“Tomorrow's playground insults are often foretold by today's professional diagnoses” (Ferguson, 1994, p. x).
Since its inception in 1876, the American Association on Mental Retardation (AAMR) has operated under a series of names featuring the standard professional terms of each historical era: feeble minded, idiot, mental deficiency, and mental retardation. These sound more like the barbed taunts of third graders than the professional jargon of physicians, psychologists, or educators. They have been, or are, both.
In order to consider the question of what the AAMR might name itself now, I will explore the historical and linguistic roots of the mental retardation terms that have been used by leading organizations and the professions. My reason for moving backward in order to look forward arises out of a serious hunch that Professor Ferguson is unfortunately correct about both the past and the future. Terms such as moron, idiot, and retard have originated within the circles of respectable professional jargon only to be passed on to the lips of playground bullies. The various new mental retardation terms generated within professional circles today—cognitive disability, intellectual disability—are likely to follow the same historical path. They are born as seemingly unsoiled words with an apparent absence of cultural stigma. They are initially circulated among professionals as enlightened replacements for the older, stigma-stained terms. Yet, quite predictably, within a decade or so, the new terms accumulate the negative social weight of stigma that marked the old terms. The negativity of moron is soon forwarded to the apparently sanitary intellectual disability.
Mental retardation terms are invented and distributed for scientific and professional use. Over time, the latest terms accrue the deep and harmful cultural stigma that characterizes the older terms. Concerned professionals and family members scramble to outrun the encroaching stigma by inventing and popularizing new words to replace the old. Yet, this effort is unsuccessful. Professionals and important organizations such as the AAMR end up trapped in the half-life of our own terminology, racing ever ahead to invent unblemished new terms to replace the tainted old, finding that we can never quite outrun the stigma and negativity that our terms gather in wider cultural circles. The organizations and the professionals end up in the ironic and sad position of providing the broader society with terms and concepts that maintain the social devaluation and political oppression of persons trapped under these terms.
Why and how do the mental retardation terms invented and used by professionals end up as playground insults? Perhaps if we know something about how and why this has occurred in the past, we can avoid making this mistake in the future. We can avoid choosing seemingly enlightened and stigma-free terms such as intellectual disability or cognitive disability with the foreknowledge that these words will likely begin to accumulate cultural stigma the moment they are adopted.
Metaphors of Disease and Efficiency
Between approximately 1900 and 1930, as a new field of research and practice seeking legitimacy, psychology built its ground floor concepts on two metaphors borrowed from fully established professions: the disease metaphor used by medical doctors and the efficiency metaphor used by engineers. These metaphors filled the new psychological discipline with seemingly scientific terms and ideas that supported the new field's claim to authoritative scientific status. Early psychologists united the disease and efficiency metaphors to “invent” the disease called “mental deficiency/retardation” and thrust the new “scientific” psychology into popular acceptance and prominence.
The development of modern professions such as psychology, education, and social work during the early 1900s did not occur without a struggle. The American public of the year 1910 or even 1925 was not accustomed to the now-common notion that a group of persons trained in knowledge base and array of social practices knew more about certain social concerns than they did. It took decades to convince the public and the politicians to embrace the belief that these professions had a scientific knowledge base that was superior to the common sense, religious convictions, and cultural traditions of nonprofessionals (Brown, 1992; Jones, 1999).
The political process of gaining legitimacy for developing professions, such as psychology in the early 1900s, depended on those professionals adopting the authoritative language, concepts, and metaphors of the already established professions. We have seen this same process in recent years as chiropractors have gained legitimacy for their work by borrowing medical terms and concepts. At the turn of the century, two fully established and respected professional fields were the source of psychological language and thought: engineering and medicine (Brown, 1992). Engineering had demonstrated its practical utility in the building of railroads, bridges, and industrial factories. Engineers were known as men of science, invention, practicality, and technical expertise. Medical doctors had gained prominence after the discovery of bacteria and the development of vaccinations for smallpox and other contagious diseases. Together, medicine and engineering represented the foremost images of men of modern science and practical action.
