Caregivers, or “supporters” as we prefer to call them in the field of intellectual and developmental disabilities, help people live lives more independently than they might be able to on their own. Frankly, all of us need support from time to time but to those with disabilities, those who are aging, many with dementia, and others with conditions or circumstances that limit their self-support abilities, a supporter is a very important person in their life. And while it’s harder than ever to find people to fill these roles, the demand is only growing. The Bureau of Labor Statistics projects that from 2019 to 2029, overall employment of home health and personal care aides is projected to grow 34%, much faster than the average for all occupations, which they project at a 4% growth during the same time period.

The need for direct support training: large and growing

One of the most important components of being a successful direct support professional (DSP), especially in the field of intellectual and developmental disabilities (IDD), is being appropriately trained to perform the job. In people with IDD, there are often communication challenges that make it difficult for supporters to understand the needs of the person they are supporting. And, in people with IDD, behavior is often a form of communication. But, because many of us are not used to interacting and working with people with disabilities, we often mistake behaviors as “just something they do because of their disability” or worse yet, as something that they should be medicated for to control without attempting to determine possible underlying causes.

For example, a person with a disability may be thought of as non-compliant or aggressive because whenever they are served food, they begin to appear agitated and throw their plate or spit out their food. Someone who is trained to recognize patterns of behavior in this field would astutely note that these could be signs that the person is experiencing a painful dental condition. They become agitated around mealtimes because they know that it will hurt when they try to chew. A simple dental evaluation might completely resolve the issue and reduce needless suffering, not to mention prevent the person from being placed on a medication to control this “disruptive” behavior. While my example here was about people with disabilities, the same would apply to any person who might have difficulty communicating with words, be it ageing, aphasia from a stroke, dementia, or other such conditions.

Meeting the need for educating direct support professionals

Educating supporters about different health conditions that are more common in people with intellectual disabilities—how to recognize them, and what to do when they are noted—has been challenging because there has been little focus placed on the roughly 7.5 million people in the US estimated to have an intellectual and/or developmental disability. Even healthcare providers, including nurses and physicians, have received little training in health professional schools about this important field of healthcare.

Online training for direct support professionals

In recent years, online training has flourished in a number of fields including the field of direct support for people with disabilities and other conditions which limit full independence. In terms of educating direct support professionals in the field of IDD, the National Association of Direct Support Professionals ( is one organization where members have the ability to earn e-Badges that demonstrate their knowledge and skills learned about different subjects. They also provide a certification process for direct support professionals, as well. In terms of specifically learning about health and wellness-related issues for DSPs and others who work with people with IDD, IntellectAbility has developed a number of eLearning courses that teach fundamental principles to people who work in this high-demand field of support-giving. Their most widely used training is called “The Fatal Five.” This eLearning course covers several of the most serious medical conditions that are more commonly seen in people with IDD and pose significant health risks. This group of conditions includes major but preventable causes of illness and death, such as aspiration, bowel obstruction, seizures, dehydration, and sepsis. A number of states and provider agencies license these courses to teach supporters about the identification, prevention, and management of these conditions.

About IntellectAbility

IntellectAbility’s roots began in 1992. Along with training courses, webinars, and materials, IntellectAbility, formerly Health Risk Screening, is the sole developer, producer, and distributor of the web-based Health Risk Screening Tool. The HRST is the most widely used and validated health risk screening instrument of its kind for people with intellectual and developmental disabilities. IntellectAbility’s focus is on developing tools and training for the person-centered support of vulnerable populations. IntellectAbility educates and empowers support teams, administrators, and clinicians with necessary and proven tools for early risk detection. With unrelenting focus, we work to fulfill our mission of providing tools and training to those who support people with vulnerabilities, helping them replace risk with health and wellness. Visit us at

Teaching points for online IDD course design

For those who design health-related training for clinicians and support staff such as physicians, nurses, DSPs, and others, including information about the specific health needs of people with disabilities can help introduce these concepts to wider audiences. If case studies about a particular health condition are part of your course, consider making one of your patients someone with, for instance, a moderate intellectual disability. The case can still be about the main condition but there might be additional teaching points that can be included such as communications challenges, working with a person’s support staff, or understanding that a change in behavior might be an indication of pain.

Online instructional designers are part of the picture

Training is an important factor for being a success in any field. As the demand for direct support professionals and caregivers for those needing support grows, we must also grow the number of trained supporters to meet the need. It’s certainly possible that many of us in our lifetimes will rely on someone else to support us or a loved one for daily needs. Wouldn’t we want someone who is appropriately trained to do so?