Evaluating problem areas in activities of daily living of adults with severe and profound intellectual disabilities and physical impairments.

Background: Activities of daily living (ADL) have rarely been investigated in adults with severe and profound intellectual disabilities (SPID). The aim of this study was to evaluate ADL of adults with SPID and physical impairments. Method: A questionnaire was composed using a Delphi-like methodology, using the Pediatric Evaluation of Disability Inventory (PEDI) as a framework. Thirty direct care givers were interviewed. All ADL items had a performance answer and a separate answer if there was a problem with that specific ADL. Explorative analyzing techniques were used to describe the results. Subgroups in age, developmental age and gross motor function were described. A cut off point was made at 20% of all problem items to extract the final problem areas. Results: A first description of problem areas in ADL of adults with SPID and physical impairments is given. The results indicate no relation between the performance of ADL and problem areas in ADL. Conclusion: The problem areas generate insight in which activities need to be evaluated when assessing interventions aiming to maintain or optimize ADL in this population. Further research and development of the questionnaire may lead to an ADL assessment tool for adults with SPID and physical impairments