The Invention of Mental Retardation
2.5 million people in the USA have an intellectual disability, about 1% of the population. Individuals are considered to have an intellectual disability when their IQ score is below 70-75, when they have significant limitations in adaptive skills (self-care, home living, social skills, communication, functional academics, and work) and when they developed the disability before age 18.
In the 18th century, they were placed in large publicly run institutions, sometimes housing thousands of “feeble-minded individuals. This continued until the 1970’s when a new model began to call for seeing the “retardate” as a developing person, and more like normal individuals than different from them. It takes the optimistic view of the modifiability of behavior, and does not invest the differences of the retarded with strong negative value. They are capable of growth, development and learning. People will behave normally when placed in normal settings. Many with intellectual disabilities were taken out of institutions and placed in residential settings that had a homelike atmosphere. However, stereotypes still endure about them being less worthy than so-called normal people.
Stereotypes are preserved as the statistical norm uses IQ testing. IQs of 50-70 have mild intellectual disabilities; 35-50 moderate; 20-35 severe, less than 20 profound.
In 1905, Alfred Binet devised the first test for the Paris public school system. A German psychologist, William Stern gave the test a “score”. In 1910, the American psychologist Henry Goddard brought these IQ scoring methods to the USA. He believed it was a single innate entity that could not be changed through training. He coined the term ‘moron’ an IQ of 50-70, imbeciles 26-50 and idiots 0-25 and these designations were actual scientific terms used in the first half of the 20th century. Terman and Goddard were both eugenicists, that breeding should be controlled to weed out undesirables and create a superior race. Nazi Germany took eugenics to its ultimate. In 1916, Stanford psychologist Lewis Terman revised Binet’s test and it became the Stanford-Binet Intelligence Scales, the foundation for all future intelligence tests.
It’s Not How Smart You Are, It’s How You’re Smart
One of the major reasons why people with intellectual disabilities have had difficulty integrating into the mainstream of society is that they violate a core American value: the belief that intelligence is a single innate entity that can be measured by an intelligence test. Ever since the development of the Stanford-Binet IQ test, laypeople and professionals alike have given credence to the concept of intelligence in general, and the IQ test in particular. In public schools in the US, IQ tests have been used as a measure of a student’s “potential”, as opposed to their actual achievement. It seems strange that anyone could take someone’s rich potential and complexity and reduce it to a single number. It is unjust that differences in IQ scores could affect an individual’s attitude toward them so profoundly. IQ scores are just numbers and that truth can only be found in numbers, statistics, or equivalent empirical data.
Professionals have challenged this sacrosanct idea. IQ tests only test what a person has already learned but doesn’t evaluate their ability to learn over time. We limit an individual’s potential when we ascribe it to heredity. The key is finding out how well a person can learn when a teacher or mentor helps them think through a problem. It is a return to Alfred Binet’s belief that intelligence can be improved through training. A program of “cognitive modifiability” have been shown to be effective. A 4-year-old girl with an IQ of 48 was taught to concentrate, love to study and pay attention. A 16-year-old considered incorrigible was placed with normal children and eventually worked at a carpentry shop and became a well-adapted person.
There are several intelligences, each relatively equivalent to the others in legitimacy.
1. Linguistic Intelligence: sensitivity to sounds, structure, meanings, and functions of words and language. This is the intelligence of the writer, orator, persuasive salesperson, linguist, editor, and storyteller.
2. Logical-mathematical Intelligence: sensitivity to and the capacity to discern logical or numerical patterns; the ability to handle long chains of reasoning. This is the intelligence of the scientist, mathematician, tax accountant, statistician, and computer programmer.
3. Spatial Intelligence: the capacity to perceive the visual-spatial world accurately and to perform transformations on one’s initial perceptions. This is the intelligence of the artist, architect, photographer, cartographer, surveyor, and inventor.
4. Bodily Kinesthetic Intelligence: the ability to control one’s body movements and to handle objects skillfully. This is the intelligence of the athlete, dancer, sculptor, carpenter, and mechanic.
5. Musical Intelligence: the ability to produce and appreciate rhythm, pitch, and timbre and to have a sensitivity to the forms of musical expressiveness. This is the intelligence of the composer, violinist, piano tuner, conductor, and music therapist.
