Practitioner Development

Adverse Childhood Experiences Among Direct Support Professionals.

Keesler (2018) · Intellectual and developmental disabilities 2018
★ The Verdict

Most DSPs carry childhood trauma—screen for ACEs and use trauma-informed supervision to keep them on the job.

✓ Read this if BCBAs who run or consult in adult IDD residential or day programs.
✗ Skip if Clinicians who only serve young children with no DSP staff.

01Research in Context

01

What this study did

The author sent a short survey to Direct Support Professionals. The survey asked how many Adverse Childhood Experiences each worker had lived through.

DSPs are the staff who help adults with intellectual and developmental disabilities in group homes and day programs.

02

What they found

Three out of four DSPs reported at least one ACE. One in three had four or more ACEs.

Both numbers are higher than rates seen in the general public.

03

How this fits with other research

Laws et al. (2024) and Hutchins et al. (2020) pull this 2018 ACE data into their big-picture reviews. They show the same workforce now faces a deepening crisis.

Adams et al. (2021) asked DSPs what support they need most. Their answers line up with trauma-informed care: better bosses, clear rules, and safe places.

Howard et al. (2023) surveyed the same group during COVID-19. They found pay and life-quality gaps that build on the stress already flagged by high ACE counts.

04

Why it matters

High ACE scores can prime staff for burnout, sick days, and turnover. You can’t change their past, but you can change supervision. Add quick ACE screens at hire, offer choice of shift length, train supervisors to ask “What happened to you?” instead of “What’s wrong with you?” Small moves like these cut turnover where raises alone have failed.

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Add two ACE questions to your new-hire paperwork and pick one trauma-informed team-leader tactic to pilot this week.

02At a glance

Intervention
not applicable
Design
survey
Sample size
386
Finding
not reported

03Original abstract

Direct support professionals (DSPs) provide integral support to many individuals with intellectual and developmental disabilities (IDD). Yet, individuals' access to qualified DSPs is often compromised as organizations struggle to hire and retain DSPs. Despite a vast body of research exploring factors associated with turnover, adverse childhood experiences (ACEs) among DSPs remain absent from the literature. ACEs encompass abuse and familial dysfunction prior to the age of 18 and, in the general population, have been linked to compromised well-being and work-related challenges in adult life. An online survey was conducted to explore the prevalence of ACE categories and ACE scores (i.e., the sum of each ACE category experienced by a person) among DSPs ( n = 386) working in licensed settings. Seventy-five percent of DSPs experienced at least one ACE and 30% had an ACE score of four or more. DSPs who identified as female and those who had been in their position less than one year had significantly higher ACE scores than males and others who had been in their position longer, respectively. In comparison with other studies, the four most common ACE categories among DSPs (i.e., divorce, emotional abuse, mental illness, and substance abuse) were the same, however, DSPs in the present study had a higher average ACE score and nearly twice the percentage of persons having an ACE score of four or more. The potential implications of ACEs among DSPs, at the intersection of their work with individuals with IDD, are discussed.

Intellectual and developmental disabilities, 2018 · doi:10.1352/1934-9556-56.2.119