[ON THE PROBLEM OF ADMISSION AND THE DEGREE OF EDUCABILITY (MANUAL OR SCHOLASTIC) OF SO-CALLED MODERATELY MENTALLY DEFECTIVES].
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Information was gathered via a mailed questionnaire from approximately 85% of Maryland service providers offering vocational services funded by the Maryland Developmental Disabilities Administration. The weekly earnings of persons placed in supported employment were 3.5 times the earnings of persons employed on the premises of the service provider. Nevertheless, there was strong evidence that substantial improvements are needed, and possible, in supported employment. Among urgently needed improvements are (a) the ability to recruit and retain qualified vocational workers, (b) enhanced procedures for locating more and higher quality jobs, (c) expanded transportation arrangements, (d) improved training for vocational workers, and (e) an information system to measure performance and identify problems.
Medical discourse on "racial hygiene" and the law on the prevention of hereditary disease in progeny passed in 1933 in Nazi Germany presents us the historical background to the topic. By analyzing six case histories from "hereditary health" court decisions during the years 1942-45, we illuminate how the law of 1933 was applied in Austria. Coming to the present, we put historical events into a more general perspective by reviewing recent debates and presenting a case history from today. There are similarities between the past and present decisions regarding carrying out sterilization of mentally handicapped persons, but the justification given for doing so has changed. The argument of today "protection of the individual" supplants "racial hygiene".
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Lobbying is a competitive effort directed to reaching legislators who are attempting to balance the demands of individuals, organized groups, political parties and the complex economic realities of our times. Unfortunately, the use of all-inclusive "mega numbers" (whether it is the millions of individuals with intellectual disabilities or the billions of dollars for needed services) is difficult for any person to place in proper perspective. As a result, the millions of children and adults with intellectual/developmental disabilities become "just numbers" - not actual people. The need is to somehow personalize these numbers if we are to bring increased attention to these individuals with special needs. Census Bureau and private research foundation data are used to illustrate an approach to personalize the information for individual politicians.
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Few studies have examined the relationship of behavior and health status among aging persons with intellectual and developmental disabilities (I/DD). Behavioral disorders, which often are coincident with functional decline in older persons with I/DD, may be more related to medical morbidity than previously reported. This cross-sectional study examined the association between health status and behavior disorders with increasing age in a cohort of 60,752 adults with I/DD clustered into four adult-age groupings (21-44, 45-59, 60-74, and >74). Age grouping data suggested an association between morbidity and increased likelihood of behavior symptoms in all but the oldest age grouping. The magnitude of the association and trend varied by specific disease across age groupings compared to that found in healthy cohorts. About 25% of the adults with I/DD had psychiatric diagnoses and the frequency of such diagnoses did not decrease with age grouping. These results suggest that adverse health status may increase the likelihood of persistent behavioral disturbances in older persons with I/DD. Moreover, behavioral disorders may be sentinels for occult medical morbidity, which in turn may be responsive to intervention.
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