Diagnostic grouping among adults with intellectual disabilities and autistic spectrum disorders in staffed housing.
Mixing adults with and without ASD in staffed housing yields the same adaptive gains as grouping by diagnosis.
01Research in Context
What this study did
Researchers matched adults with ID and ASD on their daily living skills.
They compared two housing types: homes where everyone had ASD and homes where residents had mixed diagnoses.
The study tracked adaptive behavior and problem behavior for both groups.
What they found
After matching, both housing types produced the same outcomes.
Adults improved equally whether they lived with others who had ASD or not.
The only difference was size: non-congregate homes were larger and used more organized routines.
How this fits with other research
Young (2006) showed adults with ID gain more skills in dispersed community houses than cluster centers.
Mansell et al. (2003) warned that grouping people with severe challenging behavior together hurts staff warmth and teamwork.
These studies seem to clash, but they test different questions. The 2012 paper holds adaptive level constant, so it isolates the effect of ASD grouping, not housing size or staff ratio.
Why it matters
You can stop worrying about diagnostic labels when placing adults with ID and ASD. Match residents on skill level instead. Mixing or separating by ASD makes no difference for daily living gains. Focus on small, well-staffed homes and good routines.
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02At a glance
03Original abstract
BACKGROUND: There is little evidence to guide the commissioning of residential provision for adults with autistic spectrum disorder (ASD) in the UK. We aim to explore the degree and impact of diagnostic congregation among adults with intellectual disabilities (ID) and ASD living in staffed housing. METHODS: One hundred and fifty-seven adults with intellectual disabilities from a sample of 424 in staffed housing were assessed as having the triad of impairments characteristic of ASD. They lived in 88 houses: 26 were non-congregate (40% or fewer residents had the triad) and 50 congregate (60% or more had the triad); 12 with intermediate groupings were eliminated. Non-congregate and congregate groups were compared on age, gender, adaptive and challenging behaviour, house size, staff per resident and various measures of quality of care and quality of outcome. Comparisons were repeated for Adaptive Behavior Scale (ABS)-matched, congregate and non-congregate subsamples. RESULTS: Non-congregate settings were larger, had lower staff per resident and more individualised social milieus. Groups were similar in age and gender but the non-congregate group had non-significantly higher ABS scores. The non-congregate group did more social, community and household activities. After matching for ABS, these outcome differences ceased to be significant. Non-congregate settings were significantly larger and had significantly more organised working methods. CONCLUSIONS: The findings are consistent with other research that finds few advantages to diagnostic grouping.
Journal of intellectual disability research : JIDR, 2012 · doi:10.1111/j.1365-2788.2011.01496.x