Why Belonging Is Becoming the Core Measure of Quality in IDD Care

For decades, quality in intellectual or developmental disability (IDD) services has been measured through compliance: completed plans, required visits, documented outcomes, and adherence to regulations. These measures matter, but they don’t tell the full story of whether support is actually improving someone’s life.

A growing body of research is now pushing the field toward a deeper, more human metric: belonging.

Belonging goes beyond access to services or presence in the community. It reflects whether a person with an intellectual or developmental disability (IDD) feels known, valued, included, and connected. Increasingly, researchers and advocates argue that belonging is not an abstract ideal, but a foundational driver of well-being, autonomy, and long-term outcomes for people with IDD.

From Access to Belonging

Historically, the IDD system has focused on ensuring people are served: enrolled in programs, attending activities, living in community settings rather than institutions. While these shifts represent meaningful progress, access alone does not guarantee inclusion.

Belonging requires more than physical presence. It includes having choice, forming relationships, participating meaningfully, and being recognized as a person with preferences, strengths, and goals. Research shows that when people with IDD experience belonging, they demonstrate higher self-esteem, stronger mental health, and greater engagement in daily life. (Villhauer et al., 2026)

This evolution mirrors a broader shift in human services, from “doing for” people to “supporting with” people. The implications for providers are significant. If belonging is a legitimate outcome, then organizations must be able to show how daily support practices contribute to it.

What Belonging Means for Providers

For IDD providers, belonging isn’t created by a policy statement or mission page. It’s built (or undermined) through thousands of everyday interactions: how staff listen, how choices are honored, how progress is recognized, and how challenges are addressed.

This creates a new expectation: quality care must be observable, explainable, and defensible — not just compassionate.

Providers are increasingly asked to demonstrate that services are person-centered in practice, not just in principle. That includes showing how individuals are supported to make decisions, build relationships, and participate in their communities in ways that matter to them.

This is where operational realities collide with philosophical goals.

The Role of Documentation in Belonging

Documentation has long been treated as an administrative requirement — something to complete after care happens. But in a system that values belonging, documentation plays a more central role: it becomes the narrative record of whether person-centered care actually occurred.

When notes are written days later, copied forward, or reduced to generic language, they fail to capture what makes care individualized. Important context is lost: why a choice mattered, how someone expressed preference, what progress looked like in real terms.

Over time, documentation shapes how care is understood by supervisors, auditors, clinicians, and funding agencies. If belonging is invisible in the record, it may as well not exist.

The risk is for providers who are doing meaningful work but cannot clearly demonstrate it. It also places pressure on staff, who may know the person well but lack the tools or time to reflect that understanding accurately. 

Belonging Requires Timeliness and Specificity

Belonging is lived in moments, not summaries. A meaningful interaction, a decision respected, a relationship strengthened, these details are easiest to capture while they’re happening, not after the fact.

That’s why real-time documentation is increasingly important. When staff can record observations and context as care unfolds, documentation becomes more accurate, more specific, and more reflective of the individual’s experience.

Equally important is the structure of documentation itself.  Systems work best when they pair structured fields with brief person-centered prompts to capture voice, preference, and progress in ways  that meet compliance and reflect the individual’s experience of belonging.

This isn’t about adding work; it’s about eliminating lift for everyone in the ecosystem and aligning on  the details effectuating goals of IDD services.

Raising the Bar on Quality

As belonging becomes more central to how quality is defined in IDD care, providers face a broader challenge than compliance or reporting. 

The question is no longer just whether services were delivered, but whether they created connection, agency, and participation in a person’s life.

This raises the bar for organizations across the field. Supporting belonging requires consistent staff, thoughtful daily interactions, and systems that reinforce person-centered practices over time. It also requires leadership alignment, making sure values like choice, dignity, and inclusion are not only discussed, but operationalized in real settings.

Providers that succeed  share a common trait: they focus less on proving care after the fact, and more on shaping care as it happens. Belonging isn’t something that can be manufactured retroactively. It emerges from clarity, continuity, and trust — built moment by moment.