Assessing placement tendency in families with children who have severe handicaps.

The author followed the families who had a child with severe intellectual disability. Each month for up to two years parents filled out a six-point scale that asked, 'How close are you to placing your child outside the home?'

The scale went from 1 (no thought of placement) to 6 (child already placed). No therapy was given; the goal was to see if the numbers moved in a steady line over time.

Parents did not jump from 'never' to 'yes' overnight. Their scores crept upward in a straight-line trend for 12–24 months before placement happened.

The simple six-point index caught this slow slide early, long before the family asked for a bed.

Steege et al. (1989) watched adults who already lived in facilities. Only 8 % moved in a year, and most shifts were toward more normal community homes. Wall (1990) looks earlier—at the slow parent decision that starts while the child is still at home.

Benderix et al. (2006) interviewed parents two years after a group-home move. They felt relief, guilt, and worry all at once. The linear index in Wall (1990) predicts when families reach this mixed-emotion point.

Pilowsky et al. (1998) showed that smaller, active homes help adults learn daily skills. Wall (1990) gives you the tool to time the move so families can pick those better settings instead of last-resort ones.

You can spot placement risk early. Plot the six-point score each team visit; a rising line tells you to start teaching coping skills, lining up respite, and touring homes before crisis hits. Early planning keeps kids out of poor-quality placements and lowers family stress.