Community Supports and COVID-19: Self-Determination in a Pandemic.
Keep safety rules, but let clients make the small choices so dignity and health both win.
01Research in Context
What this study did
Mulder et al. (2020) wrote a position paper for community providers.
They asked: how do we keep people with IDD safe from COVID-19 without taking away their choices?
The paper lists practical ways to balance health rules and self-determination.
What they found
The authors say supported decision-making is the key.
Let the person pick masks, times, and routes while staff give clear facts.
Creative fixes—like outdoor visits or plastic dividers—keep both safety and choice.
How this fits with other research
Matson et al. (2013) already showed choice is best practice for people with IDD.
Mulder et al. (2020) apply that old rule to the new crisis.
Rosencrans et al. (2021) later proved remote supports work during COVID-19, backing the paper’s call for flexible tech.
Navas et al. (2025) go further: choice itself is the active ingredient that makes community living better, not the move alone.
Why it matters
You can copy the paper’s low-cost hacks right now. Offer two mask colors, let clients choose visit times, and explain risks in plain words. These tiny choices cut resistance and keep dignity intact while you still follow health rules.
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02At a glance
03Original abstract
The coronavirus disease 2019 (COVID-19) is impacting people with intellectual and developmental disabilities (IDD) significantly. Early data on the impact of COVID-19 suggests that people with IDD are experiencing more severe health outcomes compared to the general population. In addition to their elevated health risks, people with IDD, like the rest of the population, are struggling with boredom, isolation, and loneliness as they shelter in place. As people with IDD seek a return to their jobs, friends and families, and the activities of their community, community-based provider organizations must strike a difficult balance between actions that are intended to protect the health and safety of people they support and actions that honor people's choices and encourage self-determination. Practical issues that community-based provider organizations must consider when striking the correct balance are discussed, and recommendations on ways to support people with IDD to make informed, self-determined choices during the pandemic are offered.
Intellectual and developmental disabilities, 2020 · doi:10.1352/1934-9556-58.6.453