Skip to main content
×
×
Home

The Maintenance of Client Activity and Staff–Client Interaction in Small Community Houses for Severely and Profoundly Mentally Handicapped Adults: A Two-Year Follow-Up

  • Helen Saxby (a1), David Felce (a1), Martin Harman (a1) and Alan Repp (a1)
Abstract

In a previous study (Felce, de Kock and Repp, 1986), appropriate client activity was found to be considerably higher in two community homes for severely and profoundly mentally handicapped adults than in a number of institutions. Client activity was also shown to be related to the extent of staff interaction. The method of this study was replicated in a two-year follow-up to investigate whether these desirable levels of staff interaction and client activity were maintained. Client engagement in appropriate activity remained similar for five subjects but had fallen slightly for a further five. The duration of instruction given to the majority of subjects by staff had declined but so too, for a variety of reasons, had staff–client ratios. Overall, the follow-up data give a general impression of the maintenance of client activity with some subjects engaging with greater independence. However, interpretation is dependent on the role that staff–client ratio may play in determining staff performance and in particular their level of interaction with clients.

Copyright
References
Hide All
Birenbaum, A. and Re, M. A. (1979). Resettling mentally retarded adults in the community: almost 4 years later. American journal of Mental Deficiency 83, 323329.
Brown, K. M., Willis, B. S. and Reid, D. H. (1981). Differential effects of supervisor verbal feedback and feedback plus approval on institutional staff performance. Journal of Organizational Behavior Management 3, 5768.
Burg, M. M., Reid, D. H. and Lattimore, J. (1979). Use of a self-recording and supervision program to change institutional staff behaviour. Journal of Applied Behavior Analysis 12, 363375.
Christian, W. P. (1983). A case study in the programming and maintenance of institutional change. Journal of Organizational Behavior Management 5, 99154.
Close, D. W. (1977). Community living for severely and profoundly retarded adults: a group home study. Education and Training of the Mentally Retarded 12, 256263.
Coles, E. and Blunden, R. (1981). Maintaining new procedures using feedback to staff: a hierarchical reporting system and a multi-disciplinary management group. Journal of Organizational Behavior Management 3, 1933.
Conroy, J., Efthimiou, J. and Lemanowicz, J. (1982). A matched comparison of the developmental growth of institutionalized and deinstitutionalized mentally retarded clients. American Journal of Mental Deficiency 86, 581587.
Crowell, C. R. and Anderson, D. C. (1982). Systematic behavior management: general program considerations. Journal of Organizational Behavior Management 4, 129163.
Dalgleish, M. and Mathews, R. (1981). Some effects of staffing levels and group size on the quality of day care for severely mentally handicapped adults. British Journal of Mental Subnormality 27, 3035.
Departmental of Health and Social Security (DHSS) (1971). Better Services for the Mentally Handicapped. London: HMSO.
Department of Health and Social Security (DHSS) (1978). Report of the Committee of Inquiry into Normansfield Hospital. London: HMSO.
Department of Health and Social Security (DHSS) (1979). Report of the Committee of Inquiry into Mental Handicap Nursing and Care. London, HMSO.
Department of Health and Social Security (DHSS) (1985). Government Response to the Second Report from the Social Services Committee, 1984–85 Session. Community Care with Special Reference to Adult Mentally Ill and Mentally Handicapped People. London: HMSO.
de Kock, U., Felce, D., Saxby, H. and Thomas, M. (1985). Community and family contact: an evaluation of small community homes for severely and profoundly mentally handicapped adults. Health Care Evaluation Research Team, Southampton University.
de Kock, U., Felce, D., Saxby, H. and Thomas, M. (1987). Staff turnover and ease of recruitment: an evaluation of small community-based homes for severely and profoundly mentally handicapped adults. Mental Handicap 15, 97101.
Felce, D. and De Kock, U. (1983). Planning client activity: a handbook. Health Care Evaluation Research Team, Southampton University.
Felce, D., de Kock, U., Harman, M. and Repp, A. (1984). Using the Epson HX-20 as a fully self-contained unit for data capture and analysis.Paper presented for conference on microcomputers and observational data. Thomas Coram Research Unit, University of London.
Felce, D., de Kock, U. and Repp, A. C. (1986). An eco-behavioral comparison of small home and institutional settings for severely and profoundly mentally handicapped adults. Applied Research in Mental Retardation 7, 393408.
Felce, D., Jenkins, J., Mansell, J.de Kock, U., Toogood, S. and Pomphrey, A. (1982). Staff induction training. University of Southampton: Health Care Evaluation Research Team.
Felce, D., Lunt, B. and Kushlick, A. (1980). Evaluation of alternative residential facilities for the severely mentally handicapped in Wessex: family contact. Advances in Behaviour Research and Therapy 3, 1923.
Felce, D., Saxby, H., de Kock, U., Repp, A. C., Ager, A. and Blunden, R. (1987). To what behaviors do attending adults respond?—a replication. American Journal of Mental Deficiency 91, 496503.
Felce, D., Thomas, M., de Kock, U., Saxby, H. and Repp, A. (1985). An ecological comparison of small community-based houses and traditional institutions: II Physical setting and the use of opportunities. Behaviour Research and Therapy 23(3), 337348.