6. Interpersonal Intelligence: access to one’s own “feeling” life and the ability to discriminate among one’s emotions, as well as knowledge of one’s own thoughts and weaknesses. This is the intelligence of the entrepreneur, manager, and public relations specialist.
7. Naturalist Intelligence: expertise in distinguishing among members of a species, recognizing the existence of other neighboring species, and charting out the relations, formally and informally, among several species. This is the intelligence of the naturalist, biologist, animal activist, zoologist, and veterinarian.
Each intelligence has
– core cognitive components (described above)
– can be symbolized (e.g. letters for linguistic intelligence, musical notes for musical intelligence)
– has unique end states (e.g. Einstein for logical-mathematical intelligence, Barack Obama for interpersonal intelligence)
– is valued by all cultures (e.g. the Israeli Knesset for interpersonal intelligence, Arabic numerals for logical-mathematical intelligence)
– can be found in the animal kingdom (e.g. birdsong for musical intelligence, bees for spatial intelligence)
– can be found in prehistoric times (e.g. the cave paintings of Lascaux for spatial intelligence, Stonehenge for logical-mathematical intelligence)
Each intelligence is located in specific areas of the brain, providing a unique map for the field of neurodiversity. Selective impairment as a result of injury or illness in different areas of the brain compromises specific intelligences.
Maurice Ravel had a stroke in his seventies affecting Broca’s area in the left hemisphere, an area that affects language abilities. He was unable to express himself verbally, but he could compose and conduct music, because musical intelligence expresses itself in the auditory cortex in the temporal lobe of the right and sometimes the left hemisphere, and that area was unaffected by the stroke.
Personal intelligence (inter- and interpersonal) seem to reside largely in the frontal lobes. In the 19th century, Phineas P. Gage was laying railroad track, and a dynamite charge sent a metal rod through the frontal lobes of his brain. He recovered, but his personality underwent a dramatic change. Previously, he had been a very responsible worker. After the accident he became difficult to get along with, could not hold a job, and became an alcoholic. Besides the frontal lobes, the limbic system (“emotional brain”) is important to personal intelligence. It is made up of a number of subcortical structures such as the amygdala, hippocampus, and cingulate gyrus. Information about the external world is first funneled through the emotional brain before it goes on to the neocortex. That means we have feelings about things before we them about them abstractly.
The naturalist intelligence seems to be tied to areas of the left parietal lobe that are important for discriminating “living” from “nonliving” things. There are actual aphasias (severe language disorders) in which a person is able to recognize words that represent living things but not able to recognize words that represent nonliving things.
The logical-mathematical intelligence appears to be represented in the left hemisphere by the ability to read and produce the signs of mathematics, while the right hemisphere involves the understanding of numerical relations and concepts.
The bodily-kinesthetic intelligence is related to the motor cortex, the cerebellum, and the basal ganglia, while spatial intelligence is correlated with activity in the occipital lobes in the back of the head.
When the neurological components are understood, it is easier to understand the reasons for the different cognitive profiles of neurodiverse individuals: the linguistic deficits of dyslexics, as well as their spatial and interpersonal gifts; the interpersonal shortcomings of autistic people, as well as their logical-mathematical abilities; ADHD people have strengths in spatial and naturalist intelligences yet difficulties in personal intelligence; the uneven profile of Williams syndrome with their spatial and logical-mathematical difficulties, as well as their musical, linguistic, and interpersonal talents. The cognitive map of the brain and theory of multiple intelligences provides a rough-and-ready model to help understand how someone can do well in one area of endeavor while having so much trouble functioning in another area.
Williams Syndrome. This genetic syndrome affects one in 7500 births. It is a result of a missing gene on chromosome 7 (plus several missing genes on either side), responsible for making the protein elastin, which gives “elasticity” and flexibility to human tissue, including arteries, lungs, intestines, the brain, and skin. They have heart and digestive problems, high blood pressure, early wrinkling skin, and the characteristic elfin facial features that make many of them look very similar to each other. They also have an unusual profile of cognitive abilities and disabilities. They have very poor visual-spatial skills but excellent conversational abilities. When a teenager with an IQ of 48 was asked to draw an elephant, only an indecipherable collection of squiggles and scratches was produced. When asked to describe an elephant “it has long gray ears, fan ears, ears that can blow in the wind…” They have a good memory for faces and tend to be empathetic, loquacious, and sociable, although their innate trust can lead to their being taken advantage of by unscrupulous strangers.
