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The head of the Danish National Mental Retardation Service, Bank-Mikkelsen, describes the first model. This model involves an urban-metropolitan area, i.e., Copenhagen, which is one of 11 service regions of Denmark. Of special interest here is the extensive application of normalization principles, as described by Nirje, to a service system. Similarly, this principle is expressed in Grunewald's description of Malmöhus County in Sweden, a geopolitical area which, in contrast to Copenhagen, is mostly rural in nature. These two chapters, together with material presented by Nirje in Chapter 7, provide a great deal of information on the legislative underpinnings of services of two countries considered exemplary in many aspects of mental retardation provisions.

In Chapter 12, Norris describes the services of Essex County in Britain. This county is widely regarded as a model in Britain. Also, while Scandinavia appears to lead in the elaboration of residential provisions, some counties in Britain are more advanced in developmental services for severely retarded young children and in vocational services for retarded adults. This type of emphasis clearly emerges in the Essex system, especially in relation to the large number of sheltered workshop places provided or planned by that system.

Finally, the service system in the State of Connecticut is described. In including this description by Klaber, it is not intended to present the Connecticut model as an ideal or even desirable model for all states and areas. However, it is intended to show how an attitude of dissatisfaction, combined with relatively consistent concepts, has led to popular acceptance of a new service system that is vastly preferable to the old one, and that is superior to most systems now existing in the United States.

Part 7 contains three chapters which, in some ways, are similar to those contained in Part 5, since they present service-related issues and propose new solutions. However, these three chapters are presented separately because they either go far beyond the thinking of Part 5, or because the models in Part 6 do not exemplify the content of these three chapters.

In the first chapter of Part 7, Sarason makes a number of critical points. One of these is the importance of viewing residential facilities as human service settings generally, all subject to similar social processes, dynamics, and trends. Secondly, those in the human service area will fail to understand and control events unless they view the operation of their settings from a larger social system viewpoint, rather than the narrow, individual-oriented clinical perspective of traditional service agencies. Finally, Sarason, points to the importance of consciously conceptionalizing an ideology and a concomitant set of general practices from the very inception of a setting, and letting these rule the specifics of operation rather than the reverse.

The next two chapters contain service conceptionalizations which might be interpreted as being "typically American." Cooke proposes an extension of Medicare principles and legislation to permit public moneys to be used to pay for private residential services selected by the parents. He feels that such an approach would quickly result in the development of numerous small, dispersed, residential homes; that presently unutilized manpower would come forth to serve in these facilities; and that these facilities, being of high quality since they would have to meet stringent acquirements, would "drive out" big and poor institutions.

In the third chapter of Part 7, Wolfensberger presents what appears to be the most radical innovation suggested in this book: a human service system based on a cost-benefit rationale. He suggests that residential services in retardation should be considered not only an integral part of a wider retardation service system but part of a broad system of human services generally. The publicly supported part of this system, he feels, should be reorganized so as to reduce the autonomy of service agencies, and decision-making regarding specific service allocations should be based on considerations of how service benefits can be maximized for the largest number of citizens, given the limited resources available at any one point in time. Perhaps this proposal is utopian -- perhaps it is prophetic. Indeed, the cost-benefit concept is gaining in ascendancy in industry. Congress, and elsewhere, and the question of national priorities that is now widely discussed for the first time is closely bound up with cost-benefit notions.

The final part and chapter of this monograph is written by Dybwad, one of the most prominent thinkers about mental retardation services in this country, and perhaps the world. In this chapter, he attempts to interpret and place into perspective the contributions of the other authors. Most importantly, from the vast amount of problems, issues, examples, and solutions discussed, he attempts to isolate implications on various levels of action and implementation. From the material presented in the preceding parts of the book, he attempts to translate theoretical notions into concrete proposals, and judge concrete measures as to their feasibility and priority in the America of today.