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THE HANDLING OF DOWN SYNDROME AND RELATED TERMS IN MODERN DICTIONARIES DAVID A. JOST and ALLEN C. CROCKER In the past two decades a social revolution has occurred, a revolution in which the human rights of persons with disabilities have been defined, promoted, and extensively secured. During this exciting period there has emerged a particular vitality to the advocacy for individuals with mental retardation , for whom vastly improved circumstances now exist regarding appropriate education, health care, employment, and community living. Among that group, persons with Down syndrome have often been in the forefront. This sporadically occurring chromosomal disorder has a birth incidence of 1 in 1000. Its specific origin, based on an excess ("trisomy") of material derived from the twenty-first chromosome, renders its description somewhat more uniform than is common in many other conditions that have mental retardation as an expressed symptomatic element. As such, it is referred to in the public educational materials of the National Down Syndrome Congress (a parent group) as "the leading clinical cause of mental retardation." Persons with Down syndrome are identified by the medical system at birth and are commonly recognized by the general public by virtue of their characteristic physical appearance. A base of cultural lore has developed around this syndrome, and a very strong supportive force exists in behalf of these exceptional humans. Although all individuals with mental retardation have been subjed to frequent public misrepresentation and devaluation by virtue of careless and demeaning reference terminology, in the situation of those with Down syndrome the language issues have been especially onerous. Deriving from the historic conjectures of the first definitive descriptive author, Dr. John Langdon Down (1866), the terms of mongolian and mongoloid have been promulgated as germane. This inaccuracy brings no particular credit to either group, persons of Mongolian racial derivation or individuals with Down syndrome. The issue has 97 98Down Syndrome in Modern Dictionaries been particularly compounded by perpetuation of the term mongolian idiot, which in present times constitutes the ultimate insult. In the world in which the person with Down syndrome is assisted and valued, the term mongoloid is referred to as "the 'M' word" and is an object of strict taboo. It is clear that terminology matters. The fashion in which a person is labeled contributes to public attitudes. Negativistic applications provide a barrier to fair play in formation of societal value judgments. Such an effect would influence the potential for social acceptance, justice in allocation of educational and other resources, and determination of long-range policy for opportunity. Further, families of persons with Down syndrome are discouraged by perpetuation of archaic, inaccurate, and pejorative terminology, which they perceive as a threat to support and integration. Most critically, however, the directly involved person, the individual with Down syndrome , is well aware of current usage in categorical terminology and is wounded in many ways by what amounts to name-calling, resulting in a loss of self-esteem. A review of the principal entries for Down's syndrome or mongolism in the four major American semi-unabridged dictionaries shows that each contains three components of definition.1 The first is an orienting phrase that designates the word as a description of a human situation, thus: "a congenital condition," "the abnormal condition of a child," "a congenital disease," and "a congenital disorder." We feel that the "congenital" terminology is appropriate, since Down syndrome is indeed established before birth. The remark "disorder" serves reasonably to acknowledge that the syndrome is an aberrant state, and the word is more accurate than "disease." Usually the second element mentions the intellectual disability, as: "moderate to severe mental retardation," "moderate to severe mental deficiency," "generally a mental deficiency," and "mental defitiency." There is indeed mental retardation present in virtually all individuals with Down syndrome , but in the circumstances of current support systems David A. Jost and Allen C. Crocker99 this is seen in milder form, as "mild to moderate" retardation. The term "mental deficiency" is obsolete. The most problematic section is the third, an attempt to list physical features of persons with Down syndrome. All four books comment on slanting eyes. All also mention craniofacial abnormality, as "broad short skull," "wide flattened skull," "broad face...


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