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Trends And Issues In Mental Retardation

Creator: Gunnar Dybwad (author)
Date: 1960
Publication: Children and Youth in the 1960s: Survey Papers Prepared for the 1960 Conference on Children and Youth
Publisher: Golden Anniversary White House Conference on Children and Youth
Source: Friends of the Samuel Gridley Howe Library and the Dybwad Family

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"Mental retardation refers to subaverage general intellectual functioning which originates during the developmental period and is associated with impairment in one or more of the following: (1) maturation, (2) learning, and (3) social adjustment". This is the definition on which the American Association on Mental Deficiency has based, its new "Manual on Terminology and Classification in Mental Retardation." Accordingly mental retardation will be used in this paper as encompassing all types and degrees of this disability.

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It should be noted, however, that there is no common agreement on terminology. For instance in 1954, the World Health Organization proposed that the overall problem be termed "mental subnormality" with two major subdivisions reflecting causative factors: mental deficiency for those cases where biological factors have resulted in pathology of the central nervous system, and mental retardation for those cases where the causative factors are in the social, economic, cultural, and psychological realms. Many scientists and practitioners in this country, on the other hand, use the terms "mental retardation" and "mental deficiency" interchangeably while other English-speaking countries have terms of their own. This means that great care has to be taken to establish in discussions or in using literature what particular terminology is involved.

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There are no exacting statistics available concerning the number of mentally retarded in the United States. A substantial portion of the scientists and practitioners in the field set the number of mentally retarded in this country in excess of 5 million, or 3 percent of the population. However, some writers give a substantially smaller figure down to as little as 1 percent of the population. While such discrepancies in estimates do constitute a problem, the source of disagreement does not lie with the main body of the supporting figures but with the point at which the upper limits of mental retardation are established.

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The normal distribution curve provides for a rapid increment of the estimated number of individuals covered as one moves upward on an intelligence scale. Hence, if one writer uses as the upper limit of those called retarded a Binet IQ of 70, while another writer chooses to use a Binet IQ of 75, the second estimate would be about twice as large as that of the first one.

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During the past 10 years a number of surveys and reports have been published which list in various ways the figures regarding the "known" mentally retarded. It is important to recognize the limitations of such figures. Relatively few preschool retarded children are "known" to agencies, yet we know they exist. Furthermore, the fact that no service is requested for them by parents does not mean that no such service is needed; recent studies (such as Kirk's) have indicated the advantage of early work with the very young retarded child, in other words, it is hazardous and misleading to base program planning mainly on statistics regarding known cases. Availability of good, accessible mental retardation services will result in distinctly more cases becoming "known, " and thus in increasing the estimates of future needs.

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Causation

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While, in general, there has been no inclination in this country to accept the terminology of the World Health Organization, there is general acceptance of the basic premise underlying it, namely the differentiation between mental retardation which is related directly to biological factors and mental retardation that does not indicate pathology of the central nervous system. It is in accord with the general status of knowledge in human affairs that we have far more exacting information about the biological than the sociocultural-economic causes. One of the outstanding leaders in the field, Dr. George Jervis, wrote in 1957 that "it would be easy to compile a list of some hundred diseases characterized by mental retardation, each one exhibiting its own etiologic determinants."

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In general, the biologically conditioned and the sociocultural-economic types of mental retardation face each other in juxtaposition, qualitatively and quantitatively. The former encompasses a larger number of the severe cases but constitutes only a small percentage of all the retardates, while the latter is more typical of milder forms but numerically is by far in the majority.

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A great deal of confusion exists with regard to so-called environmental influences in mental retardation, since this term is used in two entirely different frames of reference. The sociologist will use it with regard to cases where, for instance, lack of a minimum of stimulating influences and emotional deprivation have resulted in an individual's intellectual and social inadequacy. The biologist, on the other hand, uses this phrase to differentiate a genetic factor, such as is operative in gargoylism, from such prenatal environmental factors as effects of an infectious disease of the mother during pregnancy.

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