Exercising autonomy-The effectiveness and meaningfulness of autonomy support interventions engaged by adults with intellectual disability. A mixed-methods review

Background The United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) recommend all disabled people receive support to develop their autonomy. Subsequently, evolving models for supported decision-making and informed consent present guidance to enable autonomy support, which have relevance to people with intellectual disabilities. To date, reviews have explored how adults with intellectual disabilities exercise their autonomy or factors impacting the development of their self-determination. This review aimed to establish the effectiveness of 'autonomy support interventions' engaged by adults with intellectual disability and the meaning of these interventions to this cohort. Methods A systematic search of Cinahl Complete, PsychINFO and Scopus databases was undertaken. The search was limited to studies published between 2000 and 2020. Identified citations were uploaded to EndNote X9, duplicates removed, search outputs imported into Covidence and titles and abstracts screened. Data were extracted using an amended JBI data extraction Tool. The search strategy is reported in the adapted PRISMA flow diagram. Findings Twelve studies were included in the mixed methods review. Critical appraisal was undertaken using the Crowe Critical Appraisal Tool. These findings identified varied and creative autonomy support interventions utilised across ordinary activities with adults with intellectual disabilities. Conclusion This review identifies the essential components of how autonomy support interventions can enhance ordinary experiences for adults with intellectual disabilities while enabling them to develop skill sets to be more self-directed in the choices they make.