Introduction
The value of paid employment or other meaningful occupations is emphasized in societies. This is highlighted in The Convention on the Rights of Persons with Disabilities which states the rights of people with disabilities to work, gain a living, have an inclusive work environment, and exert autonomy (United Nations 2006). However, individuals with intellectual disability have great difficulties with establishment in the labor market (Arvidsson 2016; Emerson et al. 2018; Karhina, Ineland and Vikström 2022; Luthra 2020; McCausland et al. 2020; Voermans et al. 2023). Intellectual disability is a diagnosis characterized by reduced intellectual and adaptive functioning, with symptoms present in early development (The American Psychiatric Association, DMS-5 2013).
Internationally, as well as in Sweden, the proportion of people with intellectual disability who are employed or in higher education is small, and they face multiple challenges in obtaining these occupations (Arvidsson 2016; McCausland et al. 2020; Morris et al. 2024; Voermans et al. 2023). In Sweden, many people with intellectual disability have disability day programs called Daily Activity as their occupation (Arvidsson, Widén and Tideman 2015; Luthra, Tideman and Nyman 2024). Daily Activity is provided as one of ten supports under The Swedish Disability Act (LSS Act). The goal of the LSS Act is to ensure good living conditions for people with disability, including intellectual disability (LSS 1993, 387). Daily Activity is meant for people with intellectual disability of working age, who are not employed or studying (LSS 1993, 387), and has the purpose of fostering skills, preparing for employment, and increasing participation in society (Nikku 2011). Daily Activity should consist of habilitation- and production-oriented activities, as well as be adapted to individual needs and interests. Daily Activities are operated by municipalities, companies, and organizations.
Daily Activity is the most used support under the LSS Act and has increased in usage over the years (National Board of Health and Welfare 2023). Reasons for the continuous increase include an exclusive labor market, people with intellectual disability not being a priority among agencies, and increased demands for education and skills in the labor market (Nikku 2011). According to the Swedish National Board of Health and Welfare (2008), Daily Activities vary in settings and content but have a common emphasis on providing opportunities to gain employment. Examples of daily activities include working in restaurants/kitchens, music, carpentry, media, and landscaping.
Daily Activity provides daily structure and increased quality of life (Hartnett et al. 2008; Nikku 2011). Simultaneously, there is stigmatization surrounding Daily Activity as it does not provide an income and is not seen as a real job among individuals (Luthra et al. 2018; Ringsby-Jansson and Olsson 2006). This negative perception has been discussed as a reason why some choose not to attend Daily Activity, which results in having no occupation (Luthra 2020). One of the goals of Daily Activity is to increase opportunities and transitions to employment; however, findings suggest that these transitions are limited (Luthra, Tideman and Nyman 2024).
The research on Daily Activity as an occupation remains limited. Specifically, there is limited knowledge of experiences of participation in Daily Activity among people with intellectual disability regarding its quality, value, and meaning, as well as understanding movements between Daily Activity and other types of occupations. The importance of studying experiences of Daily Activity centers on gaining first-hand knowledge through semi-structured interviews with people with intellectual disability, in order to highlight their perspectives and voices. Moreover, the findings can increase knowledge on Daily Activity as a meaningful occupation, as well as demonstrate potential challenges and necessary improvements.
Aim
The aim of the study is to examine people with intellectual disability’s experiences of Daily Activity in Sweden and their transitions between Daily Activity and other occupations.
The research questions are:
What characterizes people with intellectual disability start in Daily Activity, and how do they experience and describe their participation in Daily Activity?
What are the experiences of people with intellectual disability who attend Daily Activity, with transitioning between Daily Activity and other occupations (employment, education, and no occupation)?
Previous Research
Daily Activity
Despite that day programs for people with intellectual disability vary across countries, common elements of activity, productivity, care, training, or connections to work also exist (Engeset, Söderström and Vik 2015; Frounfelker, Anne and Bartone 2021; Hartnett et al. 2008). This study uses the term Daily Activity since this is specific to the Swedish context. However, due to variations in name, design, and structure among day programs internationally, terms such as day centers or work activities also occur when specific to previous research.
