What Is Mental Retardation? Ideas for an Evolving Disability in the 21st Century (Rev.), H. N. Switzky and S. Greenspan, Editors. Washington, DC: American Association on Mental Retardation (AAMR) (now the American Association on Intellectual and Developmental Disabilities; AAIDD), 2006.
The day before Memorial Day 2007, I visited Mount Auburn Cemetery, the nation's oldest garden cemetery. Founded in 1831 on the southwest corner of Cambridge, Massachusetts, the cemetery contains the graves of many New England merchants, scientists, reformers, and literary figures. I went to Mount Auburn to find the grave of Samuel Gridley Howe. Among the other notables there, I also located the grave of B. F. Skinner. At the time, I had just finished reading the book under review, What Is Mental Retardation? As I walked among the graves on that Sunday afternoon, I wondered what Howe and Skinner would think of this curious book and of the claim for evolving ideas that it makes.
It is ironic that What Is Mental Retardation? and its sponsoring publisher, the AAMR, now represent an obsolete title and a superseded organization. With “intellectual and developmental disabilities,” an official judgment changed labels and titles. Why would an interdisciplinary association like the AAIDD continue to advance a book whose anachronistic title suggests the book's same fate? And why would it produce essays that criticize, and not at all defend, its 1992 and 2002 definitions—definitions that look to the new label, disabilities, rather than to its predecessor, mental retardation? Indeed, why would AAIDD produce a collection of essays more interested in criticizing recent definitions of what, since 2007, it identifies as intellectual and developmental disabilities than in arguing the question its title asks?
The apparently anachronistic book is about definition, but of course definition is always about more than definition. Definition calls to mind the use of a definition for the meaning it creates about the defined. But it also provides meaning about the definers. Indeed, sometimes words, labels, and meaning tell readers of books like the one under review more about the definition makers than they do about objects that the words, labels, and meaning identify. Also definitions, and the words and labels that constitute definitions, bring stability to an idea, even one like mental retardation, whose very name is now lost to history. And with loss— what Peter Marris (1987) called “the conservative impulse”—the traditionalists long for an old permanency that verifies rooted meaning, familiar enterprise, and constructions of self.
Of course, the whiff of anachronism falls more places than one, and stability is never more longed for than in a time of change. So it would be wrong to call the book's subtitle, Ideas for an Evolving Disability in the 21st Century, disingenuous. Evolving change suggests steady, reasonable, and natural movement; ideas suggest that experts control the change. Mental retardation, the subtitle selectors imply, is an idea that follows change disembodied from its political, judgmental, and contextual exigencies. If there are exigencies, their effects are like the effects on evolving species—measured, understandable, and even predictable. Mental retardation, a name for which most of the book's essayists claim no discomfort, appears as a stable idea whose meaning, if it changes at all, occurs out of their research. Their research, in many cases accumulated over shared, overlapping lifetimes, suggests the progress, advancement, even the evolving of knowledge, about mental retardation. This change is, of course, always controlled. The 1992 and 2002 definitions, whose evaluations are the central theme of this volume, are, with a few exceptions, neither the products of these experts nor of their accumulated, advancing knowledge.
Who are these experts, what the volume's editors call “a rare collection of leading thinkers in the MR field, representing a highly varied cross section of perspectives, world views, and suggestions for the future of the MR construct” (p. xxiii)? Contrary to this hyperbolic claim, the 26 contributors' thinking is hardly rare, and their contributions reflect neither varied perspectives nor a future construct. Among them are 20 men (77%) and 6 women (23%). Each of the authors comes from ethnic backgrounds most people would label White. Nine of the authors, including both of the editors, are retired and 1 is deceased (38%). Most of the remaining contributors are, as the English say, of a certain age. Two of the authors are physicians (8%), 1 is a member of the clergy (4%), and 6 identify themselves with special education (23%). All of the remaining 17 authors, by far the largest number, are psychologists (65%). Four (15%) of the authors (as best I can tell) played a part in the 1992 or 2002 definitions, or in both. Twenty-two (85%) did not participate. Among the 4 definition contributors, 2 are physicians and 2 are psychologists. Thus, among the 17 psychologists who contributed to What Is Mental Retardation?, 15 (88%) criticize the 1992 and 2002 definitional documents, the creation of which they played no part.
