Nature of Mental Retardation (US Dept of Health, Education, and Welfare,  1968)

Nature of Mental Retardation (US Dept of Health, Education, and Welfare, 1968)

[Student:] 500 plus… [Narrator:] Children born with normal intelligence readily understand facts and [?]. [Student:] Plus 30, plus 2, plus 2. [Narrator:] They can grasp abstract concepts and interpret signs and symbols. [Student:] …around the 60 and the 30, around the 2 and the 2. 500 plus 300… [Narrator:] They learn to perceive relationships between facts and ideas. [Student:] Sixty plus 30 equals 90. [Narrator:] And they are able to solve new problems with old knowledge using well-developed combinations of motor and intellectual skills. They learn to anticipate danger through signs and sounds of warning: talking to strangers, moving about the streets without apprehension, using public transportation, getting from one place to another without becoming lost. These are all things which normal children learn without formal training. [Sounds of large machinery] As normal children grow older, they are able to exist independently in complex surroundings. They develop skills which allow them to adapt with ease, sometimes working calmly and quietly without direct supervision in jobs surrounded by noise and motion. [Sounds of large construction machinery] Coordination and judgment are natural attributes which help them adapt to their environment to perform precision tasks and to control complex machines. For others, each new learning task is a difficult process. They encounter problems in meeting the demands of the world about them. This is because they are handicapped by mental retardation. Everything they do is affected by an inadequacy in general intellectual functioning. What retarded persons see and hear may be confusing to them. And their behavior sometimes sets them apart from those who are considered to be normal. Every new experience, each new endeavor means a new adjustment. They must be given special consideration by associates and special help from service workers if they are to learn to live and work in a community designed for those with normal intelligence and normal senses. [Siren wails] Each level of mental retardation has a different potential for rehabilitation, a potential best determined by specialists knowledgeable in mental retardation. Counselors concerned with the vocational rehabilitation of the retarded will find the background in the nature of mental retardation most helpful as they make judgments about what is and what is not possible for retarded clients. About three percent of our national population is retarded. Most can be helped to hold productive jobs and can behave so they blend almost unnoticed into the human continuum. Relatively few are so handicapped that they have no hope for rehabilitation. The cutoff point between what is considered normal, and where mental retardation begins, is about 84 IQ points. To the vocational counselor, the adaptive behavior of his client, or how well he is able to adapt into his environment is more important than his intelligence quotient. Retarded persons are often handicapped by bizarre motor movements and slovenly eating habits. Others are unable to dress without assistance. It may take half an hour to tie one shoe, or to button half a dozen buttons, and merely putting on a coat may be a monumental task. [Child makes high-pitched sounds.] Many have speech which is all but unintelligible until they have had months or years of speech therapy from persons trained to work with the retarded. What causes mental retardation? What malfunction in human development so sets these apart from average persons? There are dozens of known causes which are grouped into eight general categories. The following scenes include several examples of each category. Many of the examples represent the most severe form of a handicap. Most vocational counselors will not come in contact with such severe cases. They are not pleasant to observe. They are relatively few in number, and their potential for rehabilitation is slight. They are included here only to establish the contrast between the few who are this extensively retarded and those in the majority having the greatest potential for rehabilitation. Retardation may be caused by prenatal or postnatal damage resulting from some inflammation which is caused by an infection within the skull. This category includes encephalopathy due to postnatal infections from a virus, bacteria, or other microorganisms. Chicken pox encephalitis…congenital toxoplasmosis… mental retardation sometimes results where there is brain damage from serums, drugs, or toxic agents which are ingested by the mother before or at the time of birth, or by the child in the postnatal stage. Congenital encephalopathy associated with maternal intoxication…bilirubin encephalopathy… bilirubin encephalopathy…bilirubin encephalopathy… and again, congenital encephalopathy associated with maternal intoxication. Brain injuries caused by trauma or mechanical or physical agents at birth or following birth comprise another category of causes of mental retardation. Encephalopathy due to mechanical injury at birth… encephalopathy due to anoxemia at birth… [Doctor:] Thatta boy. Now put it wherever you want it. And again, encephalopathy due to anoxemia at birth. Diseases which create disorders in metabolism, growth, or nutrition often cause mental retardation and associated physical impairments. Hypothyroidism, phenylketonuria. Phenylketonuria is a congenital faulty metabolism of phenylalanine which is associated with mental defect. [Children are banging or drumming while someone hums along.] Another category in the causes of mental retardation includes those cases resulting from diseases which develop some abnormal growth in the brain of the child. Sturge-Weber-Dimitri’s disease. This syndrome is characterized by vascular nevi along the course of the superior and middle branches of the trigeminal nerve, glaucoma on the same side, and nevi [?], the inner of three membranes covering the brain and spinal cord. This category also includes tuberous fluorosis. It is characterized pathologically by tumors on the surfaces of the lateral ventricles of the brain, and clinically by progressive mental deterioration, epileptic seizures, sebaceous tumors over the nose in butterfly distribution, and congenital tumor of the eye. Again, an example of Sturge-Weber-Dimitri’s disease. [People grunt and attempt to communicate.] Some children are born retarded without apparent cause. Those cases for which no definite cause can be established but for which it can be established that the condition existed at birth are placed in this group. Congenital cerebral defect associated with primary cranial anomaly. Mongolism is the most common of the so-called clinical types of mental retardation. It is also referred to as Down’s syndrome. It is a disturbance of growth which begins at an early embryonic age and affects almost every system and organ in the body. Another category contains those cases which involve postnatal disease of a hereditary nature. Encephalopathy due to unknown or uncertain causes. [A mix of talking and vocalizations in the background] And conditions where