MR 71 

Entering the Era of Human Ecology 

The President 

The White House 

Washington, D. C. 

My dear Mr. President: 

It is my privilege to transmit to you the fifth annual report of the President's 

Committee on Mental Retardation. 

This report emphasizes the "new thrust" approach to mental retardation adopted 

by the Committee during the past year. Based on the concept of human ecology, 

the approach focuses on the societal conditions in which retardation is bred and 

thrives. 

The report reflects Committee activities of the past year in such specific 

areas as educational placement, legal rights, lead poisoning, and the special 

needs of Indian people and of the Pacific region. During the months ahead, 

the Committee hopes to extend its field of activity to include problems of 

insurance, screening, the identification and dissemination of models of 

excellence in facilities and services, joint U.S.-Canadian manpower training, 

and fuller enlistment of the resources of voluntary and professional 

organizations, including youth. 

The concerned citizens who serve on this Committee believe that by full scale 

concentration of our knowledge and resources, we can in great measure 

prevent and modify a condition which now afflicts six million Americans. The 

problem transects government missions in many areas—housing, nutrition, 

justice, equal economic opportunity, transportation, in addition to the readily 

recognized impact of health, education, and welfare. The Committee already 

has begun to develop a broader working partnership among Federal departments. 

To make continued forward strides will require the concerted efforts of all 

levels of government and the tremendous reservoir of the voluntary sector. 

We look forward to your continued leadership in mobilizing the Federal 

agencies and inspiring others who strive at the grass roots level. With these 

two forces working together, millions of Americans now living and still to 

be born will have the opportunity to achieve their full potential. The dollar 

returns will be great, the value in human terms beyond measure. 

Faithfully yours, 

Elliot L. Richardson 

Chairman 

1 

Mr. President: 

An increased understanding of the factors that 

shape human development is now emerging 

as the result of the new thrust of human 

ecology—man's interaction with his total 

environment. 

The explosion of knowledge in the social 

and biological sciences as well as the 

physical sciences has opened our minds to the 

interrelationship of all aspects of life. The 

pattern of development for each individual, 

formed by the warp and woof of his 

environment and inheritance, is just now 

becoming discernible. And we are just now 

becoming capable of changing the pattern. 

Since human development occurs in an 

open system, not a closed, predetermined, static 

one, it is therefore open to change. 

Using what he is endowed with genetically, 

man is in constant and creative interaction

with the forces of his environment, 

beginning the moment he is conceived. It is 

this dynamic exchange that determines what 

each individual becomes, mentally, 

physically and emotionally. 

There are few individuals who so 

reflect both genetic and environmental 

influences as the over six million mentally 

retarded people in the United States. Elements 

of the environment not only affect their lives, 

but often are the agents that cause them to be 

retarded. 

If our current and accelerating knowledge of 

human development were incorporated into 

all phases of education, health care, city 

planning, architecture, politics, economics, 

religion and all other systems that affect the 

quality of life, our society could then be 

oriented to the human dimension. The 

incidence and socio-economic burden of 

mental retardation would decline 

significantly; the quality of life for all of 

society would be uplifted. 

Emphasizing human ecology, this report 

recognizes mental retardation as a part of an 

interlocking and pathological network of 

problems weighing heavily on a great mass 

of humanity. 

We have attempted to bring to your 

attention, and to the attention of the Nation, 

some significant and recent findings on these 

matters, with the hope that knowledge can 

lead to action. 

3 

Entering the Era of Human Ecology 

It is no coincidence that in isolated rural areas 

and crowded city slums where the incidence 

of mental retardation is abnormally high, 

there is also an unusually high rate of 

malnutrition, illness, unsanitary conditions, 

inadequate housing, accidents, lack of 

health care and education, and the 

pervading apathy of poverty. 

They are all related conditions, with common, 

interlocking causes. The result is a selfperpetuating cycle. 

It is evident that mental retardation is one of 

the symptoms of these ills of society, as 

well as one of the causes. 

The social system, the economic system, 

the health system, the education system, 

the political system, among others, are 

inexorably linked together also. They are 

largely responsible for determining the 

quality of life for everyone, but especially 

for the mentally retarded who are more 

dependent on them than others who have 

greater control over their own destiny. 

The systems, however, are run by people. 

They, like each individual, are influenced by 

environment and human capabilities and 

limitations. They, too, are operating within 

the framework of the total environment. 

In Appalachia, for example, health care and 

educational opportunity are far below the 

nation's average. Both would improve if 

more roads were built to bring the people to 

the clinics and schools, or to allow mobile 

units to get to the isolated areas. But the 

mountains of the region make road building 

difficult and expensive. 

Even if the roads were there, obviously there 

would still be human problems. One young 

mountaineer, when complaining about his 

family's troubles, was asked why he didn't 

move to the city. He had a car that ran, he 

lived not far from a paved road, and a 

5 
little over 200 miles away was a city where he 

could possibly find work as an unskilled 

laborer.

"I'd go," he said, with some embarrassment, 

"but I cain't read the road signs." 

His family's living conditions are typical of 

many families in Appalachia. They get their 

water for drinking and all other purposes from 

a nearby creek, which also serves as a 

disposal for waste matter. Further upstream 

are some old cars which were disposed of in 

the only way that seems feasible in such a 

remote area—dumped on the creek bank. 

Lead from the batteries can seep into the 

running water. Mine acid drains into the 

creek from the unsealed shafts of abandoned 

mines. 

There are five children under eight years of 

age, and the mother is pregnant. She feels 

"poorly" but accepts this with resignation, 

just as she accepts her anemia and the thyroid 

condition that has affected her health and 

complicated her pregnancies. Her mother 

and her mother before her usually felt 

"poorly," too. 

At least two of the children are mentally 

retarded—one severely retarded. The other 

three might be called "dull-normal." Since 

the mother herself never went beyond fourth 

grade in school, she is not concerned about 

the children's IQ. What worries her is their 

dysentery, the constant cough that one of 

them seems to have—like her husband's—, 

and the open, unhealing sore that another 

has on his leg. She also worries about their 

poverty. 

