Analysis of Dissertation Articles: DSPs, Leadership, and Skills

This report provides a comprehensive summary and analysis of six articles focusing on various aspects of Direct Support Professionals (DSPs) and their work with individuals with intellectual and developmental disabilities. The articles explore topics such as appreciative management in institutional care, the challenges faced by DSPs including wages and training, the importance of skills development, the role of DSPs in ambulatory healthcare, and the impact of leadership on DSP performance. The articles highlight research gaps, particularly in the development of leadership traits and the need for improved training programs. The report synthesizes the findings of each article, identifies key themes, and discusses the implications for the overall understanding of DSPs and their contributions to the quality of life for individuals with intellectual and developmental disabilities. The report emphasizes the significance of DSPs as the backbone of long-term services and the importance of addressing their training needs and leadership strategies to enhance their effectiveness.

Running head: DISSERTATION ARTICLES SUMMARY
Dissertation articles summary and gap presentation
Name of the Student
Name of the University
Author notes

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DISSERTATION ARTICLES SUMMARY
Article 1
Summary
The purpose of the article by Astala et al., (2017), is to examine the staff experience of the
institution for people with intellectual disabilities, are discussed. The author talks about the
appreciative management process of the staffs in these institutions. Their work process and
the impact of the management leaders over them is analysed in this study. This comprises of
the descriptive study on the experience of the staffs in appreciative management process.
The research has been done using the primary descriptive method. The data collection has
been done from the staffs of the institution for intellectual disabilities through the e-survey.
Total sample number for the study was 87. The Appreciative Management Scale was used for
the data analysis of the study.
The findings of the study is quite interesting. Most of the staffs thinks that the appreciative
management has been implemented well in the organisation. Among the appreciative
management, the best implemented dimension was equality and the worst implemented
dimension was the systematic management. The structural changes are another thing that
influences the appreciative management of the institution.
Research Gap
The study can lead to the further study of the leadership impact on the DSP. This study is
useful for the study of the dissertation as the researcher could get an idea of the appreciative
management and leadership in the case of the intellectually disabled institution staffs. The
study by Astala et al., (2017) is directed for the overall staffs of the institutions. Therefore,
the study could be further developed for the DSPs or the direct support professional of such
institution to get broader and detailed idea. The managers or the leaders of these

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organisations might be utilised by the study results as they would understand the changes
they might do in their transactional leadership styles to get the ultimate results. Thus, this
study is useful for the dissertation to understand the staffs’ requirements and their
management by the leaders.
Article 2
Summary
This article by Friedman (2019) is quite important for the dissertation study as this addresses
several problems in the profession of DSPs. Medicaid Home and Community Based Services
(HCBS) is the United Sates organisation that provides healthcare and other supports to the
people with intellectual and developmental Disabilities. In this particular study, the purpose
of the researcher is to examine how the HCBS treats with the matters like wages of DSPs and
their overall treatment in the IDD care. Total 101 DSP staffs were selected for the study and
the expenses and reimbursement rates were analysed. The cost neutrality information of these
DSPs were collected to get the idea of the service costs. Descriptive statistics were used in
order to analyse the data. This is secondary descriptive study to understand the different
trends of the DSP costs and wages in the States.
The lack of standardisation could be seen in the practice of DSP services. The quality of life
for the IDD are hugely depended on the services by these DSP performance. Yet their
reimbursement rate are quite low in the country and wages are minimum. This is why, there
could be seen a lack in the number of DSPs in the State and their services are lacking in
quality. The improvement in the services of the IDD people, the role of DSPs are huge and
therefore, there are requirement for the HCBS to work on their training and wage
improvement.
Research Gap

