Evaluation of the Dissemination of Active Support Training and Training Trainers

Abstract

The aim of the present study was to replicate active support (AS) and train the service managers of community housing services as trainers in so doing. Training was conducted in three phases: (1) in 22 houses, it was led by one of the researchers, with identified managers assisting (Apprenticeship); (2) in 16, it was led by a manager who had participated in the previous phase, assisted by the researcher (Supervision); and (3) in 36 houses, it was undertaken independently by managers who had participated in the previous two phases (Independent). Changes in the extent of planned activity, resident involvement in domestic, social and community activities, the observed staff:resident interaction, and observed resident engagement in activity were evaluated. Resident views about the introduction of AS were canvassed. Active support training was fully implemented in the first two phases, but not in the third. There was an increase in planned activity in all phases after AS training. Significant increases in assistance and resident engagement in activity were found in the first two phases, but not in the third. Active support was shown to be of greater benefit to people with more severe disabilities. The resident feedback was positive. The approach taken to training managers as trainers was not sufficient to enable them to implement the training in its entirety during the third phase. The absence of change in this phase indicated the necessity of the practical interaction training, which was the element mainly missed out. Since AS was once again shown to be an effective approach for people with more severe intellectual disabilities, the challenge of creating a widespread ability to train staff within community housing services requires further effort.

Implementation of active support over time in Australia

“…In contrast, the increase in staff reporting no training in active support in Organisation 2 could be linked to the decline in active support. Although not many staff reported hands-on training (which had been found to be important in other studies such as Jones, Felce, Lowe, Bowley, Pagler, Gallagher, et al, 2001;Jones, Felce, Lowe, Bowley, Pagler, Strong, et al, 2001), those that did were more likely to be working in services where active support was good. A possible confounding factor is that not all organisations directly labelled training as active support although active support principles were included in training as part of an overall practice framework.…”

“…The evidence base spans four decades, involves at least 1400 people, uses different methodologies, in different countries, in different settings and involves different research teams and training approaches. Studies of effectiveness have ranged from small-scale pre-post training comparisons through to larger scale observational studies (see Bigby & Beadle-Brown, 2016;Jones, Felce, Lowe, Bowley, Pagler, Gallagher, et al, 2001;Jones, Felce, Lowe, Bowley, Pagler, Strong, et al, 2001;.…”

“…Similar to Hastings (1995), Mansell et al (2008) noted that factors influencing staff practice were likely to work in combination. For example, while training staff in active support improves the quality of support and outcomes for people supported this needs to happen by combining classroom and hands-on training (Jones, Felce, Lowe, Bowley, Pagler, Gallagher, et al, 2001;Jones, Felce, Lowe, Bowley, Pagler, Strong, et al, 2001) and in the context of ongoing management commitment and support (McGill & Toogood, 1994). Mansell et al (2008) found that most structural, organisational, and managerial factors were only weakly associated with good staff performance and that higher active support scores were predicted by a range of individual items in combination including higher resident adaptive behaviour and having more experienced staff, who received supervision more than annually.…”

Behavior Problems, Psychiatric Symptoms, and Quality of Life for Older Adults With Intellectual Disability With and Without Autism

“…Participants were drawn from four studies on staffed group homes (Felce et al , 2003Jones et al 2001 [baseline data only]; Perry and Felce 2005) and a fifth study established through collaboration with 44 local primary health service providers (Baxter et al 2006). Participants were on average 44.5 years of age (range 18-90 years, SD 14.6), 52.7% were male and 34.3% were assessed as having the triad of impairments characteristic of ASD (N = 281).…”

Interventions for challenging behaviour in intellectual disability

“…Staff receive training in developing person-centred activity plans for those in their care and receive coaching on how to encourage them to engage in activities to deflect them from challenging behaviour. Trials (mainly small case studies) have shown contrasting results, including no effect (Jones 2001;Stancliffe 2008), a decrease in challenging behaviour (Toogood 2009) and an increase in challenging behaviour (Bradshaw 2004). Further evaluation of active support is warranted.…”