Out-of-home placement of children and adolescents with severe handicaps: behavioral intentions and behavior.

Researchers asked 59 parents of kids with severe disabilities one simple question: 'Do you think your child will ever live outside your home?' They tracked families for six years to see who actually moved their child to a group home, hospital, or other out-of-home setting.

The kids had IQs under 50 and serious behavior or medical needs. The team wanted to know if that single parent rating could predict future placement.

Parents who said 'yes, I expect placement' were more likely to place their child within six years. The one-item forecast got stronger over time. By year six it showed a modest but clear link to real moves.

Most kids stayed home, but the scale still picked out the families at highest risk.

Thillainathan et al. (2024) shows what happens after placement: adults in a high-quality ABA group home gained adaptive skills and lost severe behavior. Szempruch et al. (1993) tells us who might enter that door in the first place.

van der Miesen et al. (2024) found caregiver-delivered SIB treatment at home works as well as clinic care. That seems to clash with J's finding that some families still seek out-of-home care. The difference is severity: R's meta kept kids safe at home; J's sample had medical issues and profound ID that outstripped family capacity.

Holwerda et al. (2013) extends the idea: just as parent intent predicts placement in kids, motivation and expectations predict job success in young adults with mild ID.

You can add one question to your intake or re-assessment: 'On a scale from 1-5, how likely is it that your child will live outside your home in the next few years?' A rising score flags families who may need respite funding, crisis planning, or residential options before burnout hits. Re-ask yearly; the predictive power grows over time.