Evidence suggests that integrated support, combining both natural and formal supports, is often essential for individuals with developmental disabilities to achieve their preferred quality of life. However, studies are limited on how to organize supports so that people with developmental disabilities and their families find a balance between formal and natural supports. Often, there are systemic and personal boundaries around the nature and extent of support that can be offered to persons with developmental disabilities through formal mechanisms, yet the value of natural supports in the lives of persons with developmental disabilities is often undervalued in society. Therefore, the objectives of this study were to explore formal support providers’ perspectives on (a) the unique skillsets and attributes of natural support providers and formal support providers; and (b) how we might best enable both natural and formal supports for persons with developmental disabilities and their families. Following a qualitative approach, we interviewed 16 formal support providers working with adults with developmental disabilities and their families via Zoom. We analyzed data using thematic analysis. We organized results into three themes: the role of natural supports, the role of formal supports, and strategies to best configure a system of supports. Results imply that there is a need for investment of funding to incentivize both support structures for adults with developmental disabilities and their families. Future studies should explore the perspectives from people with developmental disabilities and their natural support providers.

Augmentative and Alternative Communication (AAC) supports individuals with complex communication needs. Conceptual models and frameworks exist to evaluate, implement, and assess the needs of persons with communication disabilities, however, it is unknown which models were grounded in previous evidence-based research. What are the models and frameworks grounded in empirical or conceptual research that enable communication outcomes for persons who require aided AAC systems? The study had to be the original publication of a defined model or framework that included aided AAC and the model had to be developed through research, either conceptual or empirical. Eleven databases were searched using terms associated with AAC devices, conceptual models, and assessment processes. Fifteen articles presenting 14 independent assessment models were included. A custom data extraction form included model development using existing models and research evidence, the model's input parameters, and explicit outcome measures. Four models were specific to AAC while ten models were general evaluations for assistive technology systems. Models used a variety of descriptive traits during assessment including: person, technology, environment and context, and the activity or task. Only nine models sought to iteratively assess the client. Eleven of the models identified the inclusion of members from different disciplines in the assessment process. There is a need to standardize descriptive traits: personal abilities, environmental characteristics, potential assistive technology, and contextual factors. Models should include teams of different disciplines to provide holistic assessments. Models should include outcomes and include iterative solutions.Implications for RehabilitationStandardizing the definitions of descriptive traits used in the assessment of the personal abilities, environmental characteristics, potential assistive technology, and contextual factors would enable better evaluation of outcomes across disciplines and abilities.By identifying what factors are instrumental in the successful recommendation of assistive technology, professionals may achieve a well-organized and efficient assessment tool.An assessment model tailored specifically to individuals who may benefit from Augmentative and Alternative Communication (AAC) should be considered that are rooted in existing theories, research evidence, and the experiences of those in the AAC community.An AAC specific model would allow for consistent outcome tracking across individuals or assessment teams and the comparison of the effectiveness of various models for research purposes.

Despite the recognition of the importance of both formal and natural supports for adults with developmental disabilities, there is limited research on how organizations integrate these supports in the Canadian context. Using a collective case study design, this study explored how three organizations in British Columbia, Canada, facilitate the integration of formal and natural supports to improve the lives of adults with developmental disabilities. Data were collected through a comprehensive document review, interviews, and focus groups. The analysis was conducted in multiple phases, focusing initially on individual cases and then on cross-case themes. This research revealed both similarities and differences across three organizational approaches to integrating formal and natural supports for adults with developmental disabilities and their families. Key themes were identified, including the importance of relationships in this work, the creation of natural supports through formal supports and brokered community connections, systemic changes and innovative approaches, and the impact of funding models on organizational support. The findings highlight the critical need for organizations to build trust-based relationships between staff and the people they serve and to provide flexible support that adapts to changing needs and circumstances, facilitated by funders allowing for such flexibility. This study also underlines the value of formal supports in establishing natural networks and the necessity for cross-organizational partnerships to foster innovation and implement effective changes in the provision of services for people with developmental disabilities and their families.

Background: Natural supports provide crucial emotional, informational, and instrumental support for people with disabilities and can facilitate social inclusion and belonging. Minimal research explores natural support in Canadian contexts for people with disabilities. Purpose: This scoping review identifies how natural supports for adults with disabilities in Canada are described in published research literature. Method: Using Arksey and O’Malley’s scoping review framework, coupled with recommendations from Levac et al., and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for scoping reviews, we searched a range of academic databases for relevant empirical studies related to the following research question: How are natural supports for adults with disabilities in Canada described in published research literature? Results: Fifteen articles met the inclusion criteria. Family and non-family support systems and other social networks provided crucial natural support to Canadians with disabilities. We organized content related to the role of natural supports into the categories of: (a) being financially secure; (b) contributing to and participating in caring and inclusive communities; (c) being respected and empowered to make decisions; (d) knowing the loving support of friends and family; and (e) choosing a place to live and call home. Caregiver burnout and stigmatization of disability were reported as barriers to natural support, and formal and natural support provision at times, overlapped. There was a notable absence of information related to having a well-planned future, and limited diverse representation in the studies. Conclusion: Support is vital to the wellbeing of individuals with disabilities in many different life domains. This scoping review reveals a dearth of research on natural supports in Canada, and calls for increased engagement with and recognition of natural supports from a diversity of perspectives.

Assistive products can enhance the social functioning of an individual with disability and could offer support for meaningful engagement in society. The research paper focuses on users' perspective to identify ease and comfortability of use of assistive products which enhances mobility. Improved mobility is an important tool to enable people with disabilities' integration into society and in the working environment. The study focused particularly on use of lower limb orthoses (commonly referred to locally as walking callipers) by people with locomotor disabilities having functional limitations in the lower limbs. An exploratory qualitative approach was employed that included semi-structured interviews with people who use callipers to explore their usage, unmet needs and barriers to accessing callipers. Findings indicated the interplay of economical, availability, repair and maintenance, awareness, accessibility, and psychological factors that either inhibit or increase the access to assistive products. Further the understanding of the user's need and context (environment) are critical to designing callipers. The findings also suggest recommendations for disability social work and improving access to assistive products for people with locomotor disabilities.