ArticlePublisher preview available

Scoping Review of the Factors Influencing Compatibility of Autistic Roommates

November 2022
Current Developmental Disorders Reports 9(3)

Authors:

Brock University

Purpose of Review Roommate compatibility of adults on the spectrum with intellectual disabilities has been under-investigated. Following the PRISMA-ScR guidelines, this scoping review explored the current research on the factors that influence the compatibility of Autistic adults’ roommates and their living arrangements. Recent Findings Recently, literature has included the experiences and preferences of adults with intellectual disabilities in the arrangement of their living spaces. Factors that might inform compatibility were related to six domains (i.e., general house details, behavioural profile, sensory, lifestyle, health, and social interactions). Research also suggests that safety, choice, and culture should be considered. Summary Although autistic adults with intellectual disabilities often live in community settings, no comprehensive assessment has been found to inform placement decisions that consider all relevant aspects of compatibility. This scoping review could be used to inform an assessment to guide placement decisions of prospective housemates and improve the transition process.

PRISMA flow chart

…

Figures - available from: Current Developmental Disorders Reports

This content is subject to copyright. Terms and conditions apply.

A preview of this full-text is provided by Springer Nature.

Learn more

Content available from Current Developmental Disorders Reports

This content is subject to copyright. Terms and conditions apply.

Vol.:(0123456789)

1 3

https://doi.org/10.1007/s40474-022-00264-2

INTELLECTUAL DISABILITY (R CONDILLAC ANDL MULLINS, SECTION EDITORS)

Scoping Review oftheFactors Inﬂuencing Compatibility ofAutistic

Roommates

AmandaBailey1· LauraE.Mullins1

Accepted: 3 November 2022

Abstract

Purpose of Review Roommate compatibility of adults on the spectrum with intellectual disabilities has been under-investi-

gated. Following the PRISMA-ScR guidelines, this scoping review explored the current research on the factors that inﬂuence

the compatibility of Autistic adults’ roommates and their living arrangements.

Recent Findings Recently, literature has included the experiences and preferences of adults with intellectual disabilities in

the arrangement of their living spaces. Factors that might inform compatibility were related to six domains (i.e., general

house details, behavioural proﬁle, sensory, lifestyle, health, and social interactions). Research also suggests that safety,

choice, and culture should be considered.

Summary Although autistic adults with intellectual disabilities often live in community settings, no comprehensive assess-

ment has been found to inform placement decisions that consider all relevant aspects of compatibility. This scoping review

could be used to inform an assessment to guide placement decisions of prospective housemates and improve the transition

process.

Keywords Group living· Roommate compatibility· Autism· Living arrangements· Transition planning

Introduction

In Canada, approximately 1 in 66 children and youth is

diagnosed with autism spectrum disorder (ASD) [1, 2] and

50,000 reach adulthood each year [3]. Accordingly, there

has been considerable growth in the residential sector for

persons on the autism spectrum with intellectual disabili-

ties1 [4], and housing has evolved from institutional to

community-based housing models [5]. In group homes in

community settings, adults usually have multiple room-

mates [5]. Longtin and colleagues [6] recently identiﬁed

gaps in the transition to community living as persons with

an intellectual disabilities felt a lack of accommodations

and planning. Research suggests the need to consider room-

mate compatibility when planning living arrangements for

people on the autism spectrum [7]. However, Emerson and

Hatton [8] found that 53% of persons with an intellectual

disability were not involved in decisions about where they

live, and 67% had no say in their roommates. McCarron

and colleagues [9] found that consideration for roommate

compatibility positively impacts a person’s quality of life.

Compatibility is a broad and complex relationship

dynamic that multiple variables can inﬂuence. Two of these

elements are roommate compatibility and the ﬁt between the

person and their environment [10]. Within these elements,

the literature suggests that general house details [11], behav-

ioural proﬁle [8], sensory [12], lifestyle [11], health [13],

and social interactions [14] inﬂuence compatibility.

