Jennifer Hall-Lande

Status and Trends in the Direct Support Workforce in Self-Directed Supports

Self-directed programs that allow individuals with intellectual and developmental disabilities to exercise greater control over their finances have become increasingly common in recent years. At the same time, challenges in the recruitment, retention, and training of direct support workers in the field have grown more acute. In this article, the authors investigate the status of the direct support workforce for people using self-directed supports in 1 Midwestern state, based on the results of a statewide survey of service users. Although additional research is needed, the results of this study suggest that people who use self-directed funding options are satisfied with their ability to direct staffing, though challenges remain. Among these challenges, the presence of higher than expected wages but lower than expected benefits provision compared with traditional services may have serious policy and staff retention ramifications that affect the long-term viability of self-directed funding options. In addition, staff training remains a challenge, with service users in this sample reporting low rates of training beyond a general skill set. Implications of these findings are discussed.

Involvement of Children With Autism Spectrum Disorder (ASD) in the Child Protection System

The present study provides information about children with autism spectrum disorder (ASD) who are involved in the child protection system in a large, Midwestern state. Findings revealed that children with ASD (and children with other disabilities) were more likely to receive services from the child protection system (CPS) than children without disabilities. Children with ASD in CPS were more likely to be elementary school-age (6–10 years) and Caucasian than other children involved in CPS. Children diagnosed with ASD and other disabilities were significantly overrepresented for physical abuse as the primary reason for involvement in CPS. Parental mental health issues were more evident than was expected for families of children with ASD (17%) as compared with children diagnosed with other disabilities (10%) and children not diagnosed with any disability (10%). The implications of these findings as they relate to interventions for children with ASD in CPS are discussed.

Autism Spectrum Disorder (ASD) Prevalence in Somali and Non-Somali Children

The current study presents results from an autism spectrum disorder (ASD) public health surveillance project conducted in Minneapolis. The study was designed to compare ASD prevalence in Somali children (ages 7–9) to that of non-Somali children. The study adapted methodology used by the Centers for Disease Control and Prevention’s Autism and Developmental Disabilities Monitoring Network. Results indicated that Somali (1 in 32) and White (1 in 36) children were about equally likely to be identified with ASD, but more likely to be identified with ASD than Black and Hispanic children. Somali children with ASD were significantly more likely to have an intellectual disability than children with ASD in all other racial and ethnic groups.

County Administrator Perspectives on the Implementation of Self-Directed Supports

Self-directed supports are a program or service option in which individuals with Intellectual and Developmental Disabilities (IDD), their families, and their allies directly manage their supports. This study explores the perspectives of county-level administrators in the implementation of one state’s self-directed support option for people with IDD. Perspectives of local-level administrators are important as they have key leadership roles concerning policy, program implementation, and program accountability. As the prevalence of self-directed supports increases, it is important to understand both the successes and challenges faced by local administrators as they implement this service option. A qualitative research methodology was used for this study, following a grounded theory analytic approach. In-depth semi-structured telephone interviews were conducted with county directors of Developmental Disability Services as the primary source of data for this study. Analysis of the semi-structured interviews with the county-level administrators and staff revealed both successes and challenges with the self-directed waiver option. Many county administrators cited changes in professional philosophy, improved quality of life, higher staff quality, and lower costs as major sucof the self-directed waiver option. Challenges of the self-directed waiver option consisted of need for clear policy guidelines, program changes, and monitoring of outcomes. The results of this study illuminate both the successes and chalof self-directed service implementation for individuals with IDD from the perspectives of the local adminwho are responsible for the direct management of programs for individuals with IDD. This research presents important implications for the design, implementation, and modification of future self-directed initiatives.

Phenotypic Characteristics of Autism Spectrum Disorder in a Diverse Sample of Somali and Other Children

The potential for culture to impact diagnosis of autism spectrum disorder (ASD) is high, yet remains largely unstudied. This study examined differences across racial/ethnic groups in ASD symptoms, cognitive and adaptive skills, and related behaviors in children with ASD that included a unique subgroup, children from the Somali diaspora. Somali children were more likely to have ASD with intellectual disability than children from all other racial/ethnic groups. Few differences were found in the presence of specific symptoms and behaviors across groups once IQ was controlled. Results lend support to previous studies that found higher rates of ASD intellectual disability in children of immigrants from low human resource index countries compared to other groups. Implications for future research are discussed.

Implementation of Self-Directed Supports for People With Intellectual and Developmental Disabilities in the United States

Self-direction is an approach to human service delivery within long-term services and supports that aims to provide greater control for individuals with disabilities and their closest supporters. The purpose of this study was to understand the implementation of self-directed supports for individuals with intellectual and developmental disabilities. Researchers interviewed state developmental disabilities administrators in 34 of 42 states that currently operate self-directed service options and used qualitative analysis to arrive at a thematic map of the strengths and challenges currently experienced by state administrators. Common strengths identified by state administrators were increased opportunities for participant self-determination and improved relationships with support staff. Common challenges included restructuring case management relationships, as well as rulemaking and enforcement. Administrators’ suggestions for the future of self-direction focused on increasing program size and streamlining services using technology.

Community Living and Participation

Community living used to mean “not living in an institution.” Today, in the USA, community living means much more. It means living in the community in which a person wants to live and it also means participating in a person’s community of choice. Community living means having opportunities to work in the community, to develop skills related to home living, to navigate the community, to ensure self-care, safety, and personal health. It also means participating in community activities and things of personal interest and being able to maintain and expand social networks, friends, family members, and allies. Most children and adults with intellectual and developmental disabilities (IDD) live at home with their families or in supported community living arrangements. This is the result of tremendous advocacy on the part of families, people with disabilities and their allies. It is also the result of litigation and policies that provide certain promises and protections related to community, local, national, and in some ways, international levels. This chapter provides an overview of community living and participation for people with IDD with a focus on where they live, work, and have fun, and about the people and processes that support them in having quality lives in their communities of choice.

Test Review: Hresko, W., Schlieve, P., Herron, S., Swain, C., & Sherbenau, R. (2003). Comprehensive Mathematical Abilities Test (CMAT). Austin, TX: PRO-ED:

its lightweight, condensed size contributes to its convenience and utility in school settings. Administration of the core subtests requires approximately 40 minutes to 1 hour, contingent upon the age, skill level, and processing speed of the student. The CMAT is not a timed test, and subtests do not have specified time limits. Calculators are permitted with the exception of the Addition, Subtraction, Multiplication, and Division subtests. The directions for administration are relatively clear and concise. Basals, ceilings, and entry points are clearly delineated in the test manual. For practitioners with experience in assessment, administration of the items