The new field of psychology gained legitimacy with politicians, parents, schools, and businesses, psychologists consciously (and often unconsciously) talking and thinking like physicians and engineers. In 1904, leading promoter of the new psychological profession James McKeen Cattell stated:
If I did not believe that psychology affected conduct and could be applied in useful ways, I should regard my occupation as nearer to that of a professional chess-player or sword-swallower than that of the engineer or scientific physician. (cited in Brown, 1992, p. 62).
Early psychologists grasped the professional languages of medicine and engineering as the most scientific, authoritative, and practical strands of rhetoric, thought, and professional activity within American society.
Appropriating the Language of Medicine
How did psychologists use the medical and engineering discourses? Both discourses can be readily seen in the primary vehicle of the rise of the psychological profession, the fulcrum of the modern definition of mental retardation—the intelligence test. Goddard produced the first English translation of Binet's intelligence test in 1909. Terman published the Stanford version of the Binet test in 1916. During World War I, the military employed leading psychologists such as Robert Yerkes and Edward Thorndike to administer various mental tests to 1.7 million soldiers. In the decade following the War, the publication and utilization of intelligence and other mental tests expanded dramatically. Almost overnight, the science and cultural practice of intelligence testing gained authority and popularity with the public schools, business, politics, and society in general (Baritz, 1960; Brown, 1992; Trent, 1994).
The early psychologists framed mental deficiency within the metaphor of disease by describing the phenomenon as a biophysical illness of primarily genetic origin that could be objectively diagnosed with the proper scientific instrument. Goddard, Cattell, Terman, and other leading early psychologists frequently described intelligence tests as diagnostic instruments that would allow them to discern mental health from mental deficiency. In both professional and popular writing, early psychologists repeatedly compared the new intelligence tests to the standard diagnostic instruments used by physicians: thermometers, sphygmomanometers, even x-rays. Subnormal IQs were described as objective indications of a mental disease. Practicing within the metaphors of medical science, psychologists developed the early conceptualizations of what we now call “mental retardation” as an illness effectively diagnosed with the psychometric equivalent to the thermometer—the intelligence test (Brown, 1992).
The key sleight of hand in the use of the disease metaphor was the almost unnoticeable shift in reference from the realm of the physical to the mental, from the tangible body to the hidden mind, from the seen to the unseen. While medical doctors diagnosed ailments and maladies of the physical body through the use of measurement techniques, the new psychologists created what they claimed to be parallel instruments to measure what could not be seen, the implied mental realm. The use of the comfortable and politically potent disease metaphor allowed this shift to occur with an air of professional mastery and a minimum of cultural critique.
Appropriating the Language of Engineering
As the early psychologists appropriated the medical language of objective diagnosis, they also crafted their terms, practices, and purpose within the efficiency lexicon of engineers. Engineering developed as a profession in the mid- to late-1800s out of the industrial machine shops. The shop men worked with steel and engines to design and build the industrial plants and mills of mass production. The primary metaphor of engineering work was efficiency, the precision of measurement and machinery seeking to produce the maximum output possible. The method of the engineer consisted of precise calculations and measurements designed to get more and better products out of an industrial process (Brown, 1992; Callahan, 1964; Kanigel, 1997).
The efficiency metaphor operated on two levels for the early psychologists. They developed mental tests and measurements as instruments imitating and enacting the mathematical precision of engineers, claiming to measure the mental realm just as engineers measured the physical realm. In addition, they viewed their diagnostic work as part of a cultural movement toward greater social efficiency in a time of tremendous immigration and cultural change.
The years between 1910 and 1929 have been described by historian Raymond Callahan (1964). as the “Age of Efficiency” (p. 42). Efficiency ideas caught on within the broader society and professional fields— inhabiting, for instance, the scientific management movement within educational and business administration (Callahan, 1964; Tyack & Hansot, 1980). The new professional fields of psychology and educational administration were captured by the appealing notion that the principles of engineering that had served as the foundations of mass production could be adapted to accomplish a new kind of distinctly social engineering. Efficiency could solve social problems.
