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Descriptors:
Independent Living; Mental Retardation; Group Homes; Foreign Countries; Comparative Analysis; Residential Programs; Adults; Place of Residence; Planning; Access to Health Care; Access to Information; Locus of Control; Self Determination; Community Programs; Satisfaction; Attitude Measures

Abstract:
Background: This paper reports on some of the findings of a large-scale survey (n = 852) of family members and support staff of adults with intellectual disabilities receiving community living services in British Columbia, Canada, concentrating on comparison of outcomes across four types of community residential settings: group homes, family model homes, independent home or apartment, and family home. Method: Comparisons were conducted on six domains: "information and planning"; "access to and delivery of supports"; "choice and control"; "community connections"; "satisfaction"; and, "overall perception of outcomes". Where applicable, further multivariate analyses were undertaken to determine the effect of the degree of help required by the residents and the respondent type. Results: Findings indicate that on all measures other than choice and control, group homes and family model homes showed better outcomes than either independent settings or family homes. Conclusion: The findings may indicate that the move to more independent living settings is not being accompanied by appropriate supports. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Program Design; Program Development; Mental Retardation; Quality of Life; Foreign Countries; Adults; Behavior Problems; Residential Programs; Theories; Severe Disabilities; Program Effectiveness; Cooperation; Teamwork; Observation; Interviews

Abstract:
Background: Adults with severe challenging behaviour can achieve good "quality of life" outcomes in small supported accommodation services. Yet, the research indicates that they typically experience poorer outcomes than other adults with intellectual disability. This raises questions about the degree to which research has informed program design and implementation. Methodology: Data from an evaluation of a residential support service outlines a "program theory" for supporting people with intellectual disabilities and severe challenging behaviour. Results: One aspect of the "program theory," the "practice framework," which details how support staff should interact with service-users, is illustrated through documentary, observational and interview data. Conclusions: Policy and practice should be informed by the knowledge we have about what works. Describing a "program theory" demonstrates the utility of developing a "program theory" for human service organizations and underscores the value of practitioners being familiar with the findings of relevant, good-quality research. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Mental Retardation; Autism; Quality of Life; Rating Scales; Questionnaires; Residential Programs; Adults; Pervasive Developmental Disorders; Behavior Problems; Behavior Change; Program Effectiveness; Severity (of Disability); Observation; Scores

Abstract:
Background: Owing to methodological issues, little research has been conducted to examine quality of life (QoL) as a treatment outcome in autism spectrum disorders (ASD) and intellectual disabilities (ID). This study was conducted to combine QoL measures and objective observations of challenging behaviours (CB) in order to evaluate changes over time in adults with ASD and ID who were treated in two different residential programmes; we hypothesised that a decrease in CB would be related to an improved QoL. Method: In a longitudinal study (45 months), we followed 31 adults with ASD and ID who had been integrated into two residential programmes [Autism Programme with a Structured Method (PAMS) vs. traditional programme for ID (No-PAMS)] for 2-19 years. QoL [Quality of Life Inventory in a Residential Environment (IQVMR)] and severity of autistic features (Childhood Autism Rating Scales) were evaluated annually. CB, as measured by the Aberrant Behaviour Checklist (ABC), including stereotypic behaviour and inappropriate speech, were repeatedly assessed every 3 months. Results: Observed separately, the groups' results were different. In the PAMS programme, stereotypic behaviour and inappropriate speech (ABC scores) significantly decreased, and the IQVMR total score increased; in contrast, in the comparison group, ABC scores did not change and the IQVMR total score decreased. In all, three mixed-effect ANCOVAs partially confirmed that the PAMS programme had an effect on CB and that QoL improvement did not directly depend on the type of programme but on reducing CB as measured by the ABC. Conclusion: The PAMS programme has a positive and indirect influence on QoL by reducing CB. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Mental Retardation; Quality of Life; Foreign Countries; Financial Support; Residential Programs; Adults; Followup Studies; Social Support Groups; Interviews; Family Relationship; Behavior Modification; Behavior Problems

