Longitudinal outcomes of a consumer-directed program supporting adults with developmental disabilities and their families.
Personal budgets cut unmet needs and keep families happy, but you must add supports to hold onto early community and caregiver gains.
01Research in Context
What this study did
Caldwell et al. (2007) tracked families who got their own budgets to buy adult services.
They compared these families to a wait-list group for nine years.
Both groups had adults with developmental disabilities living at home.
What they found
Families with budgets kept saying fewer needs went unmet.
They also stayed happier with services.
Community outings and caregiver stress improved at first, then matched the wait-list by the end.
How this fits with other research
Dinora et al. (2020) extends this idea. They show sponsored residential homes, not big facilities, lead to more community participation.
Lakin et al. (2010) sets the scene. During the same years, Medicaid moved money out of institutions and into home-and-community care.
Wilson et al. (2023) looks younger. Customized employment for teens with IDD raised independence in home, work, and self-advocacy.
Together the papers say: give people control and tailor the setting, but check that gains last.
Why it matters
You can fight for individualized budgets for adults you serve. Expect families to feel better and get needed supports. Plan extra steps so community use and caregiver relief do not fade. Revisit goals each year and add brief booster training or respite vouchers to keep early wins alive.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Add a yearly check-in form that asks about unmet needs and caregiver stress so you can request budget changes before gains slip.
02At a glance
03Original abstract
Longitudinal impacts of a consumer-directed support program that provides families with an individualized budget were studied at three points in time over a 9-year period: Time 1 (1991), Time 2 (1995), and Time 3 (2000). At Time 3, families in the program were also compared with families on the waiting list. Over time, families in the program experienced decreased unmet service needs, higher service satisfaction, increased community participation of individuals with disabilities, and decreased caregiver burden. At Time 3 families in the program had fewer unmet needs and higher service satisfaction than did families on the waiting list; there were no differences in community participation and caregiver burden.
Intellectual and developmental disabilities, 2007 · doi:10.1352/1934-9556(2007)45[161:LOOACP]2.0.CO;2