Library Collections: Document: Full Text

Action Implications, U.S.A. Today

From: Changing Patterns in Residential Services for the Mentally Retarded
Creator: Gunnar Dybwad (author)
Date: January 10, 1969
Publisher: President's Committee on Mental Retardation, Washington, D.C.
Source: Available at selected libraries

Next Page   All Pages 

Page 1:



(1) The author wishes to acknowledge his great indebtedness to Wolf Wolfensberger for considerable aid in the conceptualization and realization of the material in this chapter.


The contributions to this volume have brought together the best thought available today in the realm of services in mental retardation. It is an impressive collection and one that adds substance to our hopes for a better future for the retarded. In this final chapter an attempt will be made to pull together the main trends of thought and relate them to issues which need to be faced in our country and our states, and our Federal Government as much as by the citizenry at large.


This discussion has been structured around six broad areas of concern: philosophies and concepts; strategies of change (e.g., planning legislation, research, evaluation); human management programming; administration and financing; manpower and staffing considerations; and location and design of facilities. Obviously, there will be points which have relevance to more than one area; while there will be some loss-referencing, a point will generally be discussed in the area to which it appears to be most relevant.


Philosophies and Concepts


Without a doubt, as far as the future of residential (as well as many other) services (2) is concerned, the concept of normalization presented in Nirje's chapter has emerged as the most important one in this book. Developed in Scandinavia where it had long been reflected in the broad network of human welfare services even before the particular term was adopted, this concept is elegant in its simplicity and parsimony. It can be readily understood by everyone, and it has most far-reaching implications in practice.

(2) There is need to clarify some terms that influence the way people think. One should think in terms of "residential services," as indicated in the title of this volume, rather than "institutions," a term which refers to congregate care practices of the past -- but not the future. "Residential services" is also more appropriate than "residential care," which implies a more narrow concept. Finally, the term "residential services" is appropriate in the plural, referring not merely to a relatively unitary concept such as embodied in the traditional institution, but to a range of diversified and specialized services as described by Tizard and Dunn.


The normalization principle draws together a number of other lines of thought on social role, role perception, deviancy, and stigma that had their origin in sociology and social psychology. It implies programming on three distinct levels.


1. On the first level, a deviant individual, in our case a mentally retarded person, should be enabled to behave in such a fashion that he will be perceived as non-deviant or at least less deviant. Nirje has outlined in considerable detail the course of action that is implied. Briefly, normalization entails helping a deviant person, within the limits of his capacities, to learn to speak, act, groom, eat, dress, etc., like typical (3) persons of his age and sex. In other words, on this level, normalization parallels many of the practices of rehabilitation.

(3) The term "typical" is chosen here because it refers more clearly to a statistical concept such as the median, or mode, in contradistinction to the term "normal," which evokes controversial theoretical notions regarding the nature of normality.


2. On the second level, the main task is to interpret the deviant person to others in such a fashion as to minimize his differences from and maximize his similarities with them. Here communication assumes great importance. It makes a big difference whether an adult person is presented in a normal tone of voice as "Mr. John Smith," or somewhat condescendingly as "John," or, in whatever spirit, as "a mongoloid." Interpretation can, of course, also be nonverbal. A person who is housed in a tile-decked hall with a drain in the floor and an open toilet in the corner and who is seen going about in diapers or an ill-fitting hospital coverall is, of necessity, perceived as a creature which bears little relation to a human being.


We must keep in mind that interpretation of this nature has a circular effect. It affects not only outside observers but also those who work with the interpreted person. Thus, an attendant who constantly sees retardates exist in zoo-like surroundings will cast them into the animal role and will, in turn, himself assume the keeper role. Similarly, an institutional worker who sees retardates in an environment which makes no developmental demands and which emphasizes the deficiencies rather than the strengths of residents will come to believe that they are not capable of growth and learning. In turn, a mentally retarded person will tend to go along with this "nonlearning" role that is thrust upon him.


3. On the third level of programming for normalization, emphasis is on molding attitudes of the public so as to make it more accepting of deviancy in general, including deviancy in intelligence, education, appearance, manners, dress, grooming, speech, etc. The deviancy of the retardate will be diminished to the degree that ordinary citizens gain a broader perception of normality and become accepting of a wider range of variation in the performance, appearance, and capability of fellow human beings.

Next Page

Pages:  1  2  3  4  5  6  7  8  9  10  11  12  13  14  15  16  17  18  19  20  21  22  23    All Pages