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Part One: Service development in Scandinavia, Britain and the United States. Dissolution of institutions in the Nordic countries. Development of community services in Britain. Origins and development of mental retardation services in the United States. Part Two: Case studies of institutional closure. Closing institutions in Norway. The Darenth Park Hospital Project. Closing Laconia. Part Three: Models of community services. Models of community services in Sweden. Models of community services: the British perspective. The development of supported living programs and policies in the US. Part Four: Management issues in community services. Policy reform in Norway. Management issues in community services in Britain. Quality assurance in developmental disabilities residential services. Implementation and management issues in New York State. Part Five: The effects of institutional replacement on service users and families. The experience of clients and their families in Norway and Finland. The impact of institutional replacement on service users. Families and institutional replacement. The impact of community integration on clients and families. Conclusion: Integrating diverse experience.