Dr. Craig Escudé discusses the significance of coaching docs to take care of the IDD and neurodivergent communities.
Dr. Craig Escudé is a board-certified Fellow of the American Academy of Household Physicians and the American Academy of Developmental Medication with over 20 years of scientific expertise offering medical take care of folks with mental and developmental disabilities and complicated medical circumstances. He’s the president of IntellectAbility, the mission of which is to “…present instruments and coaching to those that assist folks with vulnerabilities, serving to them substitute threat with well being and wellness.”
Dr. Escudé’s pursuit of training clinicians led him to create the Curriculum in IDD Healthcare, the first-of-its-kind eLearn course that teaches the basics of IDD healthcare to physicians, nurses, medical college students, and different clinicians. Via this course, his lectures, and his writings, he has taught 1000’s of clinicians and supporters all through the US and past.
Along with being recurrently printed in Distinctive Mum or dad Journal, he additionally co-authors “Unlocking Behaviors” article collection in Helen: The Journal of Human Exceptionality which sheds gentle on what number of so-called “adversarial behaviors” in folks with IDD are literally attributable to treatable medical, environmental or social causes. He additionally hosts the podcast “IDD Well being Issues with Craig Escudé, MD,” the place he speaks with a variety of leaders, self-advocates, company administrators, clinicians, directors, and others from throughout the globe concerned in designing and facilitating service supply to folks with IDD.
For extra about Dr. Escudé’s work: https://www.replacingrisk.com/
And search for IDD Well being Issues Podcast, together with on YouTube: https://www.youtube.com/@IDDHealthMatters/featured
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Notice: the next transcription was routinely generated. Some imperfections could exist.
DR HACKIE REITMAN (HR):
Welcome to Exploring Completely different Brains. I’m your host, Dr. Hackie Reitman, and right now we have now becoming a member of us, Dr. Craig Escudé who’s bought lots of stuff occurring to assist these of us with completely different brains. He’s the president of mind, stability, and the host of IDD Well being Issues podcast. Welcome, Craig.
DR CRAIG ESCUDÉ (CE):
Thanks for having me. Hackie. I actually admire the chance to be right here.
HR:
Properly, I do know you’re busy. And I do know, it’s schedules are powerful. Now inform us all about mind capability.
CE:
Certain. So mind stability is an organization that focuses on offering instruments and coaching to assist individuals who assist folks with mental and developmental disabilities, to have the ability to higher determine well being dangers which are usually missed, and to know what to do to mitigate these well being dangers, to attempt to enhance well being and well being and well being and wellness for folks with mental and developmental disabilities.
HR:
Properly, that’s nice, however I’m going to even take you again a step as a result of as an MD, who educated in Boston College, we by no means discovered something about ID D, and it’s nonetheless not studying. So you have got the practitioners who’re first line of protection, and what are you doing to vary all of that?
CE:
So I’ll again up earlier than I reply that query and inform you that I share the very same story of actually not receiving coaching to offer good well being take care of folks with mental and developmental disabilities. And whereas we’ve made some progress, that’s nonetheless an issue right now, most well being skilled coaching packages, together with medical faculties, nursing faculties, and different well being professions, actually don’t present any, or no less than not sufficient coaching, to assist well being practitioners to raised have the ability to present well being take care of folks with IDD. So that’s one thing that’s is, you recognize, by means of my very own challenges, in after I first began working on this subject alone recognition that I actually didn’t have the most effective abilities to have the ability to present good well being care. I developed a program to offer coaching and training particularly to well being care suppliers along with all the different providers that that we provide by means of our firm.
HR:
And what’s the title of that?
CE:
In order that’s a program referred to as the curriculum in IDD healthcare. It’s a net based mostly curriculum that consists of six completely different modules, that, to me train the basics of offering good well being take care of folks with mental and developmental disabilities.
HR:
And the way lengthy a course is that.
CE:
So the the runtime of the course is about 4 and a half hours and you’ll throw in one other 2030 minutes as a result of there are information checks and questions after every of the modules. The course is accepted for persevering with medical training credit, and in addition for persevering with training items for nurses. So you recognize, we maintain monitor of the progress by means of the course and supply these these submit exams on the finish to make sure that folks do full the course to have the ability to qualify to get the credit.