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DISSERTATION ARTICLES SUMMARY
This study reveals that the waivers provided by the HCBS to the DSPs are minimum in
amount. This is why the DSPs are showing less interest in their job and retention of this
professional is becoming a big challenge in the institutions. The dissertation topic is to
understand the transactional leadership traits impression on the DSPs services. Therefore, the
study result of the paper could give an insight of the standardisation that the leaders have to
do in the job profiles of the DSPs. The wages and waivers have a crucial role in managing the
standardisation of the DSP tasks.
Article 3
Summary
The purpose of the study by Morlino (2019), is to analyse the different skills setting training
programs of the DSP workers and how they are being modified for the service of the
intellectually disabled persons in the home and institutional backgrounds. The need of the
qualified workers in the service of intellectually disabled person. The research is done
specifically on the DSP worker and their individual skills attitudes and values. The Direct
Support Professionals provide help and care for the intellectually disabled persons in home or
institutional backgrounds. The study analyses how the institutions work for the betterment of
the skills of DSP staffs and develop the qualified workers. The method of the study is
primary qualitative. The data has been used using the interviews, document analysis and
observations. The study has been designed to identify various strengths and needs of the
workers in this profession.
The results of the study shows that the DSP workers are more directly related to the care of
the patients in both the home and the institutional background. The problems increases when
the quality or skills of these workers are not up to the mark. There need to be some core
competencies of the worker to support the intellectually challenged patients. Also, these

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workers need to be in constant developmental and motivational mood to improve their work
all by themselves. This study shows that the trainings provided to these staffs are often too
much for the workers. The lack of conceptual knowledge among the DSP workers are evident
in every sections. There are huge scopes of changes in the training planning and execution of
these trainings. These trainings are the base through which the skills sets of the workers could
be improved and the quality of performance and service would be elevated.
Research Gap
This research studies the gap between the supply and delivery of the skills of the DSP
workers. These workers are the one who have direct exposure to the intellectually disabled
persons for their treatments. As the dissertation is trying to examine the influence of
transactional leadership traits on the professional competence of these workers, it is necessary
to understand the lack of skills sets and the problems in the training methods of these people.
The main problem with these kind of job profile is that most of the workers do not have any
professional training and lack the cognitive understanding of the term related to the treatment.
This study by Morlino (2019) talks about the problems in the training and skills development
of the workers. One can further study the methods through which they can improve their
training settings to improve the performance of the workers so that leadership can work
effectively.
Article 4
Summary
The paper by Tyler et al., (2019) is about the perspective of the direct support professionals
about the ambulatory healthcare. The main theme of the paper is the role of these DSP
workers in the care of the intellectual and other developmental disabilities (IDD) patients
care. In the ambulatory care of the patients the observations of DSP are considered a good

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source of information. The main cause is that the patients themselves are not able to
understand the changes or improvements in their health therefore, the doctors have to depend
on the insights of the DSP to analyse the case. The data for the study was collected from the
DSPs who accompany their adult IDD patients while going to the ambulatory health care
services. The study was been done through the survey method. A series of face to face
meetings were done with these DSPs to get their perspective of the healthcare quality
provided by the physicians in the nonemergency background.
The results of the study DSP workers interviews shows that there are a lot of scope of
improvement in the service and care of the intellectually and other disability persons. The
physicians in the field feel that they lack clinical experience to work with these patients. The
disability factors of the patients causes the lack of connection between the patients and the
physician as well. Here the role of DSPs are inevitable. They could work as the bridge
between the patient and the physicians. Again, there could be the training program for these
DSP so that they can do their work with competency. The increase in the competencies
through trainings would be instrumental in providing more insightful comments on the
patient health and care.
Research Gap
This study could be further developed in the dissertation topic chosen for this assignment.
The first important research gap in this study by Tyler et al., (2019) is that there is limited
discussion of the process through which the direct support professionals can develop their
leadership traits. The type of leadership suitable for the job is depended on the type of task
they are assigned to do. Therefore, through this study, the researcher could develop the idea
of how these DSP workers can develop their skills in managing the patients and their profiles