To understand the dynamic interplay of these areas,

we conceptualized compatibility consistent with a

biopsychosocial approach to challenging behaviour [15].

According to Griffith and colleagues [16], challenging

behaviour (e.g., self-injuries, property destruction, and

aggression) is culturally abnormal behaviour that jeopardizes

the safety of the person or others and can result in limited

This article is part of the Topical Collection on Intellectual

Disability

* Laura E. Mullins

Lmullins@brocku.ca

1 Department ofApplied Disability Studies, Brock University,

St.Catharines, ON, Canada

1 In recognition of the diﬀerences in preference among the autism

community, we used identity-ﬁrst (autistic) and “on the spectrum”

in an attempt to avoid using ableist language (Bottema-Beutel etal.,

2020).

/ Published online: 21 November 2022

Current Developmental Disorders Reports (2022) 9:225–234

Content courtesy of Springer Nature, terms of use apply. Rights reserved.

ResearchGate has not been able to resolve any citations for this publication.

Person‐centred respite supports: The perspectives of adults with intellectual disabilities in Ireland

Article

Full-text available

Oct 2020

Teresa Gadd

Accessible Summary • This study looks at the experiences of adults with intellectual disabilities using respite services in Ireland. Some adults stayed overnight in a respite house, and others were part of evening and weekend groups. • Overall, the adults were happy with their respite supports. • They suggested nine important ways that respite services can meet a person's needs and support them to do the things they want to do. • The adults said it was important to have fun, time and space, choice, and to be independent at respite. They should have a chance to build friendships and be in groups that work well together. It is important to get on well with staff too. Respite supports must meet different needs. Persons with disabilities should take part in the design and management of respite supports. • A national policy for respite in disability services is needed in Ireland. The views and suggestions of persons with disabilities should be considered if a policy is developed. Abstract 1.1 Background Respite supports are highly valued by persons with disabilities and their families/carers. In Ireland, there has been regular commentary in relation to a lack of respite services, with users and other stakeholders reporting limited access, inequity of provision, and long waiting lists for support. 1.2 Materials and Methods Much of the research on respite focuses on the views of carers, with little account of the experiences of persons with disabilities. This study examines the perspectives of twenty‐eight adults with intellectual disabilities; most are regular users of traditional and/or alternative respite services. Information was gathered through individual interviews and focus groups. 1.3 Findings Participants identified nine key elements of a person‐centred respite service; fun, time and space, choice, independence, friendships, compatible groupings, positive relationships with staff, flexible supports, and user involvement in service design and delivery. 1.4 Conclusions Person‐centred supports should enable individuals to achieve maximum well‐being and flourish in all aspects of their lives. This study found that at a personal level, respite services and the interactions that occur within them are person‐centred in that they support the individual to do the things they want to do, make everyday choices, try new activities, develop positive relationships, and have a good quality of life. However, at the level of service planning and decision‐making, there is less evidence of a person‐centred approach. Participants reported having little involvement in the design and delivery of respite services at local or national level. The development of a respite policy in Ireland, that considers the views of respite service users, would be welcome.

‘I never realised everybody felt as happy as I do when I am around autistic people’: A thematic analysis of autistic adults’ relationships with autistic and neurotypical friends and family

