Guidelines for Ear, Nose, and Throat Examination of Adults With Intellectual Disabilities: Report of a Clinical Practice Application

Abstract

Health problems among people with intellectual and developmental disabilities (I/DD) are considered more prevalent than among the general population, but there are very few studies that have described a detailed ear, nose, and throat examination of this group. The purpose of this paper is to provide a set of guidelines that can result in a structured ear, nose, and throat examination, describe one experience with implementing the guidelines for otorhinolaryngological care with a heteroegnous sample of adults with intellectual disability, discuss relevant care principles derived from the experience, and specifically address the issue of cerumen impaction. The subjects, 356 adult residents of two residential care centers for people with I/DD, were examined by four otolaryngologists, assisted by an audiologist/speech-language pathologist, and a nurse. The examinations lasted 8 h over 2 days. Of the residents, 292 (82%) had at least one main finding; impacted cerumen was observed among 54.9% of the examined ears. Of these, 103 residents (206 ears) were examined again after cerumenolytic treatment and cerumen cleared. The authors concluded that there is a need for focused physical examination in order to recognize and treat ear, nose, and throat disorders in this population. Examinations of adults with I/DD are feasible and important in enabling good communication and maintaining general health.

Hearing Loss Diagnosis and Management in Adults with Intellectual and Developmental Disabilities

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Development and validation of a functional screening tool for adults with intellectual disabilities

“…Individuals with intellectual disabilities, especially those with severe disabilities, are generally at a high risk for functional and health‐related problems. Consequently, in addition to intellectual disabilities, these individuals may also be diagnosed with additional disorders (Ben David et al, 2022; Kadari & Shiri, 2015), including emotional–mental difficulties, challenging behaviours (Ahlstorm et al, 2020; Jonker et al, 2021), communication disorders, eating and swallowing disorders, hearing impairments, physical disabilities (Icht et al, 2021; Lotan et al, 2009; Manduchi et al, 2020; Oron et al, 2015; Zalmstra et al, 2021), epilepsy and autism (Perkins et al, 2010). The comorbidity characterising this population makes it more fragile than the general population (Perkins et al, 2010), causing relatively frequent hospitalizations and more extensive use of drugs, the effectiveness of which is not always evident (Matson & Neal, 2009).…”