Service Delivery

A community living experience: Views of people with intellectual disability with extensive support needs, families, and professionals.

Esteban et al. (2023) · Research in developmental disabilities 2023
★ The Verdict

Community homes lift mood and autonomy for adults with severe ID only if you add constant choice opportunities and staff support.

✓ Read this if BCBAs helping adults with ID transition from institutions to group homes.
✗ Skip if Clinicians focused solely on early-childhood home-based ABA.

01Research in Context

01

What this study did

Bassette et al. (2023) asked adults with severe intellectual disability, their families, and staff how life felt six months after leaving large institutions.

The team used open interviews and small group talks to capture real-life stories.

Everyone shared views on freedom, daily routines, and lingering rules.

02

What they found

People felt happier, joined more activities, and made more choices each day.

Yet some old habits stayed: staff still used restraints or tight schedules.

The gains were clear, but full independence was still a work in progress.

03

How this fits with other research

Navas et al. (2025) tracked a bigger group and found very-large quality-of-life jumps when adults also got daily choice-making chances.

Armas Junco et al. (2025) used the same movers to show that choice opportunities, not the move itself, drove later self-determination gains.

Finke et al. (2017) paints a different picture: staff in UK community teams felt burned out and lacked shared goals, explaining why restrictive habits linger.

Matson et al. (2009) review agrees small homes and positive staff attitudes boost participation, matching the user joy seen here.

04

Why it matters

You can celebrate community placement, but keep two eyes open. First, build in real choices every hour, not just on paper. Second, support staff with clear team goals and burnout buffers so they can drop old medical habits. Do both and the glow reported by Bassette et al. (2023) can last.

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→ Action — try this Monday

Add two client-chosen activities to the daily schedule and give staff a five-minute huddle to plan how to honor those choices.

02At a glance

Intervention
not applicable
Design
qualitative
Sample size
77
Population
intellectual disability
Finding
positive

03Original abstract

BACKGROUND: Despite the benefits of community living for people with intellectual disabilities (ID) and extensive support needs, they remain highly institutionalized. AIMS: To qualitatively analyze the perceptions of people with ID, including those with extensive support needs, professionals, and family members six months after the implementation of 11 community homes for 47 people in different regions of Spain METHODS: Thematic analysis of 77 individual interviews conducted with 13 people with ID, 30 professionals and 34 family members was performed using Nvivo12. RESULTS: Seven themes were found: (1) "the room as I like it", (2) "sometimes I don't obey", (3) "here I do a bit of everything", (4) "lots of people love me here", (5) "all thanks to them, who have helped me" (6) "I miss my mom", and (7) "I'm happy here". IMPLICATIONS: Transitioning into the community has shown a clear positive change in emotional well-being, opportunities to participate in activities or exercise control over one's life. Nevertheless, certain restrictions were still present in people's lives, which significantly limit their right to independent living. While many of these restrictions may disappear, professional practices typical of a medical model can be recreated in services located in the community.

Research in developmental disabilities, 2023 · doi:10.1016/j.ridd.2023.104503