Institutions versus community placements: the effects of different residential environments on the behaviour of intellectually handicapped adults.

A major issue in the care of the intellectually handicapped is whether they should continue to be cared for in large institutions, or live in community homes. The community homes are presumed to provide more normal environments than institutions, and to therefore encourage residents to behave more normally than they would in institutions. This study used a measure of normalisation to compare three hospital and four community residences for the intellectually handicapped. It also measured changes in the behaviour of residents who moved from one environment to another. Results showed overlap in the level of normalisation of hospital and community units. Whether in the hospital or the community, the more normal environments had residents with higher levels of adaptive behaviour and mental functioning. The everyday behaviour of residents who moved to more normalised units generally remained unchanged but some adaptive skills and interactive behaviours declined. The existence of continued training programmes appeared more critical than the normalisation of the home in developing and maintaining residents' behaviour.