Understand the person’s baseline
Assessment of risks needs to be tailored to the person. This includes understanding how the person is when they are well, in particular their behaviour, so that any changes can be investigated.
Understanding how someone communicates or usually behaves forms the basis for accurate clinical assessment. The person with intellectual disability may have individual information in personalised resources – such as a My Health Matters folder or Admission 2 Discharge Together (A2D) folder – that clinicians can use during an assessment.
The involvement of the family, NDIS disability support worker or guardian during screening, with the person’s permission, assists in gaining relevant information – for example, if the person is uncharacteristically subdued, agitated, distressed, or experiencing appetite changes or sleep disturbance. Feedback and concerns from family, supporters or guardians should be treated as clinically important information.
Take a person-centred approach to screening
Training clinicians in person-centred approaches for people with intellectual disability builds their capacity to adapt their approach and use reasonable adjustments in conducting assessments. A person-centred approach includes allowing more time and checking that the person understands the information they have been given. The clinician needs to be aware of the person’s non-verbal cues so they can adjust their behaviour as a clinician accordingly. The reasonable adjustments required for each person may be different.
The NSW Statewide Intellectual Disability Health Service provides consultative healthcare services for children and adults with intellectual disability and complex health needs. It also works to build capacity among mainstream health staff and general practice teams, to better meet the health needs of people with intellectual disability.
