New Frontier: The First Year of an Adult Neurodevelopmental Disabilities Clinic.
Journal
Cognitive and behavioral neurology : official journal of the Society for Behavioral and Cognitive Neurology
ISSN: 1543-3641
Titre abrégé: Cogn Behav Neurol
Pays: United States
ID NLM: 101167278
Informations de publication
Date de publication:
11 Dec 2023
11 Dec 2023
Historique:
received:
02
11
2022
accepted:
20
07
2023
medline:
8
12
2023
pubmed:
8
12
2023
entrez:
8
12
2023
Statut:
aheadofprint
Résumé
As patients with neurodevelopmental disorders (NDDs) transition from pediatric to adult health care systems, they often have difficulty finding physicians to address their NDD-related needs. In response to this care gap, we established a new consultation clinic within a behavioral neurology clinic in an adult neurology department to address the neurodevelopmental concerns of these adult patients. To characterize the population of adult patients with NDDs seen in the adult NDD clinic in its first year. Data were obtained by a retrospective chart review of all patients with NDDs seen in the adult NDD clinic from September 2020 through December 2021. Of the 86 patients who were seen in the adult NDD clinic, the average age was 34 years (SD = 15, range = 18-74 years). Developmental diagnoses included intellectual disability (63%), autism spectrum disorder (47%), Down syndrome (15%), cerebral palsy (9%), and other genetic disorders (26%). Comorbidities addressed included behavioral concerns (34%), anxiety (29%), seizure disorders (22%), and depression (15%). Behavioral and/or mental health concerns prompted 65% of the initial clinic visits. The most common recommendation made was to begin or increase exercise (59%), followed by facilitating connection to community, social, and employment resources. Adults with NDDs have diagnoses, comorbidities, and concerns that are similar to, but also distinct from, those addressed in other adult neurology clinics. This study addresses the need for, and feasibility of, caring for the diverse population of adults with NDDs in an adult neurology setting.
Sections du résumé
BACKGROUND
BACKGROUND
As patients with neurodevelopmental disorders (NDDs) transition from pediatric to adult health care systems, they often have difficulty finding physicians to address their NDD-related needs. In response to this care gap, we established a new consultation clinic within a behavioral neurology clinic in an adult neurology department to address the neurodevelopmental concerns of these adult patients.
OBJECTIVE
OBJECTIVE
To characterize the population of adult patients with NDDs seen in the adult NDD clinic in its first year.
METHOD
METHODS
Data were obtained by a retrospective chart review of all patients with NDDs seen in the adult NDD clinic from September 2020 through December 2021.
RESULTS
RESULTS
Of the 86 patients who were seen in the adult NDD clinic, the average age was 34 years (SD = 15, range = 18-74 years). Developmental diagnoses included intellectual disability (63%), autism spectrum disorder (47%), Down syndrome (15%), cerebral palsy (9%), and other genetic disorders (26%). Comorbidities addressed included behavioral concerns (34%), anxiety (29%), seizure disorders (22%), and depression (15%). Behavioral and/or mental health concerns prompted 65% of the initial clinic visits. The most common recommendation made was to begin or increase exercise (59%), followed by facilitating connection to community, social, and employment resources.
CONCLUSION
CONCLUSIONS
Adults with NDDs have diagnoses, comorbidities, and concerns that are similar to, but also distinct from, those addressed in other adult neurology clinics. This study addresses the need for, and feasibility of, caring for the diverse population of adults with NDDs in an adult neurology setting.
Identifiants
pubmed: 38063505
doi: 10.1097/WNN.0000000000000362
pii: 00146965-990000000-00063
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
The authors declare no conflicts of interest.
