Taking a medical history

Taking a medical history for a person with developmental disability should be as for the general population, with some additional considerations; see Specific information needed when assessing a person with developmental disability. The type of information and level of detail will vary depending on the aetiology and type of disability, and the clinical presentation.

Assess the person’s capacity to provide an accurate history—information may be needed from other sources; see Obtaining information from other sources.

For advice on communicating with a person with developmental disability during a consultation, see here. For tools to assess pain or distress in people with communication difficulty, see Pain assessment tools.

Consider using a disability health assessment templateto prompt information gathering. These are specific to people with developmental disability, and help to identify health problems that are often missed or misdiagnosed in this group; see also Commonly missed health problems in people with developmental disability.

Medicare items may apply for health assessments and care planning for people with intellectual disability. See the Australian Government Department of Health Medicare Benefit Schedule Health Assessment for people with intellectual disability fact sheet.

Figure 1. Specific information needed when assessing a person with developmental disability.

[NB1]

Patient details (essential)

cause of disability (if known)

preferred effective communication method

neuromuscular, cognitive and sensory functioning

capacity for decision making, support needed to participate in decisions, and responsible person or medical decision maker (if applicable)

current medications

Additional information (if available) [NB2]

mealtime plan (detailing oral intake and mealtime assistance needs)

bowel care plan

seizure charts

behavioural records, including a behaviour support plan [NB3]

screening for syndrome-specific conditions (eg hypothyroidism in Down syndrome)

current NDIS plan

past specialist assessments

immunisation history

Personal history

family involvement

preferences (eg activities, support person, end-of-life plans [eg advance care plan])

past residential information

Note: NDIS = National Disability Insurance Scheme

NB1:The type of information and level of detail will vary depending on the aetiology and type of disability, and the clinical presentation.

NB2: Consider using a Comprehensive health assessment template to prompt information gathering.

NB3: Especially recent changes in behaviour (eg what, when, where, with whom the changes occur).