RESIDENTIAL PROGRAMMING FOR

MENTALLY RETARDED PERSONS

Prevailing Attitudes and Practices in the

Field of Mental Retardation

This series of materials was developed in conjunction with the

NARC project Parent Training in Residential Programming,
supported by grant 56-P-70771-6-01 (R-1) from the Division
of Developmental Disabilities, Social and Rehabilitation Service,
U. S. Department of Health, Education, and Welfare.

National Association for Retarded Children

2709 Avenue E East, Arlington, Texas 76011

1972
 ACKNOWLEDGEMENTS
For their generous help and cooperation during the development
of these materials, we w o u l d like to express our appreciation t o :

Frank J. Menolascino, M.D.

Board Coordinator for Program Services
National Association for Retarded Children
Philip Roos, Ph.D.
Executive Director
National Association for Retarded Children
H. David Sokoloff, AIA
Chairman, Residential Services & Facilities Committee
National Association for Retarded Children

We are particularly grateful to the Division of Developmental Dis-

abilities, Social and Rehabilitation Service, U. S. Department of
Health, Education, and Welfare, for their financial support of this
project.

Max R. Addison, M.S.

Project Coordinator
Parent Training in Residential Programming
National Association for Retarded Children
Robert E. Luckey, M.S.
Consultant, Program Services Department
National Association for Retarded Children
Brian M. McCann, Ph.D.
Assistant Executive Director for Program Services
National Association for Retarded Children
 PREFACE

Standards for residential facilities have been developed, and we

are in the process of designing similar standards for community
programs. Now the question remains: how can these standards
best be implemented to insure quality programming? In this regard,
parents have been generally hesitant to ask questions concerning
the nature of programs for the mentally retarded. The materials
that follow review for parents and other representatives of con-
sumers of residential services the prevailing definitions, attitudes
and practices in the area of residential programming. They also
discuss needed modifications in traditional residential models, areas
of program emphasis, evaluation procedures, and strategies for
implementing change in existing facilities.
Today, more than 200,000 mentally retarded persons live in
approximately 175 public residential institutions, while up to 60,000
persons reside in private facilities (NARC, 1971). Commenting on
present day conditions, the President's Committee on Mental Re-
tardation (PCMR, 1968) reports that institutions for retarded persons
are usually located in remote areas and are characterized by in-
appropriately designed, overcrowded and antiquated buildings. The
problem is compounded by the fact that most residential personnel
are underpaid, poorly trained and often have little chance of
achieving better working conditions or advancement. It is widely
recognized that former concepts of "custodial care" are no longer
acceptable. Parents as well as professionals are becoming increas-
ingly vocal in their demands that every retarded resident be p r o -
vided with an institutional program designed to optimize his
development level — regardless of ultimate functional potential.
NARC has means for auditing these mental retardation programs
throughout the nation, being represented in 50 states by some
1500 State and Local Associations. However, NARC firmly believes
that in order to have a significant impact upon residential pro-
gramming, the Association must better inform its constituents c o n -
cerning existing problems and constructive approaches which w i l l
lead to improvements.

Early steps to clarify the evaluation of residential services were

taken in 1952 by the American Association on Mental Deficiency.
A significant outgrowth of A A M D ' s early evaluative efforts was the
formation in 1966 of the National Planning Committee on Ac-
creditation of Residential Centers for the Retarded. Member or-
ganizations of the National Planning Committee were the A A M D ,
American Psychiatric Association, the Council for Exceptional Chil-
dren, the United Cerebral Palsy Association and NARC. In 1969,
the Accreditation Council for Facilities for the Mentally Retarded
evolved from the National Planning Committee. Standards for resi-
dential facilities (ACFMR, 1971) were adopted in May, 1971, and
 the voluntary accreditation of residential facilities began in early
1972.
In an effort to effectively involve parents in residential program-
ming and the new accreditation process, NARC (through funding
by H.E.W.'s Division of Developmental Disabilities) has developed
the present training materials. The materials are intended to help
parents and other concerned citizens to become more knowledge-
able consumer-representatives, so they can become significantly
involved in program planning and evaluation.
The training materials are organized into four sections:

I. Prevailing Attitudes and Practices in the Field of Mental

Retardation;
II. A Developmental Model for Residential Services;
III. Developmental Programming in the Residential Facility;
IV. The Process of Change.

