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Deinstitutionalization of People With Developmental Disabilities: A Review of the Literature

A good article for those teaching and implementing SRV, especially given the influence which SRV and normalization have had on deinstitutionalization efforts in North America:

Deinstitutionalization of People With Developmental Disabilities: A Review of the Literature by Raymond A. Lemay

CANADIAN JOURNAL OF COMMUNITY MENTAL HEALTH VOL. 28 NO. 1, SPRING 2009 (181-194)

http://www.turningforward.org/documents/Lemay2009-Deinstitutionalization.pdf

Major headings in the article:
• PARENTS AND DEINSTITUTIONALIZATION
• MORTALITY
• ADAPTIVE BEHAVIOURS
• COST BENEFIT
• QUALITY OF LIFE CONDITIONS AND EXPERIENCES
• SOCIAL RELATIONSHIPS
• CHALLENGING BEHAVIOURS

A few relevant quotes:

“The analysis is generally informed by normalization and social role valorization theory (Lemay, 1995, 1999, 2006; Wolfensberger, 1972, 1983, 1998); thus the findings may be applicable to other populations with severe disabilities.”

“Reviews of program evaluation data using PASS (Program Analysis of Service Systems; Wolfensberger & Glenn, 1975) and PASSING (Program Analysis of Service Systems’ Implementation of Normalization Goals; Wolfensberger & Thomas, 1983, 2007) that measure QLCE have consistently found that community residential services do significantly better than institutional settings (Flynn, 1980, 1999; Flynn, Lapointe, Wolfensberger, & Thomas, 1991). Though community settings do better in these studies, they do not achieve high scores of quality or excellence, averaging less than 50% of the possible score. Indeed, Perry and Felce (2005) found much variability in the quality of the living arrangements of 154 people living in 47 different community residences in the UK.”

“Lemay (2006) argues that the community is rich in role opportunities and relationship possibilities, but social integration requires a deliberate and well-thought-out strategy to move individuals with developmental disabilities out of their social isolation.”

“People, irrespective of their degree of disability, are apt to do better in the community on most measures and do no worse when it comes to challenging behaviours. Moreover, these findings suggest a serious underperformance by community-based services, which can be addressed through systematic training approaches that teach staff and family members the attitudes and competencies required for taking advantage of community living.”

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