Remote Supports for People with Intellectual and Developmental Disabilities: Balancing Independence, Privacy, and Safety

By Shaden Alsuwayh

Introduction: Beyond Monitoring, Toward Meaningful Independence

For people with intellectual and developmental disabilities (IDD), independence is often discussed in terms of what a person can do without assistance. Yet meaningful independence is not simply the absence of support. It is the ability to make choices, participate in everyday life, develop skills, and exercise control over one’s own environment with support available when it is needed.

Remote supports offer one way to make this possible. Through technologies such as two-way video communication, motion and door sensors, emergency alert systems, and smart-home devices, individuals can receive assistance without requiring a support professional to remain physically present at all times. These systems can help people navigate daily routines, respond to unexpected situations, and live in homes and communities with greater autonomy.

Research suggests that remote supports can promote independent living and increase feelings of security among adults with IDD. However, their benefits depend on how they are implemented and whether they reflect the preferences and needs of the people using them (Tassé et al., 2020). 

The central challenge is not deciding whether independence or safety matters more. Both matter. The challenge is determining how to provide appropriate protection without turning a person’s home into an environment of constant observation.

For organizations such as 3DA, this distinction is essential: remote supports should be evaluated not only by whether they reduce risk or staff presence, but also by whether they expand a person’s opportunities, preserve their privacy, and strengthen their control over daily life.

1. Independence: Making Support Less Intrusive, Not Less Available

Traditional support arrangements can sometimes require a professional to be physically present even when an individual can complete many activities independently. Depending on the person’s needs, remote supports may offer an alternative that provides assistance on demand rather than continuous in-person supervision.

For example, a person preparing a meal might use a visual prompt to follow a recipe, contact a remote support professional when uncertain about a step, or receive an alert if an agreed-upon safety concern arises. Another person may use reminders to manage a daily routine while retaining the ability to decide how and when to complete tasks.

These examples illustrate an important distinction: technology should make it easier for a person to do more for themselves, rather than simply make it easier for others to observe them.

The 2020 study by Tassé and colleagues examined the experiences of adults with IDD using remote support services. Participants identified increased independence and a greater sense of security at home as principal benefits. These findings suggest that autonomy and safety can reinforce one another when support is designed appropriately (Tassé et al., 2020). 

Nevertheless, independence should not be measured solely by reductions in staff hours, the number of tasks completed, or the frequency of assistance requests. A person who receives fewer prompts may be developing confidence and skills, but reduced interaction could also mean that the available support is insufficient or difficult to access.

A more meaningful assessment considers whether the individual has gained greater control over everyday decisions, developed skills they value, participated more fully in community life, and retained reliable access to help.

This requires individualized planning. Two people with the same diagnosis may have very different communication styles, sensory needs, risk profiles, preferences, and abilities. One person may welcome remote check-ins but dislike cameras in their home. Another may benefit from visual reminders and an emergency call device but find frequent notifications stressful.

Remote supports should therefore begin with the person’s goals and preferred ways of receiving assistance, not with a predetermined technology package.

2. Privacy, Dignity, and the Right to Have a Private Life

The home is more than a place where daily living tasks occur. It is a personal environment in which people should be able to relax, form relationships, make choices, and spend time without unnecessary observation.

Remote support technologies can complicate this expectation. Cameras, microphones, motion sensors, location-based systems, and digital records may reveal information about a person’s routines, visitors, movements, and private activities. Even when a device is introduced for a legitimate safety purpose, its use may become intrusive if its scope is not carefully defined.

The ethical concern is not limited to whether information is collected. It also involves who can access that information, how long it is retained, when staff can observe or contact the individual, and whether the person understands what the technology does.

A scoping review of remote supports for people with intellectual disabilities identified privacy concerns, individualized implementation, and support-worker training as important considerations. The review also highlighted the need for stronger research on ethical issues and the experiences of people receiving support (Lawrason et al., 2025). 

For service providers, privacy should be addressed during planning rather than after a device has been installed. Practical safeguards include:

• Use the least intrusive effective option. If a door sensor or scheduled check-in can meet an identified need, continuous video monitoring may not be necessary.

• Explain technology accessibly. Describe what a device detects, when it operates, who receives information, and what happens when an alert is triggered. Use plain language, visual explanations, demonstrations, or other communication supports as appropriate.

• Establish clear boundaries. Define when remote staff may initiate contact, what information they may access, and which areas or activities should remain private.