This series is designed to acquaint the reader with current infor-

mation, attitudes and practices related to residential services, and
provide basic information regarding specific residential training pro-
grams and suggested strategies for achieving improved residential
services. The materials are intended for use in conjunction with a
seven-hour workshop consisting of structured audio-visual presen-
tations and group exercises. These training materials are available
through the six NARC Regional Offices. The addresses of the
Regional Offices are as follows:

Northwest Regional Representative

4706 Lacey Boulevard
Lacey, Washington 98501
Southwest Regional Representative
1842 El Camino Real, Suite 1
Burlingame, California 94010
North Central Regional Representative
737 Michigan National Tower
Lansing, Michigan 48933
Southeast Regional Representative
3950 Peachtree Road, N.E.
Suite 115
Atlanta, Georgia 30319
Northeast Regional Representative
III 420 Lexington Avenue
New York, New York 10017
South Central Regional Office
2709 Avenue "E" East
Arlington, Texas 76011
Prevailing Attitudes and Practices
in the Field of Mental Retardation
Our future is deeply trainted by our past, and today's reactions
to the mentally retarded still carry the imprint of negative and
destructive definitions and labels. This section attempts to review
many of these current attitudes and practices, particularly as they
relate to the provision of services in residential facilities for retarded
persons.

THE PROBLEM OF DEFINITIONS

Over the years, there have been many definitions of mental
retardation which attempted to differentiate between the intellec-
tually subaverage and those persons having " n o r m a l " intelligence.
Unfortunately, these definitions have generally been couched in
extremely negative terms. Early definitions of the problem have
included the f o l l o w i n g :

Mental deficiency is a state of social incompetence obtaining at

maturity or likely to obtain at maturity, resulting from devel-
oped mental arrest of constitutional origin; the condition is
essentially incurable through treatment and unremediable
through training except as a treatment in training instills
habits which superficially or temporarily compensate for the
limitations of the person so affected while under favorable
circumstances and for more or less limited periods of time
(Doll, 1941).
Mental defectiveness represents a condition of mental non-
development, arrest, deficiency, or deterioration which is very
grave and permanent, which dates from early life, and which
always effects the intelligence, judgment, or understanding and
the capacity for social and economic adjustment (Wallin, 1949).
A mentally defective person is a person who is incapable of
managing himself and his affairs, or being taught to do so, and
who requires supervision, control, and care for his own wel-
fare and the welfare of the community (Benda, 1954).
Mental retardation refers to a condition of intellectual inade-
quacy which renders an individual incapable of performing
at the level required for acceptable adjustment within his cul-
tural environment (Masland, 1963).

In addition to these general definitions, a number of terms have

been used to define varying degrees of mental retardation. Such
unfortunate misnomers as " i d i o t " , " i m b e c i l e " , " m o r o n " , " l o w -
grade", "high-grade", "custodial", "trainable", and "educable" were
once, and in some cases still are, used to describe the retarded.
These terms not only set the mentally retarded apart from other
members of society, but convey a picture of subhuman status,
prolonged dependence, and a seriously restricted ability to develop
or learn. Such images have all been employed as justifications for
isolation from the community, custodial care and over-protection.
One of the most harmful effects of past definitions and related
terminology is their negative impact upon the attitudes and expec-
tations of persons directly or indirectly responsible for the care,
education and training of the mentally retarded. Thus, self-fulfilling
prophecies are set in motion which w o r k against successfully maxi-
mizing the retarded person's level of functioning. For example, once
labeled as custodial, a retarded person's living and learning environ-
ments are likely to be structured to reflect that label. A person
incapable of benefiting from more than custodial care is incapable
of learning and development, isn't he? Then, education and training
programs are unnecessary for persons w h o cannot learn . . .
On the basis of this type of reasoning, retarded persons are
frequently denied appropriate educative programs, thereby pre-
venting further learning and development. Thus, the original proph-
ecies are " c o n f i r m e d " .
This is not to say that labeling, in itself, is necessarily destructive.
Categorization and classification are basic to scientific inquiry.
However, in the case of human beings, it is too often assumed that
once a person has been tagged "diabetic", or " m i l d l y retarded",
such a label w i l l automatically provide appropriate services. In
theory, at least, labeling should serve as a first step toward needed
services. Unfortunately, in the case of the mentally retarded, labels
are too often used as an excuse for exclusion from benefits and
services ordinarily available to nonretarded persons.

