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Siegel J, McGrath K, Muniz E, Siasoco V, Chandan P, Noonan E, Bonuck K. Infusing intellectual and Developmental disability training into Medical School curriculum: a Pilot intervention. Med Educ Online 2023; 28:2271224. [PMID: 37859424 PMCID: PMC10591531 DOI: 10.1080/10872981.2023.2271224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 10/11/2023] [Indexed: 10/21/2023]
Abstract
PURPOSE Despite the rising prevalence of developmental disabilities (DD) in the US, there remains insufficient training for healthcare professionals to care for this medically underserved population - particularly adults. The National Inclusive Curriculum for Health Education (NICHE) aims to improve attitudes and knowledge towards people with intellectual and developmental disabilities (PWIDD); herein we describe one such intervention. METHOD The intervention integrated didactic, panel presentation and clinical skills components into a 2nd year medical school curriculum. The didactic session, covering health and assessment of PWIDDs, history of IDD, stigma, etc., was co-taught by a developmental pediatrician, family medicine physician and social worker. A panel of 3 adult self-advocates (SAs) with DD and a parent of a child with DD spoke about their lived experiences. One week later, students practiced taking clinical histories of SAs within small group settings with adult PWIDDs, facilitated by medical school faculty. Students completed the NICHE Knowledge(49 items) and Attitudes (60 items) surveys. The evaluation analyzed pre/post intervention differences in a) knowledge and attitude scores overall and b) by student age, gender, intended medical specialty, and prior experiences with PWIDDs. Open-ended comments were analyzed with content analysis. RESULTS Overall Knowledge scores increased from pre-to posttest (n = 85; 65[19] vs. 73[17], p = 0.00), while Attitudes score improved (i.e., decreased) (n = 88; 0.55 [.06] vs. 0.53 [0.06]); p = 0.00). Higher pretest knowledge was found among female identified students (vs. others; p = 0.01) and those knowing > = 5 PWIDD (vs < 5; p = 0.02). Students characterize their IDD training and experience prior to intervention as 'lacking' and described the sessions as effective. CONCLUSIONS A brief (4 hours total) intervention was associated with modest but significant improved knowledge and attitudes towards PWIDDs. Replication and sustainability of this and other NICHE interventions are needed to fill gaps in PWIDDs' health care.
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Affiliation(s)
- Joanne Siegel
- Department of Pediatrics, Co-director, Rose F. Kennedy Univeristy Center of Excellence (UCEDD) at Chidlren’s Evaluation and Rehabilitation Center (CERC), Albert Einstein College of Medicine-Montefiore Medical Center, Bronx, NY, USA
| | - Kathleen McGrath
- Department of Pediatrics, CERC/Rose F. Kennedy Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Elisa Muniz
- Developmental-Behavioral Pediatrics Fellowship Program, Department of Pediatrics (Developmental Medicine), CERC/Rose F. Kennedy Center, Albert Einstein College of Medicine-Montefiore Medical Center, Bronx, NY, USA
| | - Vincent Siasoco
- Department of Pediatrics (Developmental Medicine), Department of Family & Social Medicine, CERC/Rose F. KennedyCenter, Albert Einstein College of Medicine-Montefiore Medical Center, Bronx, NY, USA
| | - Priya Chandan
- Healthcare Quality and Analytics, Kramer DavisHealth, Clinical Associate, Professor, Division of Physical Medicine & Rehabilitation, University of Louisville School of Medicine, Louisville, KY, USA
| | - Emily Noonan
- Department of Undergraduate Medical Education, University of Louisville School of Medicine, Louisville, KY, USA
| | - Karen Bonuck
- Department of Pediatrics, Co-director, Rose F. Kennedy Univeristy Center of Excellence (UCEDD) at Chidlren’s Evaluation and Rehabilitation Center (CERC), Albert Einstein College of Medicine-Montefiore Medical Center, Bronx, NY, USA
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Sanders JS, Pillai RLI, Sturley R, Sillau S, Asato MR, Aravamuthan BR, Bonuck K, Cervenka MC, Hammond N, Siegel JF, Siasoco V, Margolis BA. Impact of the COVID-19 Pandemic on the Behavioral Health of People With Intellectual and Developmental Disabilities. Psychiatr Serv 2022; 73:1389-1392. [PMID: 35734865 DOI: 10.1176/appi.ps.202100524] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The authors examined how the COVID-19 pandemic affected the behavioral health of people with intellectual and developmental disabilities (IDD). METHODS A modified version of the Coronavirus Health Impact Survey-Adapted for Autism and Related Neurodevelopmental Conditions was sent to the authors' clinical networks and IDD-affiliated organizations from March to June 2021. RESULTS In total, 437 people with IDD or their caregivers responded to the survey. Diagnoses included intellectual disability (51%) and autism spectrum disorder (48%). More than half (52%) of respondents reported worsened mental health. Losing access to services correlated with declining mental health. Interventions suggested to improve behavioral health included more time with friends and family (68%), more time outdoors (61%), and access to community activities (59%). CONCLUSIONS COVID-19 affected the behavioral health of individuals with IDD. Survey results highlight the opportunity to leverage physical activity and pandemic-safe social supports as accessible means to mitigate gaps in services.
