Adult Day Services for People with Intellectual and Developmental Disabilities: A Scoping Review

Background and Purpose

Adult day services (ADS) consist of therapeutic, social, and health-related activities that are designed to keep people living within their homes and communities, rather than in institutional settings. About a third of all U.S. ADS participants have intellectual and/or developmental disabilities (IDD). While there is a growing body of literature describing the impact of ADS on older adults and their caregivers, there is far less information available about the experiences and outcomes of younger adults (ages 18 to 54) with IDD who participate in ADS. To fill this gap in the literature, researchers conducted a scoping review to further understand the state of the literature on ADS for this population. Specifically, we explored the types of ADS services described in the literature as well as the methodological approaches employed in articles on this topic.

Methods

Following the five-step framework established by Arksey and O’Malley (2005), researchers conducted a scoping review of peer-reviewed empirical research conducted in the United States or Canada. Seven databases were searched in April 2022, yielding a total of 892 potential articles. References of articles included after a full text review were hand searched for additional studies. For each included article, the research team charted basic article information along with sample characteristics (e.g., size, ages, diagnoses), methodology, study design, instrument used, key findings, and notes.

Results

After applying the study’s inclusion and exclusion criteria, the complete text of 74 articles were reviewed for study eligibility, with 10 articles meeting the requirements for data charting. Analysis of these 10 articles revealed that the literature is scant and limited to simple descriptive reports (n =3) or interventions that use ADS as a platform (n = 7). Descriptive reports included a phenomenological analysis of the meaning behind activities in ADS, as well as two surveys that discussed ADS center characteristics (e.g., attendance, percentage of budgets coming from private pay, and disability characteristics of attendees). The remaining studies tested a wide range of interventions that can be implemented in ADS settings. Each of these studies had small sample sizes (1 to 20 participants) and utilized case study, single subject, or one group pre- and posttest research designs. No articles were identified that replicated these interventions using larger samples or quasi-experimental or experimental designs.

Conclusions and Implications

Simply put, we know very little about the services provided to younger adults with IDD in ADS, nor about the impact and effectiveness of these services. Implications for future research include the need to catalogue the specific services offered in ADS centers that cater to younger adults with IDD, such as through an audit of services and identification of best practices in ADS for this population. In terms of methodology, studies with larger and more representative samples as well as more rigorous research designs (both quantitative and qualitative) are needed to evaluate ADS “services as usual” and novel interventions. Such approaches would allow interested parties to begin to evaluate the impact ADS has on younger adults with IDD’s health and well-being.