Références
Abreu NJ, Urion DK, Asato MR. 2020. Emerging subspecialties in neurology: neurodevelopmental disabilities. Neurology. 95:1113–1115. doi:10.1212/wnl.0000000000010654
doi: 10.1212/wnl.0000000000010654
Bobbette N, Ouellette-Kuntz H, Tranmer J, et al. 2020. Adults with intellectual and developmental disabilities and interprofessional, team-based primary health care: a scoping review. JBI Evid Synth. 18:1470–1514. doi:10.11124/jbisrir-d-19-00200
doi: 10.11124/jbisrir-d-19-00200
Bridgemohan C, Bauer NS, Nielsen BA, et al. 2018. A workforce survey on developmental–behavioral pediatrics. Pediatrics. 141:e20172164. doi:10.1542/peds.2017-2164
doi: 10.1542/peds.2017-2164
Butryn T, Bryant L, Marchionni C, et al. 2017. The shortage of psychiatrists and other mental health providers: causes, current state, and potential solutions. Int J Acad Med. 3:5–9. doi:10.4103/ijam.Ijam_49_17
doi: 10.4103/ijam.Ijam_49_17
Ervin DA, Hennen B, Merrick J, et al. 2014. Healthcare for persons with intellectual and developmental disability in the community. Front Public Health. 2:83. doi:10.3389/fpubh.2014.00083
doi: 10.3389/fpubh.2014.00083
Friedman C. 2017. Community integration of people with intellectual and developmental disabilities: a national longitudinal analysis. Disabil Health J. 10:616–620. doi:10.1016/j.dhjo.2016.12.018
doi: 10.1016/j.dhjo.2016.12.018
Frueh JS, Press DZ, Sanders JSS. 2021. Diagnosis and workup of intellectual disability in adults: suggested strategies for the adult neurologist. Neurol Clin Pract. 11:534–540. doi:10.1212/CPJ.0000000000001128
doi: 10.1212/CPJ.0000000000001128
Gandy M, Michaelis R, Acraman J, et al. 2023. Integrated psychological care services within seizure settings: key components and implementation factors among example services in four ILAE regions: a report by the ILAE Psychiatry Commission. Epilepsia. 64:1766–1784. doi:10.1111/epi.17647
doi: 10.1111/epi.17647
Haxby JV. 1989. Neuropsychological evaluation of adults with Down’s syndrome: patterns of selective impairment in non-demented old adults. J Ment Defic Res. 33:193–210. doi:10.1111/j.1365-2788.1989.tb01467.x
doi: 10.1111/j.1365-2788.1989.tb01467.x
Health Resources and Services Administration/National Center for Health Workforce Analysis; Substance Abuse and Mental Health Services Administration/Office of Policy, Planning, and Innovation.. 2016. National Projections of Supply and Demand for Behavioral Health Practitioners: 2013–2025. Rockville, Maryland: U.S. Department of Health and Human Services.
Individuals with Disabilities Education Act. 2004. 20 USCA; United States Code Annotated, Title 20. Chapter 33.
Juul D, Gutmann L, Adams HP Jr, et al. 2021. Training in neurology: feedback from graduates about the psychiatry component of residency training. Neurology. 96:233–236. doi:10.1212/wnl.0000000000010857
doi: 10.1212/wnl.0000000000010857
Krahn GL, Fox MH. 2014. Health disparities of adults with intellectual disabilities: What do we know? What do we do? J Appl Res Intellect Disabil. 27:431–446. doi:10.1111/jar.12067
doi: 10.1111/jar.12067
Larson SA, van der Salm B, Pettingell S, et al. 2021. Long-Term Supports and Services for Persons With Intellectual or Developmental Disabilities: Status and Trends Through 2018. Minneapolis, Minnesota: University of Minnesota, Research and Training Center on Community Living, Institute on Community Integration.