She sees no connection between her 

husband's sister who is "feeble-minded" and 

her own retarded children. The possibility of 

familial defects is as foreign to her as would 

be genetic counseling. 

The family's main food staple is corn—in 

many different forms—which lacks amino 

acids essential for healthy development. Thus, 

protein deficiency, which can be responsible 

for learning disorders, is another of their 

unrecognized problems. 

Substitute a cold water flat in East Harlem for 

the mountain cabin, change the source of lead 

poisoning to paint flaking off the tenement 

walls, add air pollution, violence, and the 

stresses of crowded living, and you find the 

same problems. Is there any question of the 

environmental influence on the thinking 

process—the ability to learn? 

Every aspect of a poor environment is a 

potential threat to healthy human 

development, mental and physical. 

There is evidence to indicate that 

environmental factors may even alter brain 

structure and function. 

Cornell's Myron Winick and Pedro Rosso of 

the University of Chile compared the brains 

of children who had died of malnutrition to 

the brains of well-nourished children of 

similar age who had died by accident. They 

found that the malnourished children's brains 

consistently had fewer brain cells. 

Research suggests that the intelligence of the 

parent is a vital factor in the intelligence of 

the children—mainly because of the 

environment that the parents create for the 

young child. 

Rick Heber, of the University of Wisconsin, 

found that maternal intelligence was the 

most reliable single indicator of the level 

and character of intellectual development in 

children. The lower the mother's IQ, the 

greater the possibility of the children scoring 

low on intelligence tests. 

However, Heber and his associates, over a 

four-year period in a project focused on 

children of mothers with IQ's under 70, were 

able to raise the average IQ of their children 

significantly. (See page 10). 

By enriching their environment, he allowed a 

fuller expression of the genetic potential of 

these children. 

No amount of effort, of course, could make a

6 
genius of a child with an inborn genetic 

defect or brain malformation. But the 

achievement of maximum intellectual 

development requires mental, emotional 

and physical nourishment at the critical 

time when the brain is developing most 

rapidly. That critical time is from 

conception to age four. 

At birth, a baby's brain is about 40 percent 

of its adult size, and it doubles its birth size 

by age two. By the age of three, a child's 

brain reaches about 80 percent of its adult 

weight. 

Evidence is accumulating that these 

formative years are the crucial time to act 

if we are to overcome the deficit that 

underprivileged children bring to the 

classroom at age 6.

 

7 
It is not the genetic endowment but the 

crushing weight of a hostile environment that 

either packs its victims down into an apathetic 

conformity of the lowest order or else results 

in frantic, sometimes violent attempts to 

escape. 

Improving the environment has the effect 

of liberating each individual, especially 

those caught in the poverty trap, to be his 

own, genetically unique self, capable of 

then improving the environment which he, 

in turn, creates. 

The time when the environmental 

agent is introduced is vital. 

For example, a deprivation of oxygen on 

the eighth day of pregnancy in mice 

produces incompletely formed skulls. 

When the same experiment is done on the 

12th fetal day, the result is harelip. 

Effective action to encourage 

development of normal human beings 

must begin even before conception. 

Current research emphasizes three 

approaches: 

1. Improving the health of potential 

mothers prior to conception by increasing 

health resources and the availability of 

family planning. 

2. Protecting mothers-to-be against hazards 

during fetal development through more 

cautious use of medications, decreasing 

the hazards of environmental 

contaminants, and more widely applied 

advances in immunization. 

3. Preventing the complications of 

prematurity—a major cause of infant death 

and retardation—through prenatal care, 

nutritional improvement, and more uniform 

availability of new technology. 

Thus, controllable environmental factors—

prenatal and postnatal—can be used to 

encourage the full development of the 

individual's genetic potential. 

These facts are now beginning to be used 

constructively, as is evident in the rapid 

expansion of fetal medicine and early 

childhood education, developmental day 

care, and infant programs. Forty percent of 

the Nation's children aged 3 to 5 are now 

attending pre-primary educational 

programs, compared with about 25 percent 

seven years ago. 

The way the baby is handled, rocked, 

fondled, talked to, sung to, and loved, 

affects his mental and emotional 

development from the very beginning. 

"Research is accumulating data to indicate 

that meaningful early sensory-motor 

experiences can prevent functional mental 

retardation by the time the child is ready 

for school," says Columbia's Edmund 

Gordon. "During the child's early 

developmental years he passes through 

significant critical periods when the need 

to learn is at its optimum. With the 

passing of certain critical periods, 

learning then becomes more difficult." 

It is at this time, also, when the young 

child living in poverty begins to be 

assaulted by an essentially hostile 

environment that further stunts his 

capability to develop his innate potential. 

In his mother's womb he was relatively 

protected; he is now virtually going it 

alone. 

How is it possible to break into the 

noxious cycle of hostile environment, 

genetic errors, and mental retardation 

perpetuating itself? 

Unlike the illiterate mountaineer, some 

advanced thinkers among the social and 

biological scientists can read road signs. And 

signs are now appearing that point in a new 

direction and give hope for a way out of 

the wilderness for future generations. 

Already there are demands for 

innovation in colleges of medicine, law, 

education, theology, architecture and other 

areas related to the quality of life, whose 

students are insisting on—and often 

achieving—curricula focused more on 

persons than on abstract theory.

8 
There is also increasing recognition of the role 

of ancillary personnel and their potential for 

improving delivery of services. 

The trend is away from the 

compartmentalized view of specialists, who 

have tended to divide man into their own 

specialties, and thus take him apart. The time 

has come to put him back together again. 

Our current comprehension of the 

interrelated nature of human development 

makes it mandatory to interrelate the 

knowledge of divergent specialties and 

converge that knowledge by applying it 

constructively throughout the life cycle. 

