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Background: Active Support is a staff practice that aims to increase engagement of people with intellectual disabilities. This study seeks to: (1) identify the outcomes of staff using Active Support and how these are measured; (2) identify how the views of people with intellectual disabilities have been included in Active Support research., Method: A scoping review was conducted of peer-reviewed articles about Active Support published between 2009 and 2023., Results: Sixteen articles were identified. Outcomes included engagement, the quality of staff support, choice and challenging behaviour. Structured observations were the most frequently used measurement method. Only two studies explored people with intellectual disabilities' perspectives about Active Support., Conclusions: Consistent use of similar measures is a strength of Active Support research. Including perspectives of people with intellectual disabilities may provide insight into dimensions of support not been measured and assist in further developing these measures and Active Support practice., (© 2024 The Author(s). Journal of Applied Research in Intellectual Disabilities published by John Wiley & Sons Ltd.)

Background: Active Support is a person-centred practice that enables people with intellectual disabilities (IDs) to engage in meaningful activities and social interactions. The Active Support Measure (ASM) is an observational tool designed to measure the quality of support that people with IDs living in supported accommodation services receive from staff. The aim of the study was to explore the underlying constructs of the ASM., Methods: Multilevel exploratory factor analysis was conducted on ASM data (n = 884 people with IDs across 236 accommodation services) collected during a longitudinal study of Active Support in Australian accommodation services., Results: Multilevel exploratory factor analysis indicated that 12 of the ASM's 15 items loaded on two factors, named Supporting Engagement in Activities and Interacting with the Person., Conclusions: The 12-item ASM measures two dimensions of the quality of staff support. Both technical and interpersonal skills comprise good Active Support., (© 2024 The Authors. Journal of Intellectual Disability Research published by John Wiley & Sons and MENCAP.)

Background: The strength of practice leadership predicts the quality of Active Support but it can be compromised by other demands on frontline managers. The study aimed to identify and understand differences in practice leadership over time and between organisations., Method: Data collected in 2022 in 96 services from 11 organisations using the Observed Measure of Practice Leadership were compared to similar data from 2013 and 2018. Qualitative fieldnotes were analysed thematically., Findings: Practice leadership scores increased significantly between 2013 and 2018 but declined significantly between 2018 and 2022. Scores were significantly higher in organisations that had implemented Active Support since 2013 compared to later adopters. Higher scoring organisations had structures that supported frontline managers with practice leadership and that countered increasing administrative demands., Conclusions: Establishment of support structures for practice leadership by organisations warrants further investigation together with the relative importance of each task of practice leadership., (© 2024 The Authors. Journal of Applied Research in Intellectual Disabilities published by John Wiley & Sons Ltd.)

Background: Adults with intellectual disability are often disengaged in disability services. While Active Support has found efficacy in residential settings, less is known in day services. This study examines the impact of Active Support in day services for adults with intellectual disability in Singapore, particularly on engagement and behaviours of concern., Method: An experimental design was used, with a group of 32 participants receiving an Active Support programme over 6 months, compared to a control group of 16 participants with treatment as usual. Time sampling of behaviours was conducted every 4 weeks., Results: The Active Support group saw increases in activity engagement and social engagement with staff, and decreases in disengagement and stereotypical behaviours, compared to the control group over time., Conclusion: Results support the implementation of Active Support across other day services for adults with intellectual disability. Active Support principles should be considered in planning policies and service outcome measures., (© 2020 John Wiley & Sons Ltd.)

Background: Active Support, now widely adopted by disability support organizations, is difficult to implement. The study aim was to identify the factors associated with good Active Support., Methods: Data on service user and staff characteristics, quality of Active Support and practice leadership were collected from a sample of services from 14 organizations annually for between 2 and 7 years, using questionnaires, structured observations and interviews. Data were analysed using multilevel modelling (MLM)., Results: Predictors of good Active Support were adaptive behaviour, practice leadership, Active Support training, and time since its implementation. Heterogeneity, having more than six people in a service and larger organizations were associated with lower quality of Active Support., Conclusions: In order to ensure that Active Support is consistently implemented, and thus, quality of life outcomes improved, organizations need to pay attention to both service design and support for staff through training and practice leadership., (© 2019 The Authors. Journal of Applied Research in Intellectual Disabilities published by John Wiley & Sons Ltd.)

