Behavioral Outcomes of Moving from Institutional to Community Living for People with Intellectual and Developmental Disabilities: U.S. Studies from 1977 to 2010

Abstract

This article reviews 43 U.S. studies assessing adaptive and challenging behavior outcomes associated with people with intellectual and developmental disabilities (IDD) who moved from institutions to community residential settings. These studies were published between 1977 and 2010. Longitudinal and comparison group studies were selected based on a set of screening criteria. Seven of 11 treatment/comparison group studies reported that people who moved had statistically significant improvements in adaptive behavior skills compared to those who stayed in the institution. The movers in four remaining studies had improvements in adaptive behavior that were not large enough to be statistically significant. Of 27 longitudinal studies, 15 reported statistically significant improvements in adaptive behavior and 5 showed nonsignificant positive change. Only 5 reported decreases in adaptive behavior, including 3 that found statistically significant decreases. Of 26 studies that examined changes in challenging behavior, 8 reported statistically significant changes (5 showing significant improvement in challenging behavior and 3 showing significant worsening of challenging behavior). The consistently positive changes in adaptive behavior skills in studies conducted over the course of 33 years support earlier conclusions that people with IDD gain skills when moving from an institution to a community setting, although they may or may not experience improvements in challenging behavior.