Lessons Learned in Scaling Up Effective Practices: Implications for Promoting Self-Determination within Developmental Disabilities

Abstract

The public's increasing demands for greater accountability and a better return on investment from research supported by federal funding requires that organizations studying and solving problems in areas like health, education, disability, and child mental health document the impact of their work. Human service and educational professionals agree that implementation science is the missing link that connects research outcomes to the delivery of effective practices. Implementation science informs the scaling up of effective practices and addresses critical issues like social marketing, adoption decisions, capacity building, training, technical assistance, consumer participation and satisfaction, and long-term impact. There has been a dearth of evidence-based scaling up efforts in the field of developmental disabilities, particularly in relation to self-determination, yet the demonstrated benefits of self-determination justify its scaling up and broad-based diffusion. This article addresses the following topics: (1) definition and overview of scaling up, (2) seminal examples of practices that have successfully scaled up, (3) levers and incentives for scaling up self-determination, (4) generic scaling up issues, (5) the National Training Initiative in Self-Determination template for scaling up efforts to promote self-determination, and (6) concluding remarks. Significant issues addressed include the use of evidenced-based practices in promoting scaling up, reliance on nationally recognized metrics to operationally define self-determination and measure scaling up outcomes, and the need to focus on sustainability of disseminated and adopted practices. In this regard, the state summit approach to the scaling up of self-determination within developmental disabilities systems provides an exceptional opportunity for collaboration and the forging of working partnerships among important elements of the national developmental disabilities service delivery network.