Introduction

Introduction William E. Castle, Ph.D. In 1815, an English physician wrote an article titled "Some accounts of rash liable to be mistaken for scarlatina" (Mantón, 1815). He could not have known the implications of what he had detected. For over a century, rubella or German measles was considered merely a mild viral discomfort, and for the 80% of us who have had rubella, it is just that. But in 1941, an Australian physician published an article titled "Congenital cataract following German measles in the mother (Gregg, 1941). For the first time attention was drawn to a congenital defect among infants whose mothers had contracted rubella during pregnancy . By 1943, maternal rubella had become associated with deafness, blindness, heart disease , and other congenital impairments among infants (Swan, Tostevin, Moore, Mayo, & Black, 1943). Today we recognize maternal rubella to be among the leading causes of childhood deafness . Excluding children born in the 1963-65 period, over 8% of all children enrolled in programs for the hearing impaired are known to be deaf due to maternal rubella (Jensema, 1974; Vernon, 1969). Among children born in 1964 and enrolled in programs for the hearing impaired, 44% have congenital rubella, and among those born in 1965, there are 37% (Jensema, 1974). This dramatic increase, sometimes described as the "rubella bulge," was due directly to the calamitous rubella epidemic which swept this country in 1963, 1964, and 1965, resulting in 8,000 or more children being born deaf and 4,000 or more other children being born both deaf and blind. This was a worldwide William Castle is Vice President of Rochester Institute of Technology and the Director of the National Technical Institute for the Deaf. He was Chairman of the conference "Rubella and Deafness: Infants in the '60s, Adults in the '80s," September 1980. epidemic, and the total number of infants directly affected in one way or another must surely be in the hundreds of thousands. Little good can be said of that epidemic, but it did lead to the development of a vaccine and in 1969, to the creation of a national rubella immunization program. In time, perhaps we can look for the total eradication of rubella as a cause of deafness and of blindness. But our immediate concern just now is not for tomorrow's children. It is for the thousands of adolescent youngsters who live today with congenital rubella and its various manifestations . Most of these youngsters are now 15, 16, and 17 years old. Each one has a name and a family; each one has an intellect and emotions; each one also has a future. For some, this future is bleak and for others it is full of promise. In large measure, we are their future. Educators and others who provide services to handicapped children have by and large been responsive to the needs of these children. They have worked under difficult circumstances brought about by the sheer number of children in this group and by the fact that many in addition to their deafness have visual, orthopedic, cardiovascular, neurological, and other disorders . But soon they will no longer be children, and the gavel will be turned over to those of us who are responsible for providing services to young adults. This brings me to the point of the conference and to this special issue of the American Annals of the Deaf. The planning committee had three goals in mind: (a) to bring national attention to the educational, vocational, and rehabilitation needs of the thousands of young adults born deaf and deaf-blind in the aftermath of the 1963-65 rubella epidemic; (b) to give appropriate attention to the special needs of multiply handicapped young deaf adults, including the deaf-blind; and (c) to stimulate state, regional, and national plans of action to assure that all A.A.D. I November 1980 961 Introduction these children shall receive the needed services to which they are entitled as young adults. While this issue of the Annals, like the conference , should contribute to meeting these goals, we would be deluding ourselves if we thought these two activities alone would suffice. It is evident from the broad sponsorship of the conference and the...