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One hundred twelve profoundly and severely retarded children, ages 5 to 12, lived in a building at Institution No. 2 in state N. Some had physical disabilities, and a few were bedridden. The children lived in dormitories with 23, 44, and 45 beds respectively; they had one large terrazzoed dayroom with about 30 to 40 chairs and one TV set. Most of the children received occupational therapy on the bottom floor of the building once a day, aided by two therapists. The personnel consisted of 28 persons during a 24-hour period, with 9 to each 8-hour shift.

In another building in Institution No. 2, 146 severely and profoundly retarded adult men lived in three bedrooms and one enormous, long dayroom with some wooden chairs. There was also a large fenced outdoor area which could be entered from the dayroom. About one-third of the residents left the building for occupational training a few hours a day. Walks outside the building and the fenced-in area were arranged three times a week. The residents were regularly served by 8 to 10 attendants during the day and by 5 during the night.

One superintendent told me about an institution in state O where a building for 180 moderately and severely mentally retarded males also had a fenced-in outdoor area. Ninety of the men were regularly led out to the fence, where they were attached with leather straps to the fence posts, their hands buckled to their waists with leather loops. They could move in a radius of only 24 inches, and along the fence there were a series of deep circles of that size.

The dayrooms at the various institutions described permitted only aimless and endless milling around or lying on the floor. No personal activity nor group interaction in any meaningful sense of the word was observed. Methods of feeding were often primitive and hurried. A superintendent told me about another institution (in state P) with 109 profoundly and severely retarded children living in four wards where one attendant has to spoon-feed 25 children in 75 minutes. Such a task can never be satisfactorily completed, as it consists of only three hurried minutes per child -- the spoon clanking against the teeth.

The backwards as well as the regular wards of the large institutions I saw all had a uniform pattern: the large facilities with their often ceramic tile and terrazzo floors were seemingly constructed as extensions of the open toilet facilities. The construction seemed to make it as easy as possible for the attendants to mop up feces and urine from the floor. Organized activities, either individual or group, are out of the question in this type of setting; nor can the results of any training or occupational therapy activities be consolidated or reinforced in these dayrooms and bedroom settings. Retarded residents and attendants have little opportunity to interrelate in a personal and constructive way. In these wards, a mentally retarded person is mainly left to contacts with other retardates who might be as withdrawn, confused, and insecure as he is -- the single individual always is the outsider here "where one becomes one of the far too many" (Lindegren).

But it is not only the backwards that are too large. Even the so-called good wards, houses, or sections are too large, even though they are admittedly overcrowded and understaffed. Very often the sleeping halls are designed for 30 to 40 persons, and the inhabitants of two sleeping halls frequently have to share a single common dayroom. Even in brand new institutions I have seen sleeping facilities arranged in two sections of 28 beds with only a wall between sections. Frequently, all buildings are of the same construction, irrespective of whether they are intended for children or adults, physically disabled or ambulatory, profoundly or mildly retarded residents.

Conditions like these allow for a minimum of social life, since few meaningful contacts between individuals are feasible. There is no privacy, and nothing personal is possible. Such wards offer only dehumanizing and impersonal life conditions. The persons living in these wards seem to be anonymous, having neither name nor number. They cannot count -- much less be counted upon.

Such conditions are shocking denials of human dignity. They force the retarded to function far below their levels of developmental possibilities. The large institutions where such conditions occur are no schools for proper training, nor are they hospitals for care and betterment, as they really increase mental retardation by producing further handicapping conditions for the mentally retarded. They represent a self-defeating system with shockingly dehumanizing effects. Here, hunger for experiences is left unstilled; here, poverty in the life conditions is sustained; here, a cultural deprivation is created -- with the taxpayers' money, with the concurrence of the medical profession, by the decisions of the responsible political bodies of society.

I have been told that not all the institutions are as bad as some I have seen, or that within a given institution, good buildings and programs may be found as well as bad ones. However, I find this type of apologetics difficult to understand. Even the so-called good institutions or units are too far from a decent interpretation of the rights to life, liberty, and pursuit of happiness -- and in the backwards these words are almost quenchable. Prejudice is built on the seemingly firm foundation of fear--but if society's fears of the mentally retarded had any firm grounds whatsoever, the walls of the wards would have been broken through long ago. Because they understand less, have less know-how and initiative, and are essentially too kind and inoffensive, the mentally retarded have not broken through those walls, not escaped from those wards. They would have broken out and been free long ago -- if they were not retarded. Who and what devised "this abyss of the rat trap and the long hour of waiting"? (Lindegren).