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Mental Retardation

Creator: Gunnar Dybwad (author)
Date: 1960
Publication: Social Work Year Book
Source: Friends of the Samuel Gridley Howe Library and the Dybwad Family

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Reprinted by permission of the National Association of Social Workers from Social Work Year Book 1960
NATIONAL ASSOCIATION FOR RETARDED CHILDREN, INC.
386 Park Avenue South
New York 16, N.Y.

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MENTAL RETARDATION is a condition which originates during the developmental period and is characterized by markedly sub-average intellectual functioning, resulting to some degree in social inadequacy.

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There is a great variation in the use of terminology relating to this condition, both in the United States and abroad. Several years ago the World Health Organization proposed that the problem be referred to as mental subnormality with two major sub-divisions reflecting causative factors: mental deficiency for those cases where biological factors have resulted in an impairment of the central nervous system, and mental retardation for those cases where the causative factor are in the social, economic, cultural, and psychological realms. Masland, Sarason, and Gladwin used this terminology for their survey. (1) However, there has been little inclination to follow their lead, and the American Association on Mental Deficiency has gone on record as recommending the overall use of the term mental retardation, their own official name notwithstanding. In any case, in perusing the literature in this field one needs to ascertain the particular author's use of terms, and this is especially important with foreign sources.


(1) See Masland, Sarason, and Gladwin, infra.

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Another point of confusion of significance to the social worker also relates to etiology and involves the phrase "environmental factors." At first glance one would relate this term to the cases originating from social, economic, cultural, and environmental influences, and this is indeed appropriate. However, the term is also used within the broad biological category to separate endogenous -- that is, genetic -- factors from exogenous -- that is, environmental -- factors such as damage to the embryo from a virus infection of the mother, or injuries suffered during the birth process.

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Even in limiting mental retardation to a markedly subaverage intellectual functioning, leaving out the sizable "dull normal" group, a wide realm is covered, from those so severely impaired as to require permanent bed care to those whose retardation is a problem only during the exacting days of public school attendance. Until recently the terms moron, imbecile, and idiot were used to denote degrees of impairment. Because of the unhappy connotations these words had assumed, the terms mildly retarded, moderately retarded, and severely retarded have been substituted. Another new terminology speaks functionally of these groups as marginally independent, semidependent, and totally dependent. With the increasing emphasis on educational programs the mildly retarded are often referred to as educable, the moderately retarded as trainable. The term feeble-minded has fallen into disuse altogether.

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The problem of proper identification and classification does not pertain just to the individual afflicted with the condition but to the condition itself. Traditionally mental retardation was looked upon merely as a mental health concern, in so far as text books and governmental activities were concerned. Today's more comprehensive knowledge has made it clear that such unilateral identification is most misleading and apt to hinder effective program development, whether in practice, teaching, or research. Now the pediatrician claims a primary stake in this area as a general health rather than just a mental health concern, while from other sides the sociologist and social worker, the educator and the psychologist make similar claims. Not only have more than 90 causative factors been identified as operative in mental retardation, representative of these various fields, but they frequently manifest themselves in combinations requiring diagnostic and therapeutic measures from different fields. In practice this has resulted at the present time in heated legislative arguments as to which state agency should have prime responsibility for this field, and has similarly vexed the community planners.

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No definite statistics are available regarding the numerical extent of mental retardation, and even the estimates differ widely. However, the most authoritative sources agree that the present number of mental retardates should be estimated for the United States as five million individuals or approximately thirty per thousand population. Of these thirty, about twenty-five are mildly retarded and five are moderately retarded, leaving one in thirty in the severely retarded group.

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Several important considerations suggest caution in the use of these figures. First, in many cases the basis for these classifications remains in practice the intelligence quotient (I.Q.) arrived at on the basis of one or more standard tests, with different ceilings prevailing from state to state. In view of the fact that the numbers sharply increase the higher the ceiling is pushed, those using an I.Q. of 75 would include a far larger group among the mentally retarded than those using a lower figure of 70. Furthermore, we are not dealing with static groups. Studies both here and abroad have shown that an individual can move from one group into another as a result of improved performance. Finally, recent medical advances also substantially affect these figures: the advent of antibiotics has markedly decreased the previously high number of deaths from infectious diseases during childhood and adolescence, and this will increase the number of adult retardates in our communities. Medical skill also keeps alive an increasing number of infants who formerly would have died before or during birth.

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