1. Outpatient clinic for people with ID, ‘s Heeren Loo location Apeldoorn Barber Tinselboer, ID physician ‘s Heeren Loo, location Apeldoorn Bridge 2010: Outpatient clinics for people with ID in the Netherlands

2. ‘s Heeren Loo, location Apeldoorn Multiple forms of support and care for people with ID Residential and community living 400 residential clients 350 community living clients Bridge 2010: Outpatient clinics for people with ID in the Netherlands

3. Outpatient clinic Started in March 2008 At first in hospital, later at residential setting ‘s Heeren Loo Large catchment area Bridge 2010: Outpatient clinics for people with ID in the Netherlands

4. Mode of operation 2 ID physicians (plus 2 other colleagues and 1 trainee ID physician) Referral by GP or physician (no CIZ indication needed) No waiting list About 4 hours per week available but very flexible Multidisciplinary approach possible (psychologist, paramedic, etc.), but CIZ indication required Bridge 2010: Outpatient clinics for people with ID in the Netherlands

5. Statistics In 2 years (2008-2010): 103 patients: 62 male, 41 female Bridge 2010: Outpatient clinics for people with ID in the Netherlands

6. Statistics Bridge 2010: Outpatient clinics for people with ID in the Netherlands

7. Statistics Referral by: GP85 Paediatrician7 Neurologist4 Child psychiatrist4 Psychiatrist1 Autism-outpt clinic1 Other ID physician1 Bridge 2010: Outpatient clinics for people with ID in the Netherlands

8. Reasons for referral Behavioural problems29Medical check / follow-up20 Psychiatric disorders10Somatic disorders16 Functional decline / dementia7Epilepsy4 Sleep disorders4Medication assessment3 Inappropriate sexual behaviour2Etiological diagnostics3 5246 Bridge 2010: Outpatient clinics for people with ID in the Netherlands

9. New diagnoses Environmental demands13 Gastro-esophageal reflux4 Depression4 Constipation3 Bipolar disorder2 Visual impairment2 Parenting problems2 Hypothyroidism1 ADHD2 Elevated ammonium level1 Anxiety disorder2 Oral candidacies1 Compulsive disorder1 Epilepsy1 Tic disorder1 Sleep disordered breathing1 Autism spectrum disorder1 Diabetes1 No PDD-nos1 Rectal carcinoma1 Alzheimer’s disease1 Hypertension1 No dementia1 14q- syndrome1 Mood disorder nos1 Myotonic dystrophy1 32 19 Bridge 2010: Outpatient clinics for people with ID in the Netherlands

10. Questions or remarks? Bridge 2010: Outpatient clinics for people with ID in the Netherlands