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Developing Patterns For Aid To The Aging Retarded And Their Families

Creator: Gunnar Dybwad (author)
Date: May 1960
Source: Friends of the Samuel Gridley Howe Library and the Dybwad Family

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GUNNAR DYBWAD, J.D.

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Executive Director, National Association for Retarded Children, New York City

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It is a particular privilege to participate in this Conference on "The Outlook for the Adult Retarded" under the auspices of The Woods Schools.

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In the still very limited literature in the field of mental retardation, the many volumes of Proceedings of the past Woods Schools Conferences have a place of high distinction because of both the quality and the timeliness of their presentations. Indeed, a good deal of what is going to be discussed here tonight and tomorrow was already foreshadowed to a considerable extent by the 1957 Woods Schools Conference on Vocational Training and Rehabilitation of Exceptional Children.

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It is not without significance that while at that Conference, the topic mentioned only children -- now, three years later, we jump all the way to the aged. There have been many indications during the past several years that we are confronted with a very rapid increase in the life span of the mentally retarded, but if we look for documentation by statistics, we have to be content with information that is limited to the institutional population.

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I am indebted to the State authorities in New York and New Jersey for some recent figures documenting the increasing longevity of the more seriously retarded. At the Woodbine Colony in New Jersey, which is limited to this type of resident, the median age at time of death has moved up from 27 years, 6 months in 1951 to 38 years plus in 1959.

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In New York, figures from the various institutions indicate an increase in the age at death in their imbecile classification from age 28.2 in 1951 to 40.1 in 1959, and in their idiot classification from 15.4 in 1951 to 21.5 in 1959.

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These changes have been brought about largely by improved medical care, and in particular new drugs including antibiotics, and also by advances in general patient care, diet, and so forth.

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It is important to note in the context of our discussion here that, notwithstanding this marked trend, in most of our institutions residents of all ages are still referred to as "boys" and "girls." Yet one of the most important of the "Developing Patterns for Aid to the Aging Retarded and Their Families" I am to discuss with you tonight is the beginning recognition that the older retardate is entitled to adult status.

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This new insight, stemming largely from the more progressive work in community facilities for the retarded, reflects a rejection of the old cliche which termed a twenty-year-old mongoloid with an I.Q. of 40 as a "child at heart." Today we recognize that such a person is an adult with a severe mental handicap, but one who may well be capable of performing tasks of reasoning and expressing feelings considerably beyond those of the child whose "mental age" he presumably possesses.

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Looking into the future, I do not hesitate to predict that there will be an increasing readiness to accord even the severely retarded a greater degree of human dignity.

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Last year in addressing the National Conference on Social Welfare on the topic "Total Community Planning for the Mentally Retarded Young Adult," Dr. Henry V. Cobb, himself a psychologist, emphasized that those who are working directly with the retarded in any kind of ameliorative way need, above all, to discover the resources and assets of the person, not merely his limitations. He added to this obvious criticism of present routine psychological evaluation that this was a truism but not a trivial one.

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I am well aware that there are exceptions to this general observation, particularly in our good private residential facilities, and that indeed in all institutions there is a group of retardates whose devoted service in the maintenance of the facility has earned them a privileged status. But looking at our institutions in general, the indictment must stand, and we cannot expect to make progress unless we first acknowledge its existence.

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In this connection it was heartening to me to read in the excellent journal, "Mental Hospitals," published by the American Psychiatric Association, the following statement by a psychiatrist with long experience in hospitals for the mentally ill:

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"We used to believe that the spectacle of 50 to 100 patients, all wearing identical hospital clothes, all looking the same, standing about or shambling around an airing court, was the product of mental illness, and since the illness was incurable, nothing could be done about it except to keep the patients in some comfort until they died. We have now had the experience of seeing what changes are brought about in normal people as a result of herding them together and destroying their individuality. When one saw, after the war, gruesome pictures of the concentration camps, then one saw the further stages in the process of destruction of the individual. I am not suggesting that our hospitals have been run like concentration camps, but I do think that this example forcibly illustrates the point that it is not the mental illness as such which brings about some of the changes which have been seen in the chronic psychiatric patient."

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