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effectively. It is necessary to know what they think about the medical treatments of their
patients so that they can work on the care and service procedure.
Article 5
Summary
The paper by Hoge et al., (2016) talks about the skills and their importance in the job
of the direct support professional in the health care sectors. The researcher finds that most of
the professionals attached with this job profile lacks in their knowledge and skills. The DSP
workers are the professionals who have direct and keener connection with the care of
disabled patients. But the irony is that most of the time the DSP have less educational
qualification and minimum on-job training. This is the theoretical paper and the researcher
has gathered the data in qualitative method. The study concentrates on the Alaskan Core
Competencies Initiative and discusses various aspects of training, curriculum and tools used
for the training and skill development of the DSP workers.
The study findings are related to the plan for the skills development measures of the
DSP workers. There are four sections in this study to narrate the process and tools that could
be used to educate and train the DSP workers for long term results. The four phases of
developmental plan are competency development, competency assessment tools, competency
curriculum and the training of the trainers. The article gives a detailed outline of the
necessary developmental plan for the concerned DSP workers. The training of the trainers is
the part of the plan which is required to build the capacity of the workers to deliver quality
services.
Research Gap
The article is no doubt a useful tools for the developmental plans of the DSP workers. This
article concentrates on the process and phases of developmental tools and training

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curriculum. The dissertation question could be addressed through the further studies in this
direction. The research gap of the study by Hoge et al. can be developed into a leadership
strategy for the DSPs. The basic idea is that through the findings of this article one can
understand the training needs of the DSP workers. If their training is done appropriately, the
workers would be able to imply the importance of transactional leadership in their work
process. The developmental plan suggested in this study can be effective to build their
cognitive base and ideas of the job they are doing.
Article 6
Summary
The paper calls the direct support professional to be the ‘backbone’ of the long term services
and supports. The purpose of the study is to examine the relationship between the DSP
services and the quality of life for the people with intellectual and developmental disabilities.
The job duties of the DSP workers for the well-being of the patients are various. The
problems is that most of the time these workers role are supposed to be minimal in the
process. The truth is actually the opposite. In this study, Friedman (2018) talks about the
importance of these workers in the life of IDD people. The problems related to the turnover
arte of the DSP workers are also discussed in this study.
The study is been done in the secondary quantitative method. Interviews were done for
understanding the changes in the DSP over the past two years. The number of participant in
this study was over 1300. The participants were the people with IDD, the DSPs and the
employers of these DSPs. The research design for this study was exploratory. The tolls used
for the research was interview. The research instrument was Personal Outcome Measures.
The findings of the research was that the role of DSP is huge in the normalisation and
improvement of the life styles of the people with IDD. The continuity of the DSP actually

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influences the social security, relationships and goals of the IDD people. The people with
IDD and with DSP change are tend to achieve the quality of life more effectively than the
people who do not have the support.
Research Gap
This study has some limitations like- the study has been conducted in the United Sates only.
The dissertation would try to have a generalised approach to the transactional leadership traits
and its impact on the DSP worker job roles. The study by Friedman shows what are the
important role of the DSP workers and how they are been influenced by a number of internal
and external factors. This would give the researcher further scope to highlight the main
sectors in IDD care to develop the right type of leadership techniques in the DSPs. Therefore,
it could be concluded that this study limitations could be reassessed and mended by the
dissertation topic analysis.
Article 7
Summary
The purpose of the story is to understand the role of the DSP workers in implementing the
active services in U.S. the study results of the UK and Australia is different than that of the
US and Taiwan. In this study the researcher Qian, Tichá & Stancliffe (2017) highlights the
different aspect and challenges in implementing the active services in different part of US.
The main goal of the active services is to increase the engagement of the IDD people. The
study is concentrated in the small communities. The research design for the study is
qualitative and this approach has been used in collecting the data nd analysing it. The tool
used for the date collection was interview and focus group surveys. The sample of the study
were four DSP workers and six program directors who participated in the active service or
AS study conducted in US.