So what do we make of these leading thinkers— entirely White, mostly men, mostly older, mostly psychologists, and mostly noncontributors to the 1992 and 2002 AAMR definitions? What does this dominant disciplinary group in an apparently interdisciplinary volume tells us about definition and definers? Among the 17 psychologists, all are (or have been) members of the AAIDD, usually over their entire careers. Several contributors have served as officers of the association; several have also been members and served in leadership positions of the American Psychological Association's Division 33, now called Intellectual and Developmental Disabilities. Most of the 15 men and 2 women remember AAIDD when it was the AAMR and even the AAMD (American Association on Mental Deficiency). Several began their careers when “mentally defective,” “mental defect,” “mental deficiency,” and “mongoloid” were familiar labels, and several can remember when distinctions between “high grades” and “low grades” were commonly made.
Several contributors can recall a time when large residential institutions were numerous, not exceptional. Indeed, not a few of these psychologists began their careers when institutional inmates provided readily available participants for dissertations and publications. In the days before institutional review boards and written consent from participants, these researchers look back to the places like Murdoch Center, Clover Bottom Center, Partlow State School, Vineland Training School, Fernald State School, and Lincoln State School, where inmates enjoyed time away from institutional boredom on the one hand or labor on the institution's farm on the other to participate as participants in a researcher's latest project. Only a few of the group enthusiastically embraced deinstitutionalization in the 1970s and 1980s; most remained publicly neutral, if privately uneasy. As the championing of civil rights, normalization, least-restricted environments, and finally self-advocacy began to shift the focus of services away from intelligence and pathology toward community resources and socialization, several of the members of this group began to express concern about directions in the field. In the book under review, most members of this group argue (in different ways and using different tones) the position that the 1992 AAMR definition and its substantial reaffirmation in 2002 depart from reality, from evidential history, even from professional competence.
If, as I claim, the contributors to this volume do not particularly represent “a highly varied cross section of perspectives, world views, and suggestions for the future of the MR construct” (p. xxviii), especially among the professional representation from psychology, what, then, do the contributors claim, and what are we to make of their claims? What do they contend about AAIDD's 1992 and 2002 definitions? What are their “ideas for an evolving disability”? What do their claims suggest for 21st-century meaning about this so-called evolution?
In their summary, the book's 21st and final chapter, the editors divide the book's essayists into two groups. Into what they label the functionalist–objectivist paradigm, they place 18 of the contributors, and they associate this group with what they call modernism. Into what they identify as the interpretative paradigm, they enroll 6 of the contributors, whom they link with what they call postmodernism. (They do not include 2 contributors who wrote introductions to the volume.) They construct this Manichean bifurcation, they claim, because the contributors' perspectives are “so … diverse” (p. 354). Their division and their claim suggest several problems.
Most egregiously the editors show, but do not acknowledge, that their division is lopsided. Three times as many contributors represent the functionalist–objectivist–modernist group as they do the interpretative–postmodernist group. These modernist contributors are critical of the AAMR definitions. Put another way, three times as many essayists wrote articles that were critical of the 1992 and 2002 AAMR definitions as did those who might have offered a defense of the definitions. Yet compounding this imbalance, in no essay did the so-called postmodernists offer such a defense.
In addition, the editors claim, the definitional critics grounded their evaluations on neither judgments nor interpretations but on universally apparent findings. These findings are in every case tied to general intelligence. Timeless, disembodied, transcultural, and universal, intelligence becomes the group's primary interest because it is, in the case of intellectual and developmental disabilities (a.k.a. “mental retardation”), the primary modern tool for defining the otherwise historical, embodied, culturally bound, and parochial thing known by many names. Apart from the demand of judgmental and interpretative passions, intelligence to the modernists represents a cool indifference—the type of object that Bacon and Descartes, Diderot and Condillac, and Franklin and Jefferson saw as freedom from premodern superstition, bigotry, and cruelty. Intelligence—measurable and general—becomes a quintessential example of what is modern because it is objective and mechanical, but also because it fulfills other claims of modernity—the primacy of the individual as the fundamental social unit and the freedom of the individual to do whatever he is capable of doing in the various larger social units that she encounters.