Article

Full-text available

Aug 2020
AUTISM

Many autistic people are motivated to have friends, relationships and close family bonds, despite the clinical characterisation of autism as a condition negatively affecting social interaction. Many first-hand accounts of autistic people describe feelings of comfort and ease specifically with other autistic people. This qualitative research explored and contrasted autistic experiences of spending social time with neurotypical and autistic friends and family. In total, 12 autistic adults (10 females, aged 21–51) completed semi-structured interviews focused on time spent with friends and family; positive and negative aspects of time spent with neurotypical and autistic friends and family; and feelings during and after spending time together. Three themes were identified: cross-neurotype understanding, minority status and belonging. Investigation of these themes reveals the benefits of autistic people creating and maintaining social relationships with other autistic people, in a more systematic way than previous individual reports. They highlight the need for autistic-led social opportunities and indicate benefits of informal peer support for autistic adults. Lay abstract Although autistic people may struggle to interact with others, many autistic people have said they find interacting with other autistic people more comfortable. To find out whether this was a common experience, we did hour-long interviews with 12 autistic adults. We asked them questions about how it feels when spending time with their friends and family, and whether it felt different depending on whether the friends and family were autistic or neurotypical. We analysed the interviews and found three common themes in what our participants said. First, they found spending with other autistic people easier and more comfortable than spending time with neurotypical people, and felt they were better understood by other autistic people. Second, autistic people often felt they were in a social minority, and in order to spend time with neurotypical friends and family, they had to conform with what the neurotypical people wanted and were used to. Third, autistic people felt like they belonged with other autistic people and that they could be themselves around them. These findings show that having time with autistic friends and family can be very beneficial for autistic people and played an important role in a happy social life.

Using a Bio-Psycho-Social Approach for Students With Severe Challenging Behaviours

Article

Full-text available

Jul 2014

Lisa Reisinger

What teachers learn about classroom management in education classes often results in behaviour strategies that do not account for the individuality of each student. Teachers would benefit greatly from a common formula for effective problem solving and decision making with regard to choosing when to use the strategies in their "tool box." The solution proposed is the building of an individual biopsychosocial, multimodal profile for each student with chronic challenging behaviours.

Effect of deinstitutionalisation on quality of life for adults with intellectual disabilities: A systematic review

Article

Full-text available

Apr 2019

Objective To review systematically the evidence on how deinstitutionalisation affects quality of life (QoL) for adults with intellectual disabilities. Design Systematic review. Population Adults (aged 18 years and over) with intellectual disabilities. Interventions A move from residential to community setting. Primary and secondary outcome measures Studies were eligible if evaluating effect on QoL or life quality, as defined by study authors. Search We searched MEDLINE, PsycINFO, CENTRAL, CINAHL, EconLit, Embase and Scopus to September 2017 and supplemented this with grey literature searches. We assessed study quality using the Critical Appraisal Skills Programme suite of tools, excluding those judged to be of poor methodological quality. Results Thirteen studies were included; eight quantitative studies, two qualitative, two mixed methods studies and one case study. There was substantial agreement across quantitative and qualitative studies that a move to community living was associated with improved QoL. QoL for people with any level of intellectual disabilities who move from any type of institutional setting to any type of community setting was increased at up to 1 year postmove (standardised mean difference [SMD] 2.03; 95% CI [1.21 to 2.85], five studies, 246 participants) and beyond 1 year postmove (SMD 2.34. 95% CI [0.49 to 4.20], three studies, 160 participants), with total QoL change scores higher at 24 months comparative to 12 months, regardless of QoL measure used. Conclusion Our systematic review demonstrated a consistent pattern that moving to the community was associated with improved QoL compared with the institution. It is recommended that gaps in the evidence base, for example, with regard to growing populations of older people with intellectual disability and complex needs are addressed. PROSPERO registration number CRD42018077406.

Adolescent/Adult Sensory Profile

Chapter

May 2024

Catana Brown

At Home With Autism: Designing housing for the spectrum

Book

Nov 2015

At Home with Autism introduces readers to conditions and aspirations of adults on the autism spectrum that demand a new approach to how we provide, locate, design and develop homes in which they live. The book argues that there is no singular stellar residential model, just as there is no singular prototype of autism. Grounded in an extensive array of research sources, the book identifies resident-focused quality of life goals, and profiles design guidelines directed to those goals. The book implores those involved in housing design, production and policy to expand their exposure to what is possible, what is desirable, and to direct their efforts towards expanding residential choices for those on the spectrum.

At Home with Autism: Designing Housing for the Spectrum

Book

Sep 2022

Grounded in an extensive array of research sources, this valuable book introduces readers to conditions and aspirations of adults on the autism spectrum that demand a new approach to how we provide, locate, design and develop homes in which they live.