HR:
Does it offer you a certification?
CE:
So it provides you once more, the persevering with training Credit, however we additionally provide by means of our firm what we name the acknowledged supplier in IDD well being care. So there’s a badge and a certificates that goes together with the completion, the profitable completion of that course. And that’s actually to assist acknowledge that these suppliers usually are not solely however have had some further coaching in offering good well being take care of folks with IDD. And so they can use that badge as an example, on their web site, or in different, you recognize, promoting materials to point that they’ve an curiosity in offering good well being take care of folks with IDD.
HR:
So, in educating medical professionals about IDD well being care, what are among the details that should be emphasised?
CE:
Wow, there’s so many. So, I’ll begin, I’ll begin with, with one which I believe is necessary. And one of many first issues that anybody who works with folks with IDD or offers well being care or talks with folks with IDD ought to do is is basically presume competence, presume that the individual you’re talking with that you would be able to have a dialog with them that they will present info to you and communicate to the individual themselves. So many occasions, there is likely to be somebody who accompanies the individual with mental and developmental disabilities to a well being care go to. And we have a tendency to talk straight to the the one that’s there with the individual and by no means actually even talk with the individual immediately who had been there who’s there to obtain the well being care. So we actually want to make sure that we’re speaking with with people who find themselves the affected person, primarily, and different folks can definitely chime in as assist is required. However we actually ought to embody the individual with the with the mental incapacity within the dialog, to the most effective of their capability. Now, one other one I’m going so as to add, which I believe can also be equally necessary when it comes to scientific and prognosis is there’s an idea referred to as diagnostic overshadowing on this in that that we see in after we present well being take care of folks with IDD or severe psychological sicknesses. And that’s the place we, we, as clinicians are likely to possibly take some some signs that we see and attributed, attribute these signs to the general prognosis of the mental incapacity, fairly than on the lookout for a treatable underlying trigger. And so a terrific instance of that is the place an individual as an example, may begin having some agitated conduct possibly that possibly the individual can’t talk with phrases to allow them to’t inform you what’s occurring. However they begin possibly hitting themselves within the face or or hitting different folks or mealtimes they grow to be very agitated they usually spit out meals. So what what usually occurs is the clinician see the sort of conduct as effectively. That is simply one thing that might that folks with IDD do typically. And so we have to put them on a medicine to cease that conduct with out ever an underlying treatable trigger, comparable to possibly the individual has a toothache, they usually’re in ache, they usually can’t talk that to another person. So the one method they will talk it’s by spitting out meals as a result of it hurts each time. They they attempt to chew or they grow to be upset they usually hit their their face or their mouth as a result of it as a result of they’re in ache. So one other factor that I believe is basically necessary for clinicians to acknowledge is, is that idea and to pay attention to it and to all the time search for underlying treatable causes, fairly than attributing some symptom or or conduct to the general prognosis.
HR:
Very effectively mentioned and it’s one thing that any type of clinician has to pay attention to. Completely. So the IDD Well being Issues podcast — inform us all about that.
