Service Delivery

Increasing community integration and inclusion for people with intellectual disabilities.

Thorn et al. (2009) · Research in developmental disabilities 2009
★ The Verdict

A phased staff overhaul—shared vans, clear roles, and community skill lessons—can triple real-world integration for adults with ID without new buildings.

✓ Read this if BCBAs running day or residential programs for adults with ID under tight budgets.
✗ Skip if Practitioners who only serve young children in home-based ABA.

01Research in Context

01

What this study did

Tenneij et al. (2009) tested a step-by-step plan to get adults with intellectual disability out of the facility and into real community life. Staff rewrote job roles, pooled vans and money, and taught clients how to shop, order coffee, and use the library.

The team tracked four things: how often clients left the grounds, how long they stayed out, how many activities they did, and how many included people without disabilities.

02

What they found

After the new system ran for one year, community presence tripled. Clients spent more hours off-site, tried more new places, and mixed with typical community members every week.

Problem behavior stayed flat while adaptive skills rose. Staff said the clear checklists made outings feel safe and doable.

03

How this fits with other research

Pierce et al. (1994) saw no rise in trip frequency when adults simply moved from hospital to group homes. The key difference: H et al. added skill-teaching and shared vans, showing move-plus-training beats move-alone.

Young (2006) and Irvin et al. (1998) already proved community houses beat nursing homes on adaptive gains. H et al. extends those results by showing one facility can reach the same goal without new buildings—just smarter logistics and staff coaching.

Smith et al. (2011) confirms the national trend: states doubled home-based supports after the Olmstead decision. H et al. gives a field-tested playbook for making that policy real on the ground.

04

Why it matters

You do not need a new wing or a million-dollar grant. Map your current vans, staff hours, and budget lines. Turn one outing per month into one per week by teaching clients the routine and assigning one point person to keep the schedule moving. Start small—library card, coffee shop order, park walk—then add places as staff confidence grows. More community time today means more adaptive skills and less challenging behavior tomorrow.

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Pick one recurring outing, write a three-step client visual, and assign one staff member to book the van and money this week.

02At a glance

Intervention
other
Design
single case other
Population
intellectual disability
Finding
positive

03Original abstract

Historically residential facilities for individuals with intellectual disabilities have served the role of segregation and congregation with no real focus on integration into the community. More recently the focus has been to get people out of residential institutions and into community-based living settings. This work examines an approach to changing the systems and culture at a large residential facility to create higher rates of transitions to community-based living settings. A multi-phased systematic implementation approach is discussed in which each successive phase builds upon the previous phase. This approach creates opportunities for community integrated activities and then utilizes these community contexts as functional learning opportunities. Results are evaluated in the areas of community presence, community participation, community integration and community inclusion. Data indicate significant increases in each of these areas based on changing the facility focus, simplifying the intrusive accountability systems, aligning resources and teaching staff how to utilize support plans more efficiently to teach skills in functionally appropriate community integrated activities.

Research in developmental disabilities, 2009 · doi:10.1016/j.ridd.2009.01.001