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DISSERTATION ARTICLES SUMMARY
The findings of the study is quite interesting and positive for the people with IDD. The
impact of active service implementation was positive in increasing the participation of the
IDD people. There could be seen a clear reduction in the challenging behaviours of the
people. The active services changed the mind sets of the patients in more positive ones. The
DSPs narrates how the active services have changed the individual participations in daily
works. Therefore, the author concludes that after the DSPs receive the training in the active
services, they are more consistent in their care services. They are inspiring the participants to
do their regular work all by themselves instead of depending on the DSPs to do them.
Research Gap
The study could be further developed into something related to the supervising and
management tasks of the DSPs. The dissertation would focus on improving the service
qualities of the DSPs while providing the care services. They are the people who need to be
constantly motivated by themselves to take care of the needs of the IDD people. The active
service trainings can be instrumental in improving their decision making capabilities and
making things accessible in their job roles. The compatible leadership and management roles
would be easy to decide after knowing the work process.
Article 8
Summary
This paper by Gormly, Gormly & Johnson (1971) is about the interpersonal attraction, the
study is based on two aspects of the same- reinforcement theory and the competence
motivation. The purpose of the study is understand the attitude and competence of person and
how they are interrelated to each other. The method of this study is secondary qualitative.
The paper is instrumental to understand the psychological and behavioural aspects of the
persons in various social and situational contexts. The sample size for the study was 40, 121

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and 172 for three different aspects of the study. Students who have enrolled themselves for
the introductory psychology courses were the sample selected for the study.
Research Gap
This study by Gormly, Gormly & Johnson is indirectly related to the DSP workers and their
relationship with IDD patients. The competence motivation and reinforcement theories sheds
light towards the agreement and disagreement context of the person attitudes. The building of
the leadership traits for IDD people could be judged from the perspective of the theory to
give it a concrete base. Thus, this study would be associated with the dissertation topic and
the theories could be used to fulfil the gaps of the research to some extent.
Article 9
Summary
In their article “Knowledge and expectations of direct support professionals towards effects
of psychotropic drug use in people with intellectual disabilities” by de Kuijper & van der
Putten (2017), the authors discusses the expectation and knowledge of the DSP workers
towards the special kind of medication used in the treatment of the patients. This study is
related to the skills and knowledge contexts of the DSPs who are the care takers of the IDD
people in home or institutional set ups. The study has been done using the interview method.
The research design was secondary and quantitative. The number of total sample for the
study is 215. The sample were the direct support staffs who work in the residential facilities
for the people with IDD. The questionnaire were designed to understand the expectations of
the DSPs psychotropic drugs. These drugs are used for the behavioural and cognitive
functioning conditioning of the IDD people.
The study finds that most of the DSP workers have an unrealistic expectations regarding the
benefits of the drugs. The knowledge of the workers were minimum about the psychotropic

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drugs and they also have minimal idea of the effects of antipsychotics on the cognitive,
behavioural and mental functioning of the people who are using these drugs. The results of
this study shows a clear lack of knowledge among the DSPs in their patient care and
medication aspects. The vocational trainings are the only way out to help the situation. The
DSP workers must not have the unrealistic ideas of the positive effect of the drug. Their
cognitive development along with the skill development is needed to have better outcome in
IDD treatments.
Research Gap
There are some research gaps in the study of de Kuijper, G., & van der Putten as it could be a
biased study in respect of DSP workers’ knowledge. Each and every one of the sample size
has not responded. The study gives us the scope to have further information of the
multidisciplinary methods of treating the psychopathic disabilities of the people. The
knowledge of this could actually help the DSP workers to decide their work process. The
motivational factors and the leadership traits are all related to the knowledge they have
regarding the care process. Other than that, it could be said that the findings of this study will
help to develop the training and other educational plans for the DSP workers so that they can
deliver better service in the treatment of the people with IDD.
Article 10
Summary
This article by Beadle‐Brown, Bigby & Bould (2015) directory addresses the topic of
leadership practices in the intellectual and developmental disability services. The main
purpose of the study is to find the way to improve the performance of the staffs in IDD care
and service. The leaders are the persons who stands at the front line of the service providers
and judges the improvement according to the outcome of the services. Their importance also

