Library Collections: Document: Full Text

It should be obvious that lack of attention to basic terminology makes it very difficult for us to communicate. One of our biggest problems right now is to establish communication between the field in which we first began most of our activities, that of the schooling of the mentally retarded and the newly developing field of programming for the adult retarded. To put roadblocks in our way by using misleading and confused terms at a time when we have a better terminology available is the kind of thing we all must work hard to avoid.

While I have used as an example a report released just two weeks ago, I could of course make reference to many other States where similar confusion exists and exists to the peril of the mentally retarded.

It is bad enough that we have among the leading professional organizations still no common agreement. As you know the American Psychiatric Association still goes its own way with regard to mental retardation terminology and any time you deal with a member of that professional group you have to be very careful to find out what he is talking about because his classification scheme is quite different from that which, for example, psychologists are using. Anyone who is following educational literature knows that the educators have anything but a common terminology in mental retardation but that we ourselves continue to add to this confusion is particularly deplorable and, as I said, is something that occurs to the peril of the mentally retarded.

A situation which is similar in terms of the misapplied use of words, and which I would like to pick up as another example, relates to the term "crib cases" in the field of residential care. We still talk a great deal of crib cases. Now, if institutional reports do this simply because this is the way their statistics were set up in the past, this is one thing. If people in our own organization do it, this is quite a different matter. What are we doing here semantically? What is wrong? A crib case is an individual who on admission was judged to need 24-hour bed care. Many of these individuals not only are young in years and need the protection of a crib, they often are on admission physically in such a condition that they need this special protection. But what we are doing wrong is that we label the person rather than the service or facility he needs as we first see him. Once and for all he is a "crib case". To be sure, in a few of our States new programs have been introduced which for the first time provide a planned aggressive therapeutic approach to these profoundly retarded patients. These States have recognized that though an individual may need a crib type of care at one point, the grave error made in the past was simply to take for granted that this was the care he should receive indefinitely. Thus, our crib wards provided an environment and a type of care that hardly was conducive to improvement.

The same type of problem has been so damaging to many of the children with mongolism (or as we are now supposed to say, "Down's Syndrome"). There was insistence that they could not learn and that for this reason they should not be admitted to classes. Then it was proved with their subsequent inadequate performance as young adults and adults that indeed they were quite incapable of learning! However, just as we now have in our progressive institutions a breakthrough, a turning away from this negative approach to a positive treatment program for the profoundly retarded, so we see an increasing number of school systems ready to take a second look at the child with mongolism and to admit him to school if his individual performance makes his progress there a probability.

In any case, the point I wish to make in this context is that we certainly should not fall any longer into this mistake of thoughtlessly labeling a human being in terms of the kind of care which at any one time was thought to be appropriate for him.

I wish we had the time to go on with this and to give a searching look at our institutions and community services in terms of existing terminology, since we would find over and over again programs which are at a standstill because the kind of words used to describe the program are restrictive in themselves, and therefore do not suggest providing the proper care for these individuals. "Custodial care" is an example.

The question, of course, is can we endow a given term with a new meaning or must we replace it with another term so as not to harm the very program we wish to pursue. There have been those among us who have taken it as a bit of an artificial way of doing things that NARC, for instance, has insisted we no longer have an Institutions Committee but a Residential Care Committee. Yet, if we use promiscuously the term "institution" with its past and present connotation, and at the same time set out, as some States are now doing, to create new types of facilities, (small residential units for temporary care, for example) can we really do a good job of selling to the community what we want to do by using language no longer equal to the new challenge we want to pursue? If you still don't quite see the point, just change this to the verb form and speak of institutionalizing a child, and you immediately will recognize that this just doesn't fit anymore, this is no longer what we wish to imply with the new program of residential care.