The concept calls for more than reforms within 

the various disciplines. It calls for the 

educational restructuring of many disciplines 

within the biological and social sciences, and 

bringing them together, so that the center of 

their concern and their education and their 

practice is the whole human being living 

within his environment. 

The need for specialists remains pressing, as 

pressing as the continuing need for treatment. 

Even more vital to the future of our society, 

however, is the need to pool the relevant 

knowledge of the specialists and apply it in 

preventive ways before the development of 

such disorders as mental retardation. 

The first step toward the achievement of this 

goal is the designing of an educational 

framework based on human ecology to train 

people to meet biological, behavioral, educational 

and social needs within the human development 

timetable throughout the life cycle. 

This approach to the understanding of the 

nature of man and his potential wholeness is an 

essential academic requirement of this nation. 

The President's Committee on Mental 

Retardation therefore recommends, Mr. 

President, with a deep sense of urgency: 

That the universities be encouraged to develop a 

comprehensive curriculum and academic 

program for a new kind of college devoted to 

human ecology. 

That governmental health and environmental 

services apply and coordinate knowledge of 

human ecology toward a decisive reduction in 

mental retardation. 

9 
Intelligence 

When and how and where learning takes place 

can spell the difference between the socalled normal and the so-called mentally 

retarded child, when there is no physical 

basis for the retardation. 

The effect of an improved environment in 

the earliest years is currently being 

demonstrated by the Milwaukee Project, 

now entering its fifth year. 

Rick Heber, professor of education and 

child psychology at the University of 

Wisconsin, gathered together a human 

development team including the disciplines 

of psychology, psychiatry, sociology, 

speech therapy and education, to study the 

effects of early childhood stimulation and 

education on children from the most 

disadvantaged area of Milwaukee. 

Their initial survey of several hundred poor 

families with newborn babies revealed 

that the high prevalence of mental 

retardation in American slums is not 

randomly distributed or randomly caused. 

It is concentrated in families with mothers 

of low intelligence. Mothers with IQ's 

lower than 80 made up less than half of the 

total surveyed, yet they accounted for 

about four-fifths of the children with IQ's 

under 80. 

With the mothers' willing cooperation, the 

current program of enrichment started. 

Working with newborn babies of mothers 

whose IQ is below 70, a staff member of 

the Infant Education Center visits the home 

daily for several hours until the child is 

three or four months old, holding him, 

talking to him, fondling him and 

enriching his sensory perception. 

At about four months, the child comes 

to the Center every weekday for a slightly 

more structured, though highly flexible and 

individualized program. 

By 43 months, the children in the 

enriched environment are scoring an 

average of 33 IQ points higher than the 

control group, with some scoring 
to an IQ of 135. Their intellectual 

development on the average is exceeding 

the norms generally established by peer 

groups of the majority culture. 

The superior performance is even more 

noticeable in language development. 

Children at the Infant Education Center are 

building an impressive vocabulary by 25 

months, some even speaking in sentences. 

The control group has virtually no 

vocabulary at that age. A few of the control 

group children are not speaking at all by 28 

months. 

Both groups are composed of children 

who, because of their circumstances, were 

almost certain to be classified as mentally 

retarded during their school years. 

The new understanding of the learning 

opportunity in the early years is responsible 

for the increasing emphasis on quality 

developmental day-care programs, Head 

Start, Health Start and the brand new 

Home Start. All come under HEW's Office 

of Child Development, which is the 

Administration's direct and effective 

response to the now recognized need. 

There is also a new look at the validity of 

intelligence tests. 

Jane Mercer, a sociologist at the University 

of California at Riverside, conducted a 

seven-year study of 1500 children 

classified as mentally retarded on the basis 

of their intelligence test scores. She found 

that the generally lower scores of MexicanAmerican and Negro children were 

correlated more with their socio-cultural 

status than with their ethnic or racial heritage. 

In other words, they scored low more because 

they were poor than because they were 

Mexican-American or Negro. 

When the results were adjusted to compare 

with economic, social, and cultural levels of 

middle-class white, Mexican-American and 

Negro families, the differences in IQ 

disappeared. 

In a nationwide study of 123,000 students, 

GeorgeIQ Decrements in Children 

Whose Mothers Are Retarded 

13- 36- 60- 84- 108- 132- 168

35 59 83 107 131 167 +

 Age of Children in Months 

Source: 

An Experiment in the Prevention of 

Cultural-Familial Mental Retardation by 

Rick Heber, Ph.D., and Howard Garber, 

Ph.D.,University of Wisconsin, Madison. 

11
Experimental, Control, and Contrast Group IQ Scores 

Chronological Age (mos.) 

Source: 

An Experiment in the Prevention of Cultural-Familial Mental 

Retardation by Rick Heber, Ph.D., and Howard Garber, Ph.D., 

University of Wisconsin, Madison. 

W. Mayeske of the Office of Education, 

HEW, got virtually the same results: No 

significant differences in IQ scores between 

white children and minority group children 

when social conditions were comparable. 

Dr. Mayeske said the original intention of 

the research was to study the effect of race 

on test scores. "We ended," he said, "by 

studying the effect of racism on test 

scores." 

As a result of these clear indications of the 

effects of a hostile environment on 

intellectual development, especially in the 

early years, we recommend, Mr. President: 

That developmental day care centers, including 

educational, health, and nutritional services, be 

made available to America's children, with 

priority to those with special needs. 

12 
What PCMR Is Doing 

Intelligence Tests 

In March 1971, PCMR, Bureau of Education 

for the Handicapped, and The Council for 

Exceptional Children sponsored a 

conference on the placement of children in 

special education programs for the mentally 

retarded. The conference was particularly 

concerned with the so-called educable 

mentally retarded and the "vulnerable" 

children of the poor of any race or color. 

¿Que validez tienen la evaluación, las 

pruedas, el proceso de ubicación, los 

medios para situar a los niños? ¿Cuáles son 

las implicaciones sociales de la ubicación? 

¿Cuáles son las implicaciones legales? 

Estas fueron las preguntas tomadas en 

consideración. 

