Functional grouping in residential homes for people with intellectual disabilities.
Grouping residents by challenging behavior creates colder, less collaborative staff care—mix abilities and build staff teamwork instead.
01Research in Context
What this study did
Mansell et al. (2003) visited small residential homes for adults with severe intellectual disabilities. They compared homes where all residents had severe challenging behavior with homes that mixed residents by ability level.
Trained observers rated staff warmth, teamwork, and overall care quality during everyday activities. The study used a quasi-experimental design—no random assignment, but careful matching of homes.
What they found
Homes that grouped residents by challenging behavior scored lower on every care quality measure. Staff showed less warmth and worked together less effectively.
The negative effects were clear even though both types of homes had similar sizes and funding.
How this fits with other research
Lerner et al. (2012) looked at the same question nine years later and found no real difference between grouped and mixed homes. The key difference: they matched homes by residents' adaptive skills, not just behavior severity. This suggests the 2003 negative finding may reflect unmeasured skill differences, not grouping itself.
Earlier studies painted a rosier picture. Mansell (1994) showed specialized group homes boosted daily engagement, while Hassin-Herman et al. (1992) found small community homes beat larger institutions on staff interaction. These predecessor studies focused on moving people out of institutions—the benefit source was leaving bad settings, not grouping by function.
Fyfe et al. (2007) helps explain why grouping by behavior fails: homes that later broke down had weaker staff training and teamwork from the start. Functional grouping may just concentrate already-struggling staff teams.
Why it matters
If you place adults with severe challenging behavior together, you risk creating cold, fragmented care teams without meaningfully helping residents. Before recommending specialized homes, assess the team's training, supervision, and collaboration skills. Mixed-ability placements often work just as well when residents' skill levels are balanced. Focus your energy on strengthening staff competence and teamwork rather than perfecting client group composition.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →During your next residential visit, rate staff warmth and teamwork—if low, recommend mixed-ability placement or staff training before approving specialized homes.
02At a glance
03Original abstract
The effects of functional grouping of people with intellectual disabilities on care practices in small residential homes in the community were investigated. A group comparison and a matched-pairs comparison were carried out in settings where less than or more than 75% residents were non-verbal, non-ambulant, had severe challenging behaviour, severe social impairment or were verbal and ambulant. Further analysis, focused on those with challenging behaviour was carried out using ordinal regression. In the group-comparison study, no significant differences were found for three of the five groups. Residents who were non-ambulant were rated as receiving care with less interpersonal warmth in grouped settings; residents with severe challenging behaviour were rated as receiving less good care practices in four respects (interpersonal warmth, assistance from staff, level of speech and staff teamwork) in grouped settings. The matched-pairs comparison found significant differences only for people with challenging behaviour, where grouped settings achieved less good results in terms of interpersonal warmth and staff teamwork. Higher adaptive behaviour and mixed settings were predictive of better care practices on 13 of 14 items of the Active Support Measure (ASM), with some setting variables also predictive for some items. Care practices only appear to vary for people with challenging behaviour, where grouped settings appear to offer less good results in some respects.
Research in developmental disabilities, 2003 · doi:10.1016/s0891-4222(03)00027-1