International and European research show that participation in Daily Activities has positive impacts. For example, better mental health for the individual (McCausland et al. 2020), friendships, social connections, daily structure, and quality of life (Hartnett et al. 2008; Nikku 2011; Voermans et al. 2023). Individuals with intellectual disability show increased satisfaction with their day centers when they are included in decision-making (Frounfelker, Anne and Bartone 2021). Mahoney et al. (2016), discuss that since individuals may need various supports, they may be viewed as unable to make decisions for themselves and risk occupational alienation. The authors highlight the importance of occupational choice and engagement among people with intellectual disability in day programs. Daily Activity has elements of both work and care, which can make the distinction unclear (Engeset, Söderström and Vik 2015).
Previous research in Sweden illustrates that Daily Activity facilitates a sense of community and participation (Svanelöv et al. 2019), and is the main occupation encouraged by schools, families, or agencies (Luthra et al. 2018). Daily Activity does not generate an income; many receive subsidies such as sickness compensation and activity compensation (Luthra, Tideman and Nyman 2024). The lack of income distinguishes Daily Activity from a job in the labor market and provides little initiative for its participants (Arvidsson 2016). Another negative aspect is the limited transitions from Daily Activity to employment (Luthra, Tideman and Nyman 2024). This is concerning given that Daily Activity is meant to promote gradual steps toward employment. There is also stigmatization with disability support, including a negative perception of Daily Activity (Luthra et al. 2018; Nikku 2011; Ringsby-Jansson and Olsson 2006). This negative view, combined with the individual wanting a job in the labor market, can contribute to resisting participation in Daily Activity (Luthra et al. 2018; Olsen 2009).
Alternative occupations
Employment provides daily structure, social networks, and increased health (Emerson et al. 2018; Lövgren 2013). Relationships in the workplace and being part of the work culture are central to inclusiveness (Morris et al. 2024). However, people with intellectual disability have high unemployment rates and face difficulties obtaining employment (Arvidsson 2016; Karhina, Ineland and Vikström 2022; Luthra 2020; Morris et al. 2024). Taubner et al. (2023) found that sustainable employment was facilitated by flexibility and engagement from the employers, as well as individuals with customized tasks who enjoy their workplace. Research suggests that income is the main component of a ‘real job’, whereas others equate Daily Activity as a job with little distinction between this and employment in the labor market (Lövgren 2013; Luthra et al. 2018).
An Irish study by Corby et al. (2020), demonstrated that for people with intellectual disability education can be transformative and lead to increased independence, self-esteem, and inclusion in society. Education has benefits for the individual and contributes to increased opportunities in the labor market (Corby, Cousins and Taggart 2020). In Sweden, if an individual has attended Upper Secondary School for pupils with Intellectual Disability (USSID), they are not qualified to study at higher post-secondary institutions. USSID only qualifies for further education in, for example, folk high schools, which is adult education consisting of courses and study circles that are independent of municipal adult education (Folkhögskola 2025). Research shows low attendance and rates of people with intellectual disability who pursue education after secondary school (Arvidsson, Widén and Tideman 2015; Swedish National Council of Adult Education 2023).
People with intellectual disability are a vulnerable group for alienation from the labor market or other meaningful occupations. The lack of opportunities, along with barriers in obtaining a meaningful occupation, can result in what in Swedish research has been categorized as Not in Employment, Education, or Daily Activity (NEED) (Luthra 2020). Research shows that being NEED is caused by the interaction of environmental and individual factors, with emphasis on the lack of coordinated formal support (Luthra 2020).
The challenges for people with intellectual disability in employment and higher education is illustrated in international and Swedish research. In Sweden, most individuals with intellectual disability have Daily Activity as their occupation. However, the existing research on Daily Activity is limited. This includes limited knowledge of first-hand experiences of Daily Activity, and how individuals transition between Daily Activity and other occupations. The present study aims to contribute to the knowledge gap, as well as enhance understanding useful for practitioners, agencies, and policymakers to ensure people with intellectual disability sustain a meaningful occupation whether this entails Daily Activity or another occupation.
Theory
Ryan and Deci (2017) describe self-determination as focusing on ‘how biological, social, and cultural conditions either enhance or undermine the inherent human capacities for psychological growth, engagement, and wellness’ (p. 3). Self-determination is also underlined with agreement between one’s life and one’s desires (Ryan and Deci 2017). As such, self-determination can be understood as a complex interplay of individual, environmental, and contextual factors. Wehmeyer and Garner (2003) highlight that self-determination is influenced by personal capacity and characteristics, such as the disability itself, but also environmental factors that afford opportunities for self-determination, for example, making choices. Environmental challenges in micro, meso, exo, and macrosystems, impact self-determination among people with intellectual disability (Parchomiuk, Zyta and Cwirynkało 2025; Skarstad 2018). Wehmeyer and Garner (2003) argue that self-determination is more limited by the environment than by the individual’s intellectual abilities. Whereas Parchomiuk et al. (2025) demonstrate how the interaction between individuals with intellectual disability and parents’ attitudes (microsystem), limited resources that facilitate autonomy and poor treatment from institutions (exosystem), and discrimination (macrosystem) hinder self-determination.
