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Third Caribbean Congress on Mental Retardation, Barbados, W.I., 1974.

Some time ago, Dr. Kan, the distinguished Japanese leader in mental retardation, prepared for an international congress in France a series of slides of new Japanese mental retardation institutions. In order to afford his western colleagues a more realistic opportunity to assess these institutional buildings, he started out with a number of slides showing typical Japanese middle-income and low-income housing as a basis for comparison.

I was reminded of this very thoughtful and very effective gesture when I began to think about what I wanted to say to you today, and realized how little I know about these, your Caribbean Islands, because this is indeed my first visit here.

Fortunately, I am aided by a new development in our field which evolves around the normalization principle, first formulated in the late 1960s by Bank-Mikkelsen of Denmark and Bengt Nirje of Sweden and very rapidly accepted in many countries as a guideline to programming. Most succinctly stated, the principle of normalization aims at making available to mentally retarded individuals patterns and conditions of everyday life which are as close as possible to the norms and patterns of the society of which they are a part. It goes without saying that such patterns and conditions vary according to age and differ as between city and rural areas; indeed, it is important in our context to be mindful of the fact that it is normal to be different. Thus, normalization does not denote rigid patterns -- to the contrary, in general, societal patterns make room for variations sufficiently to accommodate the major portion of mentally retarded adults. We have proof of this from the fact that in all countries where surveys of the prevalence of mental retardation are undertaken, we identify a large number of individuals as retarded in the school population, but the number identified in the adult population is distinctly smaller. In other words, many retarded individuals manage, once freed from the label of the special class, to melt into the general population, to adopt a lifestyle, however limited or marginal, which "gets by," which still falls within the flexible limits of what a community will accept. Most of us deviate in one way or another from accepted community norms, but that does not cause us to be called "deviants," as the sociologists use the term.

In any case, the principle of normalization makes it possible for me to present broad general outlines of new knowledge, new trends in the field of mental retardation which can be interpreted by you within your own societal frame of reference. There are two points which need to be underlined. Normalization does not imply that we "normalize" individuals. This would indeed have a very obnoxious connotation. Rather, it refers to the circumstances, the conditions, the rhythm of life. Furthermore, in the definition I gave before, the words "as close as possible" need to be emphasized, because this element of relativity makes it possible to apply this principle to even the most severely handicapped individuals. For them, too, we must see that provisions for their care do not deviate any more from what is commonly accepted in society than is specifically necessitated by their condition.

These introductory remarks may strike some of you as rather commonplace, as too self-evident to state them with such emphasis. Yet nothing has been more injurious to mentally retarded persons, nothing has handicapped them more than the preconceived notions, the prejudicial judgments with which they have been considered, and which, right to the present day, have constrained our programming.

The title for my presentation is "Preparing the Mentally Retarded for Adult Living." Yet some persons feel even today that mentally retarded individuals do not reach the status of adulthood. While we do not hear as much today about the "eternal child" as was the case some years ago, in many subtle and not so subtle ways the mentally retarded person is treated as if a child. In part this is reinforced by a very widespread misunderstanding of the psychologist's reference to mental age. Even in reputable psychological texts one still can read that a mental age of 9 means that the retarded adult can be expected to be like a child 9 years of age. Obviously, it would be rather futile, if this were true, to prepare such an individual for adult living. However, in the first place, a mental age of 9 signifies no more than that on one of the standard intelligence tests the overall performance of the person (i.e., his mental age) was arrived at by averaging out the individual's performance on numerous sub-tests, on some of which he or she may have scored as high as the 12 year level and on others below the 9 year level. Thus it is very misleading to liken that performance to that of a child of 9. In the second place, what is measured by the test is intellectual performance, a very partial assessment of a person that leaves out the capacity to adapt oneself to social situations, one's life experience, and the individual's degree of physical maturation, which allows for a greater range of activities than the 9 year old is capable of handling. All these factors make it possible for such a retarded person to assume adult roles which would be definitely closed to the 9 year old, and to perform adult tasks of which the 9 year old would be incapable, both physically and socially.