Choice of living arrangements.
Adults with ID rarely choose where they live—fight for individualized housing to give them voice and stability.
01Research in Context
What this study did
The team mailed a national survey to agencies serving adults with intellectual disability. They asked where each adult lived and how much choice the person had in picking that home.
Settings ranged from large state centers to small agency apartments and the person's own home.
What they found
Most adults had little say in where they lived. People in individualized settings—own home or agency apartment—reported far more choice than those in larger facilities.
Size mattered: smaller homes gave more voice.
How this fits with other research
Tichá et al. (2012) asked almost 9,000 adults across 19 states the same question and got the same answer—smaller homes and even the state you live in predict daily choice.
Leung et al. (2014) tracked the same adults for 20 years and found that better daily-living skills and fewer early moves kept people in stable, preferred homes, turning the snapshot into a life-long story.
Mount et al. (2011) looked at 14 European countries and added a twist: adults who moved out of institutions often gained choice but lost routine health screenings, showing choice and health can pull in opposite directions.
Why it matters
When you write an ISP or plan discharge, push for the smallest, most individualized housing the budget allows. Use these data to justify waivers, micro-boards, or supported-living slots. More choice now predicts longer, more stable placements later.
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02At a glance
03Original abstract
BACKGROUND: The rights to choose where and with whom to live are widely endorsed but commonly denied to adults with intellectual disabilities (ID). The current study provides a contemporary benchmark on the degree of choice exercised by adult service users in the USA. METHOD: Data came from the National Core Indicators programme. Participants were 6778 adult service users living in non-family-home service settings in 26 US states. RESULTS: Most adults with ID did not participate in choosing where and with whom to live. Those with more support needs because of more severe ID and/or co-occurring conditions experienced less choice regarding living arrangements. Individuals living in their own home or an agency-operated apartment were more likely to choose where and with whom to live than individuals in nursing homes, institutions or group homes. However, few individuals with severe or profound ID chose where and with whom to live regardless of where they lived. CONCLUSIONS: In 2008, despite community-living policies that emphasise choice, many adult service users with ID in the USA experienced little or no choice about where and with whom to live, especially those individuals with more severe ID. Our findings provide a clear endorsement of policies promoting more individualised living settings, such as one's own home or an agency apartment, because these settings do provide substantially more choice about living arrangements.
Journal of intellectual disability research : JIDR, 2011 · doi:10.1111/j.1365-2788.2010.01336.x