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Action Implications, U.S.A. Today

From: Changing Patterns in Residential Services for the Mentally Retarded
Creator: Gunnar Dybwad (author)
Date: January 10, 1969
Publisher: President's Committee on Mental Retardation, Washington, D.C.
Source: Available at selected libraries

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Strengthening the Empirical Orientation of Services. As Wolfensberger has pointed out in his discussion of cost-benefit rationales, the introduction of a service system built on these rationales would make it necessary to consider research as an integral part of service operations. One of the many advantages of a service system incorporating cost-benefit principles is that by the very nature of cost-benefit operations, the system will be tied to research designed to evaluate the comparative validity, benefits, and costs of alternative service practices and options. Inherent in such research is quality control and the ascertainment of the degree to which day-to-day procedures of management are consistent with the stated policies of the agency.

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However, large-scale operational research in institutions for the mentally retarded has been comparatively rare to date. Granted that research can not be straightjacketed in a rigid operations schedule, and that we must put a premium on the creativity of the research worker and therefore grant him sufficient freedom and independence in his pursuit, what could be more uneconomical than the hundreds and thousands of small ad hoc research studies undertaken disjointly and haphazardly in the hundred-plus institutions for the mentally retarded in the United States.

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If we wish to underpin consideration of needed changes in mental retardation programming in general and in residential services specifically with solid research findings, there is first of all the need of posing the right questions to the research workers. Since studies aimed toward change must of necessity include an assessment and analysis of that which is to be changed, we are back at a point repeatedly treated in this chapter and book, namely, the reality of the present inadequacies in institutional care. To assess these fully, the research staff must be given free and unhindered access to the totality of the institutional situation without exception. Important as these research efforts are, their value will be limited by the fact that, of necessity, they must be largely retrospective. All the more it is necessary to provide generous federal financing for evaluative research to be built into new designs for human management practices and facilities.

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The term "built-in research" should be applied rather literally to the construction of new facilities. Questions as to the desirable size of units, the number of people in different age groupings to be accommodated in one bedroom, the size and shape of rooms, the type of furnishings, the influence of acoustics or the type of floor covering, dining procedures, the proper arrangement for sanitary facilities, etc., will eventually be answered with greater certainty if the administrator, the architect, and the research worker, supported by the appropriate behavioral experts, will work out a scheme whereby different "settings" will be created so that these can be compared in terms of their effect on residents, staff, and cost. With availability of federal financing it should be possible to conduct collaborative and/or parallel research projects simultaneously in several states.

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In sum, federal funds should be made available to test out on an experimental basis in one or two states (preferably of relatively small size) Wolfensberger's decision-center model operating under a cost-benefit rationale. The cost-benefit rationale should also be applied to an appraisal of federally supported research efforts in the field of mental retardation generally. It is always somewhat dangerous to guess-in advance the result of a research assessment, but there have been some very definite indications that the millions (one could probably save scores of millions) of dollars spent in recent years on research, quasi-research, and evaluation projects have provided us with very limited returns. Partially, these limited returns are probably a result of the cautious, conservative, and unimaginative research grant proposals which have been elicited, reviewed, and approved. The question which suggests itself is whether we would not be further ahead in practical knowledge if money had been made available from federal sources for some carefully evaluated projects of daring experimentation with innovative services.

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Federal funds should be appropriated for such research, and special procedures should be instituted to elicit and review bold, imaginative, innovative, and well-designed research and evaluation proposals in the service area. One possible mechanism would be to convene one or more conferences of innovative thinkers in the field in order to discuss and define ideas and proposals. Some of these proposals could then be selected for implementation, and workers in the field could be encouraged to submit specific proposals that could be reviewed competitively in regard to quality of design, cost, and likelihood of the applying investigators and agency to be able to carry out the study.

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