Background: Disability support organisations have embraced Active Support, but it has proved difficult to embed in services., Aims: This study aimed to identify the factors associated with increases over time in the quality of Active Support., Method: Data were collected on the predicted variable of the quality of Active Support, and predictor variables of service user, staff and service characteristics, including practice leadership, and composition and size of services from 51 services in 8 organisations over 2-7 time points. Data were analysed using multi-level modelling., Results: There was significant linear change in Active Support scores (group mean centered at the organisational level) over time. Individuals with lower support needs received better Active Support and those with higher support needs experienced greater increases over time. Stronger practice leadership and more staff with training in Active Support were significant predictors of the quality of Active Support. Larger services with seven or more individuals and where there was a very heterogeneous mix of individuals were associated with lower quality of support., Conclusions: Ensuring strong practice leadership, and staff training in Active Support that emphasises the principle of adapting support to each individual's level of ability and preferences are key to delivering high levels of Active Support., (Copyright © 2019 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: The aim was to explore the relationship between quality of active support and communication support for people in group homes with high and low support needs., Methods: Data from 182 service users, 20-81 years (mean = 40), 89 with high support needs, were observed to have either good (n = 142) or poor (n = 40) communication support. Measures were of quality of active support, engagement and staff contact; field notes provided examples of good and poor communication supports., Results: We found a relationship between the quality of communication support and active support. Receiving good communication was associated with higher levels of engagement. Field notes included some examples of appropriate communication supports, but limited use of augmentative and alternative communication (AAC)., Conclusions: Staff show limited use of appropriate communication with people having high support needs who require AAC. Strategies to improve quality of practice are discussed., (© 2018 The Authors. Journal of Applied Research in Intellectual Disabilities Published by John Wiley & Sons Ltd.)

Background: The review examined the effectiveness of Active Support (RQ1) and stakeholders' experiences of the model (RQ2)., Method: Data were meta-analysed (RQ1; studies = 14) and synthesized narratively (RQ2; studies = 10)., Results: By follow-up (6 months post-training), effect sizes (RQ1) for resident total activity engagement were significant and ranged from small (d = 0.33, 95% CIs: 0.10-0.50) to large (Tau-U = 0.95, 95% CIs: 0.64-1.25) depending on study design. Follow-up changes in staff assistance were moderate (d = 0.56, 95% CIs: 0.23-0.89; Tau-U 0.63, 95% CIs: 0.32-0.93) and large for quality of support (d = 1.03, 95% CIs: 0.61-1.44). Other outcomes did not change., Conclusions: Active Support was more effective following complete staff training, in larger settings, at lower staff-to-resident ratios and with less experienced staff. Active Support training and outcomes were valued by staff and residents (RQ2), and staff experienced increased job satisfaction. Lower staff turnover and organizational readiness appear crucial for maintaining implementation., (© 2018 John Wiley & Sons Ltd.)

Background: This study reports on the feasibility of an intergenerational mentoring programme for youth with intellectual disability (ID) aimed at developing skills and building networks., Methods: Youth with ID were paired with older male mentors who were trained to support the mentees participate in activities and social interactions during weekly sessions. We interviewed the mentees and mentors, and assessed them on a range of outcomes using standardized measures., Results: Interviews highlighted that the programme presented a great "opportunity" for the mentees and mentors. The participants described facilitators and challenges to the acquisition of practical skills by mentees and the development of relationships between mentors and mentees, including communication, transportation and mentor training. The youth with ID had difficulty completing the self-report measures., Conclusions: Mentoring programmes are viable to support youth with ID during the transition to adulthood; however, refinement is required in the rollout out of a pilot intervention., (© 2017 John Wiley & Sons Ltd.)

Background: People with severe and profound intellectual disabilities often spend substantial time isolated and disengaged. The nature and quality of the support appears to be important in determining quality of life., Methods: Structured observations and staff questionnaires were used to explore the quality of life and quality of support for 110 people with severe and profound disabilities and complex needs., Results: On average, people spent approximately 40% of their time engaged in meaningful activities, received contact from staff 25% of the time (6% in the form of assistance to be engaged). Just over one-third received consistently good active support, which was associated with other measures of quality of support and emerged as the strongest predictor of outcomes., Conclusions: Quality of life and quality of support were relatively poor, although with about one-third of people receiving skilled support. Consistently good active support was the best predictor of outcome and proposed as a good indicator of skilled support., (© 2015 John Wiley & Sons Ltd.)