If you had trouble reading the above 

paragraph, should you be labeled "mentally 

retarded"? Here is what it said: 

How valid is the evaluation, the testing, the 

placement process, the use of instruments to 

place children? What are the social 

implications of placement? What are the 

legal implications? These were the questions 

considered. 

The report of the conference, titled A Very 

Special Child, is available from PCMR. 

Following are the conference 

recommendations: 

1. Improve and restructure the current 

testing, placement and evaluation process 

for identifying children as mentally 

retarded. 

2. Cease labeling children as mentally 

retarded unless a comprehensive 

assessment of mental ability, physical 

health, and adaptive behavior 

demonstrate a handicap severe enough to 

justify the designation. 

3. Advocate educational justice and freedom 

for all children through recognition of 

each child as a unique individual. 

4. Sensitize teachers, administrators, school 

counselors and staff, curriculum 

developers, and teacher educators to 

the pervading discrimination against 

children from social, cultural, ethnic, and 

economic backgrounds different from 

the so-called norm. 

5. Use the existing legislation, and the Courts, 

if necessary, to achieve educational 

justice. 

6. Support educational reform through 

Federal, state and local governmental and 

private funding.

In another project, PCMR, the Office of Child Development, the Bureau of Education 

for the Handicapped, and the Secretary's Committee on Mental Retardation have 

formed an intergroup committee to produce a manual to assist in achieving successful 

integration of handicapped children into all varieties of existing and anticipated day 

care programs. 

 13
 

Cell Division 
Genetic Damage 

A new and blessed event has occurred in 

medical science—the recognition of the fetus. 

Scientists are learning his developmental 

timetable, the processes that keep him alive and 

that damage him. Some of his problems can now 

be detected. Others can be eliminated. 

About one out of every 600 or 700 children—

15,000 per year—is born with Down's 

Syndrome (Mongolism). Down's Syndrome is a 

severe genetic error resulting from an extra 

chromosome. 

It is now technologically possible to reduce 

the incidence of this condition significantly 

in this decade. 

One percent of births in the country now has a 

chromosomal abnormality that will result in 

mental retardation or will have some 

appreciable effect upon the life cycle. A high 

risk exists in those parents carrying 

chromosomal defects themselves; those who 

have had a previous child with Down's 

Syndrome; those exposed to genetically 

damaging agents such as virus, repeated x-rays 

or chemical exposure; or those of advanced 

maternal age. 

At age 25, a woman has a risk of about one in 

1,000 of having a child with Down's Syndrome. 

At age 35, the risk is one in 250. At age 40, the 

risk is one in 100. And at age 45, the chances 

rise to at least one out of 50 for that 

chromosomal abnormality alone. These appear 

to be conservative estimates. 

Genetic counseling is now available in many of 

the major university medical centers. Before 

conception, prospective parents can be screened 

for genetic defects, and counseled on the risks. 

This procedure is especially vital if there is a 

history or indication of genetic defects, mental 

retardation or developmental problems in 

either the prospective mother's or father's 

family. 

If this precaution has not been taken, and a 

woman-at-risk has become pregnant, genetic and 

metabolic defects can be diagnosed by a study 

of fluid taken from the mother's amniotic sac. 

Termed amniocentesis, the technique can detect 

a variety of chromosomal and metabolic 

abnormalities which result in severe mental 

retardation and other disorders. Parents are then 

counseled on the risks involved and given the 

opportunity to terminate the pregnancy if the 

child is found to have defects that cannot be 

remedied. The optimal safe time for the 

diagnosis is during the fourth month of 

pregnancy. 

There are now a growing number of 

physicians trained in genetic counseling and 

prenatal screening. However, this effort must be 

expanded to increase the availability of these 

and other techniques to the nation's population. 

Therefore, Mr. President, in order to seize the 

opportunity to significantly decrease the 

incidence of Down's Syndrome and other 

genetic abnormalities within the coming 

decade, we recommend: 

That the opportunity for genetic counseling and 

amniocentesis for prenatal screening be provided to all high-risk mothers requesting such 

services. 

That research and clinical study of fetal development be increased. 

15 
The Law 

A Bureau of the Census special report states 

that in 1969 approximately 450,000 noninstitutionalized children, aged six to 15, 

were not enrolled in school. Many of these 

were excluded because they are mentally 

retarded, although the total also includes 

children who are crippled, emotionally 

disturbed, or non-English speaking. 

Of the 100,000 or more mentally retarded 

children in Pennsylvania, more than 53,000 

are not in public school. 

Within recent months, the Courts have 

changed the situation drastically. 

A panel of three Federal judges, ruling on 

a suit filed by the Pennsylvania Association 

for Retarded Children, have decreed that all 

mentally retarded children can benefit 

from an education and have the 

constitutional right to education under the 

equal protection clause of the Constitution. 

The State must begin teaching such children 

by next September. 

The Pennsylvania decision is the 

culmination of a series of similar court 

rulings in Washington, D.C., California and 

Illinois on the right to education for 

mentally retarded children. Its impact will 

be felt across the nation. In Massachusetts, 

for example, retarded children technically 

have had the right to be educated in 

Massachusetts public schools, but in 

practice, a school superintendent could 

pass on a child for "custodial care" in a 

state institution if he felt the schools in his 

jurisdiction could not provide an education. 

The Pennsylvania decision is expected to 

cause changes in such practices. 

Already, the Massachusetts Board of 

Education has taken steps so that evaluation 

of the child will no longer be made by one 

psychologist but by a panel composed of a 

special educator, a physician, a 

psychologist, and a school nurse or 

counselor, with parents having the right to 

appeal the decision. 

It will be the responsibility of the panel to 

prove why any child should be isolated from 

his peers and placed in special education 

classes. 

Many interpret such steps in terms of 

abolishing the label "retarded." Placement 

will be based on the level at which the child 

is functioning, with l.Q. measured not 

merely by tests but by evaluation of his 

personality, physical condition and 

achievement record. 

