Front Line Leadership in Organisations for Persons With Intellectual and Developmental Disabilities: A Systematic Review.
Leady V Fajardo-Castro, Sedigheh Jalili, Vicente Martínez-Tur
PMID 40996697WHAT IT FOUND
Practice leadership is the dominant model studied in disability services, linking to better staff support and user engagement.
However, its effectiveness collapses without high-quality management, and frontline managers face significant barriers like funding cuts, high turnover, and administrative overload.
Key findings
01Practice leadership was the focus of 24 of the 32 reviewed studies, representing 75% of the total.
02Practice leadership was only effective in changing staff use of Active Support when overall management quality was high; it failed in situations of poor management.
03Major obstacles to leadership include austerity measures, high staff turnover, and increased administrative tasks that reduce managers' capacity for direct support.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The review is heavily skewed towards studies from Australia and the UK, limiting generalisability to other regions. 44% of the included studies had small sample sizes (0-50 participants). No studies were excluded based on quality assessment, meaning some findings may rest on weaker evidence. Most research focused on residential settings, with very little data on community or vocational services. The review synthesises observational and qualitative data rather than testing leadership interventions experimentally.
Declared interests
The authors declare no conflicts of interest. Funding was provided by MCIN/AEI and ERDF/ESF.
The easy way to misread this
Do not assume that implementing 'Practice Leadership' techniques will automatically improve care. The review found that practice leadership was ineffective in changing staff behaviour when overall management quality was poor, meaning it cannot compensate for systemic administrative or resource failures.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →