Assessing individual support needs to enhance personal outcomes

Education and human service organizations providing services to people with intellectual and closely related developmental disabilities are increasingly being impacted by the supports paradigm, the quality of life concept, and the evaluation of personal outcomes. In this article the authors discuss the relationship among these three areas, including examples that illustrate how assessed support needs data can be aligned with quality-of-life-related core domains so as to establish individualized support systems that enhance personal outcomes. The article concludes with a discussion of the implications for educators and habilitation professionals of integrating the supports paradigm, the quality of life concept, and the evaluation of personal outcomes

A Benefit-Cost Analysis Model for Social Service Agencies

Current public policy is based on two fundamental principles: equity and efficiency. Equitable programs contribute to balancing the needs and desires of the various groups in society; whereas efficient programs are those that serve to increase the net value of goods and services available to society. Benefit-cost analysis is a tool developed to determine whether a program produces effects that justify the costs incurred to operate the program. The benefit-cost model presented in this monograph requires the reader to: Understand the concept of an analytical perspective; Move beyond viewing benefit-cost analysis as a simple ratio of benefits to costs; Include both monetized and non-monetized benefits in the analysis; and Consider what is a benefit and what is a cost, and to whom. Thus, potential users of the proposed model are encouraged to take a broader perspective on the benefits and costs of a program, intervention, or service, rather than reducing the analysis to a simple ratio of benefits to costs. The purpose of benefit-cost analysis is to determine whether a program\u27s benefits outweigh its costs. The primary issue addressed by a benefit-cost analysis is whether the impacts of a program, intervention, or service are big enough to justify the costs needed to produce them. Benefit-cost analysis depends upon the availability of cost estimates, benefits to program participants, and impact statements, which are the statistically significant mean differences of costs and benefits between the programs, interventions, or services being compared. Benefit-cost analysis requires both an understanding and use of a number of terms. The more important of these include: Benefits: Positive outcomes that accrue to program participants such as increased wages, regular job, or reduced use of alternative programs. Costs: Expenditures associated with a particular program, intervention, or service such as program expenses, forgone market output (that is, opportunity costs), or increased use of complementary programs. Efficiency: The extent to which there is an increase in the net value of goods and services available to society (that is, being productive with minimum waste). Equity: The balance between the needs and desires of the various groups in society (that is, fairness). Impacts: The significant mean differences on selected cost and benefit measures between the groups or conditions being compared. Monetized: Benefits or costs to which a monetary value can be assigned (for example, wages, taxes paid, reduced public taxes). Nonmonetized: Benefits to which a monetary value cannot be assigned (for example, improved quality of life or increased satisfaction). Analytical perspective: Benefit-cost analysis addresses the perspective of different groups in society that are effected by a program, service, or intervention. The three perspectives used in the benefit-cost model presented include the participant, rest of society (that is, the taxpayer ), and social (that is, society as a whole, which includes the sum benefits and costs generated from the previous two perspectives). The inclusion of these three perspectives in a benefit-cost analysis is necessary since a program effect (such as taxes withheld) can be a benefit to some and at the same time a cost to others. The benefit-cost analysis model presented on subsequent pages is based on the work of Conley & Noble (1990), Cimera (1998), Cimera and Rusch (1999), Kerachsky et al (1985), Noble & Conley (1987), Rossi, Freeman & Lipsey (1999), Rusch (1990), Rusch, Conley & McCaughlin (1993), Schalock (1995), Schalock and Thornton (1988), Thornton (1984), and Thornton and Maynard (1989)

A systems approach to social entrepreneurship

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Initial validation of the Chinese Quality of Life Questionnaire - Intellectual Disabilities (CQOL-ID): A cultural perspective

