Living circumstances of children and adults with mental retardation or developmental disabilities in the United States, Canada, England and Wales, and Australia

The purpose of this article was to collate evidence to describe where peopl e with mental retardation or developmental disabilities live in five develo ped countries: United States, Canada, England, Wales, and Australia. Family homes are important dwelling places for people with mental retardation. Th ey are the home of the great majority of children with mental retardation a nd a considerable proportion of adults with mental retardation. The likelih ood of placement outside the family home increases with adulthood and progr essively as people age. Adults with mental retardation live in a wide varie ty of settings, with formal residential provision frequently dependent on t he arrangements that the authorities responsible for providing service supp ort have chosen to make. There has been a considerable move away from accom modating people in large segregated and geographically isolated institution s in the countries considered. However, the current range of accommodation includes much with a distinctively different character to the homes where o ther citizens live. Many people still live in larger groups than would be o rdinarily found in typical homes and this may necessitate departure from th e architectural norm. In all of the countries considered, there has been a recent trend towards small community settings, compatible with typical hous ing architecture. This appears furthest advanced in the U.S. but is discern ible elsewhere. Availability of residential services at a national level va ries between 100 and 155 places per 100,000 total population. Regional vari ation within countries is even greater. In no case is the national availabi lity considered adequate to meet the demand arising from changing need or e xpectations, (C) 2001 Wiley-Liss. Inc.