Previous research among people with intellectual disability shows various components of self-determination, for example, choice making, independence, problem-solving, and acting on their own will (Kuld et al. 2023; Parchomiuk, Zyta and Cwirynkało 2025). Research also emphasizes that quality of life increases through an increase in self-determination (Wehmeyer 2020). According to Skarsaune et al. (2021), self-determination can be challenging for people with profound intellectual disability who require support and care. However, despite dependency, true desires being achieved is still possible (Skarsaune et al. 2021). Similarly, rather than perceiving people with disability as solely dependent beings, all humans can be viewed as interdependent where relationships facilitate development and growth (Skarstad 2018).
Self-determination relates to numerous aspects of a person’s life and as illustrated in research, has varying definitions and understandings. One aspect of self-determination is individuals being ‘causal agents’, where they themselves cause things to happen in their lives, as opposed to other people controlling them (Wehmeyer 2020). In the context of occupations and Daily Activity, this relates to people with intellectual disability choosing and obtaining a suitable, desirable, and meaningful occupation. Self-determination is impacted by the individual and environment (Parchomiuk, Zyta and Cwirynkało 2025; Wehmeyer and Garner 2003). As such, the opportunity for self-determination in occupational choice can be influenced by an individual’s capacities and desires, as well as by labor market demands and societal norms. By examining experiences of Daily Activity and occupational transitions, factors that facilitate versus inhibit people with intellectual disability’s self-determination in obtaining a meaningful occupation can be explored.
Method
Design and data collection
A qualitative design consisting of 15 semi-structured interviews was conducted. Information about the study was emailed to Daily Activities listed on municipalities’ websites. Where one lives can relate to occupational opportunities (Arvidsson et al. 2016). Therefore, the aim was to include informants living in various types and sizes of towns/ municipalities and participating in diverse Daily Activities. Staff and managers at Daily Activities contacted the researcher if they knew of individuals who were interested in participating. In a few instances communication occurred between the staff and the researcher as this was the participant’s preference, in other cases, the researcher received direct contact information for the participant.
Written and oral information about the study was given to the participants. Once they agreed to partake in the study, time for the interview was planned. Before the interviews began, the study was explained again with opportunities for questions. In general, no questions were asked, and participants were satisfied with the information about the study. The consent form was explained and signed, followed by the presentation of the theme map of questions. With permission from the participants, the interviews were recorded on a digital recorder. An interview guide was used that focused on themes of a regular day, Daily Activity, movements between occupations, and the future. Questions included: how did you start with Daily Activity? What do you think about Daily Activity? Can you make decisions about what you do in Daily Activity? What aspects do you enjoy/find difficult? Have you had experience with other occupations, and what did that process look like? Interview times ranged from 17–70 min (median = 23 min). The interviews were conducted at the participant’s Daily Activity placement in a private room. In three interviews, participants chose to have a staff member present, which can have both positive and negative influence on the interview situation. However, because this was the individual’s own choice, it is assumed that the third party provided comfort and support, rather than negative influence (Luthra 2020; McFarland et al. 2024). Research with people with intellectual disability can entail a need for adjustments throughout the process (Lövgren 2013; Luthra 2020; McFarland et al. 2024). In line with other research (Lövgren 2013; Luthra 2020; McFarland et al. 2024), adjustments were implemented including clear communication, accessible information, highlighting the importance of confidentiality and the right to withdraw, formulating specific questions, and repeating/rephrasing questions. Interviews were conducted between 2023 and 2024. The study has been approved by the Swedish Ethical Review Authority (Nos. 2023-02284-01).
Participants
The criteria for recruitment of participants were to participate in Daily Activity, be between 20 and 40 years old, and have an intellectual disability. The age criterion was chosen in relation to previous analyses of register data based on the same age group (Luthra, Tideman and Nyman 2024). In total, 15 individuals (women = 5; men = 10) between the ages of 22–40 years old, who lived in various towns/municipalities in Sweden participated in the study. The participants with pseudonyms are presented in Table 1.
