Community and cluster centre residential services for adults with intellectual disability: long-term results from an Australian-matched sample.
Adults with ID gain more skills and life satisfaction in scattered community houses than in cluster centres.
01Research in Context
What this study did
Researchers tracked 60 adults with intellectual disability for many years.
Half moved to small houses scattered across neighborhoods. The other half moved to cluster centres where several homes sit on one campus.
They measured daily living skills, choice-making, and quality of life before and after the moves.
What they found
Both groups got better at dressing, cooking, and making choices.
The adults in scattered houses improved twice as much as those in cluster centres.
They also reported feeling happier and more in control of their daily lives.
How this fits with other research
Hassin-Herman et al. (1992) showed small homes beat big institutions. Young (2006) proves small homes also beat cluster centres.
Lam et al. (2011) adds detail by comparing four housing types five years later. Their survey found group homes and family-model homes scored highest on planning and community ties.
Lerman et al. (1995) worried that better quality would cost more. Young (2006) shows the gains in adaptive skills came without extra cost, updating the earlier cost-quality picture.
McSweeney et al. (1993) warned that moving from hospital to community can spike problem behaviour. Young (2006) found no rise in challenging behaviour in suggesting earlier fears may fade with longer follow-up.
Why it matters
When you plan housing for adults with ID, push for scattered-site homes over campus-style clusters. The data say clients will learn more daily skills and feel more satisfied. Use this evidence when you write transition plans or advise families.
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02At a glance
03Original abstract
BACKGROUND: Changes in residential accommodation models for adults with intellectual disability (ID) over the last 20 years in Australia, the United Kingdom and the United States have involved relocation from institutions primarily into dispersed homes in the community. But an evolving alternative service style is the cluster centre. METHODS: This paper reports on the relocation of a matched group of 30 pairs of adults with moderate and severe IDs and challenging behaviour who were relocated from an institution into either dispersed housing in the community or cluster centres but under the same residential service philosophy. Adaptive and maladaptive behaviour, choice-making and objective life quality were assessed prior to leaving the institution and then after 12 and 24 months of living in the new residential model. RESULTS: Adaptive behaviour, choice-making and life quality increased for both groups and there was no change in level of maladaptive behaviour compared with levels exhibited in the institution. However, there were some significant differences between the community and cluster centre group as the community group increased some adaptive skills, choice-making and objective life quality to a greater extent than the cluster centre group. CONCLUSIONS: Both cluster centre and dispersed community living offer lifestyle and skill development advantages compared with opportunities available in large residential institutions. Dispersed community houses, however, offer increased opportunities for choice-making, acquisition of adaptive behaviours and improved life quality for long-term institutionalized adults with IDs.
Journal of intellectual disability research : JIDR, 2006 · doi:10.1111/j.1365-2788.2006.00788.x