Education and Training in Autism and Developmental Disabilities

involves a bias and represents missing information
from studies selected.
These various reasons can explain such variations.
However, changes in people’s condition
are not only attributable to the fact of
being transferred from an institution towards
integrated services offered in the community.
The nature of services offered in their social
environment also plays a determining role.
With the exception of residential facilities, all
other services are not well described in the
scientific literature.
Such information might well explain the
differences observed. In our study, the presence
of a mobile team composed of educational
counsellors especially trained to ensure
the clinical follow-up of each person presenting
behavioral difficulties or mental health
problems can explain, partly, the improvement
noted in behaviors of person or, at least,
the absence of deterioration. Their support
role with staff from the different residential
resources and from the daycare centers, their
collaboration with the health department,
their willingness to promote interventions
based on principles related to a positive approach
(Fraser & Labbé, 1993; Kroegel, Kroegel,
& Dunlap, 1996) combined with a pharmacological
intervention, might explain some
of the positive results of our study.
Following exit from the institution, an increase
in medication also was noted. More
precisely, this increase is related to a rise in
the number of people to whom drugs were
prescribed (nerve sedatives or anxiolytic) or
in the posology taken, in some instances. However,
the nerve sedative family medication remains
stable or decreases for 59.4% of individuals.
For medication in the anxiolytic
family, this percentage is calculated at 86%.
This medication contributed to improvements
in people’s condition, as proved by the statistical
inverse significant relation revealed between
medication and results obtained on the
behavioral problems component of the ÉQCA
and on the aggressiveness component of the
Reiss Screen for Maladaptive Behavior scale.
To this medication component, the analysis
of studies undertaken elsewhere revealed
quite variable results. Some recorded an increase
in psychotropic medication (Conroy,
1996; Hill, Balow, & Bruininks, 1985; Intagliata
& Rinck, 1985). These studies’ findings
are consistent with those related by Spreat et
al. (2004). These authors compared the evolution
of percentages of people taking drugs
according to whether they lived in institutions
(n 279) or were deinstitutionalized (n
167) between 1994 and 2000. The increase in
the percentage of people taking drugs of various
categories (anxiolytic, antidepressants
and atypical antipsychotic) was higher than
that observed in people that remained in institutions.
In 2000, 41.3% of integrated people
took psychotropic medication. This percentage
decreased to 30.5% for those who remained
in institution, a percentage which is
even lower than that revealed in a study conducted
in Oklahoma in 2000, which considered
the entire population selected. Effectively,
34% of the 3 187 individuals evaluated
took at least one type of psychotropic drug.
Other studies have not mentioned any
change. Thinn, Clarke and Corbett (1990) did
not find any difference between the medication
taken two years before the exit and six
months after for 34 individuals. In a recent
Norwegian study interested in the medication
of 109 people (Nøttestad & Linaker, 2003), no
significant change was observed after eight
years for the nerve sedative consumption. As
mentioned earlier, Nøttestad and Linaker
(1999) observed deterioration in maladaptive
behaviors for this same group of people. In a
comparative study interested in the difference
between medication taken according to the
residential medium where 873 participants
lived, McGillivray and McCabe (2005) recognized
that the transfer in the community can
be associated with an improvement of people’s
living conditions but that such a change
is not necessarily accompanied by a reduction
in medication. In their study, they did not
observe any difference between consumption
in institutions or in the community.
Conclusion
The present study tracked the evolution of
various indicators for individuals with intellectual
disabilities following their departure from
an institution. In this perspective, the tendencies
related to deteriorations or improvements
observed in certain people’s evolution, and
revealed by our analysis, were then transmitted
to counsellors in annual meetings. This
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