A Widely Used Definition

A definition of mental retardation which is generally accepted
in the United States was adopted by the American Association on
Mental Deficiency in 1961. This definition (Heber, 1961) states that:

"Mental retardation refers to subaverage intellectual function-

ing which originates during the development period and is
associated with impairment in adaptive behavior."
The terms used in this definition may be explained as follows:
SUBAVERAGE GENERAL INTELLECTUAL FUNCTIONING: Falling
below 97% of the population on standardized tests of global
intelligence (i.e., tests which attempt to measure vocabulary,
comprehension, memory, reasoning, judgment and visual-motor
functions).
DEVELOPMENTAL PERIOD: From conception to about 16 years
of age.
ADAPTIVE BEHAVIOR: The ability to adapt to and control
one's environment, usually defined in terms of maturation,
learning and social skills.
 It should be noted that the A A M D definition is based upon a
dual concept of mental retardation. That is, mental retardation is
defined in terms of reduced intellectual functioning w h i c h , in turn,
is associated with deficits in maturation, learning and the develop-
ment of social skills. Even though this definition is more general
than earlier statements and does not emphasize the deficiencies
and disabilities of the mentally retarded, it still does not adequately
stress the learning, growth and developmental potentials that exist
for mentally retarded persons.

DIAGNOSIS MAY BE DIFFICULT

No person should be classified as mentally retarded until he has
been evaluated by a team of qualified professionals — including
representatives from the social, educational, psychological and
medical disciplines. Moreover, the assessment should not be con-
sidered complete unless parents or relatives have been involved in
the evaluation process as significant observers, and the person's
adaptive behavior has been assessed in relation to his community
and family situation, taking into account the cultural norms of his
environment.
As indicated above, the diagnosis of mental retardation is made
on the basis of two dimensions: (1) measured intelligence; (2) adap-
tive behavior.

Measured Intelligence
A primary tool used in the diagnostic process is the standardized
intelligence test. Tests of this type are used to sample a w i d e range
of knowledge and skills in order to compare a person's test per-
formance to a standard established for his age level. A person
exhibiting knowledge and skills similar to the standard for his age
group is considered average. Below and above average perform-
ance, therefore, means that a person's test performance is com-
parable to persons either younger or older than himself.
Several tests are commonly used to measure general intellectual
functioning in children and adults. The most frequently used are
the Stanford-Binet Intelligence Scale, the Wechsler Intelligence
Scale for Children, and the Wechsler Adult Intelligence Scale. The
Stanford-Binet measures a wide range of abilities corresponding to
various mental ages, w h i l e the Wechsler Scales for Children and
Adults are separated into specific skill areas with performance
compared to the average abilities of persons at different chrono-
logical ages.
Persons attaining IQ's significantly below 100, ( 1 0 0 is considered
to be average),are usually classified according to levels of mental
retardation as follows:
 The classification of "borderline mental retardation" is also
frequently employed (IQ's of 68-83 and 70-84 on the Stanford-Binet
and Wechsler Scales, respectively). It is felt, however, that persons
falling within this group should not be considered as mentally
retarded. Rather, they are individuals whose measured intelligence
falls between the mentally retarded and the "normal" ranges.
Basic to the use of intelligence tests is the assumption that the
person taking the test has had similar opportunities to learn and
shares a common language and culture with those persons on
whom the test was standardized. Such an assumption appears
obvious. Still, the 1970 litigation, Dianna vs. California Board of
Education, was won by the plaintiff on the grounds that some
22,000 Mexican-Americans had been entrapped in classes for the
mentally retarded because they were given allegedly culturally
unfair tests in English rather than Spanish. Clearly, a number of
factors other than intelligence can significantly depress test scores.
These include sensory impairments, motivation to perform well in
a testing situation, anxiety associated with test taking, and so called
"mental illness". Therefore, the classification of mental retardation
should be applied only to those persons who, after a comprehensive
and appropriate evaluation, continue to function at a significantly
subaverage level — even after various attempts at remediation have
been made.

Adaptive Behavior
The second criterion used in diagnosis of mental retardation is
adaptive behavior. In the AAMD manual on terminology and
classification, Heber (1959) defines adaptive behavior as follows:

"The dimension of adaptive behavior refers primarily to the

effectiveness with which the individual copes with the natural
and social demands of his environment. It has two major
facets: (1) the degree to which the individual is able to func-
tion and maintain himself independently, and (2) the degree to
which he meets satisfactorily the culturally-imposed demands
of personal and social responsibility" (p 61).

