What's Wrong with the Poor?: Psychiatry, Race, and the War on Poverty

Chapter Four: Deprivation and Intellectual Disability: From “Mild Mental Retardation” to Resegregation

112 Chapter Four Deprivation and Intellectual Disability From “Mild Mental Retardation” to Resegregation In the late 1950s and 1960s, child mental health experts created a new category of disability: “mild mental retardation” caused by deprivation.1 Profoundly influencing public policy, this diagnosis was as a highly political category and had far-reaching practical implications.2 The diagnosis of “mild mental retardation” was often the first step in placing children in separate tracks or special education classes in their schools. Since the late 1960s, the category of mild intellectual disability has been the subject of much controversy , as it has been disproportionately used to diagnose racial and ethnic minorities as well as children from low-income homes. This diagnostic disparity remains evident today. As disability scholars have noted, “special education” classes serving the black poor provide inadequate educational services and have low exit rates, meaning that few children rejoin the mainstream educational system. In contrast , less stigmatizing categories such as “learning disabled” function as a category of“privilege fortheprivileged,” guaranteeingmainlywhitestudents access to services and accommodations such as extra time in testing situationsorone -on-onetutoring.3DisabilityscholarChristineSleeterhasargued that learning disabilities, as opposed to the categories of “mental retardation” and “cultural deprivation,” emerged in the 1960s as a privileged category to describe white middle-class children falling behind in an increasingly demanding school system while differentiating them from low-income African American children. In contrast, diagnoses of intellectual disability have been disproportionatelyemployed formorethanfivedecadesto describechildren of color. These diagnoses have consistently resulted in decreased access to general education and lower rates of transition to mainstream classes. This disturbing overrepresentation of low-income and minority children inspecialeducationcanbetracedbacktotheearly1960s.4Duringthisperiod of early desegregation, African American children with diverse educational Deprivation and Intellectual Disability 113 backgrounds joined schools that had been racially and socioeconomically homogenous. White educators viewed the academic performance of many of these children—below that of many of their white peers—as a marker for intellectual disability. Yet this diagnosis would not have been possible had deprivation not been established as an etiological factor for intellectual disability. This chapter examines how deprivation theory provided the scientific basis for the wide diagnosis of “mild mental retardation” among low-income African American children. While ostensibly designed to identify children with special needs and tailor appropriate intervention, the resultant overdiagnosis led to de facto segregated classes grouped accordingly to perceived ability and the resulting denial of appropriate educational opportunities. Deprivation theory facilitated this unfortunate outcome. Psychiatrists and psychologists revised the classifications of intellectual disability to reflect current theories of deprivation. Concepts of maternal and sensory deprivation rather thanthe ill-defined “cultural deprivation” determined how physicians, psychologist, and educators viewed intellectual disability. The discourse on deprivation as a causal factor in intellectual disability was reflected in the Kennedy administration’s attempts to implement a national plan for combating intellectual disability. I evaluate three different intervention programs developed on the basis of the deprivation hypothesis, one earlier, in which race was not addressed, and two from the mid- to late 1960s that exclusively targeted AfricanAmerican children. Finally, I examine how theories of cultural deprivation and “mildmentalretardation”facilitated theoverrepresentationofAfricanAmericans in special education classes and evaluate later critiques of the use of these diagnoses as means to resegregate recently desegregated schools into racially homogenous classes. Classifications of Intellectual Disability Deprivation made its first appearance as diagnostic category in intellectual disability in the 1959 manual of the American Association on Mental Deficiency (AAMD) and subsequently appeared in the revisions of the International Classification of Disease, 8th edition (ICD 8) (1967), and in the Diagnostic and Statistical Manual of Mental Diseases, 2nd edition (DSM II) (1968). Significantly, deprivation had not appeared in any form in earlier diagnoses of intellectual disability or in the earlier versions of the ICD and the DSM. Within a decade, deprivation appeared as an etiological factor in all three Deprivation and Intellectual Disability 114 major classifications of intellectual disability, demonstrating the profound impact deprivation theory had on the mental health profession. In 1959, the AAMD, the leading professional organization for the study of intellectual disability, published its first Manual on Terminology and Classification , formulated by Richard F. Heber, a child psychologist and researcher in the field of intellectual disability. The manual served as the foremost diagnostic classification of intellectual disability at the time and was the first to include deprivation as an etiological factor, providing the basis for the later inclusion of deprivation by both the ICD 8 and...