Maximising choice and control are key elements of policy in relation to supporting people with learning disabilities, but it is recognised that the choice of where to live and with whom is often denied to people, especially with severe or profound learning disabilities. The researchers in this USA study set out to understand the current degree of choice exercised by people using services in the United States.

They used data from the National Core Indicators programme, looking at information from 6778 adult service users living in non-family-home service settings in 26 US states.

They found that the majority of adults with learning disabilities did not participate in choosing where and with whom to live. Those described as having more support needs related to more severe learning disability or co-occurring conditions had the least choice when considering their living arrangements.

Although those who lived in their own homes, or an agency-operated apartment were more likely to make the choice of where and with whom to live than those in nursing homes, institutions or group homes, those with severe or profound learning disabilities were the least likely to choose regardless of where they lived.

The authors conclude that despite policies emphasising choice, many adults with learning disabilities in the USA experienced little or no choice about where and with whom they lived.

They suggest that the findings relating to choice in individualised living settings endorse policies promoting such individualised settings, given that these settings appeared to offer much more choice than others in terms of living arrangements.

Choice of living arrangements, Stancliffe, R et al., in  Journal of Intellectual Disability Research, 55: 746–762