Table 1
Description of participants.
| PARTICIPANTS | GENDER | AGE | TOWN SIZE* | CURRENT DAILY ACTIVITY | EXPERIENCE WITH OTHER OCCUPATIONS |
|---|---|---|---|---|---|
| Michael | Male | 39 | Medium-sized town | Culture, media, and music | Different Daily Activities, further studies, and NEED. |
| Sara | Female | 29 | Commuting town near large city | Café | Different Daily Activities. |
| Liam | Male | 39 | Commuting town near medium-sized town | Packaging, assembling, and sorting | Different Daily Activities, and NEED. |
| Alice | Female | 40 | Commuting town near medium-sized town | Packaging, assembling, and sorting. | Different Daily Activities, further studies, NEED, and subsidized employment. |
| Frank | Male | 22 | Medium-sized town | Machinery and production | Different Daily Activities, and NEED. |
| Amir | Male | 35 | Medium-sized town | Machinery and production | Different Daily Activities, and NEED. |
| Vera | Female | 25 | Medium-sized town | Cafe | Different Daily Activities. |
| Mira | Female | 30 | Medium-sized town | Cafe | Different Daily Activities, further studies, and NEED. |
| Matteo | Male | 27 | Large city | Recycling, media, and prints | Different Daily Activities, further studies, and NEED. |
| Henry | Male | 35 | Large city | Recycling, media, and prints | Different Daily Activities, and NEED. |
| James | Male | 26 | Large city | Media | One Daily Activity, and NEED. |
| Cecilia | Female | 23 | Rural municipality/and with a visitor industry | Agriculture | Different Daily Activities, and NEED. |
| Kai | Male | 24 | Rural municipality/and with a visitor industry | Agriculture | Different Daily Activities. |
| Lucas | Male | 39 | Commuting town near medium-sized town | Landscaping | One Daily Activity, and NEED. |
| Andre | Male | 23 | Commuting town near medium-sized town | Landscaping | One Daily Activity. |
[i] *Town sizes are categorized by municipalities according to the Swedish Association of Local Authorities and Regions (2025).
Analyses
The data was analyzed using thematic analysis by Braun and Clarke (2006). Thematic analysis has since evolved focusing on reflexive thematic analyses as an umbrella term consisting of diverse approaches and applications, as well as emphasizing researchers’ transparency about theme development (Braun and Clarke 2020).
In the initial phase of the analysis, the interview material was transcribed verbatim and read several times. Afterward each individual’s data was organized into a matrix and meaningful units relevant to the aim and the research questions were highlighted. These units were also labeled with codes that referenced their content. Upon completion, meaningful units from all the participants’ data were sorted together. In line with the analytical process described by Braun and Clarke (2006), the meaningful units were sorted and categorized according to their codes. For example, units about tasks at Daily Activity were sorted together, whereas units about relationships at Daily Activity were sorted in another category. These categories and their content were then analyzed to identify patterns and begin to form themes and subthemes. It is important to distinguish between themes and summaries (Braun and Clarke 2020), which guided the refining of the themes and subthemes. During this final phase where refining took place, the essence of themes could be more clearly defined and presented (Braun and Clarke 2006). An example of the analytical process is provided in Table 2. The example shows a transcribed meaningful unit and its initial code, followed by a category where sorting of similar codes was made across participants, and finally the subtheme/theme.
Table 2
Example of analytical process.
| TRANSCRIPTION | INITIAL CODE | CATEGORY | SUBTHEME/THEME |
|---|---|---|---|
| ‘I also get a lot of praise, like if I make a brie and fig sandwich (…) I get so much praise for my sandwiches. And then they say “wow what a service you have”’ | Gets lots of praise from supervisors. Proud of her tasks and contributions. Praise is important | Taking pride in doing specific tasks at Daily Activity | Pride/Tasks |
In the final step of the analysis, variations and similarities between participants were examined. Analyzing each individual’s overall experiences of Daily Activity and transitions between occupations on a broader level, resulted in classifying participants into two typologies. Typologies are useful in bringing together diverse experiences to aid analyses and understanding (Karhina, Ineland and Vikström 2022). While the challenges with reducing variation to typologies are acknowledged, it is an attempt to systematize that is conducive to further understanding and developing interventions.