CE:
Certain. Um, in order you talked about earlier, I’m the host of the podcast, and I type of bought roped into it wasn’t one thing I used to be looking for to do, for certain. However I, I used to be approached by a residential supplier group who offers residential providers for folks with with IDD. They’re based mostly out of Ohio referred to as Associates for all times. And so they, they we had just a few conversations they usually began a podcast with the mindset of serving to folks perceive this subject and serving to folks see that they will have a profession on this subject. And as a strategy to attain folks the place they’re getting info. And so they wished so as to add me on to offer a perspective on well being and wellness for folks with IDD. So at first I used to be fairly immune to be sincere And I began doing little bitty segments that we name Medical Mondays. And so they had been about two or three minutes the place I might simply speak about a medical matter associated to well being take care of folks with IDD, and did that for a few yr and a half. And so they requested me at that time to up my sport, they usually wished me to do an actual actual podcast. So I thought of it a superb bit. And over time of working on this subject, now, at a nationwide stage, I’ve gotten to fulfill so many individuals on this subject, from self advocates, to state their developmental incapacity administrators, to leaders of organizations to CEOs of, of, of residential supplier providers, and actually, so many nurses and physicians who work on this subject, together with your self hacky, they usually all people has a narrative to inform. And I thought of it. And I’m like, What an effective way to, to assist folks perceive this subject, to assist folks perceive among the challenges that we face, but in addition see among the successes which have occurred over time to the place folks can inform their story, and present once more, that it is a nice subject to work in, and that there’s lots of want for folks to be part of this subject to enhance well being fairness for folks with IDD. So I began that podcast. A few yr in the past, we launched our first episode July of 2023. And I’m completely satisfied to say that we even have already obtained nationwide recognition, we gained the AI dd The American Affiliation of mental and developmental disabilities 2024 Media Award for that podcast.
HR:
Congratulations,
CE:
Thanks.
HR:
And educating healthcare suppliers about IDD, what have been among the large challenges?
CE:
I believe the largest problem, but in addition the simplest one to beat is to acknowledge that folks talk in lots of, many various methods. And one, and in what I imply by that’s, particularly, particularly, on this subject, whenever you’re working with folks with mental and developmental disabilities, typically they don’t have the phrases to have the ability to categorical what’s occurring, they might not have the ability to inform you, Oh, my abdomen hurts, my abdomen is hurting on Oh, I really feel nauseated, which is why I don’t wish to eat and why I’m reducing weight. However they’re nonetheless going to speak these issues in several methods. Normally, it’s by means of some type of change in conduct. And after we may also help clinicians to acknowledge the completely different ways in which folks talk, then we’re going to raised have the ability to make higher diagnoses and higher therapy plans and stop pointless affected by from treatable circumstances.
HR:
What do you suppose actually has to occur to get all medical professionals on board with this?
CE:
Properly, I believe there needs to be type of extra of a pull from the highest than a push from the underside. And what I imply by that’s, I believe one of many components that one of many greater components that should happen is that we, the organizations who present accreditation, to medical medical packages to assist skilled coaching packages want to begin placing an emphasis that on the necessity for it well being take care of folks with IDD to grow to be a part of coaching packages. When our board exams, as an example, licensure exams, ought to ask questions associated to an individual with an mental incapacity and a few particular circumstances associated to these. So after we see, you recognize, the accrediting our bodies, say requiring training in that subject, and we all know that they’re going to be requested questions on board exams, then I believe that’s actually going to assist encourage or nudge well being skilled coaching packages to begin educating that info as a result of they realize it’s going to be a part of their exams, and it’s going to be a requirement by licensure our bodies.
HR:
And one of many fellows has been a pioneer in serving to make that occur. Is our pal who launched you to us Dr. Rick Rader of the AADMD, of which you’re a member. Inform us about your involvement and extra concerning the AADMD in addition to what the preliminary stand for.
CE:
Certain, so AADMD stands for the American Academy of Developmental Medication and Dentistry. And you’ll find out extra info from them at a dmd.org However I’ll inform you a bit little of the Fundamentals. So a company was began by Dr. Rader, our pal Rick and some different few different folks various years again, due to the, they acknowledge the significance and the necessity and the worth of training well being care suppliers about about well being take care of folks with IDD each, it was a bunch of medical professionals and dental professionals. And this group has continued to maneuver the agenda ahead and as and has helped facilitate incorporation of, of coaching into medical faculties and dental faculties all through the nation in addition to supplied some some perception and a few, some place statements, I assume, in some crucial, some crucial positions are crucial. Matters comparable to whether or not or not folks with IDD ought to have the ability to be eligible for organ transplants, so on and so forth. So it’s a terrific advocacy group for physicians and dentists particularly, however definitely, any well being skilled can can achieve perception. And I might extremely encourage clinicians to look into this group and grow to be a member, it was very precious to me after I came upon about it about 11 years in the past, as a result of it was the primary time I noticed that there are different individuals who work on this subject, they usually’ve had related experiences that I’ve, and I can study from them. And in some situations, I’ve been capable of to assist practice others as effectively to by means of as effectively to by means of the group.
