Table 1.

Steps for completing a health check: The suggested tools are available from H-CARDD (www.porticonetwork.ca/web/hcardd/kte/primary-care-toolkit) and the Surrey Place Centre DDPCI (surreyplace.ca/ddprimarycare).

STEP	COMPONENTS
1. Update the cumulative patient profile with information relevant to making practical management plans	IQ level and functional assessment (eg, by a psychologist or an occupational therapist or from a previous school psychoeducational report) to help inform capacity to consent to medical procedures and supports needed to enhance capacity Cause of intellectual disability, associated condition (eg, autism, cerebral palsy) or genetic syndrome, including date of last genetic assessment; a reminder to make use of additional information available for management of specific syndromes (Health Watch Tables on the DDPCI website) Names and contact information of substitute decision maker and caregivers (family members or paid caregivers) and income, housing, occupational, developmental service agency, and other social supports relevant to carrying out the management plan Accommodations needed at office appointments (eg, communication, mobility, timing, and duration of appointments); tips from parents and caregivers Dates of most recent vision, hearing, and dental assessments and specialists’ appointments Reasons for exclusions from preventive maneuvers, if any
2. Complete a history and physical examination; make an assessment and plan	Ask about current symptoms (ie, the patient’s “agenda” for the visit) Assess chronic conditions, including syndrome-specific issues (refer to the DDPCI Health Watch Tables and the document, “Commonly Missed Diagnoses,” in H-CARDD’s tool kit for primary care providers²⁸) Do an IDD-relevant systems review to identify previously undiagnosed conditions (refer to “Systems Review in Primary Care for People with DD” in H-CARDD’s tool kit²⁸) Offer screening maneuvers, as applicable to the general population Do a physical examination relevant to the data elicited above and to IDD in general (refer to the physical health section of the 2018 Canadian consensus guidelines¹) Make an assessment and plan (refer to the H-CARDD tool kit’s templates²⁸ to help identify medical specialists relevant for patients with IDD, financial supports, and patient and caregiver resources)

STEP

COMPONENTS

1. Update the cumulative patient profile with information relevant to making practical management plans

IQ level and functional assessment (eg, by a psychologist or an occupational therapist or from a previous school psychoeducational report) to help inform capacity to consent to medical procedures and supports needed to enhance capacity
Cause of intellectual disability, associated condition (eg, autism, cerebral palsy) or genetic syndrome, including date of last genetic assessment; a reminder to make use of additional information available for management of specific syndromes (Health Watch Tables on the DDPCI website)
Names and contact information of substitute decision maker and caregivers (family members or paid caregivers) and income, housing, occupational, developmental service agency, and other social supports relevant to carrying out the management plan
Accommodations needed at office appointments (eg, communication, mobility, timing, and duration of appointments); tips from parents and caregivers
Dates of most recent vision, hearing, and dental assessments and specialists’ appointments
Reasons for exclusions from preventive maneuvers, if any

2. Complete a history and physical examination; make an assessment and plan

Ask about current symptoms (ie, the patient’s “agenda” for the visit)
Assess chronic conditions, including syndrome-specific issues (refer to the DDPCI Health Watch Tables and the document, “Commonly Missed Diagnoses,” in H-CARDD’s tool kit for primary care providers²⁸)
Do an IDD-relevant systems review to identify previously undiagnosed conditions (refer to “Systems Review in Primary Care for People with DD” in H-CARDD’s tool kit²⁸)
Offer screening maneuvers, as applicable to the general population
Do a physical examination relevant to the data elicited above and to IDD in general (refer to the physical health section of the 2018 Canadian consensus guidelines¹)
Make an assessment and plan (refer to the H-CARDD tool kit’s templates²⁸ to help identify medical specialists relevant for patients with IDD, financial supports, and patient and caregiver resources)

DD—developmental disabilities, DDPCI—Developmental Disabilities Primary Care Initiative, H-CARDD—Health Care Access Research and Developmental Disabilities, IDD—intellectual and developmental disabilities, IQ—intelligence quotient.