History of Treatment

Services for people now referred to as having a developmental disability began in the United States in 1848 in Boston. The philosophy of early schools was to cure the "deviant." However, by 1877 a unidisciplinary medical model replaced the educational model and emphasized providing shelter and protection to this population. Later, the interest in Mendelian genetics led to a change in focus to protecting society from those whose disabilities were considered hereditary. By 1926, twenty-three states had laws requiring mandatory sterilization of the developmentally disabled on the books, and between 1925 and 1955 more than fifty thousand involuntary sterilizations were performed in the United States. In the 1950's, parents began to organize opportunities for individuals with developmental disabilities within public school systems.

Treatment evolved from the medical model to a multidisciplinary approach in which a physician consulted with other experts. Later, an interdisciplinary model emerged in which professionals from each discipline gathered to discuss their individual assessments and decide jointly on a plan of care. More recently, a transdisciplinary approach has been developed in which professionals, along with the individual concerned and his or her family, work together equally to identify needs, plan care, implement interventions, and evaluate progress.

Though the term "developmental disabilities" was not used in it, PL 94142, the Education for All Handicapped Children Act of 1975, mandated a free, appropriate, public education for children who could be considered developmentally disabled. The Education of the Handicapped Act Amendments of 1986 extended early intervention services under the auspices of the public schools to identified children three to five years of age and those at risk for developmental disabilities. This legislation was reauthorized as the Individuals with Disabilities Education Act (IDEA) of 1990. Guarantees of equal protection under the law were extended to adults with developmental disabilities by the Americans with Disabilities Act (ADA) of 1990.

The years since 1970 have been a period of remarkable growth and achievement in services for individuals with developmental disabilities. Cultural, legal, medical, and technological advances have occurred. Services now include protection and advocacy systems under the auspices of state councils on developmental disabilities; university centers involved in education, research, and direct service; training in self-determination; and family supports. At the heart of this growth has been a transformation from a system of services provided primarily in institutions to one provided primarily in local communities. There has been a movement away from segregation and toward integration following what has been called the principle of normalization.

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