As in the case of measured intelligence, adaptive behavior is

evaluated by comparing an individual with members of his own
age group. Thus, Heber points out that, ". . . adaptive behavior is
always evaluated in terms of the degree to which the individual
meets the standards of personal independence and social responsi-
bility expected of his chronological age g r o u p " (p 61).
Thus, maturation w o u l d be emphasized during early childhood
years in which such skills as sitting, standing, walking, self-feeding,
toileting and speech are ordinarily developed. Academic perform-
ance w o u l d be stressed during school age years, while vocational
and social effectiveness w o u l d be appropriate topics for adults.
Adaptive behavior is more difficult to assess than intellectual
functioning due to a lack of satisfactory measures. The Vineland
Social Maturity Scale is a common tool for evaluating adaptive
behavior. This instrument must, however, be supplemented by
other sources of information regarding the individual's everyday
behavior if an adequate assessment is to be made.
A positive correlation should exist between measured intelligence
and adaptive behavior. That is, an individual w h o ranks relatively
high in one dimension w o u l d be expected to rank high in the other
area as well. Marked discrepancies between measured intelligence
and adaptive behavior (e.g., an intelligence quotient w i t h i n normal
limits coupled with a subaverage adaptive behavioral level, and vice
versa) w o u l d cast serious doubt upon the diagnosis of mental
retardation.

The Eternal Child

In the diagnostic or evaluative process, there is a danger of
approaching the mentally retarded person as an "eternal c h i l d " .
Diagnostic conclusions such as, "This child will always have the
mind of a five year o l d " , are overly common. Obviously, this
approach places unnecessary limitations on the development of
the retarded person — no one "expects" them to progress beyond
the dependent stage of childhood. The retarded individual, then,
may be treated as a child even during his adult years, preventing
development of the independence associated with adult maturity.
It must be remembered that a retarded person's "mental age"
does not necessarily reflect his social interests and needs. Thus,
while the performance of a mildly retarded adolescent on a stand-
ardized intelligence test may approximate that of a non-retarded
ten year o l d , it is likely that his social interests will be similar to
those of non-retarded persons in his o w n chronological age group.

A Common Misconception
Mental retardation is frequently confused with "mental illness", 1

1
T. S. Szasz, M.D., in his book, The Myth of Mental Illness, argues that the
term "mental illness" is a misnomer. Psychiatric problems, he feels, rep-
resent deviations from social, ethical, and political norms and, thus, are
not amenable to traditional medical approaches or treatments which are
based on physiological or anatomical deviations from a norm.
even though the t w o problems have traditionally been differenti-
ated in the f o l l o w i n g respects:
Mental Retardation "Mental Illness"
1. Deficit in intellectual de- 1. Disorder of thinking, emo-
v e l o p m e n t and social tion and behavior.
adaptation.
2. R e t a r d e d d e v e l o p m e n t 2. Occurs at any life period
originating at birth or dur- after a phase of normal
ing early childhood. development.
3. Generally approached and 3. Generally approached and
treated as an educational t r e a t e d as a p s y c h i a t r i c
problem. problem.
4. Irreversible c o n d i t i o n 4. Usually reversible condi-
which may be improved tion which may be 'cured'
but not " c u r e d " in light through proper treatment;
of present knowledge. spontaneous remission also
possible.
Although mental retardation and "mental illness" should not be
confused, it must be remembered that mentally retarded persons
are also subject to psychological stress and therefore can, and do,
develop emotional and behavioral problems.

SERVICES FOR THE MENTALLY RETARDED

The public has been slow to recognize the need for appropriate
services for the mentally retarded on a community level. Through-
out the nation, serious deficiencies exist in the number and quality
of community-based programs. Thus, most communities are not
fulfilling their responsibilities to the retarded in such basic areas
as day care, special education, vocational training and competitive
and sheltered w o r k opportunities. A n d , while the concept of " f u l l
spectrum" community services has remained largely unrealized, the
general lack of sound community-based residential programs (e.g.,
group homes, hostels and apartments) is particularly evident. The
need for increased services at the community level is underscored
by the fact that traditional institutional programs serve only about
four percent (4%), or some 260,000 of America's over six million
mentally retarded citizens.