Felce, D., de Kock, U., Thomas, M. and Saxby, H. (1986). Change in adaptive behaviour of severely and profoundly mentally handicapped adults in different residential settings. British Journal of Psychology 77, 489501.
Goffman, E. (1961). Asylums. New York: Doubleday.
Grant, G. W. B. and Moores, B. (1977). Resident characteristics and staff behavior in two hospitals for mentally retarded adults. American Journal of Mental Deficiency 82, 259265.
Griffiths, R. (1954). The Abilities of Babies. London: University of London Press.
Griffiths, R. (1971). The Abilities of Young Children. Amersham: Association for Research in Infant and Child Development.
Harris, J. M., Veit, S. W., Allen, G. J. and Chinsky, J. M. (1974). Aide-resident ratio and ward population density as mediators of social interaction. American Journal of Mental Deficiency 79, 320326.
Hemming, H., Lavender, T. and Pill, R. (1981). Quality of life of mentally retarded adults transferred from large institutions to new small units. American Journal of Mental Deficiency 86(2), 157169.
Ivancic, M. T., Reid, D. H., Iwata, B. A., Faw, G. D. and Page, T. J. (1981). Evaluating a supervision program for developing and monitoring therapeutic staff-resident interactions during institutional care routines. Journal of Applied Behavior Analysis 14, 95107.
Iwata, B. A., Bailey, J. S., Brown, K. M., Foshee, T. J. and Alpern, M. (1976). A performance-based lottery to improve residential care and training by institutional staff. Journal of Applied Behavior Analysis 9, 417431.
Jenkins, J., Felce, D., Toogood, S., Mansell, J. and De Kock, U. (1988). Individual Programme Planning. Kidderminster: British Institute of Mental Handicap.
Joyce, T. and Males, B. (1983). Report of the Blue Peter Bungalow Project. Psychology Department, St Lawrence's Hospital.
Kazdin, A. (1973). Issues in behavior modification with mentally retarded persons. American Journal of Mental Deficiency 78(2), 134140.
King, R., Raynes, N. and Tizard, J. (1971). Patterns of Residential Care. London: Routledge and Kegan-Paul.
King's Fund Centre (1980). An Ordinary Life—Comprehensive Locally Based Residential Services for Mentally Handicapped People. London: King's Fund Centre.
Landesman-Dwyer, S. (1981). Living in the community. American Journal of Mental Deficiency 86(3), 233234.
Landesman-Dwyer, S., Sackett, G. P. and Kleinman, J. S. (1980). Relationship of size to resident and staff behavior in small community residences. American Journal of Mental Deficiency 85(1), 617.
Mansell, J., Felce, D., Jenkins, J. and De Kock, U. (1982). Increasing staff ratios in an activity with severely mentally handicapped people. British Journal of Mental Subnormality 28, 9799.
Mansell, J., Felce, D., Jenkins, J., de Kock, U. and Toogood, S. (1983). A Wessex home from home. Nursing Times August 3, 5166.
Montegar, C. A., Reid, D. H., Madsen, C. H. and Ewell, M. D. (1977). Increasing institutional staff-to-resident interactions through in-service training and supervisor approval. Behavior Therapy 8, 533540.
Moores, B. and Grant, G. W. B. (1976). On the nature and incidence of staff-patient interactions in hospitals for the mentally handicapped. International Journal of Nursing Studies 13, 6981.
National Development Group (1978). Helping Mentally Handicapped People in Hospital. London: Department of Health and Social Security.
Nihira, K., Foster, R., Shellhaus, M. and Leland, H. (1974). AAMD Adaptive Behavior Scale. Washington DC: American Association on Mental Deficiency.
O'Brien, J. and Tyne, A. (1981). The Principle of Normalisation: A Foundation for Effective Services. London: Campaign for the Mentally Handicapped.
O'Neill, J., Brown, M., Gordon, W., Schonhorn, R. and Greer, E. (1981). Activity patterns of mentally retarded adults in institutions and communities: a longitudinal study. Applied Research in Mental Retardation 2, 367379.
O'Neill, J., Brown, M., Gordon, W. and Schonhorn, R. (1985). The impact of deinstitutionalization on activities and skills of severely/profoundly mentally retarded multiply-handicapped adults. Applied Research in Mental Retardation 6, 361371.
Rawlings, S. (1985). Behaviour and skills of severely retarded adults in hospitals and small residential homes. British Journal of Psychiatry 146, 358366.
Raynes, N. (1980). The less you've got the less you get: functional grouping, a cause for concern. Mental Retardation 18, 217220.
Repp, A. C., Barton, L. E. and Brulle, A. R. (1981). Correspondence between effectiveness and staff use of instructions for severely retarded persons. Applied Research in Mental Retardation 2, 237245.
Schroeder, S. and Henes, C. (1978). Assessment of progress of institutionalized and deinstitutionalized retarded adults: a matched-control comparison. Mental Retardation 16, 147148.
Smith, J., Glossop, C. and Kushlick, A. (1980). Evaluation of alternative residential facilities for the severely mentally handicapped in Wessex: client progress. Advances in Behaviour Research and Therapy 3, 511.
Wing, L. and Gould, J. (1979). Severe impairments of social interaction and associated abnormalities in children: epidemiology and classification. Journal of Autism and Developmental Disorders 9, 1129.
Wolfensberger, W. (1972). Normalisation: The Principle of Normalisation in Human Services. Toronto: National Institute of Mental Retardation.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Behavioural and Cognitive Psychotherapy
  • ISSN: 1352-4658
  • EISSN: 1469-1833
  • URL: /core/journals/behavioural-and-cognitive-psychotherapy
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed