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A Comparative Observational Study of the care provided in Hospital with the care provided at Home for Profoundly Multiply Handicapped Children

Published online by Cambridge University Press:  16 June 2009

Nigel Beail
Affiliation:
Department of Psychology, University of Sheffield

Abstract

Considerable concern has been expressed about the quality of care provided for mentally handicapped children living in hospitals. Current policies aim to relocate these children in community settings, giving them a lifestyle as near as possible to that in an ordinary home. Studies of mentally handicapped children living in hospital have all shown that the quality of care is poor, but comparative studies of the quality of care provided for mentally handicapped children living at home have not been carried out. This paper reports a comparative observational study of the quality of care provided for profoundly mentally handicapped children living in a long-stay hospital with a match group who live at home. The rate and content of naturally occurring interaction patterns between nursing staff or family members and the children were observed during the hour after arrival home from school. The results show major differences between the two settings in terms of the types of behaviour exhibited by the children, the frequency and nature of attention given to the children and the quality of the interactions between the children and their carers. In all areas the children living at home fair better. The implications of these findings are discussed.

Type
Research Article
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 1988

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References

Ayllon, T. and Michael, J. (1959). The psychiatric nurse as a behavioural engineer. Journal of the Experimental Analysis of Behaviour 2, 323334.CrossRefGoogle ScholarPubMed
Beail, N. (1985). The nature of interactions between nursing staff and profoundly multiply handicapped children. Child: Care, Health and Development 11, 113129.CrossRefGoogle ScholarPubMed
Coles, E. and Blunden, R. (1982). Maintaining new procedures using feedback to staff, a hierarchical reporting system, and a multidisciplinary management group. Journal of Organizational Behaviour Management 3(2), 1933.CrossRefGoogle Scholar
Cullen, C., Burton, M., Watts, S., and Thomas, M. (1983 a). A preliminary report of interactions in a mental handicap institution. Behaviour, Research and Therapy 21, 579583.CrossRefGoogle Scholar
D.H.S.S. (1971) Better Services for the Mentally Handicapped. London: HMSO.Google Scholar
D.H.S.S. (1980). Health Notice HN (80)21, Annex III: Health Service Residential Accommodation for the Mentally Handicapped: Interim Building Design Guidance. London: D.H.S.S.Google Scholar
D.H.S.S. (1983). Draft Circular DA (83)2: Helping to get Mentally Handicapped Children out of Hospital. London: D.H.S.S.Google Scholar
Dunn, J. and Wooding, C. (1977). Play in the home and its implications for learning. In The Biology of Play, Tizard, B. and Harvey, D. (Eds). London: Heinemann.Google Scholar
Felce, D. (1986). Evaluation by Direct Observation.Paper presented to The British Institute for Mental Handicap Conference on Evaluating the Quality of Care,Nottingham.,Google Scholar
Felce, D., De Kock, U. and Repp, A. C. (1986). An eco-behavioural analysis of small community based houses and traditional large Hospitals for severely and profoundly mentally handicapped adults. Applied Research in Mental Retardation 7, 393408.CrossRefGoogle Scholar
Felce, D., Mansell, J. and Kushlick, A. (1980). Evaluation of alternative residential facilities for the severely mentally handicapped in Wessex: Client engagement. Advances in Behaviour, Research and Therapy 3, 1318.CrossRefGoogle Scholar
Felce, D., Saxby, H., De Kock, , Repp, A. and Blunden, R. (1987). To what behaviours do attending adults respond: a replication American Journal of Mental Deficiency 91(5), 496504.Google ScholarPubMed
Ferster, C. B. and Skinner, B. F. (1967). Schedules of Reinforcement, New York: Appleton-Century-Crofts.Google Scholar
Griffiths, R. (1954). The Abilities of Babies. Amersham, Bucks: Association for Research in Infant and Child Development.Google Scholar
Jay, P. (1979). Report of the Committee of Enquiry into Mental Handicap Nursing and Care. London: H.M.S.O.Google Scholar
King, R. D., Raynes, N. and Tizard, J. (1971). Patterns of Residential Care. London: Routledge & Kegan Paul.Google Scholar
Kings Fund Centre (1980). An Ordinary Life: Comprehensive locally-based residential services for mentally handicapped people. Kings Fund Project Paper No. 24. London: Kings Fund Centre.Google Scholar
National Development Group for the Mentally Handicapped (1978). Helping Mentally Handicapped People in Hospital. London: D.H.S.S.Google Scholar
Oswin, M. (1978). Children Living in Long-Stay Hospitals. London: Heinemann.Google Scholar
Porterfield, J., Blunden, R. and Blewitt, E. (1980). Improving environments for profoundly handicapped adults. Behaviour Modification 4, 225241.CrossRefGoogle Scholar
Shearer, A. (1981). Bringing Mentally Handicapped Children Out of Hospital (Kings Fund Project Paper No. 30). London: Kings Fund Centre.Google Scholar
Shearer, A. (1984). Progress in Bringing Mentally Handicapped Children Out of Hospital London: Kings Fund Centre.Google Scholar
Warren, S. A. and Monday, L. W. (1971). To what behaviours do attending adults respond? American Journal of Mental Deficiency 75, 449455.Google ScholarPubMed
Whatmore, R., Durward, L. and Kushlick, A. (1975). Measuring the quality of residential care. Behaviour, Research and Therapy 13, 227236.CrossRefGoogle ScholarPubMed
Wolfensberger, W. (1972). The Principle of Normalization in Human Services. Toronto: National Institute of Mental Retardation.Google Scholar
Wright, E. C., Abbass, K. A. and Meredith, G. (1974). A study of interactions between nursing staff and profoundly mentally retarded children. British Journal of Mental Subnormality 20, 1417.CrossRefGoogle Scholar
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