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lies in the fact that they are the one who decides what kind of improvement and training the
staffs require in order to excel their services. The planning and model of people with IDD
care need to be done carefully as there are a number of aspects to be judged. Improving the
staff performance is the constant purpose of the leaders. The study is done through the
interview method. The research has been done in primary qualitative method. The interview
questions were related to the leadership aspects of the front-line managers. The study was
conducted in Australia in 58 disability services.
The study in this paper is based on the impact of practice leadership in DSP services. The
concept of practice leadership is based on the staff practice and the outcomes in the patient
care. The research shows that there is a good consistency internally in the leadership process.
There is the comparison between self-report measures and the practice leadership measures.
The result shows that the practice leadership supports the staffs in a better way as here they
also get the chance to evaluate their own performances. The leaders are the support system in
the process who reviews the results and makes or suggests changes in the staff inputs. The
training of the managers or the leaders in order to enhance the quality of staff service is an
important aspect as well.
Research Gap
The quality of life of the intellectually disabled person depends in the services they are
receiving. Therefore, the leaders of the DSP staffs should be practicing the leadership that
provides support in full potential. The concept discussed in this study is concentrated around
the practice leadership and its relationship with IDD care and quality of life. The dissertation
paper has the discussion of the leadership traits of the transactional leadership in the
profession. The type of leadership in both of the study are different, but as the patient care
quality is at the heart of both approaches, there is no doubt in the fact that the study could be

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further developed. The study findings shows the types of challenges that the staffs and their
front-managers have to face in the IDD care system. The study subject would be broader if
the context of transactional leadership is added to the discussion. Thus, the gap of the study
could be minimised by the linking of the paper findings with dissertation topic.

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References
Astala, L., Roos, M., Harmoinen, M., & Suominen, T. (2017). Staff experiences of
appreciative management in the institutional care of people with intellectual and
developmental disabilities–a cross‐sectional study. Scandinavian journal of caring
sciences, 31(4), 930-938.
Beadle‐Brown, J., Bigby, C., & Bould, E. (2015). Observing practice leadership in
intellectual and developmental disability services. Journal of Intellectual Disability
Research, 59(12), 1081-1093.
de Kuijper, G., & van der Putten, A. A. (2017). Knowledge and expectations of direct
support professionals towards effects of psychotropic drug use in people with
intellectual disabilities. Journal of Applied Research in Intellectual Disabilities, 30, 1-
9.
Friedman, C. (2018). Direct support professionals and quality of life of people with
intellectual and developmental disabilities. Intellectual and developmental
disabilities, 56(4), 234-250.
Friedman, C. (2019). State utilization of direct support professionals in Medicaid HCBS
waivers. Intellectual and developmental disabilities, 57(1), 1-13.
Gormly, J., Gormly, A., & Johnson, C. (1971). Interpersonal attraction: Competence
motivation and reinforcement theory. Journal of Personality and Social Psychology,
19(3), 375.
Hoge, M. A., McFaul, M., Cauble, L. L., Craft, K. L., Paris Jr, M., & Calcote, R. M.
(2016). Building the skills of direct care workers: The Alaskan core competencies
initiative. Journal of Rural Mental Health, 40(1), 31.

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Morlino, R. M. (2019). Developing Qualified Workers to Support Individuals with
Intellectual and Developmental Disabilities in Home and Community Settings: An
Evaluation Study (Doctoral dissertation, University of Southern California).
Qian, X., Tichá, R., & Stancliffe, R. (2017). Contextual factors associated with
implementing active support in community group homes in the United States: A
qualitative investigation. Journal of Policy and Practice in Intellectual Disabilities,
14(4), 332-340.
Tyler, C. V., Wells, M. D., & Developmental Disabilities–Practice-Based Research
Network. (2019). Direct Support Professionals' Perspectives on Ambulatory Health
Care Processes and Quality. Intellectual and developmental disabilities, 57(3), 188-
197.