Abstract:
Background: The Taiwanese government launched a new programme in November 2004 to support adults with intellectual disabilities living in smaller facilities. This paper aims to evaluate the service outcomes of this new residential scheme over 2 years including those residents who moved from an institution and those who moved from their family. Methods: A one-group repeated-measures analysis was conducted for five interviews after the adults with intellectual disabilities entered the new environment. Forty-nine adults were initially studied (T1) and 29 adults remained in the homes until the end of the study (T5). Results: This study found significant improvements over the 2 years in the residents' quality of life and family contact. The results also highlight a decrease in maladaptive behaviour among the residents moving from institution and an increase in choice making and family contact among the residents moving from family. No significant changes in adaptive behaviour and community inclusion were found. Conclusion: Results revealed that further policy changes and financial support including service quality assurance are required in order to improve service outcomes for adults living in the new residential scheme. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Participant Characteristics; Place of Residence; Mental Retardation; Quality of Life; Adults; Group Homes; Residential Programs; Comparative Analysis; Age Differences; Gender Differences; Behavior; Interpersonal Competence; Participation; Recreational Activities

Abstract:
Background: The quality of life of adults with intellectual disabilities living in the family home is an under-researched area. The current study compared indicators of household and community activity between adults living in family homes and those in out-of-family placements. Methods: Four datasets were merged to produce information on the household participation and social and community activities of 721 adult participants living independently (n = 30) or in family (n = 142) or staffed homes (n = 559). Data on age, gender, adaptive and challenging behaviour, and social impairment were also available. Participant characteristics and household and community activity indicators were compared across places of residence. In addition, for those living in family or staffed homes, multiple regression was used to examine the association between the activity indicators and place of residence after controlling for participant characteristics. Results: People living independently had higher household participation. People living in staffed housing had higher household participation and did more community activities more frequently than people living in family homes. Place of residence was a significant factor after controlling for participant differences. Conclusions: Interpretation should take account of the limited nature of the activity indicators. However, the comparison adds weight to other recent research suggesting that adults living in family homes may have fewer activity opportunities than those living in supported accommodation. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Foreign Countries; Mental Retardation; Mass Media Use; Information Technology; Accessibility (for Disabled); Access to Information; Influence of Technology; Normalization (Disabilities); Assistive Technology; Youth Agencies; Observation; Visual Aids; Interviews; Photography; Diaries; Social Networks; Individual Activities; Youth Opportunities; Adults; Intergenerational Programs; Daily Living Skills

Abstract:
This study introduces how technology and humans are part of relationships that influence agency among people with disabilities. It aims to focus attention on the use of, and access to, information and communication technology (ICT), and agency among youths and adults with intellectual disabilities. The study draws on empirical research conducted with youths and adults with intellectual disabilities, as well as staff at a day centre. It shows that by drawing upon interests, previous experiences, and cooperating in ICT activities the participants' agency changed. Also, it shows how disability is relational and how it can be influenced by ICT. An interdisciplinary approach is adopted to interpret the findings and to explore: How do people of different ages with intellectual disabilities experience the use of ICT in their everyday lives? Are people with intellectual disabilities able to influence their level of activity by using ICT? And if so, in what ways? Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Quality of Life; Mental Retardation; Correlation; Profiles; Well Being; Social Integration; Individual Development; Self Determination; Services; Role; Civil Rights

Abstract:
Background: The changed societal views of persons with disabilities are reflected in the 2006 United Nations "Convention on the Rights of Persons with Disabilities". However, what is not specified in the Convention is how to operationalise and measure the Articles composing the Convention, and how to use that information to further enhance the human rights of persons with disabilities. Method: The authors analyse the relationships between eight core quality of life domains and the 34 Articles contained in the Convention. Results: There is a close relationship between the core quality of life domains and the 34 Articles contained in the Convention. Furthermore, the current status of these Articles can be evaluated through the assessment of indicators associated with the eight core quality of life domains. Conclusions: Based on the assessment of these quality of life-related outcomes, three strategies can be used to enhance the human rights of persons with intellectual disability. These three are to employ person-centred planning, publish provider profiles and implement a system of support. (Contains 3 tables.) Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Adults; Mental Retardation; Developmental Disabilities; Selection; Correlation; Independent Living; Institutionalized Persons; Residential Institutions; Severity (of Disability)

