45 percent. That’s the average turnover rate for direct support professionals (DSPs) at organizations that provide services to people with intellectual and developmental disabilities. Why is that rate so high? Certainly, pay is a primary reason. But it is not the only reason.
In a survey by Medisked, other reasons DSPs identified for leaving include:
- Insufficient training and guidance
- Difficulties/stress of work performed
- Lack of supervisory support and appreciation
Let’s look at these reasons and explore ways that IDD service providers can reduce turnover.
Training and Stress
In most states, IDD service organizations have a list of required trainings for their DSPs. But providing only the required training in order to “check the box” is rarely adequate to prepare someone who has never worked in direct support before.
Recently, I led Relias’ development of job knowledge assessments for DSPs. For one of the assessments, we worked with subject matter experts to determine what knowledge was essential for a DSP to provide quality person-centered services.
We determined that it takes more than a solid grasp of documentation, planning, and service coordination to provide person-centered services. It requires knowing how to support the empowerment of the individual the DSP is working with, how to find information and resources through community networks, and how to support the individual’s health and safety. Having that knowledge and the skills to put that knowledge into practice is the foundation of quality IDD services.
If a DSP does not receive that knowledge during their onboarding and ongoing training, or if they don’t receive guidance on how to put that knowledge into action, is it any surprise that they find the job to be too difficult and stressful? For any employee in any field, it is frustrating to feel as though you cannot do your job effectively.
On the flip side, DSPs who have extensive experience in the field have different reasons for frustration. No one likes sitting through trainings on things they already know — sometimes, that feels downright insulting. Those DSPs who stay with the job long enough to have mastered the usual training often want and deserve the opportunity to advance their skills with deeper, more specialized training.
Job knowledge assessments can help agencies identify knowledge gaps in their DSPs and create training plans that ensure their DSPs have what they need to be good at their jobs. They can also help agencies create professional development plans that meet the needs of their more experienced DSPs. Job satisfaction is always higher if employees feels like they have what they need to do their jobs well, that their expertise is acknowledged, and that their employer recognizes the value of investing in them.
Supervisory Support and Appreciation
It’s a universal truth of management — just because you are good at a job does not mean you will be good at supervising others who do that same job.
Odds are, some of your current frontline supervisors — Qualified Intellectual Disability Professionals (QIDPs) — started out as DSPs, and others came to your agency shortly after earning their bachelor’s degree. Few QIDPs come to the job having had training in how to be a supervisor.
Another assessment we created looks at the essential knowledge and skills of QIDPs and managers in IDD. Our subject matter experts identified numerous important knowledge areas beyond documentation and person-centered planning—including leadership and communication.
Providing effective supervision is so much more than making sure people follow the rules and show up on time. Communication, conflict management, and guidance when dealing with difficult situations are all essential parts of a QIDP’s job. And when a front-line supervisor does not have those skills, your DSPs suffer and are more likely to leave the job.
The results from a job knowledge assessment for QIDPs and managers can guide agencies in creating training and professional development plans for their employees. Ensuring that your QIDPs have the knowledge and skills to do their job well will improve the overall functioning of your agency and increase DSP retention.
As John F. Kennedy, Jr. said, “Quality is defined at the point of interaction between the staff member and the individual with a disability.” There is nothing an IDD service provider can do to improve its services that has a greater impact than investing in and retaining its DSPs.

Strategies for Decreasing DSP Turnover
DSP turnover is a problem facing most IDD service providers. Reducing DSP turnover takes concerted action throughout the employee life cycle. This e-book outlines strategies for improving hiring and placement, boosting engagement and retaining your DSPs.
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