HR:
Now, what recommendation would you have got for any individual who’s themselves neurodivergent, or the mum or dad of a neurodivergent particular person, who desires to search out a physician that understands IDD? How do you discover them?
CE:
Properly, in the event that they took the curriculum and add well being care, search for the badge, however however we nonetheless bought an extended strategy to go on that I believe, you recognize, speaking with others, and asking them, the place do they obtain their healthcare and the place have that they had good experiences, is one strategy to do it, you recognize, use it utilizing utilizing our colleagues, the assets that we have now folks which were in related conditions, is one one strategy to discover folks. However the different factor you are able to do is basically, you recognize, take time to interview somebody, or construct a relationship with a clinician outdoors of a disaster second. So possibly make an appointment with with a clinician, the place you possibly can go in as an introduction and say, Hey, I’m such and such, and I’ve, you recognize, these explicit circumstances, or should you’re a member of the family, say, Hey, right here’s my, my beloved one. And I wish to, to get to know them, and we wish to get to know you to see if we will facilitate a extremely good, wholesome, you recognize, well being care relationship. And that may go a good distance. As a result of what among the, you recognize, rightfully so many occasions folks with with IDD or their supporters are actually pissed off concerning the the possibly lower than optimum well being care visits that they’ve. And I’m utilizing good phrases right here, as a result of I’ve heard many tales of of actually appalling conditions the place we’re the place folks had been, you recognize, had had some large issues attempting to entry well being care. However after we’re in a disaster scenario, all of our feelings are up. So I believe, you recognize, discovering a clinician and attempting to construct that relationship outdoors of a severe well being care want would go an extended strategy to serving to, you recognize, serving to discover a good match between well being care supplier and an individual with with some type of neurodivergent situation.
HR:
And so a corollary to that might be within the curiosity of getting extra docs who find out about these things. What’s stopping that type of info from being taught in all medical faculties?
CE:
Properly, that’s a that’s one other nice query. Hackie. I’ll say that the very first thing that should occur for somebody to have a change in curriculum is they should see that there’s an precise want to show folks about it. And that’s one thing that even I wasn’t conscious of. I didn’t notice that there was extra info I wanted to know to have the ability to present good well being take care of folks with IDD. After I bought off my after I bought out of my medical faculty and residency coaching program. I figured I I used to be taught what I wanted to be taught. So why do I have to study extra? It wasn’t till I started working on this subject that I noticed in a short time wow, I have to study much more about this subject and I began looking for out alternatives to search out info and again Within the 90s, after I was after I was simply getting concerned on this subject, there wasn’t very a lot info on the market to study it as a well being care supplier. So I didn’t acknowledge that I had the necessity to study this info. And sadly, I believe lots of well being skilled packages nonetheless don’t suppose they’ve they’ve that there’s a have to spend precious time throughout a pupil’s, you recognize, studying coaching to show this info. Now, the opposite facet of that’s, you’ve bought the curriculum, you recognize, curricula are very packed. And there’s lots of info that needs to be taught to medical faculties and to medical college students, and nursing college students and others. So there’s a difficulty of discovering time, the place will we match this into the curriculum? How will we add extra to the curriculum? The third problem, I believe, is who’s going to show this info. You’ve bought to have clinicians who’ve sufficient expertise and experience on this subject, to have the ability to train others about it. And sadly, we don’t have sufficient of these. There aren’t sufficient of there aren’t sufficient clinicians who perceive this subject effectively sufficient. If you recognize, as an example, if proper now, each medical faculty within the nation and each nursing faculty within the nation wished to rent a college skilled on Mental and Developmental Incapacity well being care, they couldn’t discover them as a result of there’s simply not sufficient clinicians to go round. And that’s really one of many causes I created that on-line course. As a result of it’s a strategy to get info into well being skilled packages and to training clinicians, with out having to say rent an skilled to have the ability to try this.
HR:
How can our viewers study extra about you?
