Service Delivery

Direct Support Professionals: Diversity, Disparities, and Deepening Crisis.

Laws et al. (2024) · Intellectual and developmental disabilities 2024
★ The Verdict

DSP turnover has tipped from chronic problem to system-wide emergency that threatens community living for people with IDD.

✓ Read this if BCBAs who run or consult on community-based programs for adults with IDD.
✗ Skip if Clinicians who only work in acute hospital or school settings.

01Research in Context

01

What this study did

Britton and colleagues scanned the Direct Support Professional (DSP) landscape in 2024.

They pulled together policy papers, news stories, and workforce data.

The goal was to see if the DSP shortage for people with intellectual and developmental disabilities is getting worse.

02

What they found

The authors call the situation a "deepening crisis."

Pay is still low, turnover is still high, and the gaps hurt the people who need support.

They also flag new trouble: fewer young workers enter the field and more veterans burn out.

03

How this fits with other research

Hutchins et al. (2020) and Anonymous (2020) warned about the same shortage four years ago.

Laws et al. (2024) shows the warning has become reality; nothing has improved.

Howard et al. (2023) surveyed DSPs during COVID and found worse work-life scores than frontline supervisors.

That survey data backs up the new review’s claim that stress keeps climbing.

Wormald et al. (2019) revealed 28% yearly turnover among IDD case managers.

Together the papers trace a crisis that now reaches every layer of community services.

04

Why it matters

If you write budgets, train staff, or supervise programs, treat DSP retention as a clinical risk.

Push for higher wages, trauma-informed supervision, and clear promotion paths.

When DSPs stay, clients keep consistent support and behavior plans work better.

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Add a five-minute DSP check-in to your supervision agenda this week: ask what one task burns them out fastest and brainstorm a quick fix together.

02At a glance

Intervention
not applicable
Design
narrative review
Population
intellectual disability, developmental delay
Finding
not reported

03Original abstract

In the United States, direct support professionals (DSPs) support people with intellectual and developmental disabilities (IDD) so they can live in the community. Thirty years of deinstitutionalization and the development of community living options would not have been possible without DSPs. Although life for people with IDD improved greatly, working conditions, wages/benefits, demands, stress/burnout, and trauma experienced by DSPs have worsened. Turnover and vacancy rates threaten the availability of community supports for too many people with IDD. DSPs from diverse racial, ethnic, linguistic, and cultural backgrounds face significant workplace disparities. These issues were discussed during the Research and Training Center on Community Living's 2022 State of the Science Conference. We propose important research questions needing solutions to continue constructively addressing these critical issues.

Intellectual and developmental disabilities, 2024 · doi:10.1352/1934-9556-62.3.174