Emphasis on Institutionalization
The establishment of adequate community services has been
severely hampered by a long-standing emphasis on institutionaliza-
tion for persons w h o cannot easily acquire independent living
skills. A common rationale for stressing institutional placement is
the belief that the presence of a mentally retarded child or adult
represents a serious threat to family harmony and community well
being. It was c o m m o n in the not-too-distant past for professionals
to advise parents to remove a mentally retarded child from the
home and sever all emotional ties. In the face of such attitudes,
which encourage separation and isolation of the mentally retarded,
it is extremely difficult to establish alternatives to institutionalization
within the community setting.

Assumed Roles of Institutions

The institution has traditionally served to isolate and protect the
retarded from the community — or to protect the community from
the retarded. To achieve this end, most institutions have been built
far from populated areas. And, since institutions have themselves
been isolated, it has proven expedient for them to provide all
needed services to their residents, making the institution a multi-
purpose, self-contained and independent pseudocommunity. Many
new institutions, although built near population centers, continue
to follow tradition by providing the full array of basic services
(e.g., medical departments, hospitals, schools, parks and play-
grounds, on-campus stores, etc.) even though the same facilities
and services may be available in the community. The expense of
this unnecessary duplication of services is staggering. It is now
more costly to serve the four percent (4%) of the retarded who
are institutionalized than the remaining ninety-six percent (96%),
badly in need of services at the community level.

Meeting the Needs of Residents in Institutions

Many of the inadequacies in traditional institutional programs
have resulted from the dehumanizing manner in which services
are conceived and delivered.
Best-fit Approach. Traditional approaches to programming within
residential facilities have followed the rule: "Make the person fit
the program". Until recently, few efforts were made to provide for
the needs of individual residents. Instead, programs have been
designed to meet the needs of large groups, or the majority of the
group members. Under such an approach, residents functioning at
the lower limits of a group have made little progress, while in-
appropriately low ceilings of development have been forced upon
the group's more capable members.
Group Living. The large group living concept is a product of past
attempts to provide strictly custodial care, i.e., maintaining minimal
levels of cleanliness and safety, preventing injury to self or others,
and providing for the basic life needs of the residents. Large group
living has generally resulted in a life of inactivity, or in activities
without apparent purpose. There have not been sufficient personnel
assigned to groups to provide adequate levels of stimulation and
encourage growth and development on an individual basis.
The Assembly Line. Perhaps the most unfortunate result of group
living is the "assembly line" method of providing services. Speed
and efficiency are key words when staff-to-resident ratios are based
on custodial approaches. When the bulk of the direct care per-
sonnel's time is devoted to feeding, dressing and bathing, time and
efficiency become critical factors. Residents become products on a
factory assembly line — each " p a r t " handled or inspected by a
different and highly specialized person. It is not uncommon to find
total groups — especially groups of young or physically handi-
capped residents — subjected to highly mechanized and impersonal
bathing procedures in which staff members are assigned specific
tasks: One removes clothing, another soaps and rinses, another
dries and dresses, or still another controls traffic to and from the
central living area. Similar approaches are frequently used during
mealtimes, toileting, and dressing. In such an environment, there is
little, if any encouragement for a resident to develop individual
skills and abilities. In some cases, the assembly line approach is
geared to the needs of the least capable members of the group.
Other members are simply not allowed to develop — or worse,
denied the right to use skills they have previously learned.
Service Delivery Systems. Traditionally, institutional programs are
filtered through a departmental organization structure. A typical
structure finds a multitude of departments responsible for planning
and implementing education and training programs for the resident
population. In large institutions, it is not uncommon to find that
the departments responsible for training are uncoordinated, un-
communicative and involved in struggles for power and autonomy.
More time and energy may be spent in resolving departmental
differences than in planning for the education and training of the
residents.

