Comparing residential programmes for adults with autism spectrum disorders and intellectual disability: outcomes of challenging behaviour and quality of life.
A four-year autism-specific ABA residence cut stereotypy and boosted quality of life compared with standard ID services.
01Research in Context
What this study did
Gerber et al. (2011) compared two long-term homes for adults with autism and intellectual disability. One home used the Autism Programme with a Structured Method (PAMS). The other used standard intellectual disability services.
The team tracked challenging behavior and quality of life for almost four years. They wanted to see if an autism-specific ABA program works better than generic care.
What they found
Stereotypic behavior and inappropriate speech dropped in the PAMS house. Quality-of-life scores also rose. The usual ID program showed no such gains.
In plain words, adults lived better and acted out less when staff used ABA tailored for autism.
How this fits with other research
Gitimoghaddam et al. (2022) looked at 770 youth ABA studies and found almost zero quality-of-life data. Gerber et al. (2011) fills that gap by showing QoL can improve in adults.
Young (2006) tested two older residential models for generic ID. Both helped a little, but the autism-specific PAMS program in Gerber et al. (2011) moved the needle further.
Chezan et al. (2019) ran a short outpatient ABA program for kids and saw behavior gains yet no QoL change. The longer PAMS stay links ABA to both behavior and life-quality gains, hinting that duration and setting matter.
Why it matters
If you place adults with ASD and ID in long-term residential care, ask whether the program uses autism-specific ABA. Generic ID training is not enough. Push for structured daily teaching, behavior plans, and QoL tracking across years. These pieces cut stereotypy and rude talk while making life feel better for the people you serve.
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02At a glance
03Original abstract
BACKGROUND: Owing to methodological issues, little research has been conducted to examine quality of life (QoL) as a treatment outcome in autism spectrum disorders (ASD) and intellectual disabilities (ID). This study was conducted to combine QoL measures and objective observations of challenging behaviours (CB) in order to evaluate changes over time in adults with ASD and ID who were treated in two different residential programmes; we hypothesised that a decrease in CB would be related to an improved QoL. METHOD: In a longitudinal study (45 months), we followed 31 adults with ASD and ID who had been integrated into two residential programmes [Autism Programme with a Structured Method (PAMS) vs. traditional programme for ID (No-PAMS)] for 2-19 years. QoL [Quality of Life Inventory in a Residential Environment (IQVMR)] and severity of autistic features (Childhood Autism Rating Scales) were evaluated annually. CB, as measured by the Aberrant Behaviour Checklist (ABC), including stereotypic behaviour and inappropriate speech, were repeatedly assessed every 3 months. RESULTS: Observed separately, the groups' results were different. In the PAMS programme, stereotypic behaviour and inappropriate speech (ABC scores) significantly decreased, and the IQVMR total score increased; in contrast, in the comparison group, ABC scores did not change and the IQVMR total score decreased. In all, three mixed-effect ANCOVAs partially confirmed that the PAMS programme had an effect on CB and that QoL improvement did not directly depend on the type of programme but on reducing CB as measured by the ABC. CONCLUSION: The PAMS programme has a positive and indirect influence on QoL by reducing CB.
Journal of intellectual disability research : JIDR, 2011 · doi:10.1111/j.1365-2788.2011.01455.x