Results
The results are presented in two sections. The first answers the research question on experiences in Daily Activity including how people started in Daily Activity and the central features of their experiences. The second section answers the research question about transitions between occupations. The results conclude by presenting two typologies of peoples’ experiences of Daily Activity and occupational transitions.
Experiences in Daily Activity
The participants attend their Daily Activity 3–5 days a week. Some have placements in specific premises for Daily Activity such as theater or music groups, while others have placements within companies. Activities include food service, film, dance, production, sorting and assembling products, machinery, event planning, landscaping, agricultural work, and carpentry. Three individuals have had one Daily Activity placement, whereas 12 participants have tried different placements. The reasons for changing Daily Activity included following supervisors’ change in workplace, companies shutting down, not getting along with colleagues, uninteresting work, changing management, and moving to another municipality. Experiences of Daily Activity are illustrated with the themes: Autonomy, Relationships and a sense of community, Tasks, and Benefits.
Autonomy
This theme focuses on the individual’s autonomy and is presented in two subthemes: Entry into Daily Activity and Individual decision-making.
Entering Daily Activity showed variability in the individual’s autonomy. A few mentioned having little choice in starting Daily Activity, or as a choice made by for example the Swedish Public Employment Service. However, the majority expressed that they were active in their decision to start Daily Activity, and all participants chose the type of activity/placement they wanted. While some participants started at Daily Activity right after secondary school, others were reluctant or tried to find a job on their own but eventually ended up in Daily Activity. Matteo says:
It was my housing support’s suggestion (…). I did not want to start here (at Daily Activity), but I thought like f* it, I have tried to get a bunch of jobs or yeah, in my own head I have tried quite a lot to do that, and I never really succeeded.
Many describe receiving support starting at Daily Activity from agencies, their housing support, case managers, staff at USSID, and family members.
The notion of autonomy, as well as a lack thereof, emerged in different parts of the participants’ experiences. Making decisions for themselves is important as Henry says:
If I did not get that (to make decisions for himself) then I would make sure that I get that. Because I do not like, when it is about those important decisions, then I should be included. They are not going to decide things over my head.
The staff makes schedules and assigns tasks. At the same time, participants have room to make their own choices. Participants gave examples where they had expressed to their supervisors that certain tasks were difficult, which resulted in changes being made. Participants also chose how to perform or structure their own tasks. There is a degree of freedom in Daily Activity, which allows individuals to be influential. Examples of lacking autonomy centered on staff making schedules or having to follow rules. Being able to make decisions and choices for oneself, whether in the choice of Daily Activity, the tasks, or influencing change, have a positive impact on the participants’ experiences. Michael says ‘I prefer Daily Activity. Here you can decide for yourself what you want to do’.
Relationships and a sense of community
This second theme illustrates significant relationships at Daily Activity. The subthemes highlight Staff’s support within and outside Daily Activity and Other participants and inclusion.
Staff and supervisors have a central role in the participants’ experiences of Daily Activity. They provide support, help with difficult tasks, assist with administrative work, facilitate moving between different placements, and make the occupation enjoyable. Some have known their supervisors for many years. The only negative aspects were that staff could be distracted, busy, and slow in implementing changes in the workplace. Some expressed that they enjoyed socializing with supervisors, over other participants. Although staff have a professional role, some extended this relationship into the private sphere. They may share common interests, have contact on social media, and support individuals in private aspects of life. Sara says ‘The best supervisors. I love them very much. We have really good contact…we send text messages (…)’. Staff provide support both within and outside of Daily Activity and are important people in many participants’ lives.
Other participants in Daily Activity are described as friends and colleagues. However, only two people spend time with colleagues outside of the Daily Activity setting. Some expressed that conflicts could arise between participants. Relationships with both staff and others at Daily Activity facilitated a sense of community centered on camaraderie, helping and supporting each other, as well as feeling included and welcomed, as seen with Lucas and Amir’s quotes:
Lucas: I support them as well if they need it. We should help each other. Support each other.
Amir: One is welcome here. It is not them and us, but we are together, and we can talk to each other and joke with each other and no sour faces anywhere.
Relationships with other participants with intellectual disability, as well as relationships with staff and supervisors, led to Daily Activity being viewed as an inclusive and positive setting.
Tasks
The tasks vary depending on the type of Daily Activity. Two subthemes were found with participants’ daily tasks—Interests and Pride.