Background: Improving staff performance is an issue in services for people with intellectual disability. Practice leadership, where the front line leader of a staff team focuses on service user outcomes in everything they do and provides coaching, modeling, supervision and organisation to the team, has been identified as important in improving staff performance. To date this finding is based only on self-report measures., Methods: This paper describes and tests an observational measure of practice leadership based on an interview with the front-line manager, a review of paperwork and observations in 58 disability services in Australia., Results: The measure showed good internal consistency and acceptable inter-rater reliability. Practice leadership was associated with staff practice and outcomes for service users. The observed measure of practice leadership appears to be a useful tool for assessing whether leadership within a service promotes enabling and empowering support by staff. It was found to discriminate higher and lower performing services in terms of active support., Conclusions: The measure had good reliability and validity although some further testing is required to give a complete picture of the possible uses and reliability of the measure. The measure is potentially useful in contexts of both research and service development. The confirmation of previous findings from self-report measures that practice leadership is related to the quality of staff practice and outcomes for service users has implications for policy and practice in terms of the training of managers and structures for organisational management., (© 2015 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.)

Background: Being engaged in daily activities is a strong indicator of quality of life for individuals with intellectual disability (ID) who live in small community group homes. This study aimed to identify individual and organisational factors that predict high levels of engagement., Method: Individuals with ID (n = 78), direct support professionals (DSPs; n = 174) and supervisors (n = 21) from 21 US group homes participated in the study. For each individual with ID, we conducted 80 min of observation at the person's residence. Information was also gathered regarding demographic characteristics, DSP competence, supervisor years of experience and management practices. Data were analysed using multilevel modelling., Results: On average, individuals were engaged in social activities 12% of observed time and non-social activities 35% of the time. Individuals with greater adaptive skills who were supported by more competent staff showed significantly higher levels of social engagement. Individuals with less severe deficits in adaptive behaviours and less challenging behaviour showed higher levels of non-social engagement. Although none of the factors related to group homes were significant, 24% of the variance in non-social engagement existed among group homes., Conclusion: These results suggested that engagement is a dynamic construct. The extent to which an individual with ID is engaged in daily life is a result of interplay between the individual's characteristics and the group home environment. Future research is needed to investigate the influence of variables specific to the group home on the engagement level of individuals with disabilities., (© 2014 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.)

Background: We hypothesised that a key factor determining the quality of active support was 'practice leadership' - provided by the first-line manager to focus staff attention and develop staff skills in providing direct support to enable people with intellectual disabilities to have a good quality of life. This exploratory study focused on what levels of practice leadership were found and its role in explaining variation in active support., Method: Relevant aspects of management, including practice leadership, were assessed by questionnaires administered to staff in residential settings alongside observational measures of active support and resident engagement in meaningful activity. Relationships between these variables were explored using regression and post hoc group comparisons., Results: There was wide variation, with average levels of practice leadership being low, though improving over the period studied. Practice leadership had a significant impact on active support, but was fully mediated by the effect of quality of management. When the quality of management was higher better practice leadership did produce a significant difference in active support. However, higher quality of management on its own did not produce better active support., Conclusions: A number of limitations are acknowledged and further research is required. Practice leadership appears to be an important factor in enabling staff to provide active support but as part of generally good management. Given the rather low levels found, attention needs to be given to the training, career development and support of practice leaders and also to how to protect their time from their many other responsibilities., (© 2013 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.)

Background: As adults with intellectual disability age, retirement options need to be explored. One option is to attend a mainstream community group for retirees. Support within these groups could come from group members who are trained to act as mentors for the older adults with intellectual disability. This research evaluated a support training programme, Active Mentoring, which combines elements of Active Support and Co-worker Training., Method: Three older women with intellectual disability participated in a non-concurrent multiple baseline design. Effect size analyses (Percentage of Non-overlapping Data) were used to evaluate observational data., Results: Active Mentoring was effective in increasing most types of engagement in activities, but there was no observed effect for social engagement. Mentor help also increased., Conclusion: Active Mentoring was effective in eliciting support from mentors, and in increasing activity engagement of older adults with intellectual disability in mainstream community groups., (© 2012 The Authors. Journal of Intellectual Disability Research © 2012 John Wiley & Sons Ltd, MENCAP & IASSID.)

