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Historically, deviance has been handled in a number of ways.

1. Deviance can be prevented. A psycho-social means of prevention is not to attach negative value to certain types of differentness. For instance, medieval Catholicism and the more contemporary Hutterites did not place excessive value on intellectual achievement, and therefore were less likely to view the retardate as a deviant.

2. Deviance can be made undeviant, usually by means such as education, training, treatment.

3. The deviant, being perceived as unpleasant, offensive or frightening can be segregated from the mainstream of society and placed at its periphery. We have numerous examples of this in our society: we segregate the Indian in reservations, and the Negro in the ghetto; the aged are congregated in special homes, ostensibly for their own good, and these homes are often located at the periphery of our communities or in the country; deaf and blind children who could be taught in the regular schools are sent to residential schools, many of which are on the periphery of, or remote from, population centers; we have (or have had) "dying rooms" in our hospitals to save us the unpleasantness of ultimate deviancy; and the emotionally disturbed and the retarded may be placed in institutions far in the countryside.

Deviance can be seen to be someone's fault or perhaps a sign that the deviant's parents had sinned and were being punished by the lord. The belief that blemish in the offspring is the result of punishment for parental wrongdoing appears to be deeply engrained in the unconscious of the people. Often, this belief is overtly expressed. It is a belief that had been held by Howe (a leading American pioneer in the field of retardation) and was repeatedly expressed by him. In fact, he even asserted that retardation could result from a person's own wrongdoing (Howe, 1848, 1852, 1866), e.g.: "It appeared to us certain that the existence of so many idiots in every generation must be the consequence of some violation of the natural laws; -- that where there was so much suffering, there must have been sin" (1848, p. 4) Greene (1884, p. 270) said: "Our wards are innocent of crime or fault. In the large majority of instances, they are the feeble and deformed expressions of parental sins or sorrows." Parental alcoholism, for instance, was widely believed to be a major cause of retardation (e.g., Kerlin, 1886, p. 297). Perceived to be the result of sin, deviance is something to be ashamed of, hidden and "put away." The Puritans held views along these lines (Deutsch, 1949).

4. Deviance can be destroyed. In the past, some kinds of deviance were seen to be the work of the devil or other evil forces. As such, the deviant was evil too, and had to be persecuted and destroyed so as to protect society. Destruction of deviants may also be advocated for other reasons of self-preservation or self-protection. For instance, many societies have condoned the destruction of weaker, less adequate, or handicapped members. This was true of ancient Greece and Rome, of the Eskimos and bushmen, and of Nazi Germany. In the United States, the increasing sentiment for, and legalization of, abortion of high-risk fetuses can be viewed, at least in part, as a variant of this theme.

In one's professional functioning, in the literature, and in the history of the field, one can discern at least seven well-defined role perceptions of the retardate. Most of these roles are deviant ones. The relationship between these role perceptions, the management of the retardate, and the design of his life space, though of crucial significance, is not always obvious. I will attempt to demonstrate how location, architecture, interior appointments, and day-to-day operating procedures of institutions will tend to form interrelated patterns (management models) that are consistent with various role perceptions of the retardate. (1) Institutional models based on seven major role perceptions of the retardate will be discussed.

The Retardate as a Sick Person. One of the most prominent role perceptions of the retardate has been that of the sick person. The literature is replete with statements such as Fernald's (1915, p. 96): "The biological, economic and sociological bearings of feeble-mindedness have overshadowed the fact that it is fundamentally and essentially a medical question." A recent and unequivocal restatement of this role perception is contained in a very important document, viz., the Mental Retardation Handbook for the Primary Physician, issued by the American Medical Association (1965). In this work, mental retardation is repeatedly identified as a "disease" (e.g., p. 98) or an "illness" (e.g., p. 47).