The Role of Parents

Traditionally, parents or guardians of institutionalized mentally
retarded persons have not been adequately involved in decision-
making and program planning. This unfortunate situation has only
served to further isolate the retarded resident from members of his
family.
The inadequate lines of communication which frequently exist
between families and institutional personnel are due, in part, to
the negative stereotypes of parents of retarded children which have
achieved the status of prominent folk myths in the professional lore.
Parents of the retarded are sometimes viewed by the professional
as having little to offer in the way of relevant information regarding
their child's needs, feelings, problems and strengths. A rich source
of data for the formulation of program plans is, therefore, often
totally ignored or, at best, glossed over with minimal interest.
There has also been a tendency for institutional staff to w i t h h o l d
certain information from the parent (e.g., the score which the child
has achieved on an I.Q. test, the type and dosage of medication
w h i c h he is taking, or the rationale for modifying his training
program or changing his living unit assignment). This "veil of
secrecy" is usually justified on the grounds that the parent is
somehow unable to " h a n d l e " such information. This strategy is
frequently coupled w i t h the myth of professional omnipotence,
w h i c h holds that only those persons in possession of certain eso-
teric degrees are capable of making sage decisions regarding
another individual's future.
Additionally, professionals often assume that parents of the
retarded are guilt-ridden, ambivalent and rejecting toward their
children, and fraught w i t h emotional problems and conflicts. The
parents, then, are often viewed by the institutional staff as good
candidates for "psychotherapy". These ill-conceived caricatures
have been reinforced by a number of articles in the professional
literature.
While these and a number of other negative models of the parent
are prevalent in the field, it w o u l d be far more accurate to view the
typical parent of a retarded child as an intelligent and concerned
individual capable of, and entitled to, full involvement in planning
and decision-making regarding his child's current and future needs.
The blame for poor communications between parents and staff
cannot be placed solely on the shoulders of institutional personnel.
Many parents lack indepth knowledge of what constitutes sound
residential programming. They are sometimes hesitant to ask ques-
tions and express their concerns regarding services provided by the
institution — for fear of exhibiting a lack of knowledge. Such an
approach quite probably reinforces any existing attitudes of o m -
nipotence which may be present among staff. O f t e n , parents are
wary of complaining about conditions w i t h i n the institution, be-
lieving that any attempt to " r o c k the b o a t " might result in some
type of retaliation against their child. Regardless of whether this
fear has any basis in fact, some parents adopt ingratiating postures
and uncritically accept any and all proposals presented by admin-
istrators and/or central office staff.
Parents or guardians of institutionalized mentally retarded per-
sons can be, and have been, of great assistance to the institution
and its staff. In many facilities, families are encouraged to partici-
pate in parent groups and policy-making committees. The result of
such efforts is a fruitful partnership between the institution and the
consumer representative.

9
 DENIED OR ABRIDGED RIGHTS
There is an ongoing need to insure that the basic rights of
mentally retarded persons are safeguarded. Thus, Article I of the
International League of Societies for the Mentally Handicapped's
Declaration of General and Special Rights of the Mentally Retarded
states:
"A mentally retarded person has the same basic rights as other
citizens of the same country and same age."2

Article V of the Declaration further notes that:

"Some mentally retarded persons may be unable due to the
severity of their handicap, to exercise for themselves all of
their rights in a meaningful way. For others, modification of
some or all of these rights is appropriate. The procedure used
for modification or denial of rights must contain proper legal
safeguards against every form of abuse, must be based on an
evaluation of the social capability of the mentally retarded per-
son by qualified experts and must be subject to periodic re-
views and the right of appeal to higher authorities."

In reality, however, the rights of the retarded in the community

and in the institution have traditionally been abused, abridged, and
denied, regardless of the retarded person's ability to exercise these
rights.

Practices in the Community

Education. In principle, at least, our nation subscribes to the
notion of providing publicly-supported educational opportunities
for all of its citizens. We find, however, that large segments of our
mentally retarded population continue to be denied access to
public school classes. This denial to the right of education is often
based on the belief that retarded persons cannot contribute tangibly
to society. Other retarded children are excluded from public schools
on the grounds that they do not possess sufficient behavior control
and/or self-care and verbal skills to make them amenable to tradi-
tional school curricula, physical facilities and competencies of
existing teaching personnel. It is frequently advocated that it is
undesirable to mix the retarded with the non-retarded in an educa-
tional setting, and that separate school facilities are thus required.
Therefore, it is not uncommon to find the mentally retarded totally
segregated from non-retarded students in a school setting. In dis-
cussing this issue, the NARC Policy Statements on the Education of
IQ Mentally Retarded Children (NARC, 1971) state that " . . . a portion
of mildly retarded children can function in the mainstream of

2
The full text of the declaration is presented in Appendix I.
public education, some w i t h and some w i t h o u t supportive services.
Some mildly retarded and moderately retarded children should
receive their basic instruction in special classes, but can be inte-
grated into the regular education program on an individual basis
in specific areas for portions of the school day. Some severe and
all profoundly retarded children should receive their basic instruc-
tion in self-contained educational units".
The problem, of course, lies more in our concept of education
than in the differences between the retarded and non-retarded
students.
Marriage. The right of persons w h o have been identified as
mentally retarded to marry and have children has traditionally
been denied in the community. It has been thought that if mentally
retarded couples have children they: (1) w i l l not be capable of
supporting t h e m ; (2) will not be adequate parents; and (3) will be
prolific in their child bearing practices. Blanket denial of the right
to enjoy the intimate companionship afforded by marriage is un-
warranted in the case of most mildly retarded persons. If provided
w i t h appropriate counseling and support services, the majority of
these individuals are capable of supporting a family and exercising
parental and social responsibilities.

