Nearly 50 years after the federal government established a national infrastructure for developmental disability services, life for those with such conditions is markedly improved, according to a government report released Tuesday, but many hurdles remain.

Developmental disability services vary wildly from state to state, are plagued by long waiting lists and such services tend to be complicated and fragmented, according to the report from the National Council on Disability, which examined the impact of the Developmental Disabilities Assistance and Bill of Rights Act, or the DD Act, in a year-long study.

What’s more, the report found that public attitudes are outdated and that the Administration on Developmental Disabilities is not integrated well with other federal agencies, limiting what can be accomplished.

First approved in 1963, the DD Act established state councils on developmental disabilities throughout the country and led to the national system of protection and advocacy organizations, university centers for excellence in developmental disabilities and family support programs in addition to a discretionary fund known as projects of national significance.

Since that time, individuals with developmental disabilities have transitioned from living largely in institutions to residing primarily in communities. In addition, they now have access to education and live longer, the report indicates.

“Despite some identified gains in disability rights, people with developmental disabilities continue to face considerable barriers to full integration, maximum independence and self-determination,” Jonathan Young, chairman of the National Council on Disability wrote in a letter to President Barack Obama that accompanies the report.

The Council, which makes recommendations to the president and Congress on disability issues, prepared the report in anticipation of a forthcoming reauthorization of the DD Act.