Which practice is helpful to prevent diagnostic overshadowing in IDD care?

• A. Directly address patient
• B. Delay testing and rely on caregiver assumptions
• C. Speak only to the caregiver
• D. Use only written instructions

Answer: (A)

Diagnostic overshadowing happens when signs of a medical issue are mistakenly attributed to an intellectual or developmental disability, so new or non-disability-related health problems are missed. The best practice is to speak with the patient directly and invite their input about how they’re feeling. This approach respects the person’s autonomy and gives you first-hand information about symptoms like pain, fatigue, mood changes, or headaches that caregivers might not fully perceive. In IDD care, communication may require plain language, a slower pace, and alternative methods (such as pictures or assistive tools) to help the patient express what’s happening. By listening to the patient and validating their reports, clinicians can separate potential health issues from disability-related behaviors and pursue appropriate testing and treatment when needed. Relying solely on caregivers, delaying testing, or using only written instructions can obscure symptoms and contribute to diagnostic overshadowing.