State policies and practices in behavior supports for persons with intellectual and developmental disabilities in the United States: a national survey.

Providing effective behavioral supports to decrease challenging behavior and replace it with appropriate alternative skills is essential to meeting the needs of many individuals with intellectual and developmental disabilities (IDD). It is also necessary for fulfilling the requirements of Medicaid-funded individual support plans and is important for moral, ethical, and societal reasons. Unfortunately, there is no national standard for behavioral support practices or source of information on the status of behavior support policies, practices, and services for adults with IDD at either state or national levels. The collection of comprehensive data on state behavior support definitions, provider qualifications, training, and oversight requirements is a necessary starting point for the development of plans to address needed policy and practice changes. This survey is the first national assessment of state policies and practices regarding the definition and delivery of behavior support services to people with intellectual and developmental disabilities receiving publicly financed supports in the United States.

Place of residence and preventive health care for intellectual and developmental disabilities services recipients in 20 states.

OBJECTIVE: We identified trends in the receipt of preventive health care by adults with intellectual and developmental disabilities by type of residential setting. METHODS: We used data from the 2008-2009 collection round of the National Core Indicators (NCI) program. Participating states drew random samples of adults receiving developmental disabilities services. The study was observational, with both self-report and report by proxy. Once the random samples were drawn in each state, data were collected using the NCI Adult Consumer Survey. Trained interviewers administered the survey in person. RESULTS: The likelihood of a person receiving preventive care procedures was related to age, level of intellectual disability, mobility, health status, and state. Type of living arrangement also affected whether a person received these health services, even after controlling for state, level of disability, and other personal characteristics. In general, people living with parents or relatives were consistently the least likely to receive preventive health exams and procedures. CONCLUSION: With growing numbers of adults being served in the family home, educational and policy-based efforts to ensure access to preventive care are increasingly critical.