Residential school placements for children and young people with intellectual disabilities

Introduction

Out of area residential placements are associated with a range of poor outcomes for adults with intellectual disabilities and behaviours that challenge. In recent years there has been an increased drive to reduce such placements at as early a stage as possible.

Objectives

This review aimed to collate research and policy regarding use of residential schools for children and young people with intellectual disabilities and transition from these settings to adult services.

Methods

Initial searches were conducted on PsychINFO, Web of Science, and PubMed to identify relevant articles. Initial searches identified 5841 potentially relevant articles (including duplicates). The titles and abstracts of these articles were then examined and 108 articles were obtained  for further screening.

After applying inclusion and exclusion criteria, nine articles were retained. Following this, hand searches were conducted of the two journals which had published the highest number of included studies which identified a further 20 potential studies of which none met inclusion criteria. Finally, the reference lists of included articles were searched and 28 additional articles were identified of which four were included.

Thirteen articles met inclusion criteria and were retained for review. The articles were coded by two independent coders according to set variables, grouped together by theme and analysed.

Findings

The review highlighted that relatively little is known about both use of, and transition from, residential schooling for children and young people with intellectual disabilities in the UK. Thirteen articles were identified:

• 7 examining the child or families’ experiences before placement
• 4 examining outcomes during the placement, and
• 4 examining the process of transitioning from the placement and longer term outcomes.

The methodological quality of articles was often limited. A lack of control groups, independent samples, or adequate sample sizes was particularly notable. Results are discussed in relation to factors that lead to a child’s placement in a residential school, children and families’ experiences of the placement, and outcomes following placement, including the transition process.

A number of research priorities were highlighted based on gaps in the literature. Examples of alternative forms of support from clinical practice are provided, with recognition that a multi-element model is likely to be needed to provide high quality support to this group of young people.