the etiology is unknown or uncertain. Cases of mental retardation which do not have accompanying physical defects are in the last category of causes. Retardation in this category is often caused by poverty. Only the functional reaction can be observed. There are few, if any, outward manifestations at a distance. Motor skills are generally good and physical impairments are not as prevalent as in the previous seven categories. Nonetheless, if such children grow to maturity without counseling and vocational rehabilitation, they are as a rule unable to maintain themselves independently in the community. They will often not be capable of meeting the basic performance standards for competitive employment. More important than the cause of mental retardation, or the intelligence quotient of the client, is the client’s adaptive behavior level. The eight categories of causes of mental retardation may contain any of the five adaptive behavior levels. In other words, there is no direct correlation between the causes of mental retardation and the possible adaptive behavior level. This is true even though the handicaps imposed by some of the causes may make rehabilitation nearly impossible. There are five levels of adaptive behavior. The levels are in descending order according to their potential for rehabilitation. Most retardates are in the first three categories, those with the greatest rehabilitation potential. One example of each adaptive behavior level is seen in this group. [Scattered chatter] [Staffer:] What kind of work do you want to do? [Young man:] Mechanic. [Narrator:] Borderline cases, Level I, are relatively common. Borderline retardates make up the bulk of the caseload for most counselors. [Doctor talks to the patient.] Those in the next adaptive behavior level, Level II, are more limited. Level II retardates are generally referred to as mildly retarded. These persons make up the next largest group serviced by vocational counselors. The severely retarded, those classed in adaptive behavior level IV are capable of only limited productive work and must have constant supervision. Those in adaptive behavior level V are profoundly retarded. They require constant custodial care and attention. This mongoloid boy is moderately retarded. He is in adaptive behavior level III. [Patient:] Doctor! Hey there doctor. [Doctor:] How you doing? [Narrator:] Most persons in this level are unable to acquire academic skills, but they can contribute to their own support in unskilled or semi-skilled jobs, and they can live semi-independent lives in specially supervised homes. Those in adaptive behavior levels IV and V are so severely handicapped that vocational training is very limited, if not impossible. Many have physical impairments which are too gross to overcome. This is why the counselor needs specialized help in determining the potential of a retarded client. It should be noted that a low intelligence score alone does not necessarily cause a person to be considered retarded. But a low intelligence score coupled with some impairment which causes difficulty in adapting to social or working conditions, does place such a person in the retarded class. The average counselor will rarely, if ever, have the occasion to be concerned with retardates in adaptive behavior levels IV and V. Not only because their potential for rehabilitation is limited, but also because they comprise such a small percentage of the total retarded population. Most vocational counseling is done with those in adaptive behavior levels I, II, and III. Thus, the counselor’s knowledge of adaptive behavior will concentrate on the capabilities of clients in the first three levels. [Male staffer:] What’s the matter, Jerry? [Narrator:] Clients in adaptive behavior level III, the moderately retarded, are capable of productive work under sheltered and noncompetitive conditions. They can do simple assembly or disassembly work under close and continuous supervision. The work they do must not require highly developed motor skills or complex communication talents. They must be given extensive specialized education and placed in working conditions where they receive constant attention and encouragement. [Sounds of hammering and other tools being used in a workshop.] [Narrator:] Retardates in adaptive behavior level II, the mildly retarded, can learn to perform unskilled jobs under close supervision. With special care and with training to modify their behavior and to give them vocational skills, the majority of those at level II will learn to make their own way in the community environment. They can hold self-supporting jobs under only occasional guidance from a vocational counselor. But they must always have access to this guidance. They often need direct assistance and counseling even when facing only mild stress on the job or in their personal lives. Most borderline retardates, those in level I, can handle useful and productive work in positions which require only simple interactions with normal persons. Many become elevator operators, janitors, and filling station attendants. But most never advanced positions which require a rapid give and take interaction, complex computation skills, or extremely careful attention to personal appearance. Counselors with an understanding of the nature of mental retardation are better equipped to make their own efforts effective and to make the counseling and rehabilitation process more meaningful to their clients. A familiarity with the causes of mental retardation helps in understanding some of the effects and a knowledge of the different adaptive behavior levels is essential in deciding what a retarded client is capable of learning and doing. To reiterate, most counselors will work with only three adaptive behavior levels. Level I, borderline cases, need help only during times of unusual or severe stress. They can do most semi-skilled and some skilled work. Those in level II are more handicapped. They need extensive training and must have access to counseling on a continuing basis. They must always be aware that someone is available to help them. And they must know exactly how to get that help when the need arises. Level III workers are not capable of independent lives or competitive jobs. They can be trained to work under sheltered conditions, living either in an institution or in a home environment which meets their special needs. Despite this, they are quite capable of performing useful and satisfying work. At times, they perform even better at repetitious tasks than normal persons. Equipped with an understanding of the nature of mental retardation, and a realization of the aims of counseling, the counselor is ready to begin the evaluation of the retarded client. This next step in vocational counseling is the process of measuring and defining the potentials of the client. This will lead to a rehabilitation program which will train him to work with dignity in a productive job and to live as independently as possible. This film was based on Special Problems and Vocational Rehabilitation of the Mentally Retarded. United States Department of Health, Education, and Welfare, Vocational Rehabilitation Administration, Rehabilitation Service Series Number 65-16. [Music]

