System and individual outcomes and their predictors in services and support for people with IDD.

Tichá et al. (2013) pulled together big federal datasets on people with IDD. They looked at where people lived, if they worked, and what it cost.

The paper is a narrative review, not a new experiment. It sums up what the data said about service systems.

Residential and employment services give small, real gains to individuals. Costs and results swing wide depending on how the system is run.

The review gives no hard numbers, just the big-picture story from the feds.

Nord (2016) sharpens the story. His quasi-experiment shows adults who get three job services are 16 times more likely to land work. This extends the 2013 finding that employment help helps, but now we know more is better.

Dinora et al. (2023) flips the cost question. They find pouring more hours or dollars at high-need clients does not close outcome gaps. This extends the 2013 cost narrative by showing money alone is not enough.

Lam et al. (2011) and Moss et al. (2009) already showed group homes and small HCBS settings beat other housing on satisfaction. Renáta’s 2013 synthesis folds these early surveys into the federal picture.

You now know stacking job services works, but raw spending does not. Use Derek’s three-service bundle in your next employment plan. Track personal outcomes, not just hours billed. If a client has high support needs, redesign how supports are used instead of only asking for more money.