Abstract:
This article examines everyday choices made by 8,892 adults with intellectual and developmental disabilities (IDD) and support-related choices made by 6,179 adults with IDD receiving services from 19 state developmental disabilities program agencies that participated in the 2008-2009 National Core Indicators Project. Controlling for physical and sensory impairment, age, behavioral support, communication, and state, people in residential settings with 16 or more people had less everyday choice than those in other living arrangements. People with mild and moderate IDD had more control over everyday choices when living in their own homes, whereas people with severe and profound IDD had more control when living in agency homes of 3 or fewer residents. For people of all levels of IDD, institutional settings of 16 or more residents offered the lowest levels of everyday choice. Controlling for the same covariates, individuals with all levels of IDD living in their own homes had significantly more support-related choices than those in any other residential arrangement. Controlling for individual and residential setting characteristics, the state in which sample members lived was notably predictive of support-related choice. Overall, the tested variables accounted for 44% of the variability in everyday choice and 31% in support-related choice. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Adults; Autism; Foreign Countries; Residential Care; Mental Retardation; Costs; Placement; Hospitals; Behavior Disorders; Gender Differences; Age Differences

Abstract:
Background: Concern has been expressed repeatedly about the cost and quality of residential placements for adults with learning disabilities and additional needs. This study sought to identify characteristics of the highest cost placements in the South-East of England. Method: Lead learning disability commissioners in the South-East of England were asked to provide information about the five highest cost residential placements that they commissioned for adults with learning disabilities. Results: The average placement cost of 172k British Pounds per annum disguised wide variation. Individuals placed were mainly young and male with high rates of challenging behaviour and/or autism spectrum disorder. Most placements were in out-of-area residential care. The highest costs were associated with hospital placements and placements for people presenting challenging behaviour. Conclusions: Young, male adults with learning disability, challenging behaviour and/or autism continue to receive very high cost residential support, often in out-of-area residential care. There remains limited evidence of plans to redirect resources to more local service developments. (Contains 1 table and 1 figure.) Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Life Satisfaction; Mental Retardation; Residential Institutions; Quality of Life; Factor Structure; Questionnaires; Factor Analysis; Correlation; Foreign Countries; Psychometrics; Place of Residence; Comparative Analysis; Family Environment; Employment Level; Interpersonal Relationship

Abstract:
We appraised life satisfaction using the Satisfaction with Life Scale (SWLS), and analysed its psychometric properties in persons with intellectual disability (ID). Ninety-nine persons with ID from four services in Spain participated. A battery of subjective assessments was used, including the SWLS, a Quality of Life measure (WHOQOL-BREF), and health status and sociodemographic information. Psychometric properties of the SWLS were investigated using standard psychometric methods. Overall, our results showed that persons with ID were satisfied with their life (SWLS score 25-29). Internal consistency (Cronbach's alpha) was 0.79. A factor analysis using principal components method, showed a one factor structure accounting for 55.7% of the variance. Associations, using Spearman's rho correlation coefficients, were confirmed between SWLS with the overall QoL, satisfaction with health and WHOQOL-BREF total score. Regarding "known group" differences, persons living in residential institutions had lower life satisfaction compared to persons living in community facilities or living at home, though differences were not statistically significant. Student t-tests showed that SWLS scores significantly discriminated between healthy and unhealthy; and those reporting higher satisfaction with their relationships, home environment and their jobs compared to participants with lower satisfaction levels. To our best knowledge, this study is the first to report on the psychometrics properties of the SWLS in persons with ID, both in Spain and internationally. It might be a promising tool to use, with other outcome measures, in appraising persons with ID in different services and types of care; also, it might guide policymakers on the implementation of policies for persons with ID. (Contains 5 tables.) Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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