Music seems to be their most prominent ability. They are more likely to be emotionally captivated by music and more likely to have perfect pitch. Although their attention span is short, many will listen to music sing, and play instruments with astonishing persistence. Most cannot read musical notes, yet have perfect of nearly perfect pitch and an uncanny sense of rhythm. One boy learned to play an extremely complex drumbeat in 7/4 time with one hand while drumming in 4/4 time with the other hand. They may retain complex music for years, remembering melodies and long verses of long ballads. Experience Williams musicians also sing harmonies, and improvise and compose lyrics readily.
While the total brain volume is 80% of normal, they have a relatively enlarged neocerebellum as well as preserved frontal lobes and limbic system, and an enlarged primary auditory cortex, and larger than normal adjacent areas called the planum temporale thought to be important for language as well as music.
A biography of Gloria Lenhoff called “The Strangest Song”, describes a woman in her midfifties who is 4 feet 10 inches tall, wears glasses and has an elfin nose, puffy eyes, and an expansive mouth. She walks on the balls of her feet, can’t make change for a dollar, can’t subtract seven from fifteen, can’t tell left from right, can’t cross the street alone, and can’t write her name legibly. She has an IQ of 55. But she can sing opera in 25 different languages, including Chinese. As a small child, her parents noticed her interest in music and showered her with musical toys and rhythm instruments – tambourines, flutophones, drums, xylophones, and toy pianos. They sought and found teachers who could help her develop her musical skills. She can’t read music, but she sings, plays the accordion, and has perfect pitch. She needs to hear a piece of music once of twice to be able to remember it in its entirety. As a result, she has a repertoire of thousands of songs. Her mother doesn’t think that she is a savant, but has an ability or proclivity that had to be developed. It took a great deal of time and hard work for Gloria to become the musician she is today.
Prader-Willi Syndrome. Another example of an intellectual disability is Prader-Willi syndrome, which affects one in every 10,000 births. Several genes are missing or not expressed on chromosome 15. They are usually of short stature, obese, have small hands and feet, and tend to overeat and skin pick. They have mild intellectual disabilities and hoard, put things in order and seek symmetry hinting at visual-spatial intelligence. They have a remarkable ability to solve jigsaw and word search puzzles and may exceed the performances of same-age peers without mental retardation. Some are avid readers. Their interpersonal strengths include a strong sense of nurturance which can lead them to work in day-care centers, schools, nursing homes, and animal shelters.
Down Syndrome
The most common intellectual disability affects one in eight hundred births. It is caused by the presence of an extra chromosome 21 which is why it is sometimes called trisomy 21. They have almond-shaped eyes, a protruding tongue, shorter limbs, poor muscle tone, a greater risk of congenital heart probems, recurrent ear infections, sleep apnea, and thyroid dysfunction. The hippocampus, found on both hemispheres inside the medial temporal lobe, is abnormal in it’s function and synapses. It is important for learning and memory. Speech development can be delayed and may require remedial training. Fine motor skills and higher cognitive thinking processes are delayed.
They have difficulties with linguistic and logical-mathematical intelligences (the ones most often assessed on IQ tests), but shine in the personal intelligences. They have considerable power of imitation, bordering on being mimics. They are humorous, and a lively sense of the ridiculous often colours their mimicry. This faculty of imitation may be cultivated and a practical direction given to the results. Coined “The Prince Charming” syndrome, there are friendly and charming, with disarming smiles (smile more than normal children). Parents spontaneously use upbeat, happy descriptors of their children. Compared to autistic children, they are more likely to laugh at funny faces, socially inappropriate acts, and shared events. They are also more likely to respond to others’ laughter with attention and smiles and tried to elicit it through acts of clowning.
At their birth, obstetricians gloomily advise them of the low expectations of their child – “Your child will be mentally retarded.” They were commonly placed in an institution immediately.
