Assessing and improving child care: a personal appearance index for children with autism.

An index of children's physical appearance and personal care was developed and used to assess youngsters with autism who lived (a) at home, (b) in an established group home, (c) in new group homes, and (d) in a large institution. Subsequently, a multiple baseline design across participants documented major changes in personal appearance and cleanliness when children moved from an institution to community-based, family-style group homes. Finally, data-based feedback generated by the appearance index was used as a training tool enabling group home staff to further improve child appearance. This research demonstrates how an evaluation instrument can be used to obtain comparative data, measure some effects of different residential placements, and provide ongoing feedback to caregivers to promote high standards of personal care among persons with severe developmental disabilities.