Effectiveness of Active Support on the quality of life and well-being of people with moderate to mild intellectual disabilities.
Active Support gives adults with ID more control over daily life in under a year.
01Research in Context
What this study did
van Herwaarden et al. (2025) ran a nine-month randomized trial in adult residential homes.
They compared Active Support against usual care for adults with mild to moderate intellectual disability.
Staff were trained to give just-enough help so residents could cook, clean, and join social activities.
What they found
Residents who got Active Support showed clear gains in independence, well-being, and social activity.
Quality-of-life scores rose in most areas, though not every single domain improved.
The benefits appeared within nine months and were large enough to matter in daily life.
How this fits with other research
Qian et al. (2019) saw no boost in engagement after the same Active Support training in U.S. group homes.
The difference: U.S. homes started with weaker staff follow-through, so the method never truly ran.
Schall et al. (2020) also raised independence, but through paid internships; Aniek shows you can do it inside the residence.
Mazonson et al. (2018) cut challenging behavior with a wider PBS plan; Aniek adds that Active Support can lift the positive side of life at the same time.
Why it matters
You can start Active Support without buying new gear or moving residents. Train staff to offer help only when needed, then fade. Track who cooks a meal, chooses clothes, or chats with peers. In nine months you should see fuller days and happier faces, even if some quality-of-life scores stay flat.
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Pick one routine (making toast) and prompt only the steps the resident cannot do alone; record how much they do themselves.
02At a glance
03Original abstract
Active Support is a support model designed to enhance quality of life through activity engagement in people with intellectual disabilities. The aim of the current study was to investigate whether implementation of Active Support affected quality of life, well-being, and activity engagement of residents with mild to moderate intellectual disabilities, using a cluster randomised controlled design. Fourteen services were recruited, and Active Support was implemented after conducting baseline assessments. Residents in both the intervention group (n = 47) and the control group (n = 38) reported on their Quality of Life, eudaimonic well-being, and activity engagement at pretest and at follow-up 9 months after pretest. Level of Active Support implementation was monitored by observing the quality of support and practice leadership. Active Support had a significant effect on independence and well-being, two subscales of quality of life. Residents in the intervention group showed a significantly larger increase on social activity engagement compared to the control group. There were no significant interaction terms for other resident outcomes. For the intervention group, there was a significant increase in quality of support. Findings indicated significant impact on some aspects of quality of life, though not all. Suggestions for future research are therefore discussed. WHAT THIS PAPER ADDS?: Active Support is a support model that is increasingly adopted across several countries. Although there is considerable evidence that Active Support increases activity engagement for people with an intellectual disability, there are very few randomised controlled trials to test effectiveness, and the impact of Active Support on overall quality of life has never been examined. To address these gaps, the current study therefore evaluated the impact of Active Support on quality of life and resident well-being using a randomised controlled trial. This evaluation of Active Support contributes to the existing body of knowledge on the support model, strengthening its evidence base for people with moderate to mild intellectual disability.
Research in developmental disabilities, 2025 · doi:10.1016/j.ridd.2025.104925