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Bedlam Approach. Because most environmentally retarded children develop physically at a normal rate, parents often fail to realize that the youngsters' minds are not keeping pace. Compensatory programs must be started early if they are to be effective. But most children of this type are not diagnosed until they have entered school, and many schools are inadequately equipped to deal with them. As a result, the child not only fails to catch up, but is likely to fall further and further behind those of his age. If he becomes mentally disturbed as well, he may be put in an institution. More likely, he will simply drop out of school to enter a labor market that has fewer and fewer jobs for the unskilled.
Whatever the cause and whenever it is made, a diagnosis of retardation can be a preface to tragedy. Nervous breakdowns, divorce, suicide and even homicidal tendencies are believed to be more common among the parents of the retarded than in families without the problem. Many parents predictably blame—and pity—themselves. One of the most difficult decisions is whether to keep the child or have him "put away." For some, an institution is the only answer; the burdens of home care are simply too great, the impact on the family too disruptive. Others, to whom that prospect is intolerable, frequently find good alternative care unavailable.
Most parents and specialists now realize that the typical large state-run custodial institution must be regarded as the very last resort. Even in states that have relatively progressive policies toward the treatment of retardation, such facilities are Hogarthian reflections of a Bedlam approach to the problem. They are chronically short of funds and personnel, do little to train the more seriously afflicted and can rarely maintain even minimal standards of hygiene. One example is New York's Willowbrook State School on Staten Island, where a cutback in state appropriations recently caused conditions to deteriorate to the crisis point (TIME, Feb. 14). Talking about the care in state custodial institutions generally, Willowbrook Director Jack Hammond says: "It's inhuman. We're treating the mentally retarded as if they have somehow offended society."
There is now a consensus that the concept symbolized by the Willow-brooks of the U.S. has failed on all counts, that even if more funds were available for them, they would merely become slightly less dismal warehouses for society's rejects. Nor are private institutions a feasible alternative for the vast majority of families; fees run from $3,600 to $8,000 a year. Most experts have concluded that all but the most seriously afflicted are best served by normal surroundings. This means living at home and having access to training and treatment, or living in small residences where close, personal attention is provided.