Predicting Injuries in Adults With Intellectual Disabilities in Supported Living: Development and Validation of Risk Assessment Tools

BACKGROUND: Adults with intellectual disabilities experience disproportionately high injury rates, yet risk prediction in community-supported living remains underdeveloped. This study aimed to identify risk and protective factors and develop validated, population-specific screening tools. METHOD: A longitudinal cohort study of 536 adults with intellectual disabilities in supported accommodation in Scotland examined 68 intrinsic and extrinsic variables across retrospective (30-month) and prospective (12-month) periods. Multivariate logistic regression identified key predictors. RESULTS: Independent risk factors for injury and fall-related injury included poor balance or coordination, polypharmacy, use of antiepileptic and antipsychotic medications, and restlessness. Protective factors included family co-residence and a diagnosed heart condition. Two tools, the Risk Injury Assessment Tool and Risk Fall-Injury Assessment Tool, demonstrated moderate-to-good predictive validity, particularly in excluding low-risk individuals. CONCLUSIONS: This study provides the first validated tools to assess injury and fall-related injury risk in adults with intellectual disabilities in community settings, supporting more equitable, preventive care.