• Protect personal information. Limit access to authorized individuals, use appropriate security measures, and establish clear policies for data storage, retention, and disclosure.

• Review the arrangement regularly. As a person’s skills, preferences, and circumstances change, some monitoring may become unnecessary or require adjustment.

Privacy must also be considered in the context of supported decision-making. A person may need assistance understanding a technology or communicating a preference, but requiring support does not automatically mean their wishes should be replaced by those of a family member, provider, or professional.

When a person communicates discomfort, refuses a particular device, or requests greater privacy, that response should prompt meaningful discussion about alternatives. The appropriate response is not automatically to interpret disagreement as a lack of understanding or as evidence that the person cannot live independently.

3. Safety: Preparing for Risk Without Restricting Everyday Life

Safety is a legitimate concern in remote support arrangements. An individual may experience a fall, encounter a household hazard, become disoriented, or need assistance that cannot be provided through a simple reminder. A technology failure, interrupted internet connection, missed alert, or delayed response can also create risks.

However, eliminating every possible risk is neither realistic nor necessarily consistent with a person’s autonomy. Everyday activities—including cooking, traveling, managing money, and living alone-involve opportunities to learn and make decisions. An approach that prevents all potential mistakes may also prevent the development of confidence and practical skills.

The 2018 Ohio remote-support white paper from The Ohio State University’s Nisonger Center explored remote supports and emerging technologies intended to promote independence among people with developmental disabilities. It provides a useful foundation for considering how technology can support individuals while responding to legitimate safety needs (Wagner et al., 2018). 

The goal should be proportionate safety: matching the level and type of support to the actual risk, the individual’s preferences, and the consequences of a possible failure.

This begins with an individualized assessment. Providers and the person receiving support should identify the specific situations in which assistance may be needed, the person’s existing abilities, potential hazards, and the least restrictive ways to address those concerns.

For instance, if an individual wants to prepare meals independently, the response should not automatically be to prohibit cooking. Depending on the person’s needs, appropriate measures might include accessible instructions, adapted kitchen equipment, skills training, a scheduled check-in, or a clearly defined way to contact a remote professional.

Technology alone is not a complete safety plan. Providers should establish what happens when a device malfunctions, an alert goes unanswered, or an emergency requires someone to be physically present. Backup communication methods, escalation procedures, and access to in-person assistance are important parts of responsible implementation.

Safety plans should also distinguish between an emergency and a situation that merely differs from a staff member’s expectations. A missed routine, an unexpected visitor, or a decision to complete a task differently does not necessarily indicate danger. Clear response protocols can help prevent unnecessary intervention while ensuring that genuine emergencies receive appropriate attention.

4. Consent, Choice, and the Risk of Turning Support Into Surveillance

The balance between independence, privacy, and safety cannot be resolved through technology selection alone. It also depends on who makes decisions about the technology and whose interests shape its use.

The Council on Quality and Leadership has highlighted ethical questions surrounding remote technologies, including whether their primary purpose is to benefit the person receiving services or to reduce demands on staff and providers. Its discussion of ethical technology use emphasizes the importance of considering autonomy, well-being, potential harms, and alternatives (Clausen, 2020; Fridman, 2020).  

These questions are particularly relevant when organizations face staffing shortages or financial pressures. Remote supports may offer operational advantages, but those advantages should not become the primary justification for replacing in-person assistance that an individual still needs.

A reduction in staff presence is not inherently a positive outcome. It is positive when the individual gains a preferred level of independence while receiving effective, reliable support. It is concerning when reduced staffing leaves the person isolated, unable to access help, or dependent on technology that does not meet their needs.

Consent should be treated as an ongoing process rather than a one-time signature. Before implementation, individuals should receive information they can understand and meaningful opportunities to express preferences, ask questions, and consider alternatives. Their views should be revisited when the system changes or when they indicate that it no longer meets their needs.

When individuals communicate without speech or use alternative and augmentative communication, providers should make appropriate accommodations so that their preferences can be understood. Family members, advocates, and trusted supporters may contribute valuable knowledge, but their involvement should support—not automatically override—the individual’s participation in decisions.

Organizations should also recognize that a person may accept one form of remote support while rejecting another. Agreement to use an emergency alert system, for example, should not be interpreted as blanket agreement to continuous monitoring.

A person-centered approach recognizes that the ethical question is not simply whether a technology can be used, but whether its use is justified, proportionate, understood, and consistent with the individual’s rights and preferences.

