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| Improving Health Outcomes for Individuals With Intellectual and Developmental Disabilities |
| Monday, May 27, 2024 |
| 10:00 AM–11:50 AM |
| Marriott Downtown, Level 4, Franklin Hall 12-13 |
| Area: CBM/TBA; Domain: Applied Research |
| Chair: Robert K. Lehardy (University of Houston - Clear Lake) |
| Discussant: Iser Guillermo DeLeon (University of Florida) |
| CE Instructor: Iser Guillermo DeLeon, Ph.D. |
| Abstract: Individuals who are diagnosed with intellectual and developmental disabilities experience greater health disparities than neurotypical individuals. The research presented at this symposium aims to reduce health disparities by improving health outcomes for individuals who are diagnosed with intellectual and developmental disabilities. Shanker and Simmons studied the healthcare experiences of individuals with autism or their caregivers and developed a digital application to help them meet their healthcare needs. Salvatore and Simmons developed a survey to study physicians’ knowledge of behavioral function and suggested ways to incorporate behavioral principles and training into medical curricula to improve care for individuals diagnosed with intellectual and developmental disabilities. McCafferty et al. studied the efficacy of a tactile stimulus (i.e., TAGTeach®) to improve medical students’ acquisition of procedures learned during medical training. Lehardy et al. developed and evaluated time-efficient training to increase healthcare providers' confidence and competence to conduct physical examinations with individuals diagnosed with intellectual and developmental disabilities. |
| Instruction Level: Intermediate |
| Keyword(s): Healthcare, Medical Education, Medical Skills |
| Target Audience: To effect behavior change with healthcare providers, audience members should be able to communicate and network with healthcare providers and educators effectively. |
| Learning Objectives: At the conclusion of the presentation, participants will be able to: (1) describe health disparities faced by people with intellectual and developmental disabilities; (2) describe behavioral interventions that can increase patients' autonomy in obtaining healthcare; (3) describe behavioral interventions that can facilitate healthcare providers caring for people with intellectual and developmental disabilities. |
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| Exploring the Medical Experiences of Autistic Individuals: Individual and Family Perspectives |
| MAYA SHANKER (Rowan University), Christina Simmons (Rowan University) |
| Abstract: Individuals with autism spectrum disorder have higher rates of unmet healthcare needs when compared to neurotypical individuals. In this study, 12 parents of autistic individuals and six adults with autism participated in open-ended interviews about their experiences accessing medical care and shared their perspectives on technology-based support tools. Thematic analysis of participant transcripts identified 11 themes and 19 subthemes for parents and 14 themes and 27 subthemes for autistic individuals. Salient themes for both parents and autistic adults included negative and positive experiences accessing medical care, feeling that doctors lack training specific to autistic patients, and that quality of medical care is dependent on the type of provider. Participants expressed support for technology to address communication challenges and differences in executive functioning and planning. The perspectives of autistic adults and their family members contributed to the development of a digital application to meet the support needs of patients with autism transitioning from pediatric to adult medical care. This application specifically designed to help autistic adults track and organize their medical symptoms, as well as prepare for expectations of upcoming medical appointments, could serve as a valuable tool to address identified needs and barriers in healthcare access for neurodivergent patients. |
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| Quantifying Physician Knowledge of Behavioral Function |
| GIOVANNA SALVATORE (Rowan University), Christina Simmons (Rowan University) |
| Abstract: Hospital patients with autism spectrum disorder may engage in various topographies of severe behavior, with higher rates of restraint implemented than for their neurotypical counterparts. Qualitative research suggests that physician knowledge of function-based intervention is limited. The research team developed the Knowledge of Behavioral Function survey measure using an iterative user-centered development process and administered the measure to 150 multidisciplinary physicians and trainees. Results indicated low knowledge of behavioral function, with a mean percent correct of 66.60% on close-ended survey items and 14% correct on open-ended vignette items. Years of experience and discipline were each not significantly associated with knowledge of behavioral function. Despite low function-based knowledge, 91.10% of participants demonstrated adequate knowledge of autism and these scores were not significantly correlated. On Likert Scale items, 73.46% of participants indicated that they recommend restraint to manage hospital patient severe behavior and 71.43% of participants indicated that they have not received sufficient training to treat hospital patients with autism. We will discuss how principles of applied behavior analysis and function-based training may be incorporated into medical curriculum to decrease restraint implementation and promote compassionate treatment for neurodivergent patients in hospital settings. |
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| A Comparison of Tactile TAGteach® to Video Modeling to Train Medical Skills |
| KIRA ELIZABETH FLYNN (Florida Institute of Technology), Kelcie E McCafferty (Florida Institute of Technology), David A. Wilder (Florida Institute of Technology), Nicole Gravina (University of Florida), Letitia Bible (University of Florida), Rachael Ferguson (Kalamazoo Valley Community College) |
| Abstract: Modern medical training largely consists of lecture-based instruction and in-vivo or video modeling of specific skills. Other instructional methods, such as teaching with acoustical guidance or TAGteach®, have rarely been evaluated. In this study, we compared tactile TAGteach®, in which a vibratory stimulus is delivered to indicate a correct response, to video modeling and self-evaluative video feedback to teach four participants two medical skills: simple interrupted suture and endotracheal intubation. Both skills are commonly taught in medical instruction. The results show that both instructional methods improved performance. However, three participants met the mastery criterion in the tactile TAGteach® condition first. One participant met the mastery criterion in the video modeling and self-evaluative video feedback condition first. Tactile TAGteach® required more time to train the skills. These results suggest that instructors of medical skills should consider the use of TAGteach. We discuss the implications of these findings for training skills to medical practitioners. |
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Increasing Healthcare Students’ and Professionals’ Confidence and Competence to Care for Individuals With Neurodevelopmental Disorders |
| TAYLOR BURNETT (University of Houston - Clear Lake), Robert K. Lehardy (University of Houston - Clear Lake), Abigail Konecki (University of Houston - Clear Lake), Rebecca Brockman (University of Houston - Clear Lake), Sydney Gandy (University of Houston Tilman J. Fertitta Family College of Medicine), Dorothea C. Lerman (University of Houston - Clear Lake) |
| Abstract: People diagnosed with neurodevelopmental disorders experience more frequent health conditions than neurotypical people. This health disparity may stem from healthcare providers reporting that they lack sufficient training to promote the comfort and cooperation of patients with neurodevelopmental disorders. To address this, we trained healthcare providers to use the following behavior interventions during physical examinations to promote a patient’s comfort and cooperation: Providing patients non-contingent access to preferred items, telling patients about and showing them upcoming procedures, offering patients frequent breaks, using graduated exposure to increase patient cooperation during challenging procedures, and offering incentives when patients cooperate during challenging procedures. Before training, a small but representative sample (n = 12) scored a mean of 35% on a proficiency test. After training, their mean proficiency increased to 95%, and the remaining participants (n = 161 in a post-test design) scored a mean of 92%. Participants (n = 121) also reported increased confidence in helping people with neurodevelopmental disorders after the training. The results show that the training can effectively teach healthcare providers to use behavioral interventions in role-play. We suggest ways to evaluate proficiency in vivo and embed the training into medical school curricula. |
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