Abstract\nPoints of interestThe online learning resource ‘Every Moment has Potential’ (2015) aimed to teach direct support professionals about the values underlying active support, especially choice and control. This is unsurprising: these values anchor disability rights activism and policies. However, accompanying videos meant to illustrate choice and control offer a more nuanced story. My qualitative analysis brings in Lori Marso’s concept of freedom in the encounter to theorize four kinds of encounters in active support relationships: encounters that treat people as people; encounters that encourage surprise and spontaneity; encounters of mutual and safe touch; and challenging encounters. I aim to question critically the explicit values alongside the practices of active support. Plus, by using online YouTube videos as analysis, I hope to encourage more creative ways to include people with severe and profound intellectual disabilities in academic work, especially theoretical and philosophical work about intellectual disability.Support workers help people do things, like cook, clean, shop, and have fun.Some people say that support workers should help people with disabilities make choices.I watched videos that showed support workers helping people with intellectual disabilities to see if this was true.Helping people make choices is good, but good support workers help in other ways, too.Good support workers treat people with intellectual disabilities like people. They help people with intellectual disabilities have fun. They try new things together. And support workers and people with intellectual disabilities can use physical touch with each other in good and safe ways. [ABSTRACT FROM AUTHOR]

Background:Method:Results:Conclusions:Support from staff plays an important role in quality of life for people with intellectual disability. This study focuses on service users' views of Active Support as good support and whether Active Support increases the quality of everyday support in group homes.Nine service users were interviewed at baseline and at follow-up one year after staff received Active Support training. Thematic analyses were used to develop themes.Three main themes were created: (1) Home is more than just a place, it is a feeling; (2) Good care is caring with accessible communication; and (3) Time is precious. Participants were more satisfied with most of the support at follow-up, particularly choice-making, control in everyday life, relationships, and emotional support.Active Support corresponds well with service users’ perceptions of good support. In future studies of Active Support service users' voices should be a part of the follow-up. [ABSTRACT FROM AUTHOR]

Background: Organisational and service level factors are identified as influencing the implementation of Active Support. The aim was to explore differences in organisational leadership and structures to identify potential relationships between these factors and the quality of Active Support in supported accommodation services. Method: Fourteen organisations participated in this mixed methods study, which generated data from interviews with senior leaders, document reviews and observations of the quality of Active Support. Results: Qualitative analyses revealed three conceptual categories: senior leaders in organisations where at least 71% of services delivered good Active Support prioritised practice; understood Active Support; and strongly supported practice leadership. In these organisations practice leadership was structured close to everyday service delivery, and as part of frontline management. Conclusions: Patterns of coherent values, priorities and actions about practice demonstrated by senior leaders were associated with successful implementation of Active Support, rather than documented values in organisational policy or procedures. [ABSTRACT FROM AUTHOR]

Although numerous studies in the U.K. and Australia have shown that Active Support (AS) is an effective intervention in increasing staff assistance and engagement for people with intellectual and developmental disabilities (IDD) who live in small community residential settings, studies in Taiwan and the U.S. did not replicate these results. The mixed findings may be due to the unique challenges faced by small community group homes serving people with disabilities from different countries. The purpose of this qualitative study was to describe the views of participants in a AS implementation study about contextual factors that affected their efforts at implementing AS in a U.S. context. Interviews were conducted with Direct Support Professionals (DSPs) and AS trainers. A focus group was conducted with directors from organizations that implemented AS in the U.S. This study revealed several reported challenges to AS implementation, including the lack of leadership support, lack of buy-in, and high staff turnover rate. Despite these difficulties, study participants identified positive impacts of AS on both DSPs and people with disabilities. Implications of these findings are discussed. [ABSTRACT FROM AUTHOR]

Active support, despite being used for more than 20 years in other places, it is still an unknown methodology in services that support people with intellectual disabilities and high support needs, in our country. This article aims to make an approach to the philosophy and strategies promulgated by the active support, through a documental review of scientific studies. Results of 24 articles about the life of residents and the direct support professionals' work following the implementation of this methodology in different resources are analyzed. [ABSTRACT FROM AUTHOR]

Background This paper reports on the feasibility and outcomes of a transition to retirement programme for older adults with disability. Without activities and social inclusion, retirees with disability are likely to face inactivity, isolation and loneliness. Methods Matched intervention and comparison groups each consisted of 29 older individuals with disability. There were 42 men and 16 women with a mean age of 55.6 years While attending their individual mainstream community group 1 day per week, intervention group participants received support from community group members trained as mentors. We assessed participants' loneliness, social satisfaction, depression, life events, quality of life, community participation, social contacts, and work hours before and 6 months after joining a community group. Results Twenty-five (86%) of the intervention group attended their community group weekly for at least 6 months. They increased their community participation, made an average of four new social contacts and decreased their work hours. Intervention participants were more socially satisfied post-intervention than comparison group members. Conclusions The results demonstrate that participation in mainstream community groups with support from trained mentors is a viable option for developing a retirement lifestyle for older individuals with disability. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to provide a commentary on “An audit of an Intensive Interaction service”. Design/methodology/approach – Drawing on the literature regarding other related person-centred approaches and clinical and research experience, an argument is made that people with profound intellectual and multiple disabilities are particularly at risk when service innovation does not account for their unique needs. Findings – Practice and service models need to specifically account for the needs of people with profound intellectual and multiple disabilities. Originality/value – The commentary draws attention to the importance of implementation and seeks to draw lessons from well established, service wide approaches for people with intellectual disabilities. [ABSTRACT FROM AUTHOR]

