An eco-behavioral analysis of small community-based houses and traditional large hospitals for severely and profoundly mentally handicapped adults

Recently, much interest has centered on the transfer of mentally handicapped people from institutions to other settings. Most studies in this area have focused indirectly on the behavior of the mentally retarded client, usually measured intermittently by global assessments such as the American Association On Mental Deficiency's Adaptive Behavior Scale. In contrast, the present study combined these indirect measures with direct continuous observation of each subject. In doing so, it examined the effects of such a transfer to small community-based homes on the behavioral functioning of severely and profoundly mentally handicapped adults. In addition, staff activity, in terms both of providing opportunities for engagement in activity and of consequating client behavior, was also measured. Two comparisons were made, those being between a group of clients in a small home and a comparable group in institutions and between the latter group when in the institutions and after having moved to a small home. Results show increased client functioning in the small homes, particularly in domestic activity and interaction with staff, and a markedly higher level of staff provision of opportunity to engage in activities. The results are discussed in terms of size, design, staff-client ratio, and staff training in small community-based residential services. The need for more research on the determination of staff performances is highlighted