Transitions Cost More Than $2.3B in IDD Support Services

Cyclic Regression Causes Expensive Turnover, Painful Restarts, and Critical Struggles.

 Decrease staff training costs.
Create smoother transitions for clients.
Preserve your investments in human resources.
Have a sustained impact on client quality of life.

You have a clear and special mission to support people with intellectual and developmental disabilities (IDD), promote their independence, and to bring meaningful improvements to their lives. You measure success by how well you can increase their abilities and help them solve daily challenges. That’s why your organization exists, and that’s what builds a smile on your face and warms your heart. You take all the steps needed to design a high-quality program with the service payments available to drive the supports you provide.

But when a support team member leaves,  you can lose all the knowledge and best practices that person held and used so effectively. Perhaps most importantly, you lose the relationship between a staff person and supported individual and the extent to which that person feels understood by your program. The supported person loses forward momentum and can even go backwards, regressing in skills and community access. The insights and craft knowledge of departing employees leave with them, and the resources you invested in training them often evaporate as soon as they walk out the door. That happens even under the best of circumstances but it is even worse when there is a sudden termination.

Searching for and hiring a new team member takes time. Then, you need to train the new team member and they need to relearn how to best help and understand the people they will directly support.  Understandably, the person under their care doesn’t feel that supported, nor are they very trusting. The money is burned through and your effectiveness dwindles.

It’s like running uphill in knee-deep mud with ankle-high boots.

This can all end right now.  From this moment onward, you have a way to avoid this common painful regressive episode.

In the course of Cognitopia’s development and testing efforts, we’ve seen one expensive, destructive, and malignant pattern occur repeatedly in support services. It’s the problem of cyclic regression due to high turnover among support professionals, which seriously stunts ability improvement for individuals with IDD. Along with the severe impact to individual growth, Cyclical Regression Syndrome burns through money you hoped to use for positive impact, because now it gets used for turnover demands, including the need to train new staff.

Let’s look at the US numbers:

  • 45% average annual turnover for IDD Support Professionals. In some areas, the rate is as high as 76% annually (PCPID, 2017).
  • This is in comparison to 5% general all industry average (US Bureau of Labor Statistics, 2017).
  • 9% vacancy rates of Support Professionals for people with ID/DD (Hewitt et al., 2015; Hiersteiner, 2016).
  • $4,073 average turnover cost per employee (Hewitt et al., 2015).
  • $2.3 Billion est. turnover cost nationally, in 2015 (Hewitt et al., 2015).
Problem of Cyclic Regression [Infographic] – IDD Service Providers Experience Costly Turnover, Retraining, and Struggles with Quality Assurance

Cognitopia Cyclic Regression Infographic – 2019

In the 2017 Report to the President, America’s Direct Support Workforce Crisis: Effects on People with Intellectual Disabilities, Families, Communities and the U.S. Economy, we learn, “Not only does the DSP (direct support professional) crisis impact individuals and families, but it is also extremely costly to the human services system and the overall U.S. economy.”

The painful results of Cyclical Regression Syndrome are increased when you consider what common events drive a restart experience for people who are supported.  The following considerations still need to be added to the impact numbers above:

  • Teacher changes year-to-year
  • Cross-departmental/cross-team support relationships
  • Transition Program changes

High rates of turnover cause at least two major problems:

  1. As new staff are brought on, they are challenged to learn agency procedures and best-practice instructional methods and to get to know the individuals whom they will be supporting based on inadequate documentation. This results in an enormous amount of lost time while staff ramp up and during which sub-optimal support is provided to students or adult service recipients and ability level either stagnates or deteriorates. As this can repeat multiple times in a single year, it causes a kind of “cyclic regression” in ability, not unlike the experience of students whose skill levels fall off between spring and fall terms when not attending summer school.
  2. Schools and agencies incur significantly increased costs due to the lack of easily accessible information on the needs of those they are supporting, their preferences, learning styles, and materials that reflect their individualized instructional and self-management needs. If available through an integrated platform, such materials would streamline the efficient onboarding of staff and allow them to step into an environment with a rich understanding of each individual they support, knowing what works for them, and what doesn’t.

How does Cyclical Regression Syndrome reveal itself?

  • Supported people experience skill regression, decreased community access, and frustration
  • Inefficient and wasted private, state, and federal Medicaid funding
  • Repetitive disconnects between multiple supporters in programs, agencies, and facilities cause more regressive aggravation rather than help the people they are supposed to support

With Cyclical Regression Syndrome, what’s at risk?

  • Possible legal exposure caused by failure to meet care standards
  • Repeated investment in building an effective support relationship, person-centered insights, and goal discovery and support
  • Repeated cost of training new support professionals
  • Cost of hiring searches for replacement support professionals in an employment market with a high vacancy rate
  • Challenge of rebuilding lost knowledge and best practices of past support professionals

Cognitopia Delivers a Complete Solution

college student MyLife Portfolio

Cognitopia reduces Cyclical Regression Syndrome and protects your investment in human resources, while increasing positive results for people you support. You save massive amounts of money and time. You can now use resources more effectively and share critical knowledge easily between all professional supporters. Using remote support methods built into the software, with less effort, you can help more people more effectively. The best part of all, the people you support are able to keep, use, and share their person-centered information, accessible anywhere on any online device, to continue developing vast improvements driving independence and self-determination.

View of a Strengths Category in MyLife


How does Cognitopia solve this problem? In two key ways.

First, with a MyLife multimedia ePortfolio, each individual has a customized person-centered plan that describes their strengths, interests, needs, preferences, goals, and progress. As a graphically designed tool, it accelerates the ability of new staff to really understand who they will be working with. It is web-based, so it’s easily accessible and multimedia. The software as a service (SaaS) model communicates an individual’s story far more effectively than a file folder of progress notes, that often ends up stuffed in a cabinet. When information remains in the minds of support professionals, their notes, or file cabinets, it doesn’t transfer easily or quickly to others nor travel on with the supported person for their benefit. Perhaps most important, the software is team-based, so that new staff are quickly integrated into it and can benefit from the real-time insights of the larger team of support workers, teachers, therapists, and family members.

Second, Cognitopia offers powerful tools for goal tracking and task accomplishment. With Goal Guide and Routines, each user has their own library of individualized routines and goals that optimizes their ability to manage on their own, while also providing an effective way for staff to provide support and instruction that is consistent regardless of who is doing it. The importance of having consistent methods for instruction and support across staff cannot be overestimated.

Routines and Goals Easily Accessible

With goals and routines that offer images, text, or video to guide task accomplishment, self-management ability and independence is maximized and staff support is optimized. And perhaps as important, any team member can view progress data, add supportive or constructive comments, and share communications with each other.

Together these innovative tools from Cognitopia offer a solution that will promote individual development while substantially mitigating the costs of staff turnover and retraining.

To find out more, call Eric at 866-573-3658, email to, or go to

About Eric Smith

Strategic Chief Operating Officer with over 3 decades of experience specializing in software services, passionately delivering powerful results, while deeply caring about his clients. At work Eric increases the opportunity that more people can benefit from Cognitopia’s assistive software technology. He uses his experience to build a solid foundation focused on developing a targeted and purposeful business operation for customers. Outside the office Eric enjoys continually learning about and improving health, fitness, and wisdom. He is an avid art, architecture, and world culture enthusiast and loves sharing time and activities with his family.

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