The foreshadowed increase of older people with intellectual disability has become a reality in many developed countries. As these adults age, improved quality of life can be achieved through applications of conjoint policy aims of inclusion and participation. A transition-to-retirement ( TTR) program developed for employees of a large multisite disability employment service in Sydney, Australia, used these aims to effect successful partial retirement. The authors describe the program logic of the TTR, detailing its conceptual components as the first step to enabling it to be tested and replicated in other settings. The TTR program has three components: promoting the concept of retirement, laying the groundwork for inclusion of would-be retirees with intellectual disability in the community, and constructing the reality. The third component comprised five stages: planning, locating a group, mapping new routine, recruiting and training mentors, and monitoring and ongoing support. The project's participants were 24 older employees, who replaced 1 day a week of work with membership of a community group and were supported by mentors who facilitated involvement of the participants in their group. Data collected provided information on the implementation of the program, the time and costs expended, and challenges encountered. Key to the model was a coordinator, skilled in generic case management and specific disability interventions (such as active support), who collaborated with others to manage the program. The authors note that by detailing the program logic underpinning the TTR program, they have exposed the hidden work of supporting meaningful inclusion of people with intellectual disability in community groups and added to the limited stock of evidence-informed programs in this area. [ABSTRACT FROM AUTHOR]

Background Social inclusion is a widely acknowledged goal; who is best positioned to provide support and how support is delivered are key questions. Using Active Mentoring training, members of community groups mentored a person with intellectual disability and supported their inclusion in that group. Methods Interviews with 14 mentors explored their experiences of supporting a previously unknown person with intellectual disability to participate in their community group. Findings The core theme was No Different From Us. Mentors saw beyond the disability, they valued others, were community leaders, and had intrinsic qualities. With some basic orientation to the task, mentors were able to support the inclusion of their mentee in the group. Conclusion Community members are willing to support people with intellectual disability to join their community groups. The Active Mentoring training is one way of harnessing the goodwill of community groups and their members to include people with intellectual disability to participate on an individual basis in community groups. [ABSTRACT FROM AUTHOR]

Background Active support (AS) has gained popularity as an approach for assisting people with intellectual disability to engage more fully in everyday activities. Although research has identified changes in the extent that residents are engaged in meaningful activities, the experience of stakeholders such as residents, staff, and family in AS is underexplored. Method A general inductive approach was used to analyse focus group and interview transcripts of residents ( n = 4), staff ( n = 13), and family ( n = 2) about their experience of involvement in an AS pilot project at one residential care facility in New Zealand. Results Three superordinate themes common to all stakeholders' experiences emerged: 'living normal lives,' 'caring means doing with,' and 'engaging with risk.' Conclusion Transitioning to AS had been enriching but at times challenging for all stakeholders. Valuing resident autonomy and preparedness for greater exposure to risk are significant considerations in the implementation of AS. [ABSTRACT FROM AUTHOR]

Background Active support is being introduced in many residential and respite homes in an effort to improve engagement in meaningful activity of people with intellectual disability. Method A train-the-trainer approach was used in a large government organisation that supports people with intellectual disability in Australia. Five apprentice trainers were trained to provide active support training to 65 staff associated with 6 group homes. These 5 trainers were then monitored to provide training to 54 staff in another 6 group homes. Staff evaluated their interactive training experiences, and pre and post outcome data were collected for a small number of service users from the second set of group homes, along with staff outcome data regarding residential working practices, group home management, and staffing practices. Results The train-the-trainer model proved to be an effective strategy for training large numbers of staff. The interactive training component was particularly effective and was associated with improvements in service user engagement in domestic tasks and decreased depression levels. Staff job satisfaction increased and significant improvements were recorded in residential working practices. Conclusions Active support training is an effective strategy for empowering staff to better support people with an intellectual disability to be meaningfully engaged in daily activities. There are implications for organisations related to ongoing implementation and practice improvement. [ABSTRACT FROM AUTHOR]

Abstract: Active Support was implemented for the first time in Taiwan in March, 2009. This study aims to evaluate whether the supervisors and front line managers of residential services receiving Active Support Training (AST) caused a positive impact on their users with intellectual disabilities (ID) while comparing this with their counterparts with ID whose residential staff were not being involved in the training. The nonequivalent groups design was used for the evaluation; the participants included 49 residents of 12 community living homes as the experimental group and 19 residents of another 5 community living homes as the comparative group. The pretest evaluation was conducted before the AST and the post-test and follow-up evaluations were conducted following 4 months and 14 months after the pre-test respectively. The assessment package contained questionnaires relating to domestic engagement, community inclusion, choice, social network, mood scales, challenging behaviors, adaptive behavior and demographic questions among the residents with ID. Within the group, analyses showed that the residents whose staff received AST showed increased levels of choice and adaptive behavior and decreased levels of depression in the post-test and follow up in addition the residents’ engagement in domestic activities improved in the follow up. The intervention did not affect the frequency of family contact, community inclusion and challenging behavior among the residents. The residents in the comparative group showed no significant change except the levels of depression decreased comparing follow-up test and post-test. Based on a cross groups comparison of the effect of the intervention among the residents, only a decreased level of depression was found in the post-test results of the both groups. This study suggests Active Support is practicable but only partially effective in Taiwan; thus, conducting an AST Package of Taiwan version is expectable. [Copyright &y& Elsevier]

In this article the authors discuss aspects of a study investigating the potential for active mentoring to help older adults with a lifelong disabilities transition into retirement. They note that older people with a lifelong disability face barriers to enjoying active aging, which involves social participation, and discuss how the creation of access and linkage through active support and co-worker training models can overcome these barriers.

Background Identifying the factors associated with greater increases in resident engagement has the potential to enhance the effectiveness of active support (AS). Method Observational data from Stancliffe, Harman, Toogood, and McVilly's (2007) study of AS were analysed to evaluate amount of staff help, effectiveness of staff help, and staff use of praise. Results Lag analyses showed that antecedent staff help was consistently followed by resident engagement at pre-test. This strong association did not increase significantly at post-test. Resident engagement was more likely to follow staff help than the other way around. There was an increase from pre-test to post-test in help and praise by staff. The higher absolute amount of praise was largely the result of the increase in staff help. Conclusions The amount of staff help, its effectiveness, and use of praise by staff may each be important in increasing engagement. These factors should continue to be the focus of research attention and applied efforts to help ensure active support is consistently effective. [ABSTRACT FROM AUTHOR]

Background Active Support (AS) is an approach for promoting increased engagement in activities by people with intellectual disability (ID). Method We critically reviewed the available research on AS, and added a commentary to help guide future research and practice. Results Despite weaknesses in the research design of some studies, there is consistent evidence that AS results in increased engagement in activities. There is also some limited evidence of other beneficial outcomes. All published research to date has involved people with ID in community group homes with 24-hour staffing. Conclusion The established efficacy of AS for increasing engagement means that research attention can now be given to: (a) developing AS to enhance its positive impact on outcomes such as choice and relationships; (b) exploring the wider implementation of AS beyond community group homes and people with ID; and (c) examining the effectiveness of wide-scale implementation of AS, with careful attention to issues such as management, organisational and staffing factors, and cost. [ABSTRACT FROM AUTHOR]

Background The aim of this study was to evaluate active support (AS) training and to investigate changes to perceived engagement in domestic tasks, opportunities for choice, frequency of challenging behaviour, and level of support needs. Method Participants were 12 adults with ID aged 27-57 years (M = 37 years) residing in three group homes, and their support workers. The support workers completed assessments on three occasions (at baseline, post-training, and at follow-up). Results Residents' engagement in domestic tasks increased over time, and overall choice increased, although perceived choice in two life domains initially increased, but decreased to baseline levels at follow-up. Residents exhibited an overall decrease in anxiety, self-absorbed behaviour, disruptive behaviour, and problem behaviour in general. There was also an overall decrease in perceived support needs for five activity domains, with no change for one domain. Conclusions The results contribute to a growing body of evidence demonstrating favourable outcomes of AS in terms of engagement and challenging behaviour in people with ID. Surprising results are presented for choice and perceived support needs, warranting further investigation. [ABSTRACT FROM AUTHOR]