本文探討比較美、英兩國成年智障者從教養院搬到社區居住與生 活改革源起、進程與配套措施，以文件研究方法從事文獻資料收集， 含電腦檢索圖書館與網站期刊與書目及各國官方與非官方文件。研究 發現：近代，美國發展智能或發展障礙者社區居住與生活重要改革事 件爲：1999年最高法院Olmstead決議障礙者有權利在社區生活；英 國2001年學習障礙者白皮書，強調「對人支持」（supporting people) 與「重視人的價値」（valuing people)，規定地方政府2004年4月前所 有住在長期停留醫院之學習障礙者搬到社區生活。美英兩國比較發現 其相同處爲：智障者社區居住與生活改革自1960年代以來持續進 行，近代因重要事件及改革政策，有更具體成果，以重度、極重度及 有挑戰性行爲成年智障者爲對象。相關實證性研究一致發現住在社區 小型一般住宅，即使針對有密集性支持需求之重度智障者，比住在傳 統教養院或大型者，成本效益高。兩國不同處，美國屬於其醫療補助 項下之改革措施，英國爲其社區照顧一環；美國困境爲其等候排隊住 到社區一般住宅者眾多，英國則需致力於資源結合與配置適當性。

This study utilizes literature review to collect governmental documents and empirical studies regarding adults with intellectual disabilities living in the community in the United States and Britain in order to analyze the similarities and differences of their polices and services. Both the US and Britain initiated “deinstitutionalization” in the 1960s. Currently in the US the Supreme Court decision in Olmstead v. L. C. in 1999 brought big effect on the policies revolution to support persons with mental retardation/developmental disabilities living in the community. In Britain, recent policy for supporting adults with learning disabilities to live in the community independently is the 2001 White Paper —Valuing people: A new strategy for learning disability for the 21st century. Adults with severe/profound intellectual disabilities and with challenging behaviors who stay in the institutions are the primary targets moving into the community in the US and Britain at the present. Based on the consistent findings of the empirical studies in the US and Britain, community-based ordinary housing is more cost-effective than the institution-based or large scale housing.