Service Delivery

An Examination of Support Needs, Supports, and Outcomes for People With Intellectual and Developmental Disabilities.

Dinora et al. (2023) · Intellectual and developmental disabilities 2023
★ The Verdict

More support hours alone do not improve life quality for high-need adults with IDD.

✓ Read this if BCBAs who write or monitor support plans in residential or day programs.
✗ Skip if Clinicians who only run short outpatient sessions.

01Research in Context

01

What this study did

Parthenia and her team looked at the adults with intellectual or developmental disabilities.

They asked: do people who get the most support hours also show the best life outcomes?

They tracked support plans, staff time, and real-world results like jobs, friends, and daily skills.

02

What they found

The answer was no.

Adults with the highest support needs got the most hours and money, yet their outcomes stayed flat.

More support did not close the gap in jobs, choice, or community life.

03

How this fits with other research

Older studies like Lam et al. (2011) and Lerman et al. (1995) said group homes beat other settings on quality.

Those papers hinted that model matters more than money.

Dinora et al. (2023) now shows even well-funded group homes can fail the highest-need residents.

The 2020 review by L et al. warned that our yardsticks may be broken; Parthenia’s data prove the yardsticks are missing the mark for the most disabled clients.

04

Why it matters

Stop equating more hours with better lives.

Use data to tweak each person’s plan weekly, not yearly.

Track real goals like making a sandwich alone or greeting a neighbor, not just billable minutes.

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Pick one high-need client, cut one low-value support hour, and add one data-tracked skill trial instead.

02At a glance

Intervention
not applicable
Design
other
Population
intellectual disability, developmental delay
Finding
negative

03Original abstract

Researchers used a merged dataset to examine if more resources were expended on those with greater support needs and if support needs impacted personal outcomes when controlling for relevant personal and contextual factors. Results indicated that the amount of support a person receives had a direct relationship to their needs. However, we also found that people with the greatest needs had weaker personal outcomes suggesting that distribution of resources based on need may not result in equivalent outcomes. The authors suggest strategies at an individual and systems level to address the outcomes gap for people with the greatest support needs.

Intellectual and developmental disabilities, 2023 · doi:10.1352/1934-9556-61.1.65