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When many of us
did our medical training, the only adults with developmental disabilities
(DD) we saw were living in state-run institutions. Our experience was often unpleasant. The individual was most likely admitted in the middle of the
night through the emergency department with inadequate history, worrisome
symptoms and inability to communicate or even cooperate with medical
care. No one came to support or
advocate for the individual. In general residents of those facilities were
likely to have severe to profound retardation. Musculoskeletal problems were
likely to be advanced, ranging from mild scoliosis to severe generalized
deformities that interfere with simple positioning and nursing care. Both psychiatric and behavioral issues
existed in a significant percentage and seizures were likely to be present in
half or more. Other problems of
significance included GI issues such as gastro-esophageal reflux disease and
constipation, ENT and ocular problems.
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