CE:
Properly, just a few methods. I assume. First, should you search for IDD well being issues on any podcast platform that that you simply prefer to take heed to, you must have the ability to discover it. And also you’ll see a number of episodes and may study extra about some What about me, but in addition much more concerning the subject. If you happen to wished to study extra details about our firm and what we do. Our firm’s title is mind capability. And the web site is changing threat.com. So changing threat one phrase.com. And on that web site, you’ll see all the instruments that we provide. We have now the well being threat screening device, which is an internet based mostly device that’s used to display for well being dangers and other people with IDD. It’s at the moment utilized in about 26 completely different states. And it’s used to display over 100,000 individuals who obtain helps and providers who’ve mental and developmental disabilities. We even have an array of elearning programs which are accessible, not simply the one I discussed. But additionally we have now programs on the deadly 5 that are the highest preventable causes of sickness and demise, choking prevention and lots of different programs that folks can take or use of their of their packages to study extra about IDD well being care. And we additionally do Individual Centered considering coaching providers as effectively. So once more, simply leap on changing threat.com. And you may study much more about us.
HR:
Is there something you’d prefer to cowl, Craig, that we haven’t lined?
CE:
Um, you recognize, I believe I believe one of many major issues that we have now to consider is we’ve bought to consider folks with any situation as an individual first. Generally we we take into consideration folks by their prognosis, and we are saying, Oh, that’s an individual with disabilities. After which we have now, we have now preconceived notions, effectively, they will’t perceive something, effectively, they’re not going to profit from well being care. Properly, they don’t actually have the identical high quality of life as different folks. And people are, you recognize, preconceived notions that we that we have now that hinder our capability to offer good well being care and good helps for folks with IDD. So if we see the individual as an individual first, with the identical wishes, the identical pursuits, the identical likes, and despatched the identical objectives that they’ve for his or her lives and eager to stay a superb life and eager to stay a wholesome life. If we see them as folks first similar to all people else, then we’re going to be more likely to speculate our time and vitality into getting correct diagnoses, offering therapy plans which are efficient, and in actually enhancing the lives of folks that all of us assist.
HR:
Amen. That will clear up lots of issues on this world if we may simply get folks to have a look at one another as human beings and as Martin Luther King mentioned, decide me by the content material of my character, not the colour of my pores and skin. And on this case, not by my IDD.
CE:
Proper now by my skills or variations. Couldn’t agree extra.
HR:
If we had been to choose one factor, Craig, that you simply want each medical supplier understood about sufferers with mental points. What would that be?
CE:
Properly, I touched on a pair already. So I’ll go away these. One is to see folks as folks first the opposite is to is the idea of diagnostic overshadowing. So I believe these these two are necessary. However the so as to add to that, I might say that there are numerous, many individuals who don’t use phrases to speak, that undergo needlessly, from treatable or preventable circumstances. And as clinicians, it’s our job to know find out how to acknowledge indicators of these circumstances, and to know find out how to deal with these circumstances appropriately. And to, once more, present good well being care to all of our sufferers to everybody. And it does take a bit little bit of a special lens, it takes a bit bit of coaching, there’s a bit bit completely different method, that that may improve our skills as clinicians to have the ability to acknowledge these early indicators of preventable or treatable causes which are so usually missed. So the one factor I might say is, hunt down further coaching, whether or not it’s on-line coaching, whether or not you possibly can work by means of your well being skilled packages, by means of your by means of your medical faculties, or nursing faculties to implement some type of coaching, search further coaching in work to assist all folks to have the ability to obtain the identical stage of well being care whether or not they have a incapacity or not.
HR:
Very effectively mentioned Craig. And on that word, I wish to thanks for giving us a lot info and for doing all the nice work that you simply do for these of us whose brains are a bit bit completely different and have numerous disabilities and wish to encourage you to maintain up the nice work that you simply do for therefore many and please communicate with us right here at Completely different Brains.
CE:
Thanks a lot, Hackie. It’s an honor to know you and honor to be in your program and thanks for the unbelievable work that you simply do as effectively.
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