{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T17:36:46Z","timestamp":1792863406177,"version":"4.5.0"},"reference-count":13,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T00:00:00Z","timestamp":1792540800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Intellect Disabil"],"abstract":"<jats:p>This case highlights the healthcare inequities faced by people with intellectual disability, including diagnostic overshadowing, communication barriers, and the need for personalised, meaningful adjustments in care. A woman in her fifties with mild intellectual disability, epilepsy, and diabetes insipidus experienced delayed diagnosis and treatment because healthcare providers assumed she could not tolerate magnetic resonance imaging; however, when the scan was eventually completed with supported communication, it revealed a serious brain tumour with metastases. The case shows that diagnostic overshadowing can arise not only from misattributing symptoms, but also from untested assumptions about a patient\u2019s ability to engage with diagnostic procedures. It also underscores the importance of involving patients and families directly in healthcare decisions to support autonomy and prevent avoidable harm. Addressing these systemic issues is essential to deliver equitable, patient-centred care in acute hospital settings.<\/jats:p>","DOI":"10.1177\/17446295261501606","type":"journal-article","created":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T07:48:57Z","timestamp":1792568937000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Why clinicians in acute hospitals may fail to engage in direct communication with people with intellectual disability"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-8229-5686","authenticated-orcid":false,"given":"Amany","family":"Elbagoury","sequence":"first","affiliation":[{"name":"Hertfordshire Partnership University NHS Foundation Trust, Hertfordshire, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asif","family":"Zia","sequence":"additional","affiliation":[{"name":"Hertfordshire Partnership University NHS Foundation Trust, Hertfordshire, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Indermeet","family":"Sawhney","sequence":"additional","affiliation":[{"name":"Hertfordshire Partnership University NHS Foundation Trust, Hertfordshire, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,21]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/jar.12386"},{"key":"e_1_3_3_3_1","doi-asserted-by":"publisher","DOI":"10.5334\/ijic.2818"},{"key":"e_1_3_3_4_1","volume-title":"The Learning Disabilities Mortality Review (LeDeR) Programme: Annual Report","author":"Heslop P.","year":"2019","unstructured":"Heslop P., Blair P., Fleming P., Hoghton M., Marriott A., Russ L. (2019) The Learning Disabilities Mortality Review (LeDeR) Programme: Annual Report. Bristol: University of Bristol."},{"key":"e_1_3_3_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/dmcn.14591"},{"key":"e_1_3_3_6_1","doi-asserted-by":"publisher","DOI":"10.1192\/j.eurpsy.2022.178"},{"key":"e_1_3_3_7_1","doi-asserted-by":"publisher","DOI":"10.12968\/hmed.2023.0357"},{"issue":"5","key":"e_1_3_3_8_1","first-page":"22","article-title":"'Improving communication with patients with intellectual disabilities in hospital settings'","volume":"113","author":"Lewis P.","year":"2017","unstructured":"Lewis P., Gaffney A., Wilson C. (2017) 'Improving communication with patients with intellectual disabilities in hospital settings', Nursing Times, 113(5), pp. 22\u201325.","journal-title":"Nursing Times"},{"issue":"4","key":"e_1_3_3_9_1","first-page":"456","article-title":"'Barriers to effective communication in acute hospitals for people with intellectual disabilities'","volume":"24","author":"McCormick B.","year":"2020","unstructured":"McCormick B., Fleming M., McGlinchey E., O'Donnell M. (2020) 'Barriers to effective communication in acute hospitals for people with intellectual disabilities', Journal of Intellectual Disabilities, 24(4), pp. 456\u2013472.","journal-title":"Journal of Intellectual Disabilities"},{"key":"e_1_3_3_10_1","volume-title":"Death by Indifference: Following up the Treat Me Right! Report","author":"Mencap","year":"2007","unstructured":"Mencap (2007) Death by Indifference: Following up the Treat Me Right! Report. London: Mencap."},{"key":"e_1_3_3_11_1","doi-asserted-by":"publisher","unstructured":"Nash M.D. Molloy R. (2024) 'Preventing diagnostic overshadowing to improve the physical health of people with severe mental illness' Mental Health Practice. doi: 10.7748\/mhp.2024.e1707.","DOI":"10.7748\/mhp.2024.e1707"},{"key":"e_1_3_3_12_1","volume-title":"Learning Disabilities Mortality Review (LeDeR) Annual Report 2022\u20132023","author":"NHS Integrated Care Board (ICB)","year":"2023","unstructured":"NHS Integrated Care Board (ICB) (2023) Learning Disabilities Mortality Review (LeDeR) Annual Report 2022\u20132023. Bristol: NHS ICB."},{"issue":"7","key":"e_1_3_3_13_1","first-page":"475","article-title":"'Shared decision-making in people with intellectual disabilities: a scoping review'","volume":"64","author":"Noorlandt R.","year":"2020","unstructured":"Noorlandt R., van Schrojenstein Lantman-de Valk H., Hermans H. (2020) 'Shared decision-making in people with intellectual disabilities: a scoping review', Journal of Intellectual Disability Research, 64(7), pp. 475\u2013488.","journal-title":"Journal of Intellectual Disability Research"},{"issue":"2","key":"e_1_3_3_14_1","first-page":"82","article-title":"'Reasonable adjustments and the Equality Act 2010: what does the evidence tell us?'","volume":"24","author":"Redley M.","year":"2019","unstructured":"Redley M., Douglas J., Holland A., Clare I. (2019) 'Reasonable adjustments and the Equality Act 2010: what does the evidence tell us?', Tizard Learning Disability Review, 24(2), pp. 82\u201390.","journal-title":"Tizard Learning Disability Review"}],"container-title":["Journal of Intellectual Disabilities"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17446295261501606","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/17446295261501606","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17446295261501606","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T16:54:54Z","timestamp":1792860894000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/17446295261501606"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,21]]},"references-count":13,"alternative-id":["10.1177\/17446295261501606"],"URL":"https:\/\/doi.org\/10.1177\/17446295261501606","relation":{},"ISSN":["1744-6295","1744-6309"],"issn-type":[{"value":"1744-6295","type":"print"},{"value":"1744-6309","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,21]]},"article-number":"17446295261501606"}}