The Safety Net

Healthy Lifestyle
Guidelines For Prevention and Management


The International Association for the Scientific Study of Intellectual Disabilities (IASSID) has developed health targets for persons with intellectual disabilities (the term used by this organization to reference mental retardation). These guidelines have been presented to the World Health Organization (WHO) and target conditions that are prevalent among persons with disabilities. Individual members of the Special Interest Research Group (SIRG) on Physical Health have presented these health targets at international meetings and experts have further refined them. Fifteen (15) health conditions have been identified and recommendations have been made for their prevention and management. Following is a summary of the guidelines. For more information go to:

Issue Special Risks (s) Guidelines
Dental Health persons with developmental disabilities may have a much higher incidence of periodontal disease, oral mucosal pathology and moderate to severe malocclusion -establish appropriate dietary habits
-three month dental visits for those at risk and those with active oral disease
-six month prophylaxis for all
-preventive therapies such as fluoride should be used, as applicable
-use team approach for planning
Vision persons with Down syndrome at risk for cataract after age 30 routine screening for age-related visual loss at 45 and every five years thereafter
-persons with Down syndrome should receive a check at age 30
Hearing increased likelihood of ear wax -screening at age 45 and every five years thereafter
-persons with Down syndrome should be screened every three years throughout life
Nutrition obesity and chronic constipation are prevalent; people with cerebral palsy are at higher risk for GERD (gastro-esophageal reflux disease) and dysphagia simple screening using tool for that purpose
-high risk individuals should be assessed by an experienced professional
-team approach to developing interventions
Constipation higher risk for persons with limited mobility and for persons taking certain medications -dietary assessment and pro-active medical treatments
Epilepsy higher prevalence; high risk for physical trauma; impact of medication; social impact -seizure management plan
-annual medication assessment
-education for consumers and care givers
-special hazard warning for bathing and water
Thyroid Disease behavior change may be observed as only symptom -persons with previous history or with Down syndrome should have thyroid function test performed annually; all others every three to five years
-possible medication supervision
Mental Health may be limited availability of psychiatric services for this population -“Health services should implement strategies to maximize the quality of identification and management of mental disorders”.
Gastro-esophageal reflux disease (GERD) and Helicobacter pylori very high prevalence -identify and treat GERD and illness from Heliobacter pylori
Osteoperosis use of anticonvulsants; small body size; hypogonadism; Down syndrome; increased risk for fracture -early screening and prevention
-vitamin D supplement, as indicated
-bone mineral density assessment for post-menopausal women and men with hypogonadism
-prevention of falls

Medication Review reviews may be inadequate; daily medications may be necessary; possible limited ability to consent and ability to monitor

-ideally, medication reviewed quarterly when polypharmacy exists
-consumer education
-systems for packaging for individuals living in the community
-structured methods for monitoring

Immunization Status some data indicates less regular immunizations received than the general population

-follow national guidelines
-Hepatitis A & B immunizations for persons living in institutions; Hepatitis B for persons in contact with carriers
-influenza and pneumococcus immunization for medically vulnerable

Physical Activity and Exercise immobility is a predictor for mortality; presence of cardiovascular risk factors -30 minutes or more of moderate intensity physical activity on most days
-provide daily active or passive movement for those with limited mobility

Comprehensive Health Assessments support needed to access services; undetected health problems -regular, comprehensive physical assessment

Genetics need for informed genetic counseling for family members; estimates up to 50% genetic etiology

-referral to genetic clinic unless diagnosis present

Women's Health individualize screenings -Papanicolaou smears necessary; if sedation needed, balance against benefits
-mammograms as recommended for general population*

* Note: Readers of the web site may wish to obtain additional specific guidelines for women’s health at and

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