The Impact of Human Service Provider Quality on the Personal Outcomes of People With Intellectual and Developmental Disabilities

BackgroundQuality of life is multidimensional—influenced by individual, organizational, and environmental factors. As such, when examining personal outcomes, it is also important to consider meso and macro factors that contribute to people with intellectual and developmental disabilities' (IDD's) quality of life. While it is widely acknowledged that organizational factors contribute to people's quality of life, there is less research directly examining how the quality of human service providers contributes to people with IDD's personal outcomes. For these reasons, the aim of this study was to explore the relationship between provider quality and people with IDD's personal quality of life outcomes.MethodsUsing a multilevel linear regression we analyzed secondary Personal Outcome Measures® (personal outcomes) and Basic Assurances® (provider quality) data from 2,900 people with IDD served by 331 human service providers.ResultsPeople with IDD's personal outcomes, regardless of their support needs or other demographics, were significantly impacted by the quality of the human service providers they received services from—the higher the quality of the provider, the more personal outcomes they had present. In addition, the following demographic covariates were correlated with personal outcomes: gender; race; complex support needs; residence type; and organizations that offered therapy services.DiscussionWhile quality improvement initiatives may require a great deal of cost and time commitment from providers, our findings suggest the effort translates to improved personal outcomes among people with IDD. The ultimate goal of service providers should be improvement of quality of life among those they support.

A Parametric Single-Case Analysis and Social Validation of the High-Probability Request Sequence

Noncompliance with adult instruction is a common problem exhibited by individuals diagnosed with intellectual and developmental disabilities. The high-probability (high-p) request sequence was designed to increase compliance with low-probability (low-p) instructions by rapidly presenting high-p instructions immediately prior to the targeted low-p instruction. This study evaluated the use of three different levels of the high-p request sequence (i.e., one instruction, three instructions, and six instructions) to increase the compliance of five children who were diagnosed with autism spectrum disorder (ASD). Results indicated that all three levels of the high-p request sequence were often successful in increasing compliance with low-p instructions; however, when given the opportunity to choose, participants and caregivers (i.e., mothers and therapists) tended to prefer the high-p request sequence with three instructions.