User:Dave Earl/sandbox

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I am redrafting some sections of the Mental Retardation Page. Feedback is most welcome.

So far, I have made little or no changes to the original. It is not my work and I consider it very problematic.

Useful Pages

Idiot.

Moron (psychology).

Feeble-Minded.

Imbecile.

Cretinism.

Down Syndrome.

Amentia currently redirects to Mental Retardation.

Intellectual Disability is "about the general term relating to disabilities involving the mind" and suggests "Mental Retardation" for the "medical condition".

History of the condition

The terminology used to describe varying degrees of mental retardation has changed historically, often in response to new medical or social understandings of the condition, or as part of the euphemism treadmill. Historical terms used to describe people with the condition include feeble-mindedness, idiocy, imbecility, moronism and amentia.

Need to create Amentia page discussing A. F. Tredgold.

Need a page for A. F. Tredgold

Greek and Roman philosophers, who valued reasoning abilities, disparaged people with intellectual disabilities as barely human. The oldest physiological view of mental retardation is in the writings of Hippocrates in the late fifth century BCE, who believed that it was caused by an imbalance in the four humors in the brain.

Until the Enlightenment in Europe, care and asylum was provided by families and the church (in monasteries and other religious communities), focusing on the provision of basic physical needs such as food, shelter and clothing. Negative stereotypes were prominent in social attitudes of the time.

In the 13th century, England declared people with intellectual disabilities to be incapable of making decisions or managing their affairs. Guardianships were created to take over their financial affairs.

In the 17th century, Thomas Willis provided the first description of intellectual disabilities as a disease. He believed that it was caused by structural problems in the brain. According to Willis, the anatomical problems could be either an inborn condition or acquired later in life.

In the 18th and 19th centuries, housing and care moved away from families and towards an asylum model. People were placed by, or removed from, their families (usually in infancy) and housed in large professional institutions, many of which were self-sufficient through the labor of the residents. Some of these institutions provided a very basic level of education (such as differentiation between colors and basic word recognition and numeracy), but most continued to focus solely on the provision of basic needs of food, clothing, and shelter. Conditions in such institutions varied widely, but the support provided was generally non-individualized, with aberrant behavior and low levels of economic productivity regarded as a burden to society. Heavy tranquilization and assembly line methods of support were the norm, and the medical model of disability prevailed. Services were provided based on the relative ease to the provider, not based on the needs of the individual.

In the late 19th century, in response to Charles Darwin's On the Origin of Species, Francis Galton proposed selective breeding of humans to reduce intellectual disabilities. Early in the twentieth century the eugenics movement became popular throughout the world. This led to the forced sterilization and prohibition of marriage in most of the developed world and later used by Hitler as rationale for the mass murder of mentally challenged individuals during the holocaust. Eugenics was later abandoned as an evil violation of human rights, and the practice of forced sterilization and prohibition from marriage was discontinued by most of the developed world by the mid 20th century.

In 1905, Alfred Binet produced the first standardized test for measuring intelligence in children.

Although ancient Roman law had declared people with mental retardation to be incapable of the deliberate intent to harm that was necessary for a person to commit a crime, during the 1920s, Western society believed they were morally degenerate.

Ignoring the prevailing attitude, Civitans adopted service to the developmentally disabled as a major organizational emphasis in 1952. Their earliest efforts included workshops for special education teachers and daycamps for disabled children, all at a time when such training and programs were almost nonexistent. The segregation of people with developmental disabilities wasn't widely questioned by academics or policy-makers until the 1969 publication of Wolf Wolfensberger's seminal work "The Origin and Nature of Our Institutional Models", drawing on some of the ideas proposed by SG Howe 100 years earlier. This book posited that society characterizes people with disabilities as deviant, sub-human and burdens of charity, resulting in the adoption of that "deviant" role. Wolfensberger argued that this dehumanization, and the segregated institutions that result from it, ignored the potential productive contributions that all people can make to society. He pushed for a shift in policy and practice that recognized the human needs of "retardates" and provided the same basic human rights as for the rest of the population.

The publication of this book may be regarded as the first move towards the widespread adoption of the social model of disability in regard to these types of disabilities, and was the impetus for the development of government strategies for desegregation. Successful lawsuits against governments and an increasing awareness of human rights and self-advocacy also contributed to this process, resulting in the passing in the U.S. of the Civil Rights of Institutionalized Persons Act in 1980.

From the 1960s to the present, most states have moved towards the elimination of segregated institutions. Normalization and deinstitutionalization are dominant. Along with the work of Wolfensberger and others including Gunnar and Rosemary Dybwad, a number of scandalous revelations around the horrific conditions within state institutions created public outrage that led to change to a more community-based method of providing services.

By the mid-1970s, most governments had committed to de-institutionalization, and had started preparing for the wholesale movement of people into the general community, in line with the principles of normalization. In most countries, this was essentially complete by the late 1990s, although the debate over whether or not to close institutions persists in some states, including Massachusetts.

