History of Treatment

Services for people now referred to as having a developmental disability began
in the United States in 1848 in Boston. The philosophy of early schools
was to cure the “deviant.” However, by 1877 a unidisciplinary medical model
replaced the educational model and emphasized providing shelter and protection
to this population. Later, the interest in Mendelian genetics led to a
change in focus to protecting society from those whose disabilities were considered
hereditary. By 1926, twenty-three states had laws requiring mandatory
sterilization of the developmentally disabled on the books, and between 1925
and 1955 more than fifty thousand involuntary sterilizations were performed
in the United States. In the 1950’s, parents began to organize opportunities
for individuals with developmental disabilities within public school systems.

Treatment evolved from the medical model to a multidisciplinary approach
in which a physician consulted with other experts. Later, an interdisciplinary
model emerged in which professionals from each discipline gathered
to discuss their individual assessments and decide jointly on a plan of
care. More recently, a transdisciplinary approach has been developed in
which professionals, along with the individual concerned and his or her
family, work together equally to identify needs, plan care, implement interventions,
and evaluate progress.
Though the term “developmental disabilities” was not used in it, PL 94-
142, the Education for All Handicapped Children Act of 1975, mandated a
free, appropriate, public education for children who could be considered
developmentally disabled. The Education of the Handicapped Act Amendments
of 1986 extended early intervention services under the auspices of
the public schools to identified children three to five years of age and those
at risk for developmental disabilities. This legislation was reauthorized as
the Individuals with Disabilities Education Act (IDEA) of 1990. Guarantees
of equal protection under the law were extended to adults with developmental
disabilities by the Americans with Disabilities Act (ADA) of 1990.
The years since 1970 have been a period of remarkable growth and
achievement in services for individuals with developmental disabilities. Cultural,
legal, medical, and technological advances have occurred. Services
now include protection and advocacy systems under the auspices of state
councils on developmental disabilities; university centers involved in education,
research, and direct service; training in self-determination; and family
supports. At the heart of this growth has been a transformation from a system
of services provided primarily in institutions to one provided primarily
in local communities. There has been a movement away from segregation
and toward integration following what has been called the principle of normalization.
Sources for Further Study
Batshaw, Mark L., ed. Children with Disabilities. 5th ed. Baltimore: Paul H.
Brooks, 2002. A primer on developmental disabilities for educators, therapists,
psychologists, social workers, health care professionals, and child
advocates. Families can find useful information on medical and rehabilitation
aspects of developmental disabilities.
Copeland, Mildred E., and Judy R. Kimmel. Evaluation and Management of Infants
and Young Children with Developmental Disabilities. Baltimore: Paul H.
Brookes, 1989. The authors present clear and concise descriptions of
selected developmental disabilities, illustrated with photographs and
sketches. Discussion of assessment and management is geared to teachers
and parents.
Dowrick, Peter W. “University-Affiliated Programs and Other National Resources.”
In Handbook of Developmental Disabilities, edited by Lisa A. Kurtz,
Peter W. Dowrick, Susan E. Levy, and Mark L. Batshaw. Gaithersburg, Md.: Aspen, 1996. Provides a listing of referral sources by region and by
state.
Roth, Shirley P., and Joyce S. Morse, eds. A Life-Span Approach to Nursing Care
for Individuals with Developmental Disabilities. Baltimore: Paul H. Brookes,
1994. Though written for nurses, this book gives the general reader a
foundation of information regarding developmental disabilities from a
quality-of-life perspective.
Gabrielle Kowalski 270