Factors in admission of children to state-administered facilities for people with intellectual disabilities
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Texas houses the largest number of school-aged individuals with intellectual disabilities in state-administered institutions than any other state in the nation. Despite current conditions of legal and procedural constraints on such placements, the number of admissions of school-aged individuals has been increasing in recent years. Prior to conducting this study, a review of literature was completed, which provided an historical overview of the care for people with intellectual disabilities, the damaging effects of institutionalization in all areas of child development, and the reasons for placement of children with intellectual disabilities in institutions was completed. The purpose of the study was to gain an understanding of the decision-making processes involved in the placement of individuals under the age of 22 in Texas state supported living centers and the community services determined as necessary. Surveys were distributed to five groups of individuals who are typically involved in the decision-making process: parents of current residents under age 22 of state supported living centers, Local Authority interdisciplinary team members, local Community Resource Coordination Group interagency members, local County Judges, and the Directors of the state supported living centers. A sixth group surveyed included parents who sought placement for their child in the institution, but accepted Medicaid waiver-funded community-based services instead. Although the families expressed a strong commitment to keep their family member at home as long as possible, the results indicate that the Local Authority for intellectual disability services influences the majority of families' decisions to place their child in the institution as well as a severe lack of appropriate, adequate and accessible community-based services to meet the needs of families. Both parent groups rated improved public school and personal attendant services as the most necessary for the prevention of out-of-home placement. The availability of behavior supports and respite services were viewed by both the parents and the professionals as important in preventing out-of-home placement.
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