Association of state-level and individual-level factors with choice making of individuals with intellectual and developmental disabilities

James Houseworth, Roger J. Stancliffe, Renáta Tichá

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


Background: State-level factors have not been examined in research on choice, despite findings of between-state differences. Aims: To examine both individual and state-level factors associated with choice. Methods and procedures: We used multilevel modeling to explore two choice scales, support-related and everyday choice, based on the National Core Indicators (NCI) data from 2013-14. Outcomes and Results: At the individual level, milder ID, greater mobility, fewer problem behaviors, answering questions independently, communicating verbally, and living in a non-agency setting, particularly independent settings, were associated with more choice for both scales. State-level factors overall explained variance for both scales, but were more strongly associated with support-related choice. A higher proportion of people with IDD living independently within the state predicted more support-related choice. High cost of living within a state predicted less everyday choice. Higher proportion of people living with family and lower proportion being served within a state predicted more everyday choice. Conclusions and implications: These findings suggest further study of choice in relation to policies that: (1) increase independent living for individuals with IDD, and (2) assist individuals/families living in high cost states. State differences on important QOL outcomes are likely to be associated with economic and system-based factorsbeyond individual differences.

Original languageEnglish (US)
Pages (from-to)77-90
Number of pages14
JournalResearch in Developmental Disabilities
StatePublished - Dec 2018

Bibliographical note

Publisher Copyright:
© 2018 Elsevier Ltd


  • Choice
  • Community living
  • Cost of living
  • Intellectual disability
  • Residence type
  • State factors

PubMed: MeSH publication types

  • Journal Article


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