5. What Responsible Implementation Looks Like for 3DA

For 3DA and other organizations supporting people with IDD, balancing independence, privacy, and safety requires more than selecting appropriate devices. It requires a service model in which technology, staff practices, individual preferences, and ongoing evaluation work together.

Five principles can help guide implementation.

1. Start with the person’s goals. 

Identify what the individual wants to do more independently, what support they find helpful, and what aspects of privacy matter to them. Technology should respond to those priorities rather than determine them.

2. Match the technology to the need. 

Choose the least intrusive option that can reliably address the identified support need. Avoid collecting information simply because a device makes it possible.

3. Build individualized safety and backup plans. 

Specify how alerts are handled, when staff should intervene, what happens during system failures, and when in-person assistance is necessary. Review plans as circumstances change.

4. Prepare staff and support networks. 

Remote professionals need more than technical training. They must understand individualized support plans, communication differences, privacy boundaries, appropriate escalation, and the distinction between a genuine safety concern and a personal preference they would not make themselves.

5. Measure outcomes that matter to the individual. 

Evaluate whether the person experiences greater autonomy, feels safe, understands the technology, can access assistance, and is satisfied with the arrangement. Include the individual’s feedback in reviews and make adjustments when the technology creates new barriers or concerns.

These principles are consistent with the emerging evidence base. A scoping review of 22 studies found that remote supports may offer benefits, but also emphasized individualized service delivery, training, privacy considerations, and the need for additional research. The authors cautioned against assuming that one approach will work equally well for everyone (Lawrason et al., 2025)

For 3DA, these considerations also point to a practical evaluation question: What changes in the person’s life because remote supports are in place?

The answer should extend beyond equipment installed, alerts received, or staff hours reduced. Organizations should consider whether individuals have gained meaningful opportunities to make decisions, build daily living skills, pursue personal interests, maintain relationships, and participate in their communities. They should also examine whether privacy concerns, unmet support needs, or technical barriers undermine those outcomes.

Tracking both benefits and unintended consequences would help providers make more informed decisions about when remote supports are appropriate, when they need modification, and when in-person services remain essential.

Conclusion: Independence Should Remain the Measure of Success

Remote supports offer promising opportunities for people with IDD to exercise greater independence while maintaining access to assistance and a sense of security. Yet the presence of technology does not automatically create autonomy, and the reduction of risk does not automatically improve quality of life.

The distinction lies in how support is designed and delivered. A system that observes every movement may provide information without promoting independence. A system that offers accessible prompts, respects personal boundaries, and connects someone to responsive assistance may create opportunities that were previously difficult to achieve. For 3DA, the most important consideration is therefore not how much support technology can replace, but how effectively it can help people live the lives they choose.

A responsible approach recognizes independence, privacy, and safety as interconnected elements of person-centered support. It accepts that risk cannot be eliminated entirely, that preferences may change, and that different individuals will require different arrangements. Most importantly, it treats people with IDD as active participants in decisions about their homes, routines, and futures.

Remote supports are most successful when technology serves the person—not when the person is expected to adapt to the technology.

The measure of success is ultimately whether individuals have greater control over their lives, meaningful access to help, and the freedom to experience their homes and communities as their own.

References

Clausen, M. (2020, June 23). Remote supports for people with disabilities. The Council on Quality and Leadership. https://www.c-q-l.org/resources/newsletters/remote-supports-for-people-with-disabilities/

Friedman, C. (2020, June 23). The ethical implications of remote technologies. In Remote supports for people with disabilities. The Council on Quality and Leadership. https://www.c-q-l.org/resources/newsletters/remote-supports-for-people-with-disabilities/

Lawrason, S., Manley, Z., Lomness, A., & Hole, R. (2025). Remote support for individuals with intellectual disabilities living independently: A scoping review. International Journal of Developmental Disabilities, 71(7), 953–970. https://doi.org/10.1080/20473869.2023.2280862

Tassé, M. J., Wagner, J. B., & Kim, M. (2020). Using technology and remote support services to promote independent living of adults with intellectual disability and related developmental disabilities. Journal of Applied Research in Intellectual Disabilities, 33(3), 640–647. https://doi.org/10.1111/jar.12709

Wagner, J. B., Tassé, M. J., Davies, D. K., & Stock, S. E. (2018). Use of remote support in Ohio and emerging technologies on the horizon. Nisonger Center, The Ohio State University. https://nisonger.osu.edu/wp-content/uploads/2017/02/White-Paper-Use-of-Remote-Support-in-Ohio-and-Emerging-Technologies-on-the-Horizon.pdf