Interventions supporting health-related routines for children with intellectual and developmental disabilities: A systematic literature review

This systematic literature review evaluates research on interventions to increase successful participation in medical procedures and health-promoting routines by children and youth with intellectual and developmental disabilities (IDD). Electronic database searches of Eric, PsycInfo, and MEDLINE and ancestral review were conducted to identify studies published between 1968 and 2020. Across the 24 studies meeting inclusion criteria, a variety of behavioral interventions have been implemented to prevent or decrease challenging behavior and increase participation during medical procedures and health-promoting routines. The results are discussed in relation to (a) participants and intervention setting, (b) intervention procedures and targeted behavior, (c) the rigor of the study methodology according to Reichow's Evaluative Method, and (d) outcomes including magnitude of intervention effect. Findings demonstrate that dental or medical examinations, blood draws, toothbrushing, and handwashing were the most often targeted procedures or routines. Behavioral intervention packages including strategies such as video-modeling and positive reinforcement were generally effective in increasing successful completion of medical procedures and health promoting routines. However, most studies have focused on early childhood and fail to reflect the support and educational needs of individuals with IDD across the lifespan. We discuss future research directions.