In the past 3 decades, there have been substantial, important changes in the sizes of residential settings in which people with intellectual and developmental disabilities (ID/DD) live. At the same time, there has been substantial change in the number of people with ID/DD who receive residential supports while living away from the homes of their parents or other relatives, from 248,000 in 1977 (114.5 per 100,000 total U.S. residents) to 411,200 in 2005 (138.7 per 100,000 total U.S. residents). Figure 1 shows this growth between 1977 and 2005 broken down into different sizes of residential settings, including both state and non-state settings among the institutions of 16 or more residents. The years shown in Figure 1 provide as nearly as possible 5-year intervals in residential support development during the past 3 decades. The general patterns during this time period include rapid growth in residents...

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