Social impairment in the "Care in the Community" cohort: the effect of deinstitutionalization and changes over time in the community.
Moving out of an institution rarely improves social life unless the new home is small, resident-driven, and paired with planned social teaching.
01Research in Context
What this study did
Donnelly et al. (2003) followed about 250 UK adults who left large institutions. The team wanted to know if living in ordinary houses would fix their social problems. They checked social skills at move-out and again one year later.
What they found
Half the group had serious social trouble at the start. One year on, the rate dropped only a little, and some skills got worse. The change was too small to call a win.
How this fits with other research
Bhaumik et al. (2009) saw big drops in aggression after the same move, so positive change is possible. Young (2006) went further and compared housing styles; adults in small, scattered homes gained more daily-life skills than those in campus-style units. Friedman (2019) looked at a larger, newer US sample and found that provider-run group homes often copy the old ward culture, which helps explain why Julie’s group saw so little social gain. English et al. (1995) surveyed adults already living in the community and found they still talked mostly to other disabled people, backing up the idea that placement alone does not create real integration.
Why it matters
For BCBAs, the lesson is clear: don’t expect social skills to bloom just because the address changes. Write goals that target interaction with typical neighbors, not just housemates. Ask for smaller, resident-run homes and plan extra teaching rounds after move-in. Without those steps, the institution may follow your client home.
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02At a glance
03Original abstract
This paper presents data from a longitudinal collaborative study of The Care in the Community Sample (Cambrdige, Hayes, Knapp, Gould, & Fenyo, 1994; Cambridge et al., 2001; Knapp et al., 1992). The aim of the study was to investigate how social impairment changes are related to the move from institutional to community care using some preliminary analysis of the above data. A measure of social impairment using the Skills and Behavior Interview from the most recent follow-up of this cohort was found to be consistent with Wing's definition of social impairment, when applied to the cohort 12 years after deinsitutionalization. This measure was then used to retrospectively identify social impairment in the same sample (of approximately 250 people) at baseline (in the institution), at 1 year and at 5 years in the community. Prevalence data pointed to high levels of social impairment in the sample (50.1%) in institutions but the decrease to 39.8% after 1 year in the community was not significant (although conversation and social mixing and initiation of conversation and social interaction did improve over time). Once in the community, social impairment in general did not change over time, although there was a significant decrease in conversation and social mixing, non-verbal communication and initiation of conversation and social interaction. These results are compared to other research findings and the implications and limitations of the study discussed.
Research in developmental disabilities, 2003 · doi:10.1016/s0891-4222(02)00169-5