Direct Support Professionals' Perspectives on Ambulatory Health Care Processes and Quality.
DSPs see doctors skip patient talk and psychosocial questions—train DSPs to prompt both.
01Research in Context
What this study did
Williams et al. (2019) asked direct support professionals about doctor visits for adults with intellectual or developmental disabilities.
The team used a survey. DSPs answered questions about visit quality and how doctors talked to their clients.
What they found
Most visits were rated good or excellent. Yet DSPs said doctors often spoke only to staff, not to the patient.
Doctors also skipped questions about mood, relationships, and daily life.
How this fits with other research
Bradford et al. (2018) show one fix: embed a short ASD triage in the pediatric clinic. Wait times dropped from months to weeks.
Soto et al. (2024) give another tool. An emotional-development review in the hospital cut antipsychotic use for adults with IDD.
Stewart et al. (2018) and Capio et al. (2013) found similar gaps. Doctors follow some Down-syndrome screens but skip talks about spine risk or sex ed.
Why it matters
You can train DSPs to speak up during visits. Teach them to ask the doctor to face the patient and to add mood or social questions to the checklist. One extra minute can turn a good visit into a great one.
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02At a glance
03Original abstract
Direct support professionals (DSPs) frequently accompany persons with intellectual and other developmental disabilities (IDD) to their health care appointments and could offer valuable insights into potential target areas for health-care improvement. DSPs completed surveys assessing healthcare processes and quality immediately following 118 ambulatory health care encounters involving their patients with IDD. Although DSPs generally judged the quality of health care as good (44%) or excellent (52%), they also observed that physicians directed questions to the DSP that the patient could have answered in 22% of encounters, and noted that physicians failed to ask critical psychosocial information in 24% of encounters. Competency-based training of DSPs around health-care advocacy could significantly improve the quality of health care provided to persons with IDD.
Intellectual and developmental disabilities, 2019 · doi:10.1352/1934-9556-57.3.188