Background: A consumer-directed service-delivery approach to assistive technology and environmental modification intervention was examined with people who were ageing with intellectual disabilities. Material and Methods: The intervention was based on a collaborative approach involving consumers, their social supports and service deliverers. Thirty individuals were randomly selected to receive the intervention from a sample of 75 community-dwelling adults. Outcomes related to consumers' and significant others' perceptions of performance and satisfaction with goal attainment were assessed and the consumer-directed goal planning process examined. Results: Participants in the intervention group reported significantly higher levels of performance and satisfaction related to goals identified at baseline than participants in the control group. Two broad categories of goals were addressed during the intervention--basic self-care goals and participation/environmental/systems level goals. A 98% direct agreement rate between consumer-identified goals and goals addressed by service deliverers was found during the intervention. Of the environmental strategies employed during the intervention, assistive devices and systems level advocacy and action were the two most frequently used across goals. Conclusion: Results provide evidence in favour of a consumer-directed approach to assistive technology and environmental modification service delivery for consumers who are ageing with intellectual disabilities.