Many tasks at Daily Activity are related to the individual’s interests and hobbies, for example, fishing, film, media, animals, baking, and drawing. Tasks not being monotonous, enjoyable, and resembling real jobs were favorable. For Kai it was a dream come true to work at his Daily Activity: ‘one gets to watch the animals and such, so that is why I have always wanted to work here since I was little. And then it has just been like a dream come true’. Tasks were at times described as the most fun part, as illustrated by Lucas:
(…) sometimes it is carpentry work that we get to do. And that I like! That’s when I shine! (elated voice). (…) I think it is fun and figuring out how I will put things together like one does in carpentry work. That we like. To challenge myself.
The second subtheme was taking pride in one’s work. Several participants shared that they had been assigned specific tasks that only they could do. The trust and confidence that staff had in individuals in performing a task led to notable pride:
Sara: and then I serve customers, that I get a lot of praise for from my supervisors. They think I am very good. (…) the most fun is making sandwiches for the customers. Yes, they think I am super good at this.
Liam: I have received a lot of trust from *supervisor’s name* and that I will take care of that job. They trust that I will get it done.
Being good at certain tasks and receiving praise and trust to complete these, made the participants feel valued and contributed to a positive experience.
Benefits
In this theme, two subthemes illustrate the benefits of participating in Daily Activity: having Something to do and Stability and flexibility.
For many, Daily Activity is expressed as ‘something to do’. Participants prefer to be occupied, rather than sit at home and do nothing. This suggests that Daily Activity, can for some, be regarded as the only option for keeping busy. Daily Activity is described positively if it allows the participants to be active. Past placements that were sedentary contributed to a negative experience. Liam says:
(…) when it was raining outside, they (another Daily Activity) would not do so much. They would just sit indoors and twiddle their thumbs and not do anything. (…) because I am a person that wants to move as much as possible.
Daily Activity provides opportunities to try different activities and be exposed to new settings and people.
Participating in Daily Activity entailed following set schedules, which led to routines and stability. The stability of Daily Activity was also facilitated by receiving subsidies from the National Insurance Agency. Flexibility and room to learn and grow were emphasized. When participants were late or sick, they were met with understanding. The flexibility of Daily Activity allowed Henry to try different placements until he found one that suited him: ‘It may fit some, it may not fit others, it depends on which placement you are at’. The flexibility and continuous support give individuals room to develop at their own pace. Matteo says:
(…) in the beginning I would just lay on the couch most of the time. (…). They (staff at Daily Activity) say I have made a great improvement and from what I can see myself, I have made a great improvement. I am now quite an active and contributing participant.
In general, all the participants were satisfied with their Daily Activity placement. Only one participant expressed an unproductive and repetitive environment.
Experiences with transitions between occupations
The participants had various experiences of transitions between different occupations, meaning they had participated in Daily Activity, as well as employment, further education, and/or periods as NEED. Some had multiple transitions between occupations, while others had only had Daily Activity since finishing secondary school. The experiences with transitions are presented in the following themes: environmental barriers with employment, limited interest with further education, and changes and being NEED.
Environmental barriers with employment
How individuals are viewed by the labor market, employers, and agencies is highlighted as a challenge in gaining employment. An influential factor is being deemed as incapable by employers and agencies:
Liam: Him, the employer, thought that I did not behave very well. So right now, I am regarded as unable to work, because it says in their documents at the employment agency, that I am not capable to take care of a job.
A few participants had attempted to find a job or had employment training through the Swedish Public Employment Service. These attempts were unsuccessful, and either led to being NEED or starting in Daily Activity. One aspect was poor support from authorities, for example, unsupportive case managers, and overwhelming processes. Another aspect was that employers were not willing to accommodate individual needs. Alice says ‘I had to apply for new jobs, but no one wanted to hire me. Because of my needs and such. So, then I applied for Daily Activity’. Experiences with employment suggest that some participants have been and are able to work.
Limited interest with further education
Four participants had experience with further education. Some completed these, while others dropped out. Challenges with further studies focused on poor support from teachers, restrictive settings, difficulties with planning, and online teaching. Poor grades from secondary school also posed challenges, as described by Liam who was interested in higher education but not eligible: ‘(…) for a while I wanted to study electric work, (…) but I did not have any good grades for that’.
The interest in pursuing further education in the future among all the participants was low. It was considered not the right occupational choice for many, as Henry says, ‘school desks are not for me’.
