Engagement and interaction: a comparison between supported employment and day service provision

Background This paper introduces the Assimilation, Integration, Marginalization, Segregation (AIMS) interview, a new measure of community integration (defined as acculturation) and reports validation data supporting the use of AIMS with individuals with developmental disabilities. Methods Caregivers acted as informants for 66 adults with moderate‐to‐mild developmental disabilities. All participants were living in the community. Results The data gathered using AIMS provide evidence of sound psychometric properties including content, concurrent and construct validity. AIMS data for participants with developmental disabilities indicated that integration efforts have been relatively successful in the medical, dental, housing, social and community domains; however, education, employment, volunteer and spiritual activity require attention. Conclusions In addition to use as a research tool and outcome measure, AIMS can be used to inform service delivery by providing information regarding the supports available to individuals with disabilities in a number of domains.

Section: Discussionsupporting

confidence: 59%

Section: Discussionmentioning

confidence: 80%

Community Integration as Acculturation: Preliminary Validation of the AIMS Interview

Minnes

Buell

Feldman

et al. 2002

“…Employment was more cost effective in producing social integration, albeit at a modest level. The increases in engagement in activity, contact with work colleagues and contact with the public found are consistent with the results of an earlier study of more able people with learning disabilities moving from traditional day services to employment, although levels tended to be higher in that study reflecting people's greater independence ( Kilsby & Beyer 1996).…”

Section: Discussionsupporting

confidence: 88%

The Cost‐Effectiveness of Supported Employment for People with Severe Intellectual Disabilities and High Support Needs: a Pilot Study

Shearn

Beyer

Felce

2000

The costs and outcomes of supporting seven people with severe intellectual disabilities and high support needs in part‐time employment were compared with those of a Special Needs Unit (SNU) of a day centre, both within‐subject and against an equal‐sized comparison group. The income of those employed was described. Direct observation of the employment activities and representative SNU activities were undertaken to assess participant engagement in activity and receipt of assistance, social contact in general and social contact from people other than paid staff. Costs of providing service support were calculated taking account of staff : service user ratios, staff identities and wage rates and service‐administrative and management overheads. Employment was associated with greater receipt of assistance, higher task‐related engagement in activity and more social contact from people other than paid staff. SNU activities were associated with greater receipt of social contact. Supporting people in employment was more expensive than in the SNU. Cost‐effectiveness ratios of producing assistance and engagement in activities were equivalent across the comparative contexts. The SNU was more cost‐effective in producing social involvement; employment in producing social contact from people other than paid staff.

“…Provision in many service areas remains below recommended levels. Research on the quality of services shows both improvement and room for further improvement (Beyer et al, 1997 & Beyer, 1996;Todd and Shearn, 1996). As the Working Party which recommended the AWS foresaw, the first 10 years of the AWS and the resource injection associated with it were only the first part of what would eventually be needed.…”

Section: Resultsmentioning

confidence: 97%

Strategic Service Change: Development of Core Services in Wales, 1983–1995¹

Perry

Beyer

Felce

et al. 1998

National strategies for the development of services for specific client groups are rare in Britain, particularly strategies to which governments pledge significant long term financial investment. This paper attempts to guage the impact of one such strategy, the All Wales Strategy for the Development of Services for Mentally Handicapped People (AWS) (Welsh Office, 1983) by comparing the goals of the AWS with changes in the nature and coverage of services which have followed its inception. Data on the provision of residential, day, education and family support services in Wales were collected in 1995 from county annual plans, Welsh Office statistical returns and questionnaires to county officers. These sources were cross referenced and the data compared with those reported in a companion paper (Beyer et al., 1991) for 1983 (the first year of the AWS) and 1988. Between 1983 and 1995, deinstitutionalisation accelerated, residential services were reprovided by combined statutory and independent sector action, size of residential settings reduced considerably, the range of day activities diversified, mainstream education was available to more children with learning disabilities, respite care became largely community based and the availability of domiciliary support increased significantly. Although the pace of change quickened between 1988 and 1995 compared to that in the first five years of the AWS, a wholesale reorientation of traditional services is far from complete. Changes in service provision in Wales during the course of the AWS are compared where possible to development elsewhere in Britain.