Category: Clinical Practice (assessment, diagnosis, treatment, knowledge translation/EBP, implementation science, program development); Measurement
To determine whether scores on a modified Fall Risk Screening and Assessment Tool (FRAST) predicts fall risk in persons with intellectual and developmental disability (IDD).
Design : A retrospective case control study design was used. FRAST was scored based on a chart review. Spearman’s rank-order correlations determined associations among all FRAST variables including fall history. Mann Whitney-U compared FRAST scores for participants with a history of fall versus no fall.
Individuals with IDD residing in supervised community settings.
Participants (or Animals, Specimens, Cadavers) :
FRAST data was recorded for 97 persons with IDD.
Interventions : Not Applicable
Main Outcome Measure(s) :
The FRAST was modified in collaboration with the original author of the tool and iterative feedback and designed to score a number of factors related to falls risk during a chart review. The tool provides provide intervention recommendations based on the scores.
Significant correlations with fall history were noted for scores for: age, seizures, medications, cognition, eyes/ears, communication, BP, and walking but not for dizziness and bowel and bladder control. Median scores on all variables and total FRAST scores were significantly different for those with a history of a fall versus no fall except for scores related to bowel and bladder control, history of dizziness, and control of BP.
Conclusions : Scores on most areas of the FRAST as well as the total score were significantly correlated with fall history and differentiated between the groups based on fall history. Medical charts may have insufficient information related to dizziness and further modification to eliminate bowel/bladder control may be warranted. The modified FRAST has potential to serve as a simple screening tool based on a medical chart review to determine whether further evaluation and intervention related to fall risk is warranted.
Joyce Maring– Associate Professor, Department Chair, The George Washington University, Washington, District of Columbia
Lisa Alexander– Professor; Department of Physician Assistant Studies, The George Washington University, Washington, District of Columbia
Ellen Costello– Associate Professor; Program Director, The George Washington University, Washington, District of Columbia