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Everyone seeks to engage in meaningful activities. When people require assistance to engage in activities, they can be at risk for limited access to activities that they find meaningful. This can directly affect their willingness to engage in those activities. This book describes a study with adults with moderate to severe developmental disabilities and staff members who work with them in a day program. The methods include new ways to ascertain what is meaningful to individuals who cannot answer in-depth questions. The results demonstrate the importance of the relationship between staff members and individuals with developmental disabilities, factors that improve engagement in activities, and the value of active engagement on individuals'' lives. The author includes practical strategies about how to implement changes to improve the lives of individuals with moderate to severe disabilities as well as their staff members. This information is essential for people who work with individuals with moderate to severe developmental disabilities and also may be valuable for those who work with other populations with similar needs for assistance.