The California legislature has enacted into 

law a procedure for placing children in 

special education classes which requires 

that their adaptive behavior be assessed, that 

the sociocultural characteristics of their 

family be taken into account and that the 

parents be involved in the decision making. 

A further encouraging note is President 

Nixon's establishment of the National 

Center for Child Advocacy to increase 

public awareness of the social, educational, 

and emotional needs of children. Pilot 

demonstration projects have been set up, involving professionals as well as 

nonprofessionals collaborating on behalf of 

all children within the neighborhood. 

New legislation also is strengthening the 

rights of the retarded, both as to education and 

protection against being institutionalized 

indefinitely without review. 

Residents of institutions have, in many 

cases, remained there until death. Now 

Massachusetts and New York have 

incorporated into their statutes the right to 

advocacy and annual review. In one 

instance, the thrust of the proposed statute is 

that the superintendent must annually ask: 

By what right do I keep this individual in 

the institution? The burden of proof, by 

statute, would be shifted from the patient 

to the superintendent. It then becomes 

necessary to develop criteria to resolve the 

question of who shall be retained in the 

institutions. Annual review establishes a 

right of the resident, thereby lessening the 

possibility of one's becoming "lost" 

16 
in the institution. 

Where a mentally retarded person becomes 

involved in the criminal process, attention 

is being focused on his need and right to an 

advocate at all points. 

General rights of the mentally retarded 

which are receiving recognition include: 

(1) The right to training 

(2) The right to medical treatment 

(3) The right to psychiatric treatment 

(4) The right to insurance 

(5) The right not to be experimented 

upon in institutions 

(6) The right not to be sterilized 

(7) The right to privacy 

(8) The right to marry 

The mentally retarded have not gained all of 

their rights, but the recognition that the 

mentally retarded have rights is a realization 

paving the way for the progress that is 

needed. 

What PCMR Is Doing 

Law 

PCMR co-sponsored a seminar on “Retarded 

Youth and the Law Enforcement Process” 

August 18-20 at Salve Regina College, 

Newport, Rhode Island. It brought together law 

enforcement professionals and specialists in 

retardation to discuss such issue as: 

How can law officials be helped to recognize 

a child as retarded early in the law 

enforcement process? 

What are the legal implications in the 

defense of the youth who is retarded? 

What are the implications for juveniles 

before the courts when retardation is 

recognized? 

Other sponsors were the State of Rhode 

Island, HEW/SRS, and the Salve Regina 

College. 

PCMR also is planning a national conference 

on the question of legal rights.

17
Indian Health 

and Education 

Human ecology has been a way of life for 

the Indian people since time began. 

The earth is our mother. Each grain of 

desert sand, each singing bird, each 

bleating lamb, each human being has its 

place in the nature that makes all things 

one. 

That is the Indian way. 

But life within the confines of a 

reservation falls far short of the Indian 

concept of what life should be. 

Some families have to travel five miles or 

more for water. Many have no sanitary 

facilities, no adequate means of heating 

their homes, no way to refrigerate food, 

no flooring but the bare earth. 

Of the estimated 20,750 families on the 

Navajo reservation, 19,000 have incomes 

of less than $3,000 a year. The average 

income of all Indians and Alaska 

Natives is far below the poverty level. 

Average schooling is eight years. 

In a five-year study (1963-1967) of 

children admitted to the Public Health 

Service Indian Hospital in Tuba City, 

Arizona, 616 had a diagnosis of 

malnutrition; 15 had kwashiorkor; 29 had 

marasmus. Kwashiorkor is a result of 

severe malnutrition, and had been seen 

prior to that time in rare, isolated cases 

in the United States. Marasmus is also 

associated with malnutrition. Both occur 

before the child reaches age two. 

Nearly 15 percent of all pediatric 

admissions during the five-year study had 

some form of associated malnutrition. 

Many had repeated admissions to the 

hospital. 

Often the only milk available to Indian babies 

after weaning is powdered skim milk. Its 

supply depends on whether or not skim milk 

is a surplus commodity from the surplus 

food program. If this is the sole source of 

food after weaning, the baby will suffer 

18 
from a serious nutritional deficiency. 

In some cases, a small amount of evaporated 

milk has been included in the commodities. 

But it is usually given to the baby 

overdiluted and contaminated—either by 

the only water available or by lack of 

refrigeration. 

The result is malnutrition and repeated 

bacterial and viral infections. And 

sometimes death. 

While the infant death rate for children 

under 28 days has dropped dramatically in 

the last few years due to the efforts of the 

Indian Health Service, there are over three 

times as many deaths of Indian babies aged 28 

days to 11 months as the national average. 

Those malnourished children who survive 

can be seriously damaged in both mental 

and physical development, since protein 

and calorie deprivation can stunt the mind 

as well as the body. 

Indian children have further problems 

when they reach school age. Because their 

culture and orientation is so different from 

the culture of the people who design 

intelligence tests, they frequently score 

low on the tests. Some are mistakenly 

labeled mentally retarded. The problem is 

discussed in the PCMR publication A Very

Special Child. (See page 13.) 

There are still other Indian children who 

are genuinely retarded and for whom there 

are few special classes or services. 

Mental retardation is not a functional 

concept in most Indian communities, 

however. There is great tolerance for 

"special" members of the community, and a 

retarded child is not likely to be identified 

as a problem. He is accepted as another 

member of the community, who, like all 

others, has his place in the nature of things. 

That is the Indian way. 

 

Infant Death Rates by Age at 

Death Indian and Alaska Native, and 

U.S. All Races Calendar Year 1967 

 Under 1-6 7-27 28 days-

 1 day days days 11 mo

Age 

Infant Death Rates by Age at Death Indian 

and Alaska Native, and U.S. All Races Calendar 

Year 1967 

Under 1 day 

Indian and Alaska Native ~ 9.0 

All Races ~ 9.5 

1-6 days 

Indian and Alaska Native ~ 5.0 

All Races ~ 5.2 

7-27 days 

Indian and Alaska Native ~ 4.0 

All Races ~ 4.2 

28 days – 11 mos 

Indian and Alaska Native ~ 15.0 

All Races ~ 5.0 
What PCMR Is Doing 

Indian Health and Education 

What can be done to prevent the 

conditions that lead to mental 

retardation among Indian people, and 

to alleviate the problems of those now 

retarded? 