The social problems faced by early 20th century schools and businesses were complex. Enormous waves of European immigrants during the 1800s had flooded to America's young cities seeking industrial work. Overwhelmed urban public schools were faced with the difficulties of instructing children of many different cultures and languages. The challenges faced by public schools were further compounded by the widespread adoption of compulsory attendance laws at the turn of the century. A parallel but slightly different problem faced factory owners who employed the new immigrants. Certainly, the variety of tongues and traditions sharing space on the factory floor were baffling to the factory foreman attempting to run an organized operation. In addition, the growth of workers' unions and the many, often violent strikes of the late 1800s and early 1900s left capitalists wondering how to get more compliance and more profit out of labor (Callahan, 1964; Kanigel, 1997).
Efficiency experts promised to solve educational, business, and social problems of industrial America. The leading figure in the development of social engineering practices was the father of efficiency experts, Frederick H. Taylor. His much ballyhooed approach—Taylorism, or scientific management—promised to help factories and foundries produce more with fewer workers. His system relied on time and motion studies designed to figure out the one best way for a worker to efficiently perform a task. In addition, his program called for employers to carefully match workers to the task to which each worker's attitude and skills were most suited (Callahan, 1964; Kanigel, 1997.
Efficiency experts swept through the public schools too, adapting the precision of engineering to the human, social processes of teaching and learning. Most important in the context of this essay was the development of special classes and schools for students considered to be retarded or delinquent. The key activity here was the classification and removal of students who were viewed as the source of social inefficiency within the classroom, students who learned differently or at different rates (Callahan, 1964). The efficiency metaphor and intelligence testing supported the early genesis of special education systems as a reaction to the influx of immigrant students in an era of compulsory schooling (Richardson, 1993).
From Stigma to Social Purpose
“If there is a social hope it lies in the imagination—in people describing a future in terms which the past did not use” (Rorty, 1991, p. 186).
“What shall we call a thing anyhow? It seems arbitrary, for we carve out everything, just as we carve out constellations, to suit our human purposes” (James, 1981, p. 114).
Burton Blatt (1999) once wrote: “We tell stories about people who can't tell stories, people who can't stop us from telling stories about them” (p. 83). The same may be said for metaphors. Powerful people use and popularize metaphors to describe other people who are not powerful enough to stop them. Over time those metaphors may be taken as literal facts, and entire professions and segments of the nation use the literalized metaphors without noticing the comparisons inherent within. More importantly, entire professions and peoples lose track of how those metaphors lead us to somehow imagine that incarceration, sterilization, stigmatization, and economic poverty are the primary life paths that should be arranged for persons described by mental retardation metaphors.
Current concepts of mental deficiency and retardation have been primarily carved of early 20th century notions of efficiency and disease, reflecting the purposes and goals of the early field of psychology. Those twin notions were focused on the demarcation and reification of a deficient population, the very diagnosis of which demonstrated the scientific character of psychology. I believe that the social purposes of the AAMR have changed in recent years, shifting toward contemporary visions of schools and communities that accept and support all persons (Taylor & Bogdan, 1989). The metaphors that drive the new descriptions of inclusion and integration ring of well-known cultural scripts of democracy, social justice, and humanistic dignity (e.g., Lipsky & Gartner, 1996).
The opportunity now is not to create new descriptions of diagnosed populations, for such descriptions have little chance of outrunning the pervasive ghost of cultural stigma. The opportunity is to create a new description of the AAMR itself, using terms that envision and announce a social purpose for the organization. Philosophers Richard Rorty and William James challenged us to imagine new descriptions and visions of ourselves—our communities, our organizations, and our society—that intentionally serve new social and ethical purposes. To this end, the Canadian Association for Retarded Citizens has renamed itself the Canadian Association for Community Living, a clear move away from stigma and toward explicit social goals. What are the social and ethical purposes of the AAMR? How can these be demonstrated in a new name for the organization? From the answers to these questions spring the future words and ideas of this organization, the moral outlines of the path ahead.
Author: Scot Danforth, PhD, Associate Professor, 212 Marillac Hall, College of Education, University of Missouri—St. Louis, St. Louis, MO 63121.