The Direct Support Workforce: An Examination of Direct Support Professionals and Frontline Supervisors During COVID-19.
DSPs earn less and feel worse than their supervisors, and COVID-19 made the gap unbearable.
01Research in Context
What this study did
Howard et al. (2023) sent a survey to DSPs and frontline supervisors who support people with intellectual or developmental disabilities.
They asked about pay, hours, stress, and life on the job during COVID-19.
The goal was to see how the two groups differ and where the strain shows most.
What they found
DSPs earn less and feel worse about work-life balance than their frontline bosses.
The gap was already there, but the pandemic stretched it wider.
These differences feed the larger workforce crisis in IDD services.
How this fits with other research
Laws et al. (2024) now call the situation a "deepening crisis," building on the 2023 numbers and pushing the story forward.
Adams et al. (2021) interviewed DSPs two years earlier and heard the same six needs: fair pay, better bosses, more training, enough staff, funding, and doable workloads. The new survey shows those needs are still unmet.
Bottini et al. (2020) found burnout tied to workload and fairness in autism staff. Howard et al. (2023) echo that theme across the broader IDD field during COVID-19.
Why it matters
If you run or supervise IDD services, treat DSP wages and support as a clinical variable. Higher pay, clearer career steps, and manageable caseloads slow turnover and protect client programs. Start with one unit: raise hourly rate or add a weekly check-in, then track staff stay-rate and incident reports. Small moves tested fast beat big plans that never launch.
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02At a glance
03Original abstract
Direct support professionals (DSPs) and frontline supervisors (FLSs) have critical roles in home and community-based services for people with intellectual and developmental disabilities. Low wages and high levels of responsibility created a long-term crisis in recruitment and retention and are exacerbated by the COVID-19 pandemic. A national sample of DSPs and FLSs were compared on demographics and work-related circumstances using data from the third Direct Support Workforce COVID-19 Survey. Significant differences were found in demographics, hours worked, wages, wage augmentations, and quality of work-life. Policy recommendations to address the worsening workforce crisis are provided.
Intellectual and developmental disabilities, 2023 · doi:10.1001/jamainternmed.2020.3930