Published online by Cambridge University Press: 16 June 2009
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.
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