5 thoughts on “Nature of Mental Retardation (US Dept of Health, Education, and Welfare, 1968)

  1. So glad we serve a MIRACLE working GOD, who is able to EMPTY this facility at ANY time!
    REVIVAL is on its way! GLORY!

  2. St John 3:16! 💓
    JESUS is coming again SOON! HALLELUJAH! Someone who does not believe that, would want to label ME as retarded. It matters not. All we have is time to live for JESUS! 🙏🙌

  3. I am only 1:00 in but OT rant time…did anyone else hate when teachers made you solve a math problem a certain way? Because I would have hated trying to solve that beginning math problem the way that boy did. I pretty much rebelled and just solved things in the way I was most comfortable on tests because I wasn't about to waste 3 minutes on a 1 minute problem when I had 49 other questions to finish as well. It's great to teach (and practice to a certain point) each and every style of solving a problem, don't get me wrong. But as long as a kid can show their work and it leads them to the correct answer…let them use the best method that works for them. There are plenty of other subjects they'll really need to struggle to figure out.

  4. I've associated retard with dumb ass and not any form of handicap

    So I'm just listening and i thought… This is something I'd say about my friend 😂
    don't listen to him hes severely retarded

    Don't come for me many of my family members are handicappable and i would never use" retarded" to describe them
    Pretend it's 1999 and you don't get butthurt over words

  5. The guy smoking the pipe is interesting, I know in the 50s and 60s smoking was just very common, but it was not as common with the most severely disabled, I wonder who helped him learn to smoke a pipe of all things ?

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