Leach KF, Stack NJ, Jones S. 2021. Optimizing the multidisciplinary team to enhance care coordination across the continuum for children with medical complexity. Curr Probl Pediatr Adolesc Health Care. 51:101–128. doi:10.1016/j.cppeds.2021.101128
doi: 10.1016/j.cppeds.2021.101128
Liang X, Li R, Wong SHS, et al. 2022. The effects of exercise interventions on executive functions in children and adolescents with autism spectrum disorder: a systematic review and meta-analysis. Sports Med. 52:75–88. doi:10.1007/s40279-021-01545-3
doi: 10.1007/s40279-021-01545-3
Marrie RA, Fisk JD, Fitzgerald K, et al. 2023. Etiology, effects and management of comorbidities in multiple sclerosis: recent advances. Front Immunol. 14:1197195. doi:10.3389/fimmu.2023.1197195
doi: 10.3389/fimmu.2023.1197195
McGovern E, Pringsheim T, Medina A, et al. 2021. Transitional care for young people with neurological disorders: a scoping review with a focus on patients with movement disorders. Mov Disord. 36:1316–1324. doi:10.1002/mds.28381
doi: 10.1002/mds.28381
Nuzum H, Stickel A, Corona M, et al. 2020. Potential benefits of physical activity in MCI and dementia. Behav Neurol. 2020:7807856. doi:10.1155/2020/7807856
doi: 10.1155/2020/7807856
Oh ES, Rabins PV. 2019. Dementia. Ann Intern Med. 171:ITC33–ITC48. doi:10.7326/aitc201909030
doi: 10.7326/aitc201909030
Petersen RC, Lopez O, Armstrong MJ, et al. 2018. Practice guideline update summary: mild cognitive impairment: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology. 90:126–135. doi:10.1212/wnl.0000000000004826
doi: 10.1212/wnl.0000000000004826
Residential Information Systems Project. 2022. Living Arrangements of LTSS Recipients by Fiscal Year Over Time. Accessed December 27, 2022. https://risp.umn.edu/viz/living-arrangements/living-arrangements-of-ltss-recipients-by-fiscal-year-over-time
Shapiro HFJ, Frueh JS, Chiujdea M, et al. 2023. Education research: predictors of resident physician comfort with individuals with intellectual and developmental disabilities. a cross-sectional study. 2:e200045. doi:10.1212/ne9.0000000000200045
doi: 10.1212/ne9.0000000000200045
Silverman W, Krinsky-McHale SJ, Lai F, et al. 2021. Evaluation of the National Task Group-Early Detection Screen for Dementia: sensitivity to ‘mild cognitive impairment’ in adults with Down syndrome. J Appl Res Intellect Disabil. 34:905–915. doi:10.1111/jar.12849
doi: 10.1111/jar.12849
Stancliffe RJ, Anderson LL. 2017. Factors associated with meeting physical activity guidelines by adults with intellectual and developmental disabilities. Res Dev Disabil. 62:1–14. doi:10.1016/j.ridd.2017.01.009
doi: 10.1016/j.ridd.2017.01.009
Thijs RD, Surges R, O’Brien TJ, et al. 2019. Epilepsy in adults. Lancet. 393:689–701. doi:10.1016/s0140-6736(18)32596-0
doi: 10.1016/s0140-6736(18)32596-0
University of New Hampshire. 2020. 2020 Annual Disability Statistics Compendium. Accessed December 27, 2022. https://disabilitycompendium.org/compendium/2020-annual-disability-statistics-compendium?page=14
Videlefsky AS, Reznik JM, Nodvin JT, et al. 2019. Addressing health disparities in adults with developmental disabilities. Ethn Dis. 29:355–358. doi:10.18865/ed.29.S2.355
doi: 10.18865/ed.29.S2.355
Yuen AWC, Keezer MR, Sander JW. 2018. Epilepsy is a neurological and a systemic disorder. Epilepsy Behav. 78:57–61. doi:10.1016/j.yebeh.2017.10.010
doi: 10.1016/j.yebeh.2017.10.010
Zablotsky B, Black LI, Maenner MJ, et al. 2019. Prevalence and trends of developmental disabilities among children in the United States: 2009–2017. Pediatrics. 144:e20190811. doi:10.1542/peds.2019-0811
doi: 10.1542/peds.2019-0811