Residential care centers for persons with intellectual disability in Israel. Trends in the number of children 1999-2008 Academic Article uri icon

abstract

  • IntroductionDuring human history we have in different cultures seen children with severe disability neglected, maltreated or even "mercy" killed, which eventually resulted in the establishment of centers of refuge to protect these children, usually organized by religious or charitable organizations (1). As far as we know, these facilities were first established in Baghdad, Cairo, Damascus and Aleppo to later become introduced in Europe in the 18th century along with schools for deaf and blind children (1). In the 19th century, schools and special residential facilities were established for children with intellectual disability (ID) in Europe and North America (1).This change was partly the result of the revolutionary work of the French physician Jean- Marc Gaspard Itard (1775-1838) and Phillipe Pinel (1745-1826), the founder of modern psychiatry.During the 18th and 19th centuries and perhaps as a result of greater social acceptance of individuals with intellectual disability, specialized schools for children and adults were established around the world, specifically in Switzerland, Germany, England, Denmark and the United States (1). This trend continued into the 20th century despite the eugenics movement (1,4), but in the latter half of the 20th century, President John F Kennedy (1917-1963), who had a sister with intellectual disability, made the improvement of conditions for individuals with special needs a personal policy priority. In the late 1960s and 1970 de-institutionalization and normalization, which originated in Scandinavia became widespread, with many large institutions being closed and individuals moved into community settings.Clinical experience seems to demonstrate that the incidence of intellectual disability (ID) in Israel has not been decreasing due to both religious and cultural factors. However, the dignified and high quality care of this population has remained a pressing concern since the first school for children with ID was established in 1929 in Tel Aviv. Subsequently, residential care facilities for children with ID were opened in 1931 in Jerusalem and in 1945 in Herzliya (5,6). After the establishment of Israel in 1948 the Ministry of Welfare was responsible for providing care to those with ID, but in 1962 the Ministry of Labor and Social Affairs established the Division for Mental Retardation (DMR) to treat and rehabilitate those with ID. The DMR (now called the Division for Intellectual and Developmental Disabilities) is today in contact with approximately 35,000 people throughout Israel, and full-time residential care is provided to about 7,000 of those individuals at 63 residential centers. An additional 2,000 persons receive care through hostels and group homes at another more than 50 locations (7,8). Residential care centers, which in addition to ensuring that their full- time residents receive the appropriate level of support for their daily lives, also provide resources to parents, physicians, and other health care professions.The present study was conducted in order to look at the trends of the number of children with intellectual disability in residential care centers in Israel.MethodsIn 1997-1998 a questionnaire was developed by the Office of the Medical Director, Ministry of Social Affairs and Social Services. This questionnaire has aimed to assess, on a yearly basis, the health of the residents and the services provided to them by ID specific residential care centers within Israel (7). This questionnaire has been useful in evaluating a wide variety of relevant information on the age, gender and level of intellectual disability of the residents. The questionnaire included the following subsections: information on the age, gender and level of intellectual disability of children served at the residential care center in question, status of the population served (educational, treatment, rehabilitation, nursing and challenging behavior), profile (various aspects of the nursing load like number of persons with gastric tubes, catheters, dialysis, oncology, epilepsy, diabetes, hypertension, blindness etc), nursing, medical and allied professional staff, number of annual examinations, preventive medicine aspects, medications, number of annual cases of infectious disease, annual unintentional injury, number of deaths, number of hospitalizations, internal residential center hospitalization, ambulatory outpatient utilization, utilization of outside laboratory examinations and dental care. …

publication date

  • January 1, 2011