Intelligence can be measured; who can doubt it? However, by measuring intelligence, we also measure the very essence that the Enlightenment created for this fundamental social unit, the individual; when we measure this unit's ability to measure, we measure the essential individual and, by extension, we measure his or her freedom. To be is to do what citizens do; to do is to live free. Eighteen contributors (75% of the total), in one way or another, appeal to modernity to criticize what they hold are flawed definitions.
If 18 of the volume's contributors ascribe their reactions to the 1992 and 2002 AAMR definitions of mental retardation to modernity as the editors claim, the remaining 6 contributors (25% of the total) emerge out of reactions to modernity. These so-called postmodernists, the editors suggest, present a case for mental retardation that relies on interpretation and context. For this group, a construct like intelligence may be measured, and the measurement will likely provide informational understanding for the measurers. The measurers, of course, make judgments about how to use the informational understanding. Put another way, for intelligence to be a useful construct, postmodernists claim it must, in its use, be a part of an interactional, relational process. Measuring intelligence is not its own end. The information that the testing of intelligence provides is only an aid in the process of one human being interacting within his or her context. The process and movement of people in their multilayered, diverse systems and contextual environments make ludicrous the atomistic reduction of humans beings to tests that fix intelligence to unmovable intervals of a stable construct—the dream of the modernists. Following the tradition of educator John Dewey and psychologist William James, the postmodernists see intelligence as an ongoing process, its measurement as only a tool, and its efficacy as the tool's usefulness in making the process work—work, of course, for both the individual tested and for the context. They regard the so-called modernist claims of fixed intelligence as useful for little more than social stratification. When that IQ-driven stratification becomes social policy applied to intellectual and developmental disabilities (e.g., “the prevention of mental retardation”), it becomes little more than latter day eugenics.
Now, if the 6 contributors that the editors identify as postmodernists had defended the 1992 and 2002 definitions of mental retardations, we might understand the editors' justification for creating their Manichean bifurcation. However, these contributors are almost entirely silent about the definitions. They neither argue a postmodern case for the legitimacy of definitions nor do they seem to see that volume's focus as the definitions. Put another way, the so-called postmodernists allude to the definitions' reliance on community structures and adaptation, and to their measurement, but they ignore the arguments of the critics. Indeed, they say little about the definitions. I can only wonder if they were ever charged with the task of advocating the definitions' case.
Therefore, the principle flaw of the volume is its failure to include any contributors who explicitly defend the 1992 and 2002 definitions. As such, the debate of “varied” perspectives is no debate. However, there are other defects. Several essayists make references to the history of intellectual and developmental disabilities; yet, with the exception of a few citations, most of the volume's authors who refer to history write as if they are unaware of recent literature on the history of these disabilities, in particular, and on the history of disabilities, in general. Over the last 2 decades, histories of intellectual and developmental disabilities have moved away the Whiggish, triumphalist, and presentist studies of the 1960s, 1970s, and 1980s to histories that rely on critical, “total history,” with its emphasis on the social, cultural, political, and economic dimensions of the issue. As such, histories that consider disabled people, the disabling institutions that cared and controlled them, and the social forces that shaped the various forms of their incarcerations have replaced the “great men,” “great findings,” “the progress of” histories of an earlier time.
A third deficiency of the volume is another flaw of omission. With a few exceptions, the contributors represent the individual person with disabilities as the only definitional unit. When some essayists do move beyond this narrow focus, it is either to criticize the 1992 and 2002 definitions as being too contextually grounded, or it is to make a passing reference to some of Jane Mercer's studies. Indeed, the editors in their concluding remarks resurrect Mercer as if a passing reference to one sociologist might redeem a collection of essays that, for the most part, ignores the social, political, cultural, and economic dimensions of intellectual and developmental disabilities. The volume would have benefited from an essay by Jane Mercer or from any of the many social scientists interested in the topics. Their absence only points to an old order calcified in its reduction of human beings to the individual measure of their general intelligence.