Personal autonomy. The right of the retarded person to direct

his own life is frequently restricted. Persons w h o are identified as
being mentally retarded often find their lives structured and scruti-
nized by professionals in the community. In effect, if there is
continued insistence upon adopting an overly protective, pater-
nalistic posture, the retarded may have no more opportunity to
develop independence and autonomy in the community than in
the institution.

Housing requirements. The right of the mentally retarded to live

independently or semi-independently in the community is greatly
restricted by unwarranted and unnecessary "safety codes". Many
group homes and apartments which house retarded persons capa-
ble of independent living are required by law to have emergency
exits, emergency lighting, and fire safety systems which are not
required for non-retarded persons living in similar settings. Since
few residential structures meet imposed legal requirements, many
mentally retarded persons are denied the right to independent
living.

Legal rights. Basic legal rights have traditionally differed for

retarded and non-retarded persons. Relatively minor legal infrac-
tions frequently result in commitments to a residential institution 11
w h i c h , in reality, amount to "life sentences". This is in sharp con-
trast to the non-retarded offender w h o , after being convicted of a
similar offense, may be incarcerated for a specific period of time
or be given a probated sentence.
Practices in Residential Facilities
Integration of Men and Women. Retarded persons in institutions
have traditionally been denied the right to live in a heterosexual
w o r l d . They have been deprived of such normal social experiences
as having close friends of the opposite sex or participating in
" n o r m a l i z e d " , sexually integrated leisure time activities. This prac-
tice fosters a social situation which differs drastically from com-
munity living or the family setting. The rather puritanical approach
which characterizes many institutions has been extended to the
area of staff assignments. Thus, in some cases, it is required that
direct care personnel be of the same sex as the residents w i t h w h o m
they are working. In discussing the integration of men and w o m e n ,
the participants at the Stockholm Symposium on Legislative Aspects
of Mental Retardation (ILSMH, 1967) concluded:

"Being fully mindful of the need to preserve the necessary

safeguards in relations between mentally retarded men and
women, the members of the Symposium are of the opinion
that the dangers involved have been greatly exaggerated in the
past. This has often resulted in unfortunate segregation of the
sexes in an unnatural way and has militated against their inter-
ests and proper development."

It was further noted that experience in some countries has shown

it is advantageous to mix men and w o m e n in residential facilities
in a manner approximating normal living conditions.
Education and training programs. Mentally retarded residents
have traditionally been denied the right to training and education
programs which w o u l d maximize their human qualities and dignity
and foster the development of self-help and independent living
skills. Instead, they are placed in an environment which is char-
acterized by dependency and dehumanizing over-protection. Thus,
feeding, dressing, bathing, going to bed and getting up in the
morning are often scheduled for the convenience of the staff rather
than the needs of the mentally retarded. Residents are frequently
required to have close-cropped hair as a substitute for teaching
adequate grooming skills. Rather than teaching residents to handle
money, they are often required to carry coupons or tokens.

Exploitation. The right to be compensated for work has typically

been denied or abridged in the institutional setting. Many institu-
tions depend largely on resident labor in such areas as buildings
and grounds maintenance, f o o d service and laundry. It is not
uncommon for residents working on a regularly assigned j o b to
be paid no more than $1.00 or $2.00 per month. Such practices
are rationalized as "vocational therapy" or " t r a i n i n g " , even though
the "trainees" may spend many years at the same j o b , with no
opportunity for advancement or placement in a community w o r k
setting. Compensation for work should, of course, be dependent
upon the quantity and quality of j o b performance. Different stand-
ards of compensation should not be applied to the staff and
resident when work abilities are similar.
Discipline, in many institutions, harsh and unusual methods of
training and discipline are employed (e.g., physical restraint, non-
systematic isolation and chemical restraint) in an attempt to control
or punish the mentally retarded. Methods of training and control
should be no different for retarded and non-retarded persons. The
public school, for example, w o u l d find itself in an embarrassing
situation if it were disclosed that pupils were tied to the chairs to
ensure that they remained at their desks, were locked in dark isola-
tion rooms w i t h o u t supervision for minor infractions, or were
prescribed tranquilizing medications to reduce activity levels for the
convenience of the teaching staff. Traditionally, distinctly different
codes for child abuse are applied in the community and in the
institution. In many cases, parents are prosecuted for tying, re-
straining, or isolating their children, while the same practices are
condoned in some institutions under the heading of "treatment
procedures".
 References
ACFMR. Standards for Residential Facilities for the Mentally Re-
tarded. Chicago: Accreditation Council for facilities for the
Mentally Retarded, 1971.

