Success and failure in community placements for people with learning disabilities and challenging behaviour: An analysis of key variables

Abstract

Previous research has demonstrated clearly that people with learning disabilities and challenging behaviour are at increased risk of admission and re-admission to long-term institutional care. Research has also suggested that service variables may moderate this process and also impact on the effectiveness of clinical interventions for challenging behaviour in community settings. The present study used a natural group comparison design to study differences in the individual and service characteristics of two groups of people with learning disability and challenging behaviour, one of which was successfully maintained in the community and one which experienced placement breakdown. Few behavioural or psychiatric differences were observed, although the breakdown group were significantly more able. People in the breakdown group were significantly more likely to come from service settings which were rated as having less than optimal resource utilisation and internal organisation. Carers in the breakdown group were also significantly less likely to have received training in emergency management techniques. Implications for future research and clinical practice are discussed.