In order to answer the question, PCMR 

has met with key people in the Federal 

Government with responsibility for 

Indian programs, and with several Indian 

groups and individuals. At the 

invitation of the Indian Inter-tribal 

Health Board, PCMR representatives 

attended a three-day meeting in 

Colorado, followed by meetings with 

the Southern Ute reservation Tribal 

Council. 

This was followed by an invitation to 

attend the Albuquerque Area Health 

Board meeting, in which two Committee 

members participated. They later visited 

Acoma Pueblo and took part in a 

Comprehensive Health Planning 

meeting. 

As a result of these discussions, in 

addition to conferences with Bureau of 

Indian Affairs and Indian Health 

Service headquarters administrators, 

there are now plans for a joint BIA-IHS 

Inter-agency Health and Education 

Council. A series of health education 

pamphlets on maternal and child health 

designed and executed by Indian art 

students will soon be underway. These 

will go direct to Indian women on 

reservations, with material appropriate 

for the differing needs of Indian people 

in different areas, and suggested for the 

most part by Indian people in the health 

and education fields. 

Health courses for all students in BIA 

schools are now in the curriculum 

planning stage, also with advice from 

Indian people. 

PCMR is acting as "child advocate" in 

the above projects. 

In light of PCMR's experience of the 

past year, we join with you, Mr. 

President, in supporting increased 

involvement of tribal leaders and the 

Indian people in the planning and 

management of their programs.

20 
21 

Lead Poisoning 

In a follow-up study of 425 children in 

Chicago who were treated for lead 

poisoning, 39% had some kind pf 

neurological damage, 54% had recurrent 

seizures, 38% were mentally retarded, 

and 13% had cerebral palsy. 

It is impossible to say how many 

children throughout the country have 

died of lead poisoning, or how many are 

mentally retarded as a result of it, 

because the majority of cases are probably 

never diagnosed. The symptoms resemble 

those for other illnesses until the final 

stages, and even then it is often not 

suspected. 

It has been estimated that between 5 and 

10% of young children in Boston's slums 

are now harboring undetected lead 

poisoning, with no symptoms yet. They 

are like "walking time bombs," says 

John W. Graef, chief resident in 

pediatrics at Children's Hospital 

Medical Center. An illness or 

infection could light the fuse and the 

result could be death or mental 

retardation. 

In some high-risk neighborhoods, 

screening programs have revealed that as 

high as 25 percent of the children 

between one and six have elevated levels 

of lead in their blood. 

Lead poisoning is a completely 

preventable disease. 

It is contacted by young children—

usually between the ages of one and 

three—who eat lead-based paint that 

flakes off the walls, windowsills and 

woodwork of old houses. 

Legislation in 1940 restricted the use 

of lead in paint. But as plaster and newer 

paint peels in slum housing, the layers of 

the older, lead-based paint come with it. 

This is what little children have a 

tendency to eat. Surveys in Baltimore, 

Philadelphia, and Minneapolis show that 

from 40 to 80% of the houses in selected 

slum areas still contain dangerous levels 

of flaking lead paint applied over 30 

years ago.

23 
Many cities, aware of the danger, have started 

preventive programs, some of which show 

relatively encouraging results. 

The New York City Health Department 

can now report levels of lead in the blood 

within 24 hours. Time is of vital importance, 

since delay in treatment could mean 

permanent damage or death. In many other 

cities, it takes weeks to get results from the 

test. 

Programs for finding, diagnosing and 

treating children with lead poisoning in 

New York resulted in a decrease in the 

fatality rate from 27% of detected cases to 

1.4%. 

In 1963, Chicago launched an intensive casefinding, education and treatment program. 

By late 1969, over 120,000 children had 

been tested, and the 1,500 found to be 

poisoned were treated. 

But one-time attempts at detection and 

treatment cannot be called programs for 

lead control. Many treated children resume 

their lead eating habits, others will begin 

for the first time. What is required is 

continued screening in known high-risk 

areas and a continued follow-up of those 

found to be infected. 

There must also be more accurate (and less 

expensive) testing methods to determine 

the level of lead in the child's system; more 

knowledge as to what is an "acceptable" 

level in anyone, child or adult; and a 

willingness to undertake a national effort 

to prevent this largely controllable problem. 

The latter would have to include 

renovation of housing in the "lead-belts" of 

many of the nation's cities. 

What PCMR Is Doing 

Lead Poisoning 

The Committee is formulating a policy 

statement on lead poisoning to emphasize 

the Committee's interest in this preventable 

cause of mental retardation. PCMR is also 

assisting in the development of pilot projects 

based in children's hospitals in "lead belts" 

to clarify the extent and clinical severity of 

the problem and to seek solutions. 

24 
First Pacific Forum on 

Mental Retardation

With the United States having trust or 

other governmental responsibility for 

several islands in the Pacific, and a 

continuing tradition of interest in the entire 

Pacific area, PCMR deemed it important 

to establish a more effective exchange of 

ideas among the nations concerned. To 

this end, it organized the First Pacific 

Forum on Mental Retardation. Delegates 

from 17 countries convened in Honolulu 

Sept. 28-Oct. 1, 1971. 

In addition to providing the vehicle for a 

vigorous discussion of practices and 

problems in the field, the Forum 

uncovered a desire for follow-up 

programs of training, assistance, and 

sharing of knowledge. The delegates 

expressed five priority needs in a letter 

that they asked be conveyed to you, Mr. 

President: 

(1) Assistance in developing further professional 

and paraprofessional training programs for parents, 

teachers, and others; 

(2) Research, the findings to be translated and 

disseminated; 

(3) Professional assistance in enlightening the 

public; 

(4) Development of exchange leadership programs; 

(5) Periodic conferences. 

A common theme emerging in many of the 

papers, responses, and work groups was the 

impact of urbanization and 

industrialization on the problems of mental 

retardation. Delegates reported a growing 

need for programs of training and assistance 

as the complexity of modern life replaces 

the simple ways in which the retarded more 

easily found a place. 

Exemplifying unmet demands, a 

representative from Singapore said the five 

training centers there have a waiting list of 

1,474. Among the many needs identified 

were training courses to develop more 

teachers for the retarded; short courses on 

genetic services for public health workers 

and private practitioners; international 

sharing of experience in controlling 

infectious diseases; supplementing diets of 

women of child-bearing age, and carrying 

out a planned population policy. Mass 

screening of a simplified type and 

expansion of services for the preschool 

child also were proposed. 

As one outgrowth of the Forum, the 

American Association on Mental 

Deficiency has arranged to make 

literature in the field available to Pacific 

nations. 

25 
What PCMR Is Doing 

International 

PCMR and the National Association for 

Retarded Children cosponsored an 

International Symposium on Volunteers 

for the International League of Societies 

for the Mentally Handicapped, held in 

Pennsylvania. Topics included training 

volunteers; the youth volunteers; the 

volunteers and the professional; and related 

subjects. Participants came from Belgium, 

Brazil, Canada, Chile, Colombia, England, 

France, Germany, Sweden, Switzerland 

and the United States. 

The Committee has further expanded its 

international activities by forming a U.S.-

Canadian study group on manpower, with 

the hopes of developing a model 

program. 

Following a Caribbean conference on 

mental retardation, attended by PCMR 

representatives, there has been a 

continuing effort to coordinate and 

exchange information on services and 

programs. 

PCMR was represented at an 

international conference on special 

education held in Sweden, and attended 

by delegates from 24 countries. The 

meeting was followed by site visits to 

facilities in Denmark, France and 

England. 

PCMR also participated in a European 

conference on vocational training and 

rehabilitation, sponsored by the 

International Labor Organization. The 

World Health Organization has utilized 

the experience of several Committee 

members to broaden the understanding of 

how the quality of life can be improved 

through health education. 

26 
Economics 

(From a study on the Economics of Mental 

Retardation, commissioned by PCMR.) 

An estimated 5.4 million persons in the United 

States under 65 years of age have IQ's below 

70, about three percent of the population. 

Children of the poor are about ten times more 

likely to be retarded than children of the 

middle and upper classes. 

If the children of all population groups had the 

same rate of mental retardation as those of 

middle and upper class whites, the 

prevalence of retardation would decrease by 

80 percent. 

A partial estimate of the social cost of mental 

retardation in 1968 was $5.6 billion. This 

includes the loss of productivity due to 

mental retardation and the "excess" cost of 

service provided to the retarded—i.e., those 

costs that are greater than would be incurred 

for non-retarded persons. For example, the 

"excess cost" of special education is the 

difference between regular educational 

costs and special educational costs. Of this 

$5.6 billion, about $2.4 billion was paid by 

taxpayers in the form of increased taxes to 

provide services to the retarded or to 

compensate for the increased taxes that would 

be paid by retarded people if they had the 

same earning level as the general population. 

The vocational success of the mentally 

retarded is better than is generally believed. 

An estimated 87 percent of mildly retarded 

adult males (IQ 50-69) are employed, a rate 

that is only four percentage points below that 

of males in the general population. Among 

mildly retarded women, the comparable rate 

was 33 percent. Although this rate is 12 

percentage points below that of women in the 

general population, much of the difference is 

explainable by the greater tendency of mildly 

retarded females to be fulltime homemakers. 

In both cases, earnings were slightly over 85 

percent of average wages in the population. 

The mildly retarded constitute the great majority of 

27 
the mentally retarded. In most cases, mental 

retardation is not a barrier to work. Even among 

persons with the IQ’s between 40 and 50, an 

estimated 45 percent of males and 12 percent of 

females are employed at wages that are 19 percent 

of the average in the population. The retarded 

who do not work are usually persons with IQ’s 

below 50 and those who are multiply 

handicapped. 

The lifetime earning of a retarded worker are high. 

A mildly retarded male who entered the work 

force at age 18 in 1968 could expect lifetime 

earnings of over half a million dollars, assuming a 

2.5 percent annual growth rate and expressed in 

terms of 1968 prices. He can earn five to nine 

times what it costs to train him for employment 

and community living. In addition, by working, 

he reduces the rate of institutionalization.

Obligations for Mental Retardation Programs 

Department of Health, Education, and Welfare 

Fiscal Years 1965-1972 

28 
Recreation 

The inclusion of a wide choice of physical 

activities, individual games, cultural events, 

hobbies, environmental education and outdoor 

recreation opportunities in the total life span of 

the mentally retarded individual is necessary for 

total humanization. The recreation dimension of 

an individual's life needs to be formulated 

throughout the entire life span and especially in 

the early childhood years to gain some degree of 

leisure independence. 

The mentally retarded individual is being 

provided services by municipal recreation 

agencies in over 50% of our nation's cities with a 

population of over 100,000 according to recent 

projections. 

Along with these municipal recreation programs 

are several thousand camps (residential and 

day), and one-day-a-week programs, being 

sponsored by local, public and volunteer 

organizations, as well as the vital recreation 

component within residential facilities. 

Major efforts by such national organizations as 

the American Association on Health, Physical 

Education and Recreation; Programs for the 

Handicapped; the National Therapeutic 

Recreation Society of the National Recreation 

and Park Association; The Joseph P. Kennedy 

Jr. Foundation; the National Association for 

Retarded Children, and the American Association 

on Mental Deficiency's Recreation Subdivision 

have highlighted the broad national involvement 

in recreation services. 

