The continuum and current controversies in the USA

Abstract

This article reviews policy developments in deinstitutionalisation and community inclusion in North America, and, specifically, the USA. The article starts with a critique of the continuum concept and the associated principle of the least restrictive environment, which have been used as a conceptual framework for the design of services for people with intellectual disability. The author next examines past and current controversies surrounding deinstitutionalisation. The conclusion of the article briefly comments on the institution versus community debate and assesses the future of the continuum concept.