Changes and being NEED
Eleven participants had periods of being NEED that ranged from a few months up to 14 years. Many characterized this time as negative, boring, and feeling restless. Several reasons were provided as to why individuals ended up not having an occupation. One was a lack of options. Michael says ‘(…) they had no alternatives. They said there was nothing, we can’t offer you any type of occupation because nothing is available’. In such cases, being NEED occurs when transitioning between Daily Activity placements, or between different occupations. Participants also mentioned their well-being and poor formal support as factors that resulted in being NEED.
The systems of service and support seem to at times work against the individual, as opposed to in favor of them. An example is that the systems do not allow combining different occupations, with the prospect of losing subsidies. Henry says:
Because the employment agency cannot find out about that, because then it will be a damn nag. I was so stupid; I opened my mouth to them one time. But now I have learned that if it happens again, that I get another job like that, then I’m not going to say sh*t (…), the thing is that I get money from the social insurance agency and all that.
Two typologies
Two typologies are presented based on participants’ experiences of Daily Activity and transitions between occupations: The Content Group and The In-between Group.
The Content Group
This group consists of individuals who are content with Daily Activity. They enjoy their current placement and express no desire to leave or change to another occupation. Those in The Content group express the structure and content of Daily Activity as fitting and meaningful. Aspects that contribute to this contentment include the sense of community, relationships with others and their supervisors, stability of daily routines, support being individually tailored, and flexibility. Enjoying their tasks also led to contentment and satisfaction. For example, when asked what is most fun with Daily Activity, Mira refers to her tasks: ‘(…) to serve customers and ask what they want to order and give them their order and such’.
The In-between Group
This group encompasses individuals who can be considered stuck in between the transition from Daily Activity to another occupation. These individuals express a readiness or desire to leave Daily Activity and many list employment as their occupational goal. Participants describe the benefits of employment in terms of being a real job, a marker of adulthood, working with their interests, and having an income. Some found Daily Activity to be a good steppingstone, but now feel they want to move on. Many express barriers in leaving Daily Activity such as fearing change, worrying they will lose their Daily Activity placement, worrying they will lose their financial subsidy, and being uncertain about how to find a job, as Matteo says:
(…) I feel that I don’t want to do this so much longer, but I have no idea what I’m supposed to do, because I am worried about money or change and such things.
For Alice, the transition from her employment ending to returning to Daily Activity was made difficult by agencies. Subsequently, she is reluctant to find employment again in fear of losing her Daily Activity placement. This highlights issues with the systems of service and support, that rather than supporting individuals create barriers.
Discussion
The study has examined first-hand experiences of participating in Daily Activity and transitions between Daily Activity and other occupations, for people with intellectual disability in Sweden. The findings demonstrate that Daily Activity is a meaningful occupation when it consists of choices, valuable relationships, flexibility, and feeling proud of one’s contribution. The participants’ experiences of occupational transitions highlighted difficulties with pursuing paid employment, low interest in further education, and periods of being NEED. Together this suggests that transitioning out from Daily Activity can be challenging.
Self-determination is influenced by various individual and environmental factors (Parchomiuk, Zyta and Cwirynkało 2025; Ryan and Deci 2017; Wehmeyer and Garner 2003). On an individual level, aspects surrounding having an intellectual disability, personal characteristics, or preferences can influence self-determination in Daily Activity, higher education, or the labor market. On an environmental level, varied norms, contexts, and structures are influential. For example, self-determination in Daily Activity may be more feasible and present in choosing tasks or adjusting schedules to fit the individual, compared to self-determination in the labor market which is governed by other laws, regulations, competitiveness, and norms.
The magnitude of individual and environmental influence can vary (Parchomiuk, Zyta and Cwirynkało 2025; Wehmeyer and Garner 2003). However, the present study focuses on the interplay between individual and environmental factors that influence self-determination in Daily Activity and occupational choice. If the individual themselves chooses Daily Activity, in conjunction with the environment promoting autonomy, flexibility, relationships, stability, and pride, together these factors affect self-determination in occupational choice. The study found that exerting autonomy in the choice of Daily Activity and tasks had a positive impact on the participants’ experiences. Having environments that provide choices can increase self-determination (Wehmeyer and Garner 2003) and highlight the importance of occupational choice (Frounfelker, Anne and Bartone 2021; Mahoney et al. 2016). Various experiences of being ‘causal agents’ (Wehmeyer 2020) are demonstrated in the results, such as participants making decisions about entering Daily Activity, or the tasks and placements they have.
