Primary Care for the Developmentally Disabled Adult


	Primary preventive care is important for everyone. In individuals who have a primary disability, secondary prevention is equally important. Maintaining recommended immunizations including annual influenza vaccine should be done. PPDs should be performed in some cases (for specific recommendations on vaccines go to www.cdc.gov). Hearing and vision should be assessed annually. If functional issues indicate, annual PT, OT, and speech pathology exams should be performed with care plans developed and monitored at recommended intervals. Certain subgroups may require specialized assessments such as thyroid testing, echocardiograms, and bone densitometry. For more invasive or prolonged procedures, consider the use of brief sedation in order to get high quality test results. For other screening recommendations, consult the USPHS Guide to Preventive Services.
	Contractures pose a special challenge to secondary prevention care. Cleanliness and pressure reduction are needed to prevent skin breakdown. Anti-spasticity maneuvers including medications, splints and stretching are important for maintaining function and mobility in persons with motor disorders. Surgery (e.g. tenotomy) may be indicated.