Service Delivery

The prospective associations between autonomy support, basic psychological needs, motivation and well-being among people with a mild to borderline intellectual disability: a two-wave study.

Frielink et al. (2024) · Journal of intellectual disability research : JIDR 2024
★ The Verdict

Train staff to offer real choices and short reasons—this keeps adults with ID motivated and connected years later.

✓ Read this if BCBAs running residential or day programs for adults with mild to borderline ID.
✗ Skip if Clinicians focused only on severe behaviour reduction with no staff-training role.

01Research in Context

01

What this study did

Perry et al. (2024) asked the adults with mild or borderline intellectual disability the same questions twice, 4.5 years apart.

They measured how much staff gave choices and reasons. Then they tracked clients’ feelings of control, connection, and self-driven motivation.

02

What they found

More staff autonomy support predicted stronger client autonomy and relatedness later, plus higher self-driven motivation. Effect sizes were medium.

The link held even after controlling for age, gender, and initial scores.

03

How this fits with other research

Navas et al. (2025) extends this: adults who moved from institutions to community homes gained large quality-of-life jumps only when the new setting offered real daily choices. Place alone is not enough; choice is the active ingredient.

Vassos et al. (2016) reviewed earlier Person-Centred Planning studies. They found modest gains in choice-making, matching the medium effects seen here. Together, the papers show consistent but not huge benefits across decades.

McConkey et al. (2010) seems to contradict: staff still rank toileting and meds above social inclusion tasks. Yet N’s results show benefits when staff do offer choice. The gap is real: autonomy support works, but everyday practice lags behind.

04

Why it matters

You can’t assume community placement equals autonomy. Build in choice moments—menu, activity sequence, or clothing—and give brief rationales. These small staff habits predict client motivation years later.

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→ Action — try this Monday

Add a 2-minute choice routine to one daily activity: present two options, ask for a preference, and state why it matters.

02At a glance

Intervention
not applicable
Design
quasi experimental
Sample size
117
Population
intellectual disability
Finding
positive
Magnitude
medium

03Original abstract

BACKGROUND: This study, grounded in self-determination theory, examined how satisfaction of the needs for autonomy, relatedness and competence in people with mild to borderline intellectual disability (MBID) changed over a 4.5-year period. Additionally, it explored the association between life events across various domains (i.e. health, support and living situation, crime, relationships and freedom and finance) and these changes and explored the prospective associations between these needs, perceptions of support from direct support staff and the well-being and ill-being of people with MBID. METHODS: Based on a sample of 117 adults with MBID, multiple regression analyses were conducted to determine correlations between constructs at both time points and the impact of autonomy support on need satisfaction and motivation, taking into account life events. RESULTS: The analyses showed that, at both time points, most constructs were statistically significantly correlated and remained so despite a time lag of 4.5 years. Autonomy support emerged as a significant positive predictor, of medium size, for satisfying autonomy and relatedness needs. Its association with competence need satisfaction was not statistically significant after Bonferroni correction. For type of motivation, autonomy support statistically predicted increased autonomous motivation, irrespective of life events. CONCLUSIONS: Findings underline the potential of autonomy supportive direct support in the lives of individuals with MBID. Some unexpected null findings underscore the need for further study into the interplay between autonomy support, life events and the well-being of people with MBID.

Journal of intellectual disability research : JIDR, 2024 · doi:10.1111/jir.13163