In the past, lead poisoning and infectious diseases were significant causes of intellectual disabilities. Some causes of mental retardation are decreasing, as medical advances, such as vaccination, increases. Other causes are increasing, perhaps due to rising maternal age, which is associated with several syndromic forms of mental retardation.

Along with the changes in terminology, and the downward drift in acceptability of the old terms, institutions of all kinds have had to repeatedly change their names. This affects the names of schools, hospitals, societies, government departments, and academic journals. For example, the Midlands Institute of Mental Subnormality became the British Institute of Mental Handicap and is now the British Institute of Learning Disability. This phenomenon is shared with mental health and motor disabilities, and seen to a lesser degree in sensory disabilities.

Regional and Disciplinary Variations in Terminology

• Retarded comes from the Latin retardare, "to make slow, delay, keep back, or hinder," so mental retardation means the same as mentally delayed. The term was recorded in 1426 as a "fact or action of making slower in movement or time." The first record of retarded in relation to being mentally slow was in 1895. The term retarded was used to replace terms like idiot, moron, and imbecile because retarded was not (then) a derogatory term. By the 1960s, however, the term had taken on a partially derogatory meaning as well. The noun retard is particularly seen as pejorative; as of 2010, the Special Olympics, Best Buddies and over 100 other organizations are striving to eliminate the use of the "r-word" (analogous to the "n-word") in everyday conversation.

The term mental retardation is a diagnostic term denoting the group of disconnected categories of mental functioning such as idiot, imbecile, and moron derived from early IQ tests, which acquired pejorative connotations in popular discourse. The term mental retardation acquired pejorative and shameful connotations over the last few decades due to the use of the words retarded and retard as insults. This may have contributed to its replacement with euphemisms such as mentally challenged or intellectually disabled. While developmental disability includes many other disorders (see below), developmental disability and developmental delay (for people under the age of 18), are generally considered more polite terms than mental retardation.

United States

• In North America mental retardation is subsumed into the broader term developmental disability, which also includes epilepsy, autism, cerebral palsy and other disorders that develop during the developmental period (birth to age 18). Because service provision is tied to the designation developmental disability, it is used by many parents, direct support professionals, and physicians. In the United States, however, in school-based settings, the more specific term mental retardation is still typically used, and is one of 13 categories of disability under which children may be identified for special education services under Public Law 108-446.
• The phrase intellectual disability is increasingly being used as a synonym for people with significantly below-average cognitive ability. These terms are sometimes used as a means of separating general intellectual limitations from specific, limited deficits as well as indicating that it is not an emotional or psychological disability. Intellectual disability may also used to describe the outcome of traumatic brain injury or lead poisoning or dementing conditions such as Alzheimer's disease. It is not specific to congenital disorders such as Down syndrome.

The American Association on Mental Retardation continued to use the term mental retardation until 2006. In June 2006 its members voted to change the name of the organization to the "American Association on Intellectual and Developmental Disabilities," rejecting the options to become the AAID or AADD. Part of the rationale for the double name was that many members worked with people with pervasive developmental disorders, most of whom do not have mental retardation.

United Kingdom

In the UK, mental handicap had become the common medical term, replacing mental subnormality in Scotland and mental deficiency in England and Wales, until Stephen Dorrell, Secretary of State for Health for the United Kingdom from 1995–97, changed the NHS's designation to learning disability. The new term is not yet widely understood, and is often taken to refer to problems affecting schoolwork (the American usage), which are known in the UK as "learning difficulties." British social workers may use "learning difficulty" to refer to both people with MR and those with conditions such as dyslexia. In education, "learning difficulties" is applied to a wide range of conditions: "specific learning difficulty" may refer to dyslexia, dyscalculia or dyspraxia, while "moderate learning difficulties", "severe learning difficulties" and "profound learning difficulties" refer to more significant impairments.

In England and Wales between 1983 and 2008 the Mental Health Act 1983 defined "mental impairment" and "severe mental impairment" as "a state of arrested or incomplete development of mind which includes significant/severe impairment of intelligence and social functioning and is associated with abnormally aggressive or seriously irresponsible conduct on the part of the person concerned." As behavior was involved, these were not necessarily permanent conditions: they were defined for the purpose of authorizing detention in hospital or guardianship. The term mental impairment was removed from the Act in November 2008, but the grounds for detention remained. However, English statute law uses mental impairment elsewhere in a less well-defined manner—e.g. to allow exemption from taxes—implying that mental retardation without any behavioral problems is what is meant.

A BBC poll conducted in the United Kingdom came to the conclusion that 'retard' was the most offensive disability-related word. On the reverse side of that, when a contestant on Celebrity Big Brother live used the phrase "walking like a retard", despite complaints from the public and the charity Mencap, the communications regulator Ofcom did not uphold the complaint saying "it was not used in an offensive context [...] and had been used light-heartedly". It was however noted that two previous similar complaints from other shows were upheld.

Australia

In the past, Australia has used British and American terms interchangably, including "mental retardation" and "mental handicap". Today, "Intellectual disability" is the preferred and more commonly used descriptor.