Historically, the condition we now refer to as intellectual disability has been conceptualized using models that were extension of the medical model. Recent advances, however, have emphasized person-environment fit models of disability that view disability, intellectual, and other cognitive disabilities, as the lack of fit between a person's capacities and the demands of the context. This chapter examines these shifts in conceptualization and the ways in which this changes how interventions are designed to provide support to enable people with intellectual disability to live, learn, work, and play in their communities. Such interventions and supports include issues pertaining to Universal Design for Learning, multi-tiered systems of supports, and the primacy of promoting the selfdetermination of people with disabilities. The importance of efforts to promote social inclusion is also discussed, as well as strategies to promote transition to adulthood. Authors from several countries provide examples of how these new intervention paradigms are being implemented across the world.