John Kingsley, by the age of 19, had acted in a major television series, The Fall Guy, coauthored a book, Count Me In where he shared what he would say to his obstetrician “People with disabilities can learn. I am smart, like learning new languages, go to foreign nations, go to teen groups and teen parties, go to casting parties, became independent, was a lighting board operator, an actor, and the backstage crew. I can talk about history, math, English, algebra, business math, global studies. I play the violin, have relationships with other people, can sing, compete in sports, am in the drama group, have many friends and have a full life.”
Chris Burke is an actor, musician, and star of the 1990s show Life Goes On, the first TV series to be centered around a person with Down syndrome where he acted in all 83 episodes. His mother observed “He loved to perform for us, by the time was very little. He was very musical. He had talent early on. Before he verbalized, he was entertaining us. In primary school, Chris’s favorite time was when teachers brought out boxes of clothes for playing dress-up and acting out stories in the classroom. In junior high school he often played leading roles in organized plays. At age 14, Chris asked a teacher to help him write a short movie script. Then, at 20, he saw John Kingsley’s performance in The Fall Guy on TV, the first time a person with Down syndrome had had a major role in a regular prime-time series. The event was a turning point, convincing him that he had a future as an actor. At the Young Actor Institute, Chris took two or three courses a semester, studying filmmaking and improvisational theatre, among other subjects. At home he wrote short television scripts containing characters with Down syndrome. Finally, he got his chance when Jason Kingsley’s mother recommended him to a casting agent. His radiant performance caught the role of Corky Thatcher in Life Goes On. Currently, he tours the US with his three-piece folk band, is the goodwill ambassador for the National Down Syndrome Society, and serves as editor in chief for the society’s quarterly magazine.”
Intellectual Disabilities in Other Times and Cultures
Western cultures tend to “me” oriented, where individuality is prized and people are often compared to each other (by giving different IQ scores for example). Non-Western cultures seem to be “we” cultures, where cultural cohesion is key and where an individual is seen mainly in relationship to his family, tribe, or cultural group.
In the Nyole people of rural Uganda, intellectual cleverness or financial success do not of their own accord become necessary prerequisites for acceptance and respect. The total character of a person is taken into consideration, as is the situation within which a person exists and responds to the world and those around them. A Nyole person still has the potential to have a place, a role and social value whatever their individual levels of competence.
Among the Shona of Zimbabwe, competency is defined as how individuals creatively deal with the situation they’ve been placed in. “People with disabilities are clever, they have strategies, they dance while leaning against the wall.”
Western cultures have a certain respect for people with intellectual disabilities. Folktales from the Grimm Brothers often contain a reference to “Stupid Hans”, a boy who is regarded as an imbecile by his family but who ends up solving riddles and winning the hand of the princess. The father of Gloria Lenhoff, Howard Lenhoff, suggests that people with Williams syndrome many have been the elves, pixies, trolls, and fairies of folktales. The pixielike facial traits of people with Williams syndrome match the descriptions given of the “little people” in fairy tale literature. The “wee” people of folktales are often storytellers and magicians who can enchant others tith their stories an songs. The matches their musical capabilities of people with Williams syndrome, as well as their story telling abilities. Also, they are loving, gregarious, trusting, caring and sensitive to the feelings of others. Elves and pixies are often known as “the good people” or as “kind and gentle-hearted folks. Williams individuals, much like the fairies of legend, require order and predictability. This need shows up as rigid adherence to daily routines and a constant need to keep abreast of future plans. They may have provided significant cohesion to a culture by passing on songs and ballads from one generation to the next.
From an evolutionary point of view, it has been suggested that Down syndrome may represent an adaption to severe mental deprivation. Since older mothers are more likely to have Down syndrome children (the chance is one in eleven among mothers over fifty) yet less able to care for them because of advancing age (age 50 among prehistoric hunter-gatherers was very old) the phenotype may have evolved by natural selection to include muscle tone, decreased cerebral metabolism, decreased hippocampal volume a strong propensity of obesity and growth hormone, and thyroid hormone paucity. cSuch a thrifty phenotype may have allowed Down syndrome individuals to become independent of their mothers at a far earlier age and allowed them to forgo the skill intensive ecological niche that non-trisomic humans are phenotypically suited for in order to take up a less cognitively and physically rigorous one. The Down syndrome child would not have been a hunter (requiring a substantial maternal investment), and this might have saved his older mother significant amounts of energy which she wouldn’t have had anyway.
