu LT. Substance abuse among individuals with intellectual disabilities. Res Dev Disabil. 2012;33(4):1147–56.

    Google Scholar 

  31. Cotton SM, Richdale AL. Sleep patterns and behaviour in typically developing children and children with autism, Down syndrome, Prader-Willi syndrome and intellectual disability. Res Autism Spect Disord. 2010;4:490–500.

    Article  Google Scholar 

  32. Didden R, Korzillius H, Smits MG, Curfs LMG. Sleep problems in individuals with Angelman syndrome. Am J Ment Retard. 2004;109(3):275–84.

    Article  PubMed  Google Scholar 

  33. Carr EG, Smith CE, Giacin TA, Whelan BM, Pancari J. Menstrual discomfort as a biological setting event for severe problem behavior: assessment and intervention. Am J Ment Retard. 2003;108:117–33.

    Article  PubMed  Google Scholar 

  34. Servais L. Sexual health care in persons with intellectual disabilities. Ment Retard Dev Disabil Res Rev. 2006;12:48–56.

    Article  PubMed  Google Scholar 

  35. Dieffenbach CW, Fauci AS. Universal voluntary testing and treatment for prevention of HIV transmission. JAMA. 2009;301:2380–2.

    Article  CAS  PubMed  Google Scholar 

  36. Harrell E, Rand M. Crime against people with disabilities, 2008. Department of Justice; 2010. URL: http://ojp.gov/newsroom/pressreleases/2010/BJS11037.htm

  37. Evans DN. Perceptions of the victimization of individuals with intellectual disabilities. Adv Appl Sociol. 2013;3:114–23.

    Article  Google Scholar 

  38. Jones L, Bellis MA, Wood S, Hughes K, MccCoy E, Eckley L, et al. Prevalence and risk of violence against children with disabilities: a systematic review and meta-analysis of observational studies. Lancet. 2012;380(9845):899–907.

    Article  PubMed  Google Scholar 

  39. Sin CH, Hedges A, Cook C, Mguni N, Comber N. Disabled people’s experiences of targeted violence and hostility. Equality and Human Rights Commission. URL: http://www.equalityhumanrights.com/uploaded_files/research/disabled_people_s_experiences_of_targeted_violence_and_hostility.pdf

  40. Enlow MB, Blood E, Egeland B. Sociodemographic risk, developmental competence, and PTSD symptoms in young children exposed to interpersonal trauma in early life. J Trauma Stress. 2013;26:686–94.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Gallagher BJ, Jones BJ. Childhood stressors and symptoms of schizophrenia. Clin Schizophrenia Rel Psychoses. 2013;7(3):124–30.

    Article  Google Scholar 

  42. Plummer SB, Findley PA. Women with disabilities’ experience with physical and sexual abuse: a review of the literature and implications for the field. Trauma Violence Abuse. 2012;13:15–29.

    Article  PubMed  Google Scholar 

  43. Dreyfus D, Lauer E, Wilkinson J. Characteristics associated with bone mineral density screening in adults with intellectual disabilities. Am Board Family Med. 2014;27:104–15.

    Article  Google Scholar 

  44. Kripke C. Evaluation of behavior change. Office of Developmental Primary Care, UCSF; 2013. URL: http://odpc.ucsf.edu/sites/odpc.ucsf.edu/files/pdf_docs/Evaluation%20of%20Behavior%20Change.pdf

  45. Zelenski SG. Evaluation for and use of psychopharmacologic treatment in crisis intervention for people with mental retardation and mental illness. In: Hanson R, Wieseler K, Lakin C, Braddock DL, editors. Crisis: prevention and response in the community. Washington, DC: American Association on Mental Retardation; 2002. p. 243–56.

    Google Scholar 

  46. American Association on Mental Retardation. Guideline 1: diagnosis and assessment. Am J Ment Retard. 2000;105(3):165–8.

    Article  Google Scholar 

  47. Goldstein ML, Morewitz S. Sensory integration dysfunction. Chronic disorders in children and adolescents. Dordrecht: Springer; 2011. p. 125–30.

    Book  Google Scholar 

  48. American Academy of Pediatrics. Policy statement: sensory integration therapies for children with developmental and behavioral disorders. Pediatrics. 2012;129:1186–9.

    Article  Google Scholar 

  49. Werner S, Stawski M. Knowledge, attitudes and training of professionals on dual diagnosis of intellectual disability and psychiatric disorder. J Intellect Disabil Res. 2011;56:291–304.

    Article  PubMed  Google Scholar 

  50. Hurley A. Psychiatric disorders in children and adolescents with mental retardation and developmental disabilities. Curr Opin Pediatr. 1996;8:361–5.

    Google Scholar 

  51. Merrick J, Merrick E, Lunsky Y, Kandel I. A review of suicidality in persons with intellectual disability. Isr J Psychiatry Relat Sci. 2006;43:258–64.

    PubMed  Google Scholar 

  52. Chew KL, Iacono T, Tracy J. Overcoming communication barriers—working with patients with intellectual disabilities. Aust Fam Physician. 2009;38:10–4.

    Google Scholar 

  53. Drake J, Johnson NL, Stoneck AV, Martinez DM, Massey M. Evaluation of a coping kit of items to support children with developmental disorders in the hospital setting. Pediatr Nurs. 2012;38:215–21.

    PubMed  Google Scholar 

  54. Institute on Disability START Program. URL: http://iod.unh.edu/Projects/start/description_history.aspx

  55. Massachusetts Department of Developmental Services Adult Screening Recommendations 2012 based on Massachusetts Health Quality Partnership (MHQP) adult preventive care recommendations 2010/2011, consensus guidelines for primary health care of adults with developmental disabilities, URL: http://www.mass.gov/eohhs/docs/dmr/reports/health-screening-wallchart.pdf.

  56. Sullivan WF, Berg JM, Bradley E, Cheetham T, Denton R, Heng J, et al. Primary care of adults with developmental disabilities: Canadian consensus guidelines. Can Fam Physician. 2011;57:541–3.

    Google Scholar 

  57. Functional needs for people with disabilities. A guide for emergency managers, planners and responders. URL: http://nod.org/assets/downloads/Guide-Emergency-Planners.html

  58. Bradley E, Korossy M. Behavior problems. In: Woodbury-Smith M, editor. Clinical topics in the psychiatry of intellectual developmental disorders. Machealth [Internet]. Toronto: Curriculum of Caring: HELP Flowchart; 2015 [cited 2015 August 20] (in press). Available from: https://machealth.ca/programs/curriculum_of_caring/m/mediagallery/2094.

Download references

Acknowledgment 

We would like to acknowledge Nechama W. Greenwood, CPM, MA for her help with the editing of this chapter.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Deborah Dreyfus M.D., M.Sc. .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Dreyfus, D., Bullock, K.A. (2016). Emergency Care. In: Rubin, I.L., Merrick, J., Greydanus, D.E., Patel, D.R. (eds) Health Care for People with Intellectual and Developmental Disabilities across the Lifespan. Springer, Cham. https://doi.org/10.1007/978-3-319-18096-0_137

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-18096-0_137

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-18095-3

  • Online ISBN: 978-3-319-18096-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics