افزایش یکپارچگی جامعه و شمول برای افراد دارای معلولیت ذهنی

Historically residential facilities for individuals with intellectual disabilities have served the role of segregation and congregation with no real focus on integration into the community. More recently the focus has been to get people out of residential institutions and into community-based living settings. This work examines an approach to changing the systems and culture at a large residential facility to create higher rates of transitions to community-based living settings. A multi-phased systematic implementation approach is discussed in which each successive phase builds upon the previous phase. This approach creates opportunities for community integrated activities and then utilizes these community contexts as functional learning opportunities. Results are evaluated in the areas of community presence, community participation, community integration and community inclusion. Data indicate significant increases in each of these areas based on changing the facility focus, simplifying the intrusive accountability systems, aligning resources and teaching staff how to utilize support plans more efficiently to teach skills in functionally appropriate community integrated activities.

Historically, integration of individuals with intellectual disabilities (IDs) into the community was discouraged and avoided based on the theories of treatment at the time. Consequently, individuals were separated, congregated and isolated, sent away to institutions with separate schools and work options (Mirfin-Veitch, Bray, & Ross, 2001). This has proven to be ineffective from a treatment standpoint and leads to individuals with ID feeling devalued, disadvantaged, and treated like eternal children (Martin, 2006). Over the years there has been a plethora of treatment techniques that promised to ameliorate these issues with varied results. More recently avid movements to transition individuals with ID to community-based living settings and “de-institutionalization” efforts have not produced uniformly better results for everyone (Mansell, 2006). A consistent factor in both the rate of moving into a community-based setting and remaining in a community-based setting is individual level of ability. Myers, Ager, Kerr, and Myles (1998) found the more significant an individual's disability the fewer opportunities he/she has to participate in community activities. White and Dodder (2000) found that adults with higher levels of adaptive behavior have greater levels of community integration. Further complicating these issues for individuals with significant ID is the increased prevalence of comorbid behavioral challenges that effect social skills and abilities (Matson, Minshawi, Gonzalez, & Mayville, 2006). Finally, quality of life data continue to indicate that quality of life remains poor for individuals with significant ID and the higher the ability level of the person the higher they score on quality of life measures (Perry & Felce, 2003; Singh et al., 2004). Therefore, functional skills acquisition becomes paramount for individuals with significant ID to assist them in moving from a residential setting into a community-based living setting.