Background In the field of intellectual disabilities (ID), the quality of life concept has been developing rapidly in Chinese societies including Hong Kong, mainland China and Taiwan. However, there is a lack of locally validated instruments to measure the quality of life of people with ID. The study reported in this paper attempted to validate the Chinese Quality of Life Questionnaire - Intellectual Disabilities adapted from the Quality of Life Questionnaire developed by Schalock & Keith. Methods People with mild/moderate ID aged 15 years or above were recruited from special schools, skills centres, community service units and residential units in different regions of Hong Kong. A number of procedures were followed including reliability tests, factor analysis, content validity and construct validity. Results A total of 359 participants were recruited for the study. Factor analysis was conducted according to the rotated component matrix method, in which 23 items were extracted from the original 40-item version of the Quality of Life Questionnaire and three domains (renamed satisfaction, competence and daily choice making/interpersonal relations) were observed. The items in each domain were shown to have factor loadings ranging from 0.42 to 0.90. Construct validity tests indicated the positive nature of the relationship between earnings, and that self-determination and social interaction increase with more independent living environments and less segregated work environments achieving higher scores (P<0.000, P<0.01 and P<0.05 respectively). The scale also achieved a good degree of reliability (Cronbach's α=0.79). Conclusions Initial validity tests indicated that the Chinese Quality of Life Questionnaire - Intellectual Disabilities may be a useful instrument for measuring the quality of life of Chinese people with ID. Cultural issues are discussed and recommendations for future research and service development are made. © 2011 The Authors. Journal of Intellectual Disability Research © 2011 Blackwell Publishing Ltd.postprin

Defining, diagnosing, classifying, and planning supports for people with intellectual disability: an emerging consensus

Significant international work in the field of intellectual disability (ID) over the last decade has resulted in an emerging consensus regarding the definition of ID, the criteria used to diagnose a person with ID, the classification of individuals who have been diagnosed with ID, and the planning of individualized supports for people with ID. This article describes that emerging consensusDurante la última década, un importante trabajo internacional en el ámbito de la discapacidad intelectual (DI) ha dado lugar a un consenso emergente con respecto a la definición de DI, los criterios utilizados para diagnosticar a una persona con DI, la clasificación de las personas que han sido diagnosticadas con DI y la planificación de apoyos individualizados para personas con DI. Este artículo describe ese consenso emergente

Going beyond Environment to Context: Leveraging the Power of Context to Produce Change

This work is licensed under a Creative Commons Attribution 4.0 International License.This article discusses the processes and implications of going beyond environment to context. The article (a) provides an operational definition of context; (b) describes a multidimensional model of context that views context as being multilevel, multifactorial, and interactive; (c) describes how conceptual models of quality of life, human rights, and human functioning can be used in conjunction with the multidimensional model of context to identify opportunities and develop context-based change strategies that improve quality of life, human rights, and human functioning outcomes; and (d) describes a four-step approach to leveraging an understanding of context to produce change. The article concludes with a discussion of the advantages of and barriers to moving beyond environment to context

Six Ideas That Are Changing the IDD Field Internationally

The purpose of this article is to discuss six ideas that are currently impacting policy makers and service/support providers in the field of intellectual and closely related developmental disabilities.  These six ideas are that people are influenced by multiple systems, disability should be approached holistically, disability policy needs to be approached systematically, supports should encompass elements of a system of supports, evaluation is multifaceted, and organizations need to transform to be sustainable.El propósito del presente artículo es presentar seis ideas que en estos momentos están teniendo influencia en los legisladores y en los proveedores de servicios y apoyos en el ámbito de las discapacidades intelectuales y del desarrollo (que están íntimamente relacionadas). Estas seis ideas son las siguientes: las personas se ven influidas por varios sistemas, debemos enfocar la discapacidad desde un punto de vista holístico, las políticas sobre discapacidad deben tener un enfoque sistemático, los apoyos deben abarcar los elementos de un sistema de apoyos, la evaluación tiene diversos factores y las organizaciones se deben transformar para poder ser sostenibles

Factors predicting quality of life for people with intellectual disability: results from the ANFFAS study in Italy

Background This study describes the sociodemographic, clinical, and functional characteristics of a representative sample of service users in Italy. The supports provided by formal agencies, natural networks, and actual levels of quality of life (QOL) were assessed.Methods The participants were 1,285 individuals with intellectual and developmental disability served by 23 different services. The influence of availability of support strategies, environmental factors, client characteristics, personal desires and goals, and support needs on current QOL status was investigated using multiple regression.Results QOL outcomes were significantly explained by support needs, client characteristics, personal goals and desires, and marginally by the presence of support strategies and environmental factors. Further, only a minor effect was found from support activities for general QOL outcomes.Conclusions The results confirmed that the personal outcomes could be predicted providing support activities aligned to the specific personal needs and goals, confirming the importance of a person-centred planning process