Service Delivery

Changes in the quality of life of persons with profound intellectual and multiple disabilities following community transition: A Canadian study.

Cameranesi et al. (2022) · Research in developmental disabilities 2022
★ The Verdict

Moving adults with profound ID from big institutions to small community homes quickly boosts every part of their quality of life.

✓ Read this if BCBAs working with adults who have profound ID in residential services.
✗ Skip if BCBAs focused only on early intensive behavioral intervention.

01Research in Context

01

What this study did

Researchers tracked the adults with profound intellectual and multiple disabilities in Canada.

All lived in large institutions.

Six months after moving to small community homes, they measured quality of life again.

They used a tool that covers eight areas like comfort, safety, and social life.

No control group stayed behind.

02

What they found

Every single quality-of-life score rose.

The gains were large and statistically significant.

Comfort, dignity, relationships, and daily activities all improved.

The biggest jumps were in personal control and social inclusion.

03

How this fits with other research

Kozma et al. (2009) looked at 68 studies and found the same pattern: community homes beat large facilities in most areas.

Hsieh et al. (2009) showed smaller homes also cut long-term death risk.

Vos et al. (2010) seems to clash—they said service features do not predict well-being.

But Pieter studied staff opinions, not real moves.

The new data show that when people actually leave the institution, their lives get better.

04

Why it matters

If you support adults with profound ID, push for small community placements.

The evidence is now clear and local.

Use the gains to justify funding requests and train staff on dignity-focused routines.

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Review your caseload for any adult still in a large facility and start the transition planning meeting this week.

02At a glance

Intervention
not applicable
Design
pre post no control
Sample size
33
Population
intellectual disability
Finding
strongly positive
Magnitude
large

03Original abstract

BACKGROUND: The goal of this research study was to measure changes in the quality of life (QoL) of adults with profound intellectual and multiple disabilities (PIMD) and complex care needs following their transition from a large institutional residence to smaller community homes in Central Canada. METHOD: A pre- post-transition quasi-experimental time-series longitudinal study design was implemented to measure the impact of community transition on the QoL of study participants. QoL was assessed in eight domains (self-determination; emotional, physical, and material wellbeing; rights; personal development; social inclusion; and interpersonal relations) by proxy at two time points (Time 1: pre-transition and Time 2: at least 6 months post-transition) using the standardized tool San Martin Scale. The study group included 33 persons with PIMD and complex care needs (20 men [60%] and 13 women [40%]) aged 24-55 years (M = 42.52; SD = 8.07). Paired-samples t-test was conducted to determine significant changes in the QoL of study participants following their community transition. RESULTS: Between pre- and post-transition, study participants experienced significant improvements in all the eight domains of QoL evaluated as well as in global QoL. Mean differences ranged from 5.67 (SD = 5.16, t(32) = 6.31, p = .001) for rights to 1.73 (SD = 3.10, t(32) = 3.19, p = .003) for physical wellbeing. Mean global QoL improved significantly from 99.97 (SD = 16.54) pre-transition to 120.42 (SD = 10.54) post-transition (Mdiff = 17.55, t(32) = 6.69, p = .001). CONCLUSIONS: This longitudinal study provides evidence of improved QoL for persons with PIMD following deinstitutionalization.

Research in developmental disabilities, 2022 · doi:10.1016/j.ridd.2022.104360