Service Delivery

Employment Equity for People With IDD Across the Lifespan: The Effects of State Funding.

Nord et al. (2020) · Intellectual and developmental disabilities 2020
★ The Verdict

States that pour money into integrated employment services lift job rates for adults with IDD—especially the youngest and oldest.

✓ Read this if BCBAs who write funding requests or serve adults with IDD in vocational programs.
✗ Skip if Clinicians focused only on early-intervention home cases.

01Research in Context

01

What this study did

Nord et al. (2020) looked at work records for adults with intellectual or developmental disabilities. They checked age and state spending on integrated job services.

The goal was to see if extra state dollars shrink the age gap in real jobs.

02

What they found

Young adults and seniors with IDD had the worst job rates. States that spent more on integrated employment closed those age gaps.

Money aimed at community jobs, not workshops, made the difference.

03

How this fits with other research

Kramer et al. (2020) show only 19 % of state-supported adults with IDD hold integrated jobs. Derek’s team agrees, but adds that higher spenders beat this low bar.

Emerson et al. (2023) visited three high-spend states and list seven team moves that drive success. Their stories back Derek’s numbers: coordinated systems turn dollars into paychecks.

Butterworth et al. (2024) still call outcomes “dismally low” after 40 years. This could sound like a contradiction, yet the 2024 paper looks at all states while Derek highlights the best spenders. Both papers push the same fix: put more money into integrated services.

04

Why it matters

You can’t control age, but you can steer funding. Use Derek’s finding when you write grant lines or speak to state councils. Ask for integrated-employment dollars, not generic day-program funds. Target young adults and seniors first; the data show they gain the most.

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→ Action — try this Monday

Add one slide to your next team meeting: show the age-gap chart and propose one extra hour of job-coach time for clients under 25 or over 55.

02At a glance

Intervention
not applicable
Design
other
Sample size
9871
Population
intellectual disability, developmental delay
Finding
positive

03Original abstract

In the last decade, major strides have been made to elevate the importance of employment for people with intellectual and developmental disabilities (IDD). Despite progress, improvement in employment outcomes remain modest. Using extant data, a sample of 9,871 adults with IDD accessing Medicaid Home and Community-Based Services waiver services across 33 states were studied using hierarchical modeling to understand the effects of age on employment as well as assess how state fiscal effort toward integrated employment services affects employment equity across the lifespan. Key findings showed young and older adults experienced the lowest employment outcomes. The effects of age, however, were moderated in states with higher fiscal effort to integrated employment services. Implications for research, policy, and practice are discussed.

Intellectual and developmental disabilities, 2020 · doi:10.1352/1934-9556-58.4.288