Active support: A critical review and commentary

Abstract

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.

Keywords:

• active support
• engagement
• participation
• choice
• support
• staff training
• group home
• activity
• intellectual disability

Notes

1 Consider two residents (a and b) whose time engaged in activities following implementation of AS increases by the same absolute amount of 10% (or 6 minutes per hour). However, resident a's pre-test level of engagement was 10% whereas resident b's was 40%. The proportional increase for resident a (10/10 × 100 = 100%) is much higher than for resident b (10/40 × 100 = 25%), because of the lower pre-test level.