What PCMR Is Doing 

Recreation 

In several meetings sponsored by PCMR, The 

President's Council on Fitness and Sports and 

the Bureau of Education for the Handicapped, 

there has been an attempt to explore some of 

the dimensions of recreation and physical 

education for the mentally retarded. 

29 
PCMR Projects 

in Preparation 

Alist of exemplary community-level 

programs for the mentally retarded 

throughout the United States. 

A report on practical implications and 

application of the welfare program in 

providing benefits and services to the 

retarded. 

A bibliography of books, publications and 

brochures that best describe mental 

retardation. 

A study of transportation systems in order to 

aid the retarded in reaching services. 

Recommendations will be made for 

improving transportation services. 

A national survey of voluntary, lay and 

professional groups to determine innovative 

programs for children with birth defects. 

Development of a method for collecting 

data on services delivery systems to the 

mentally retarded from 50 States and D.C. 

A conference on comprehensive screening 

for all pre-school children. 

A monograph on citizen advocacy 

leadership training. 

Support of the section on mentally retarded 

children at Citizens' Conference on 

Priorities and Action for Children and 

Youth. 

Examination of administrative and program 

components of adult activity centers and 

state and local laws and regulations 

applicable to their operation. 

Fostering implementation of 

recommendations concerning training and 

employment of the retarded made in joint 

PCMR-President's Committee on 

Employment of the Handicapped 

publication, "These Too, Must Be Equal." 

Regional Staff Development conferences 

planned jointly with HEW regional offices. 

30 
Goals of PCMR’s 

New Thrust 

Using present knowledge and techniques from the 

biomedical and behavioral sciences, it is 

possible: 

To reduce the occurrence of mental retardation by 50 

percent before the end of this century.* 

To largely eliminate Down's syndrome (Mongolism) 

within the next two generations. 

To avoid the disastrous effects of rubella and other 

viral infections, by inoculation, vaccination, and 

other preventive measures. 

To undo the harm done thousands of children 

wrongly identified as retarded by faulty tests. 

To prevent the retardation that would occur because 

of social neglect and public disinterest in great 

segments of minority groups. 

To permit conception and birth of normal, healthy 

infants through genetic counseling of parents-to-be and 

prenatal care of the mother. 

To return one-third of the retarded now living in 

institutions to community living, and make them into 

useful citizens through training for productive 

employment.*

* Since this report was written, President 

Nixon has declared these to be "major 

national goals."

*U. S. GOVERNMENT PRINTING OFFICE 1972 O - 453-940 

31 
The President’s Committee on Mental Retardation MEMBERS (1971-1972) 

RICHARD M. NIXON 1969-1974

Elliot L. Richardson 

Chairman 

Senator Clair W. Burgener 

Vice Chairman 

Robert A. Aldrich, M.D. 

Mrs. Marianna Beach 

Mrs. N. Lorraine Beebe 

William H. Borders, M.D. 

Mr. Frank R. DeLuca 

Mr. David H. Echols 

Mr. Donald Lee Fox 

Cecil B. Jacobson, M.D. 

Mr. James N. Juliana 

Mr. Lawrence A. Kane, Jr. 

Mr. Aris (Bob) Mallas 

Mrs. Susann R. Ora 

Mr. Lloyd E. Rader, Sr. 

Mrs. Louise R. Ravenel 

Mr. William B. Robertson 

Mr. Kenneth S. Robinson 

Mrs. Jeanette Rockefeller 

Will Beth Stephens, Ph.D. 

Mr. David K. Udall 

Mrs. Margaret B. Ulle 

The Secretary of Labor, 

Ex Officio 

The Director of the Office of 

Economic Opportunity, 

Ex Officio 
The President's Committee on 

Mental Retardation 

Washington, D.C. 20201 

Professional Staff 

Joseph H. Douglass, Ph.D., 

Executive Director 

Fred J. Krause, 

Deputy Executive Director 

Howard R. Dentz, 

Special Assistant to the 

Executive Director 

Raymond W. Nathan, J.D., 

Director of Communications 

Stanley J. Phillips, 

Management Officer 

Mrs. Elizabeth S. Bush, 

Mrs. Mary Z. Gray, 

Richard C. Thompson, 

Miss Mary Kay Walsh, 

Program Specialists 

Office Staff 

Mrs. Nancy Borders 

Mrs. Helen Caldwell 

Mrs. Evelyn Cochran

Mrs. Gwendolyn Coleman 

Mrs. Ruth Gray 

Miss Ruth Herdman 

Mrs. Beverly Keith 

Mrs. Patricia Kramer 

Mrs. Pierrette Spiegler 

Consultants 

Charles E. Acuff 

Charles C. Bergman 

Louis A. Bransford, Ph.D. 

Alfred D. Buchmueller, M.S.W. 

Leo F. Cain, Ph.D. 

Louis Z. Cooper, M.D. 

Patrick J. Doyle, M.D. 

Mrs. Eleanor S. Elkin 

Maurice S. Flagg 

Morris L. Grant 

Edward D. Greenwood, M.D. 

Dennis E. Haggerty 

Edward L. Johnstone 

Francis P. Kelley 

Mrs. Marianna G. Paige 

Paul A. Rittmanic, Ph.D. 

PHOTO CREDITS: 

Inside front cover, page 18: Ben 

Bravence, Indian Health 

Service 

 page 2: Joan Larsen 

 page 4: Jan W. Faul 

 page 7: Phil Straw 

 page 10: Marcia Kay Keegan 

Caroline Hoffman, 

Milwaukee Early Childhood 

Education Project 

page 11 12: Paul Conklin 

page 20: Indian Health Service 

page 22: David Simpson 

page 25: White Hut Children's 

Center, Philippines 

page 26: Guam Rehabilitation 

Workshop 

page 26: Koomari Sheltered Workshop, 

Canberra, Australia 

page 29: Michael Sullivan 

DHEW Publication No. (OS) 72-7 
The President’s Committee on Mental Retardation 

Washington, D.C. 20201 

POSTAGE AND FEES PAI D 

U.S. DEPARTMENT OF H.E.W.