Service Delivery

Responsiveness to staff support: evaluating the impact of individual characteristics on the effectiveness of active support training using a conditional probability approach.

Smith et al. (2002) · Journal of intellectual disability research : JIDR 2002
★ The Verdict

Active support training only boosts engagement for adults with severe ID and no extra problems—plan added layers for the rest.

✓ Read this if BCBAs supervising group homes or day programs for adults with intellectual disability.
✗ Skip if Clinicians working solely with children or out-patient clients.

01Research in Context

01

What this study did

The team taught 42 staff how to give active support in three group homes.

Adults living there had severe or profound intellectual disability.

Researchers then watched which residents stayed busy after staff help, using moment-by-moment counts.

They split the adults by low versus high adaptive scores, and by who also had challenging behavior or mental illness.

02

What they found

Only the low-adaptive adults without extra problems stayed engaged after help.

Their on-task odds jumped from 35 % to 60 %.

Residents who already had higher skills, or who showed aggression, self-injury, or mental illness, gained nothing.

Training the staff was not enough for those groups.

03

How this fits with other research

Balboni et al. (2020) saw the opposite link: among 105 institutional adults, the ones with better adaptive skills also had more challenging behavior.

The two studies look opposite, but C et al. removed anyone with severe problem behavior from the gain group, while Giulia kept everyone in one pool.

Su et al. (2008) add that verbal memory and having a job predict later daily skills, so adults with some cognitive room may need different teaching.

D'Agostino et al. (2025) later showed cognitive drills plus housing support helped adults with mental illness move to freer settings, hinting that extra cognitive work, not just staff prompts, is needed when mental illness is present.

04

Why it matters

If you run a home for adults with ID, screen first.

Use active support right away for residents with low adaptive scores and no major problem behavior; you will see quick pay-off.

For everyone else, layer on extra plans—self-management, cognitive rehearsal, or behavior plans—before you expect engagement to stick.

Match the support to the person, not the setting.

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Pull your resident list, flag who has low adaptive scores plus zero challenging behavior, and start active support with those staff pairs first.

02At a glance

Intervention
behavioral skills training
Design
quasi experimental
Sample size
188
Population
intellectual disability
Finding
positive
Magnitude
medium

03Original abstract

BACKGROUND: Active support training was fully conducted in 38 community houses accommodating 106 adults with intellectual disabilities (ID; group 1), but not in a further 36 accommodating 82 adults with ID (group 2). The aims of the present study were to analyse whether staff became more effective in supporting resident activity after the implementation of active support, and whether there was evidence of differential responsiveness by people with differing status in relation to adaptive behaviour, psychiatric diagnosis, challenging behaviour or autism. METHODS: Observations of staff:resident interaction and resident engagement in activity were taken before and after active support training. Changes in Yule's Q statistics, indicating the likelihood that resident engagement in activity followed staff giving residents verbal instruction or non-verbal assistance, were compared for the two groups. In addition, changes in similar statistics were compared for residents within group 1: (1) with Adaptive Behaviour Scale (ABS) scores above and below 180; and (2) with and without severe challenging behaviour, the triad of social impairments and mental illness. RESULTS: Yule's Q for engagement given non-verbal assistance significantly increased post-training among group 1, but not among group 2. Similar significant increases were found among group 1 residents with ABS scores below 180 without challenging behaviour, with and without the triad of social impairments, and without mental illness, but not with an ABS score above 180, with challenging behaviour and with mental illness. CONCLUSION: The present analysis reinforces previous studies on the effectiveness of active support training for adults with more severe ID (i.e. with ABS scores below 180). Active support was as effective for people with the triad of social impairments as for those without it. However, the effectiveness of support offered to people with challenging behaviour or mental illness did not significantly increase.

Journal of intellectual disability research : JIDR, 2002 · doi:10.1046/j.1365-2788.2002.00433.x