Transforming staff practice through active support.

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.

Outcome evaluation of active support training in Taiwan.

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.

Staff behaviour and resident engagement before and after active support training.

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.