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Predictors, costs and characteristics of out of area placement for people with intellectual disability and challenging behaviour
Abstract
BACKGROUND: Out of area placements for people with challenging behaviour represent an expensive and often ineffective strategy for meeting the needs of this service user group. METHODS: More than 800 agencies and service settings in a large area of South Wales were screened to identify children and adults with challenging behaviour against a number of defined operational criteria. Detailed data on identified individuals and the services they received were collected by interviewing key informants. Univariate and multivariate statistics were employed to identify predictors of out of area placement. RESULTS: In total, 1458 people were identified. Full data were available for 901 participants, 97 of whom were placed out of area. Predictors of out of area placement included behaviours resulting in physical injury and exclusion from service settings, a history of formal detention under the mental health act, the presence of mental health problems, a diagnosis of autism and higher total score on the Adaptive Behaviour Scale. Out of area placements were typically of high cost, and associated with only limited evidence of improved service quality. CONCLUSIONS: Identifying predictors for out of area placement can be used to highlight deficiencies in local services and individuals at increased risk of exclusion from local services.
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Managing challenging behaviour comes at a high cost and often results in a significant burden of care, for example requiring special education and training for caregivers, and involvement of specialized health services.
“Furthermore, managing CB comes at a high cost and often results in a significant burden of care, for example requiring special education and training for caregivers, and involvement of specialized health services (4, 7, 8).”
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Metadata
- Authors
- Allen, D. G., Lowe, K., Moore, K., & Brophy, S.
- Affiliations
- University of Glamorgan (GB)
- Corresponding author
- Allen, D. G.
- Venue
- Journal of Intellectual Disability Research
- Publisher
- Wiley
- Published
- 2007-03-20
- Volume
- 51
- Issue
- 6
- Pages
- 409-416
- ISSN
- 0964-2633 (ISSN-L)
- 1365-2788
- OpenAlex
- W2053562822
- Cited by
- 100
- References
- 15
- Citations by year
- 2026: 2 · 2024: 4 · 2023: 14 · 2022: 1 · 2021: 2 · 2020: 7 · 2019: 5 · 2018: 8 · 2017: 3 · 2016: 6 · 2015: 6 · 2014: 6 · 2013: 9 · 2012: 6
- FWCI
- 5.50
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Intellectual Disability Research (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Down syndrome and intellectual disability research
- Social Sciences › Psychology › Clinical Psychology › Family and Disability Support Research
- Social Sciences › Sociology and Political Science › Child Welfare and Adoption
- Keywords
- out-of-area placements, intellectual disability, behavioral problems, service costs, service quality, autism spectrum disorder, adaptive behavior, Mental Health Act detention, mental illness, personal injury, local service provision
- MeSH terms
- Adult, Mental Disorders, Catchment Area, Health, Child, Community Mental Health Services, Delivery of Health Care, Health Services Accessibility, Health Services Needs and Demand, Humans, Interviews as Topic, Learning Disabilities, Intellectual Disability, Predictive Value of Tests, Surveys and Questionnaires, Wales, Small-Area Analysis, Risk Assessment, Needs Assessment
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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