Let me conclude with a comment about modernism and postmodernism. The editors and a few of the essayists refer to both, always in opposing juxtaposition, or sometimes to show the supposed influence of postmodernism on the developers of the 1992 and 2002 definitions. Although the use of the categories may have served an architectural function on the one hand or litigious function on the other, in both cases the writers showed little understanding of modernity and postmodernity. In its British and continental varieties, the Enlightenment gave us modernities, not modernity. And in at least one case, the greatest North American champion of modernities, Thomas Jefferson, even asserted modernities' greatest paradox—the equality of all human beings and the freedom of the individual to be and do all she or he can be. Equality and freedom, after all, are the oil and water of the modern age. The earliest postmodernists—Kant in German, Wordsworth in England, and Emerson in the United States—saw that science could extract oil and water, but it could not blend them.
Who among us does not benefit from the fruits of the Enlightenment, from the gifts of the modernity? And who, even in frustrating moments of what Max Weber (1905/1958) identified as the “iron cage of bureaucracy,” would want to return to a premodern time when science was entirely contextual? Postmodernists can be Luddite-like, and they can turn to primitive, fascistic sources for political authority, and for social legitimacy. However, like John Dewey, Jane Addams, William James, Oliver Wendell Holmes, Jr., and, more recently, Hannah Arendt, Richard Rorty, Cornell West, and Michael Berubé, postmodernists question disembodied scientific authority that its handlers claim exists apart from the interpretations and judgments of human beings. Rather than disparaging this rich tradition, authorities in the interdisciplinary field of intellectual and developmental disabilities might benefit from its doubts as well as from its potential for relativistic, but pragmatic and democratic, problem solving.
In 1848 Samuel Gridley Howe opened in south Boston the first publicly financed “school for idiots.” A man of science, a phrenological materialist, Howe showed no discomfort when he claimed that people with disabilities could benefit by education despite the hereditary influences that he had no doubt shaped their ability to get along in the world. Education was a process. Along with Horace Mann, Howe rejected the Boston school masters' Calvinist notion that learning consisted of pieces of information that had to be forced into the sin-filled heads of recalcitrant children, some of whom, the masters held, were destined to learn and some of whom were not. Instead of this traditional determinism, Howe argued that human beings might naturally have certain amounts of intelligence and certain kinds of intelligence, but human beings also naturally wanted to learn and could learn. Some people's blank slates might be bigger than other people's blank slates, but all slates were ready for the chalk of education. Indeed, citizenship, the highest individual and social forms of modernity, depended on education. Ever the optimist, Howe saw in education the fulfillment of modernity.
Working 100 years later, B. F. Skinner (despite the claims of the some critics to the contrary) was also an optimist. He found in human beings a capacity to learn, despite natural limitations. As such, what people learned to do in the various environments that they encountered identified who they were more than did the material they inherited from birth. Like Howe, Skinner held that art trumped nature. For Skinner, the testing of intelligence was not unlike the work of pathologists on dead bodies. In both cases, the outcome was a finding, not a method. Last, both Howe and Skinner saw in day-to-day environments the places where the art of education found its fulfillment. As early as 1843 on his trip through western Europe, Howe saw that, segregated away from ordinary experiences, people with disabilities had little chance to be a part everyday community life. As such, Howe made a normative, interpretive conclusion that integrated education and services in ordinary communities were better than segregated education and services in artificial institutions. For Howe (and Skinner), the technique was in the learning, and the natural was in the setting. After 1843, Howe spent the next 32 years working to refine the community structures—housing, employment, education, social activities—that made the community the focus, not merely the outcome of services. Skinner too argued that, when it came to learning, the context in which art and method transpired was more important than “the person.”
What would Howe and Skinner think of What Is Mental Retardation? I imagine that they would agree that, in so far as it presents essays supporting and opposing the 1992 and 2002 AAMR definitions, the book fails. Defenders of the definitions simply do not appear in the volume. In addition to this failure, the book contains little content from recent histories of intellectual and developmental disabilities, it presents a modernist–postmodernist dichotomy based on shallow understandings of either, it includes no contributions from social scientists, and, as such, it shows little appreciation for the place of the social, political, and economic in defining intellectual and developmental disabilities. However, more than these failures, many of the contributors in the volume advocate for definitions of intellectual and developmental disabilities that privilege one, and only one, construct: general intelligence. This privilege suggests pessimism and atomism, and it has about it the sulfuric odor of eugenics. The newly named American Association on Intellectual and Developmental Disabilities should reject this failed volume, except for its antiquarian value, and instead look to an expectant future that Howe envisioned more than 150 years ago.