Health status, utilization patterns, and outcomes of persons with intellectual disabilities: review of the literature.

A literature review was conducted to analyze existing data on health status, health care utilization, and medical outcomes of persons with intellectual disabilities. We found that barriers exist, but evidence indicates that (a) individuals with intellectual disability and medical needs are living in the community, (b) people with significant medical conditions can be maintained in community settings, and (c) medical supports can and are provided to people with intellectual disabilities and allied medical conditions to enable community living. However, some people had unmet medical needs, and the availability of and access to community-based services were problematic for others. These contradictory findings indicate that it is possible to provide services in the community, but the service delivery system needs improvement.

Longitudinal study on the adaptive and challenging behaviors of deinstitutionalized adults with mental retardation.

Adaptive and challenging behavior changes associated with movement from Minnesota's state institutions to community homes were examined. Most of the 148 participants who moved had severe or profound mental retardation, significant challenging behavior, and several decades of institutionalization. Adaptive and challenging behavior were assessed in the institution and thereafter annually in the community. Relative to institutional levels, adaptive behavior declined among residents who moved to community ICFs/MR but was unchanged for the HCBS Waiver group. Challenging behavior tended to worsen initially but, except for internalized behavior, no longer differed from institutional levels by the second community assessment. Change in challenging behavior was unrelated to community residence type. Previous papers involving these participants showed consistent lifestyle enhancements and reduced service costs relative to the institution.