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Affiliation(s)
- Jessica Solomon Sanders
- Department of Pediatrics (Sanders) and Department of Neurology (Sanders, Sillau), University of Colorado School of Medicine, Aurora; University of Massachusetts Chan Medical School-Baystate, Springfield (Pillai); Program in Humanistic Studies, Princeton University, Princeton, New Jersey (Sturley); Kennedy Krieger Institute (Asato) and Adult Epilepsy Diet Center (Cervenka), Johns Hopkins School of Medicine, Baltimore; Institute of Clinical and Translational Sciences, Washington University School of Medicine, St. Louis (Aravamuthan); Department of Pediatrics, Albert Einstein College of Medicine, New York City (Bonuck, Siegel, Siasoco); Department of Neurology, University of Kansas Medical Center, Kansas City (Hammond); Access: Supports for Living, Middletown, New York (Margolis)
| | - Rajapillai L I Pillai
- Department of Pediatrics (Sanders) and Department of Neurology (Sanders, Sillau), University of Colorado School of Medicine, Aurora; University of Massachusetts Chan Medical School-Baystate, Springfield (Pillai); Program in Humanistic Studies, Princeton University, Princeton, New Jersey (Sturley); Kennedy Krieger Institute (Asato) and Adult Epilepsy Diet Center (Cervenka), Johns Hopkins School of Medicine, Baltimore; Institute of Clinical and Translational Sciences, Washington University School of Medicine, St. Louis (Aravamuthan); Department of Pediatrics, Albert Einstein College of Medicine, New York City (Bonuck, Siegel, Siasoco); Department of Neurology, University of Kansas Medical Center, Kansas City (Hammond); Access: Supports for Living, Middletown, New York (Margolis)
| | - Rachel Sturley
- Department of Pediatrics (Sanders) and Department of Neurology (Sanders, Sillau), University of Colorado School of Medicine, Aurora; University of Massachusetts Chan Medical School-Baystate, Springfield (Pillai); Program in Humanistic Studies, Princeton University, Princeton, New Jersey (Sturley); Kennedy Krieger Institute (Asato) and Adult Epilepsy Diet Center (Cervenka), Johns Hopkins School of Medicine, Baltimore; Institute of Clinical and Translational Sciences, Washington University School of Medicine, St. Louis (Aravamuthan); Department of Pediatrics, Albert Einstein College of Medicine, New York City (Bonuck, Siegel, Siasoco); Department of Neurology, University of Kansas Medical Center, Kansas City (Hammond); Access: Supports for Living, Middletown, New York (Margolis)
| | - Stefan Sillau
- Department of Pediatrics (Sanders) and Department of Neurology (Sanders, Sillau), University of Colorado School of Medicine, Aurora; University of Massachusetts Chan Medical School-Baystate, Springfield (Pillai); Program in Humanistic Studies, Princeton University, Princeton, New Jersey (Sturley); Kennedy Krieger Institute (Asato) and Adult Epilepsy Diet Center (Cervenka), Johns Hopkins School of Medicine, Baltimore; Institute of Clinical and Translational Sciences, Washington University School of Medicine, St. Louis (Aravamuthan); Department of Pediatrics, Albert Einstein College of Medicine, New York City (Bonuck, Siegel, Siasoco); Department of Neurology, University of Kansas Medical Center, Kansas City (Hammond); Access: Supports for Living, Middletown, New York (Margolis)
| | - Miya R Asato
- Department of Pediatrics (Sanders) and Department of Neurology (Sanders, Sillau), University of Colorado School of Medicine, Aurora; University of Massachusetts Chan Medical School-Baystate, Springfield (Pillai); Program in Humanistic Studies, Princeton University, Princeton, New Jersey (Sturley); Kennedy Krieger Institute (Asato) and Adult Epilepsy Diet Center (Cervenka), Johns Hopkins School of Medicine, Baltimore; Institute of Clinical and Translational Sciences, Washington University School of Medicine, St. Louis (Aravamuthan); Department of Pediatrics, Albert Einstein College of Medicine, New York City (Bonuck, Siegel, Siasoco); Department of Neurology, University of Kansas Medical Center, Kansas City (Hammond); Access: Supports for Living, Middletown, New York (Margolis)
| | - Bhooma R Aravamuthan
- Department of Pediatrics (Sanders) and Department of Neurology (Sanders, Sillau), University of Colorado School of Medicine, Aurora; University of Massachusetts Chan Medical School-Baystate, Springfield (Pillai); Program in Humanistic Studies, Princeton University, Princeton, New Jersey (Sturley); Kennedy Krieger Institute (Asato) and Adult Epilepsy Diet Center (Cervenka), Johns Hopkins School of Medicine, Baltimore; Institute of Clinical and Translational Sciences, Washington University School of Medicine, St. Louis (Aravamuthan); Department of Pediatrics, Albert Einstein College of Medicine, New York City (Bonuck, Siegel, Siasoco); Department of Neurology, University of Kansas Medical Center, Kansas City (Hammond); Access: Supports for Living, Middletown, New York (Margolis)
