Few advantages found to grouping by diagnosis in staffed housing for people with learning disabilities and autistic spectrum disorder


The authors of this study were interested in looking at support to adults with autism spectrum disorder in staffed housing services. Their focus was on looking at whether diagnostic congregation, or grouping people with similar diagnoses, was prevalent in services and if so, whether it had any impact on outcomes.

They worked with 157 adults with learning disabilities from a sample of 424 in staffed housing, all of whom had been assessed as having the triad of impairments found in autistic spectrum disorder.

The participants lived in 88 staffed houses. Of these, 26 were non-congregate (where 40% of residents were assessed as having the triad of impairments) and 50 were congregate (where 60% had the triad). The authors eliminated 12 of the services which had intermediate groupings.

They compared the non-congregate and congregate groups on a range of variables, including age, gender, adaptive and challenging behaviour, house size, staff per resident and measures of quality of care and outcome.  They also made comparisons with matched congregate and non-congregate sub sample using the Adaptive Behavior Scale (ABS).

What they found was that the non-congregate settings were larger, had lower staff per resident and more individualised social milieus.

When comparing the groups on age and gender, they found the congreegate and non congregate groups were similar. They found though that the non-congregate group had non-significantly higher ABS scores.

They also found that the non-congregate group did more social, community and household activities, which after matching for ABS, they found were not significant.

They found non-congregate settings were larger with significantly more organised working methods.

They conclude that their findings add to the view that there are

few advantages to diagnostic grouping.

Diagnostic grouping among adults with intellectual disabilities and autistic spectrum disorders in staffed housing. Felce, D. & Perry, J. in Journal of Intellectual Disability Research, 56: 1187–1193

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John Northfield

After qualifying as a social worker, John worked in community learning disability teams before getting involved in a number of long-stay hospital closure programmes, working to develop individual plans for people moving into their own homes. He worked for BILD, helping to develop the Quality Network and was editorial lead for the NHS electronic library learning disabilities specialist collection. This led him to found the Learning Disabilities Elf site with Andre Tomlin as a way of making the evidence accessible to practitioners in health and social care. Most recently he has worked as part of Mencap's national quality team and also been involved in a number of national website developments, including the General Medical Council's learning disabilities site.

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