Housing Design and Modifications for Individuals With Intellectual and Developmental Disabilities and Complex Behavioral Needs: Scoping Review

Abstract

Background: Behavioral challenges exhibited by individuals with IDD can signal a poor person-environment relationship. There remains limited understanding about the physical characteristics of successful housing for this population. This article summarizes research on housing design for individuals with IDD who engage in behaviors that challenge. Specific Aims: Original, peer-reviewed research on the physical environment of housing was reviewed to determine the characteristics that can be modified to meet the needs of individuals with IDD who engage in behaviors that challenge.Method: Electronic databases and reference lists of relevant publications were searched for peer reviewed empirical research related to housing design for behaviors that challenge. Two reviewers independently applied inclusion criteria to identify studies. Content analysis identified housing features.Findings: Fourteen studies were identified that described inadequate and successful housing characteristics. Elements such as location, layout, safety, stimulation, and homelikeness were reported to contribute to successful housing. Discussion: Design of the physical environment has important policy and practice implications for supported housing that addresses behaviors that challenge. The development of design tools, guidelines, and personalized housing for this population is discussed.

Challenging Behavior in Context: A Case Study on How People, Space, and Activities Interact

“…Unpredictability is suggested to be another source of such behavior, since it may cause fright and tension in residents. Our study strengthens findings (Casson et al, 2021; Parris & Watson, 2011) on the relevance of routine for individuals showing challenging behavior as it makes life more predictable for them.…”

“…The spatial context, our analyses suggests, interrelates with challenging behavior mostly by acoustic and visual stimuli and to a lesser degree by odor and temperature. This supports studies that consider acoustics a major influence on challenging behavior and individuals on the autism spectrum (Casson et al, 2021; Embregts et al, 2009; Mostafa, 2008, 2014; Mueller-Schotte, 2022; Parris & Watson, 2011; Nguyen Lan et al, 2020). The findings on the influence of visual stimuli strengthen previous research that emphasizes the alleged importance of clarity, order, and visual calm to foster emotional well-being and reduce stress in individuals showing challenging behavior or being on the autism spectrum (Embregts et al, 2009; Khare & Mullick, 2009; Kinnaer et al, 2015; Mostafa, 2014; Resnik & Blackbourn, 2009).…”

“…Literature on the influence of space on challenging behavior shown by intellectually impaired individuals remains underexplored (Casson et al, 2021; Roos et al, 2022a). Remotely related research, for instance, on needs of individuals with autism in relation to space is better represented (Roos et al, 2022a).…”

Accessible independent housing for people with disabilities: A scoping review of promising practices, policies and interventions

“…People with disabilities are particularly vulnerable to missing out on acquiring affordable and accessible housing and deserve solutions that enhance their access to appropriate housing. Although the literature on the housing needs of people with disabilities is growing, most of the focus is on elderly populations, those with mental health conditions (and risk of homelessness and 'housing first' programs), and people with developmental or intellectual disabilities living in group homes or supported housing (e.g., onsite-support and services offered to occupants to maintain their well-being) [2,[31][32][33][34][35][36][37]. While this research is valuable, there is a critical need to synthesize the most promising practices [38][39][40], policies [41,42] and interventions (e.g., home modifications [17,27,[43][44][45][46], universal design [11,47], architectural planning and design [48], smart home technology [49][50][51], grants and funding [52][53][54] to enhance accessible independent housing for people with various types of disabilities.…”

Home environment design theories and models related to the occupational performance, participation and well-being of people with intellectual disabilities: A scoping review

“…Limited affordable housing means shared supported housing is the prevailing option but is associated with lower quality of life outcomes for people with complex needs (Bigby and Beadle-Brown, 2016). This and poorly integrated support have led to inappropriate and unsafe housing choices (Casson et al, 2021), causing isolation, poorer health, poverty and abuse (Simplican, 2019).…”