Benda, C. E. Psychopathology of childhood. I n : L. Carmichael

(Ed.) Manual of Child Psychiatry. (2nd Ed.) New York: Wiley,
1954, 1115.

D o l l , E. A. The essentials of an inclusive concept of mental retarda-

tion. American Journal of Mental Deficiency, 1941, 46, 217.

Heber, R. A Manual on Terminology and Classification. In Mental

Retardation Monograph Supplement t o : American Journal of
Mental Deficiency, September 1959, 64, 2.

Heber, R. Modifications in the manual on terminology and classifi-

cation in mental retardation. American Journal of Mental Defi-
ciency, 1961, 65, 499-500.

Masiand, R. Mental retardation. I n : Fishbein, M., Birth Defects,

Philadelphia: J. P. Lipton Company, 1963.

NARC. Fact Sheet. Arlington, Texas: National Association for Re-

tarded Children, 1971.

NARC. Policy Statements on Residential Care. Arlington, Texas:

National Association for Retarded Children, 1968.

ILSMH. Legislative Aspects of Mental Retardation. Stockholm: I n -

ternational League of Societies for the Mentally Handicapped,
1967.
 APPENDIX I
Declaration of general and special rights
of the mentally retarded
International League of Societies for the Mentally Handicapped
WHEREAS the universal declaration of human rights,
adopted by the United Nations, proclaims that all of the
human family, w i t h o u t distinction of any kind, have
equal and inalienable rights of human dignity and free-
dom;

WHEREAS the declaration of the right of the child,

adopted by the United Nations, proclaims the rights of
the physically, mentally or socially handicapped child to
special treatment, education and care required by his
particular condition.

Now Therefore
The International League of Societies for the Mentally
Handicapped expresses the general and special rights of
the mentally retarded as follows:

ARTICLE I
The mentally retarded person has the same basic right
as other citizens of the same country and same age.

ARTICLE II
The mentally retarded person has a right to proper med-
ical care and physical restoration and to such education,
training, habilitation and guidance as w i l l enable him to
develop his ability and potential to the fullest possible
extent, no matter how severe his degree of disability.
No mentally handicapped person should be deprived of
such services by reason of the costs involved.

ARTICLE III
The mentally retarded person has a right to economic
security and to a decent standard of living. He has a
right to productive work or to other meaningful occu-
pation.

ARTICLE IV
The mentally retarded person has a right to live w i t h his
o w n family or with fosterparents; to participate in all
aspects of community life; and to be provided w i t h
appropriate leisure time activities. If care in an institution
becomes necessary it should be in surroundings and
under circumstances as close to normal living as possible.
ARTICLE V
The mentally retarded person has a right to a qualified
guardian when this is required to protect his personal
wellbeing and interest. No person rendering direct serv-
ices to the mentally retarded should also serve as his
guardian.
ARTICLE VI
The mentally retarded person has a right to protection
f r o m exploitation, abuse and degrading treatment. If ac-
cused, he has a right to a fair trial w i t h full recognition
being given to his degree of responsibility.
ARTICLE VII
Some mentally retarded persons may be unable due to
the severity of their handicap, to exercise for themselves
all of their rights in a meaningful way. For others, modi-
fication of some or all of these rights is appropriate. The
procedure used for modification or denial of rights must
contain proper legal safeguards against every form of
abuse, must be based on an evaluation of the social
capability of the mentally retarded person by qualified
experts and must be subject to periodic reviews and to
the right of appeal to higher authorities.

ABOVE ALL — THE MENTALLY RETARDED PERSON HAS

THE RIGHT TO RESPECT.
October 24, 1968.