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From Integration to Inclusion: A History of Special Education in the 20th Century
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During the Civil War, the New York Hospital for the Ruptured and Crippled became the first institution to address the problem of the crippled child (Bryam, 2004). Dr. James Knight, superintendent of the hospital, decried the number of crippled beggars on the streets and sought to relieve them of the need to beg alms (Bryam, 2004). In concert, philanthropists along with a number of organizations (most notably fraternal groups such as the Shriners and Rotarians) began working to create institutions that they believed would greatly improve the lives of crippled children. The first institutions, referred to as hospital schools, emerged, as did the first programs for the vocational training of cripples, an approach that came to be known as rehabilitation (Bryam, 2004). In Boston, for example, the Industrial School for Crippled and Deformed Children (also known as the Industrial School for Crippled Children and as Cotting School for Handicapped Children) was founded in 1893 (Manzo & Peters, 2008).

Home-visiting programs in the United States created to support the development of children in disadvantaged families, date back to the late 1800s when visiting teachers worked with children in immigrant and other settlement communities (Halpern, 1999). For children with exceptionalities, the visiting teacher movement began in Boston and Hartford in 1906. Home instruction in New York City was originated in 1913 by Adela Smith and 125 volunteer teachers. After a polio epidemic in 1916 and 1917, increasing numbers of crippled children resulted in the New York board of superintendents recommending that home training be a part of organized schooling for homebound crippled children. Rochester, New York, was the first district to join visiting teachers to its school board (Howard, 1935).

Classes for physically disabled children—those with crippling conditions, heart defects, and asthma—developed in various centers. As examples, Cleveland set up classes for epileptic children in 1906. In the same year, New York initiated classes for “cardiopathics.” For crippled children, educational programs were organized in the form of decentralized, hospital-based facilities, diagnostic centers, and local clinics (Cruickshank, 1967). By 1944, 21 states had legislation to aid crippled children (Turner, 1944). By 1950, special instruction for homebound and hospitalized children was in most cases an accepted part of the state legislative program (Martens, 1951).

Special facilities for the education of crippled children expanded side by side with medical programs on their behalf. The numbers of orthopedic surgeons and physiotherapists grew (Turner, 1944). Winthrop Phelps championed the cause of cerebral palsied children and was the first medical specialist to deal directly with an educational as well as a physical problem. He operated a private school in Baltimore and spent his professional life explaining the nature of the disability as well as training hundreds of people to work as therapists and teachers for cerebral palsied children (Aiello, 1975).

Hanes (1995) notes that many of the orthopedic surgeons involved with crippled children took the work beyond the borders of medical intervention and became involved in reconstructive and rehabilitative treatments and educational programs. The Industrial School for Crippled and Deformed Children in Boston, for instance, was founded by two orthopedic surgeons from Children’s Hospital Boston (Manzo & Peters, 2008).

At the same time, many of those involved with crippled children referred to the psychological characteristics as a “mental warp” (e.g., Davis, 1914, p. 2). Given their dubious mental qualities, the education of such children foregrounded character development and the instillation of moral values. Schooling sought “to educate them in the habits of industry, order, cleanliness, self respect, and self reliance and to apply such mental, moral, and religious training as would render them true, honorable, and useful citizens” (Willard, 1909, p. 780).

The history of another entire field feeds into the development of education for students with physical disabilities. Prosthetics is the field of science concerned with the artificial replacement of body parts and includes designing, manufacturing, and fitting artificial limbs (Tiessen, 1996).

Prostheses have been used probably since the beginning of humankind: artificial limbs and braces appear in ancient frescoes, mosaics, and pottery. The first written account is 2,200 years old and concerns one Marcus Sergius, a Roman general who lost his right hand in battle and had it replaced with a metal one. Ambroise Pare (1982), the surgeon general from the French army in the 16th century, is considered to be the modern father of prosthetics and orthotics. He advanced surgical techniques and made many devices for wounded soldiers. Many other people, from pirates to panhandlers, were leg amputees who used crude peg legs fashioned out of forked sticks or tree branches (Tiessen, 1996).

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