| | - Karen Bonuck
- Department of Pediatrics (Sanders) and Department of Neurology (Sanders, Sillau), University of Colorado School of Medicine, Aurora; University of Massachusetts Chan Medical School-Baystate, Springfield (Pillai); Program in Humanistic Studies, Princeton University, Princeton, New Jersey (Sturley); Kennedy Krieger Institute (Asato) and Adult Epilepsy Diet Center (Cervenka), Johns Hopkins School of Medicine, Baltimore; Institute of Clinical and Translational Sciences, Washington University School of Medicine, St. Louis (Aravamuthan); Department of Pediatrics, Albert Einstein College of Medicine, New York City (Bonuck, Siegel, Siasoco); Department of Neurology, University of Kansas Medical Center, Kansas City (Hammond); Access: Supports for Living, Middletown, New York (Margolis)
| | - Mackenzie C Cervenka
- Department of Pediatrics (Sanders) and Department of Neurology (Sanders, Sillau), University of Colorado School of Medicine, Aurora; University of Massachusetts Chan Medical School-Baystate, Springfield (Pillai); Program in Humanistic Studies, Princeton University, Princeton, New Jersey (Sturley); Kennedy Krieger Institute (Asato) and Adult Epilepsy Diet Center (Cervenka), Johns Hopkins School of Medicine, Baltimore; Institute of Clinical and Translational Sciences, Washington University School of Medicine, St. Louis (Aravamuthan); Department of Pediatrics, Albert Einstein College of Medicine, New York City (Bonuck, Siegel, Siasoco); Department of Neurology, University of Kansas Medical Center, Kansas City (Hammond); Access: Supports for Living, Middletown, New York (Margolis)
| | - Nancy Hammond
- Department of Pediatrics (Sanders) and Department of Neurology (Sanders, Sillau), University of Colorado School of Medicine, Aurora; University of Massachusetts Chan Medical School-Baystate, Springfield (Pillai); Program in Humanistic Studies, Princeton University, Princeton, New Jersey (Sturley); Kennedy Krieger Institute (Asato) and Adult Epilepsy Diet Center (Cervenka), Johns Hopkins School of Medicine, Baltimore; Institute of Clinical and Translational Sciences, Washington University School of Medicine, St. Louis (Aravamuthan); Department of Pediatrics, Albert Einstein College of Medicine, New York City (Bonuck, Siegel, Siasoco); Department of Neurology, University of Kansas Medical Center, Kansas City (Hammond); Access: Supports for Living, Middletown, New York (Margolis)
| | - Joanne F Siegel
- Department of Pediatrics (Sanders) and Department of Neurology (Sanders, Sillau), University of Colorado School of Medicine, Aurora; University of Massachusetts Chan Medical School-Baystate, Springfield (Pillai); Program in Humanistic Studies, Princeton University, Princeton, New Jersey (Sturley); Kennedy Krieger Institute (Asato) and Adult Epilepsy Diet Center (Cervenka), Johns Hopkins School of Medicine, Baltimore; Institute of Clinical and Translational Sciences, Washington University School of Medicine, St. Louis (Aravamuthan); Department of Pediatrics, Albert Einstein College of Medicine, New York City (Bonuck, Siegel, Siasoco); Department of Neurology, University of Kansas Medical Center, Kansas City (Hammond); Access: Supports for Living, Middletown, New York (Margolis)
| | - Vincent Siasoco
- Department of Pediatrics (Sanders) and Department of Neurology (Sanders, Sillau), University of Colorado School of Medicine, Aurora; University of Massachusetts Chan Medical School-Baystate, Springfield (Pillai); Program in Humanistic Studies, Princeton University, Princeton, New Jersey (Sturley); Kennedy Krieger Institute (Asato) and Adult Epilepsy Diet Center (Cervenka), Johns Hopkins School of Medicine, Baltimore; Institute of Clinical and Translational Sciences, Washington University School of Medicine, St. Louis (Aravamuthan); Department of Pediatrics, Albert Einstein College of Medicine, New York City (Bonuck, Siegel, Siasoco); Department of Neurology, University of Kansas Medical Center, Kansas City (Hammond); Access: Supports for Living, Middletown, New York (Margolis)
| | - Benjamin A Margolis
- Department of Pediatrics (Sanders) and Department of Neurology (Sanders, Sillau), University of Colorado School of Medicine, Aurora; University of Massachusetts Chan Medical School-Baystate, Springfield (Pillai); Program in Humanistic Studies, Princeton University, Princeton, New Jersey (Sturley); Kennedy Krieger Institute (Asato) and Adult Epilepsy Diet Center (Cervenka), Johns Hopkins School of Medicine, Baltimore; Institute of Clinical and Translational Sciences, Washington University School of Medicine, St. Louis (Aravamuthan); Department of Pediatrics, Albert Einstein College of Medicine, New York City (Bonuck, Siegel, Siasoco); Department of Neurology, University of Kansas Medical Center, Kansas City (Hammond); Access: Supports for Living, Middletown, New York (Margolis)
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