Quality of life trajectories in persons with intellectual and developmental disabilities undergoing community transition in Central Canada: A longitudinal repeated measures study.
Community homes lift quality of life fast, but the lift melts away without steady staff coaching and leadership.
01Research in Context
What this study did
Cameranesi et al. (2025) tracked quality of life for adults with intellectual and developmental disabilities in Central Canada. The team asked the same people the same questions every year for four years after they moved from large institutions into small community homes.
The study used a quasi-experimental design. That means people were not randomly placed; they moved when spots opened. Still, the repeated measures let the researchers see each person's own ups and downs over time.
What they found
Right after the move, most adults reported better quality of life. Scores dropped back toward the old level as the years passed. Some people kept their gains, others lost them, and a few ended worse off.
The headline: community placement gives a quick boost, but the boost fades without steady support.
How this fits with other research
McGonigle et al. (2014) and Bould et al. (2019) show why the fade happens. Both found that strong practice leadership and trained staff keep Active Support alive in group homes. When those pieces are missing, daily help slips and quality of life follows.
Boudreau et al. (2015) backs the ruler used in the new study. They proved the Pediatric Quality of Life Inventory works well with people who have IDD, so we can trust the up-and-down pattern seen here.
Rose et al. (2000) looked at skill growth over twenty-four years and saw slow but real gains. Their long view pairs with the new four-year data: without good staff systems, skills and quality of life can stall or drop even in community settings.
Why it matters
If you help adults move to the community, plan for year-two and year-three slumps. Schedule booster training for staff, check Active Support levels, and re-visit individual goals before scores dip. Treat the move as the starting line, not the finish.
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Add a six-month ‘Active Support check-up’ to your behavior plan and train staff on the spot if scores dip.
02At a glance
03Original abstract
BACKGROUND: Strong evidence suggests that, compared to congregate care, dispersed community living offers significant quality of life (QoL) benefits for individuals with intellectual and developmental disabilities. However, it is still unclear whether these improvements apply to all domains of QoL or if they remain stable long term. AIMS: This study investigated QoL trajectories across four time points over a 4-year period (2019-2022) in a cohort of Canadian adults with severe-to-profound intellectual and developmental disabilities and extensive support needs who transitioned from an institutional setting to dispersed community group homes in Central Canada. METHODS: A repeated measures quasi-experimental time-series study, without control group was used to address the stated research objective. Four waves of QoL data on 59 study participants was collected using the proxy-report standardized assessment tool San Martin Scale and analyzed at both the individual and aggregate levels using linear mixed-effects models. RESULTS: The mean QoL scores of the study cohort across eight QoL domains changed significantly across timepoints, with the highest scores at the first post-transition assessment and a general decline towards pre-transition levels by the last assessment. Global QoL followed a similar pattern. Notably, some QoL domains showed unique patterns of change. Individual QoL trajectories were highly variable, with some participants experiencing transient improvements and others maintaining sustained gains. IMPLICATIONS: Continued efforts to promote the QoL of persons with intellectual and developmental disabilities should be rooted in a transformative social justice framework emphasizing equity, inclusion, and health and well-being as universal human rights.
Research in developmental disabilities, 2025 · doi:10.1016/j.ridd.2025.105060