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The History of Inclusion in the United States

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education personnel; and provided support for more research, research facilities, demonstration projects, and dissemination activities in mental retardation and other areas of exceptionality. The administration also directly or indirectly supported related efforts through the National Institute of Mental Health, the National Law Center of Georgetown University, and the Advertising Council. Kennedy also appointed a Special Assistant to the President on Mental Retardation and continued his direct collaboration with NARC right up until his death. In 1966, President Johnson established a permanent Committee on Mental Retardation; his administration also backed the Elementary and Secondary Education Act (ESEA, PL 89-10), a sweeping law which included grants to states to support the education of children with disabilities, and under PL 89-105 continued support for research and demonstration projects in special education. Most significant was PL 89-750, the amended Title VI of the ESEA, which established the Bureau of Education of the Handicapped and provided grants to states for special education at the preschool, elementary, and secondary levels. By the late 1960s, federal planning, action, and funding had profoundly expanded government commitment to and public awareness of issues related to the education, care, and treatment of persons with mental retardation. As a result, public sympathy, concern, and desire for action in support of disabled children elevated special education to a heightened status in the public discourse while facilitating the expansion of special education services at state and local levels. Although much of the concern and activity was indeed focused on mental retardation, other categories of exceptionality directly benefited from such attention and effort.4

Expansion of Institutions for the Disabled

While governmental activity generated significant, mostly positive publicity and discussion regarding special education and exceptionality, residential institutions—for so long the locus of education and treatment for individuals with the most serious and obvious disabilities—became the subjects of intense scrutiny. The number and size of such institutions continued their relentless growth into the late 1960s; as more and more families began to institutionalize their severely disabled family members—with the increased awareness and acceptance of disability generated during the 1950s and 1960s offering encouragement and opportunity to do so—the institutions, reflecting as well the population boom and enhanced postnatal survival rates, grew faster than at any other time in history. Physicians and other professionals felt more comfortable in recommending institutionalization, even as conditions became much more crowded and unhealthy. By 1966, over 127,000 school-age children were enrolled in institutions, an increase of over 40,000 since 1958.5

Such pressures and attention revived and accelerated efforts to investigate living conditions in institutions and to hold their administrators and overseers accountable for any problems. Reminiscent of the exposes of the 1940s, investigations during the 1960s proved harshly critical of the quality of education and care at institutions nationwide. Robert F. Kennedy’s critique of two New York state institutions (Rome and Willowbrook), Robert Edgerton’s expose of Pacific State Hospital in California, and especially Burton Blatt and Fred Kaplan’s extensive photographic essay Christmas in Purgatory once again shocked professionals, politicians, and the public and led to profound criticism, soul-searching, and policy re-evaluation. By the late 1960s, calls for dismantling the dependency on segregated institutions and instead encouraging a more normalized, community-based approach to caring for and educating this particular population of persons with disabilities gained significant ground. Concurrent and subsequent state and federal legislation and dollars encouraging just such an approach soon followed; consequently, states began the complicated and challenging process of “depopulating” their institutions, reducing their crowded conditions and rendering the institutions themselves more manageable. This radical transition from an institution- to community-based approach to the care, treatment, and education of persons with disabilities both drew from and contributed to the policy of “normalization,” an approach imported from Europe during the 1960s that would have a powerful impact on discussions about the integration of the disabled into society characterizing the special education debate during the 1970s.6


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