On the contrary, if individuals do not desire to participate in Daily Activity, as well as having a lack of opportunities, limited autonomy, and support, this hinders their self-determination. Subsequently, Daily Activity may not feel meaningful for individuals who feel stuck and would rather pursue another occupation. Self-determination includes feeling in control (Wehmeyer 2020) and congruency between individual desires and real life (Ryan and Deci 2017). An intellectual disability and a need for support should not negate autonomy and agency (Mahoney et al. 2016; Skarsaune et al. 2021; Skarstad 2018). The findings demonstrate that self-determination in the experiences of people with intellectual disability in Daily Activity varies and impacts whether this is a meaningful occupation or not.
Under the Swedish LSS Act (LSS 1993, 387), Daily Activity should promote and increase transitions to employment, but the results of the present study show that very few participants had experience with employment, and more so challenges were highlighted in obtaining and maintaining employment. On the one hand, this reinforces the difficulties for people with intellectual disability in finding employment (Morris et al. 2024; Taubner, Tideman and Staland-Nyman 2023), on the other hand, it questions whether Daily Activity is a preferred occupation or the only alternative. Few participants had further education, coupled with low interest to pursue further education, which falls in line with national statistics (Arvidsson, Widén and Tideman 2015; Swedish National Council of Adult Education 2023). Since people who have attended USSID in Sweden have limited higher education options, this could also contribute to the general low interest. Given the importance of education in a competitive labor market, it raises concerns about the opportunities for people with intellectual disability. Another concerning finding was the commonality of being NEED. During these periods, the participants described feeling restless and frustrated, as well as concerns related to their well-being. Previous research has demonstrated that being NEED is not a linear process and is a difficult time for many (Luthra 2020).
Although the use of typologies can reduce variation, it facilitates systematizing diverse experiences to aid understanding and interventions. The two typologies illustrate that individuals in Daily Activity have different needs, goals, and circumstances. For example, differences in willingness to start Daily Activity, or differences in occupational goals. This questions the notion that Daily Activity is the best occupation for everyone. Daily Activity is a meaningful and enjoyable occupation for many, as seen with The Content Group. The central aspects of contentment such as community, relationships, stability, and quality of life, adheres to other research (Hartnett et al. 2008; Nikku 2011; Svanelöv et al. 2019). Although The Content Group is currently satisfied with their occupation, it is vital to ensure that this continues. This could be enforced by continuous individual evaluations that ensure satisfaction or support in trying different placements. It is also important to consider other occupational alternatives, as illustrated with The In-between Group. Individuals in this group can be regarded as stuck in transitioning from Daily Activity to employment. The findings reinforce Daily Activity’s limitations, and that many have a desire for a job in the labor market (Luthra et al. 2018; Luthra, Tideman and Nyman 2024; Nikku 2011). Not only would individuals need continuous support to obtain and maintain employment but also support with other relevant factors such as ensuring their financial situation is not affected. A recommendation is to allow participants to retain their Daily Activity placement and the benefits this entails, while at the same time trying employment. The In-between Group is an example of how Daily Activity is a process rather than an end destination. In other words, Daily Activity can be a first step for those who need additional support and flexibility. However, as the individual develops, they should progress and have appropriate support to leave Daily Activity if they desire and feel ready to.
Implications and Conclusion
The study contributes to understanding how individuals experience Daily Activity as well as transitioning between different occupations in a Swedish context. The findings demonstrate the need for continuous evaluations of conditions and experiences of participants in Daily Activity, to ensure occupational satisfaction as well as assess progression. To promote self-determination, individuals should receive support and opportunities that facilitate autonomy and occupational choice. Finally, a system that allows for combining different occupations, while still retaining the stability of Daily Activity, is necessary. In conclusion, Daily Activity is a valuable occupation for many. However, while it fits some, it may not fit others; as such, it is important to implement strategies and initiatives that meet the needs of a diverse group of people with intellectual disability and their occupational goals.
The study has a Swedish context. However, despite varying welfare systems and labor markets, the findings also have international relevance given the necessity of choice that corresponds to self-determination, particularly in relation to a meaningful occupation. Future research should explore approaches that support a desired transition to employment for participants in Daily Activity, as well as the variability in content and design of Daily Activity, such as how it is experienced in different contexts and for people with mild versus extensive intellectual disability.
Competing Interests
The authors have no competing interests to declare.