Typology of Community Living Transitions for People with Intellectual Disabilities: Are Current Experience in Rehabilitation Centers Tied to the Best Practices?

Article

Jan 2020

Since the beginning of the deinstitutionalization of individuals with intellectual disabilities (ID), few studies have been carried out on the community living transitions process. Policies require to offer hosting services which respect the ideology of “seeking a home,” in accordance with the choices of individuals with ID. The involvement of individuals with ID in their own community living transition and concerted planning are considered to be part of the best practices. This study provides a portrait of community living transitions within rehabilitation centers. The aim was to develop new insights into the experience of community living transitions for people who have an ID. Specifically, this study identifies (1) a typology of community living transitions and (2) the gaps between best practices, desired practices, and current practices from the educators' viewpoint. Educators (n = 19) were randomly selected to participate in three focus groups and share their support experiences during community living transitions. Qualitative content analyses identified a typology of community living transitions. One out of the six types of transitions identified offered favorable conditions for a transition that involves the person with ID in his or her own transition and collaborative planning (prepared). The other types of transitions (last minute, explosive, turnkey, waiting room) all offered fewer opportunities for the person with ID to be involved in the transition process. Educators identified the characteristics of an ideal community living transition (as if it were myself). Gaps between the participants' experiences and best practices were identified, particularly regarding the involvement of individuals with ID in decisions concerning their own community living transition. The organization of the hosting services and a lack of accommodation resources influence the transition preparation time, the amount of collaborative planning, and the level of involvement of the person with ID. Implications of the gaps between experiences and best practices are identified.

Applying dignity of risk principles to improve quality of life for vulnerable persons

Article

Oct 2019

Objectives: Freedom of choice impacts quality of life. Expressed through dignity of risk (DoR), nursing home (NH) residents should be afforded the dignity to take risks to enhance well-being. How DoR is understood and implemented in the context of aged care remains largely unknown. This study explored the meaning and the barriers and facilitators to applying DoR to NH residents. Methods: Qualitative study, comprising semistructured interviews. Senior policy makers and advocate guardians working in the aged care or disability sector were invited to participate. Recruitment continued until data saturation was reached. Two researchers coded interviews, applying inductive and thematic analysis. Results: Fourteen participants took part during 2016-2017. Analysis demonstrated uniformity in participants' description of DoR, comprising four elements: (a) individuals are at the centre of decision making; (b) life involves risk; (c) individuals must have choice; and (d) DoR is a continuum of experiences. Three main barriers for implementing DoR into practice were identified: (a) balancing autonomy with risks; (b) situational nature of DoR; and (c) taking responsibility for risk. Conclusion: The novel findings provide an explicit understanding of DoR and the facilitators and barriers to applying the principle in the NH setting. These findings inform those who engage in making and implementing choices in the presence of risk for vulnerable clients. To translate the multifaceted elements of DoR into practice requires the development of unambiguous policies/guidelines about who will be responsibility for potential risks that may arise from residents' choices. Further, education programmes supporting care staff/management to enact resident choices in the presence of real or perceived risk are required.

Adults on the Autism Spectrum and Their Families: Residential Issues

Chapter

Aug 2019

When a person with ASD leaves the framework of high school, dilemmas arise regarding how to proceed into the next stage of life. The question of residence is one of the central questions that a family faces, and it may take years to resolve. The decision for the person with ASD to remain at home requires the assistance of professionals in order to allow the young adult to advance in terms of accomplishing basic life tasks and to maintain healthy and beneficial functioning in the family. The choice to move to a residence outside the home is always challenging for young people with ASD and their families. The need to find appropriate solutions for young people with ASD had led to the development of specialized services in many parts of the world. This chapter discusses the issue of independent housing options for young people on the high-functioning end of the autism spectrum (HF-ASD). The first part reviews models of residence outside the family home that are available in various parts of the world. This section covers the process of moving outside the parental home and the challenges this poses to the entire family. The second part of this chapter presents some key principles and tools for the management and development of residential frameworks outside the home for adults with HF-ASD.