- Email: [email protected]
Treatment Issues and Innovations in Mental Retardation.: Curative Aspects of Mental Retardation
239
BOOK REVIEWS
Treatment Issues and Innovations in Mental Retardation. Edited by Johnny L. Matson and Frank Andrasik. New York: Plenum Press, 1983, 662 pp., $49.50.
for the deinstitutionalization of the mentally retarded. With each legal, social and behavioral advance, retarded individuals are being further integrated into the community. The volume edited by Matson and Andrasik gives a carefully detailed history of the legal cases which for the past decade have outlined the laws now providing this population with protected rights to education, deinstitutionalization and rehabilitation in the least restrictive environment. The philosophical position of this decade is that retarded individuals should, to the greatest degree possible, be treated as if they were of normal intelligence (Menolascino and Eaton, 1980). This volume examines the most recent experiences to fulfill these philosophical goals. There is a need for scientifically based data collection concerning behavioral modification techniques in an attempt to improve educational tactics and outcomes. Areas of educational neglect, i.e. human sexuality, need further exploration. Unified, careful research into the success of specific behavioral techniques, the training of educators and parents in those techniques and the inclusion of all areas of normal human functioning will be necessary for the successful integration of the retarded individual into the community. By the use of the term "curative" in the title of the Menolescino , Neman and Stark volume, the editors explain that they intend to associate optimism with a disorder that has been historically associated with irreversibility. Though none of the work being reviewed in this volume makes one think that a reversal of the syndrome is at hand, it does an excellent job of reviewing and applying to the area of mental retardation, the exciting and significant advances in neurodevelopmental biology. It examines many phases of the present research on the plasticity of the brain and includes other rapidly expanding basic science areas like genetics. The editors include summary pages for each chapter to help explain the sometimes too tech nical scientific discussions. In their summaries, Menolescino, Neman and Stark repeat their belief that with the genetic/neuroscience information explosion, treatment possibilities as well as further definition of the mechanism of retardation will.be found. This volume is significant in its accomplishment of applying basic science to this clinical
Curative A spects of Mental Retardation. Edited by
population who are now being rechanneled into the
Frank J ~ Menolescino , Ronald Neman and Jack A. Stark. Baltimore: Paul A. Brooks Publishing Compan y, 1983, 349 pp., $25.95. Reviewed by Marcia Litzinger, M.D. * The Wyatt V. Stickeny ruling in 1971 was responsible
community. Initially, institutionalization was society's answer to stopping the spread of a disorder whose cause was not understood and whose prognosis was gloomy. It will be fortuitous if the evolution of scientific understanding should parallel the social/legal maturation of the retarded individual.
* Dr. Lit zinger is a Medical Staff Fellow at the National Institute of Child Health and Human Development associated with the Laboratory of Developmental Neurobiology and the Human Genetics Section.
MENOLESCINO, F. J. & EATON, L. F. (1980), Future trends in mental ·retardation. Child Psychiat. Hum. Deuelpm ., 10:156-168.
has been given to locus of control as a factor in childhood depression. Matthews and Glass review the concept of type A behavior and its relation to stress and coronary heart disease. A large and very useful section, with chapters by Brown, Gore, Philips and Fischer, and Liem and Liem, covers t he difficult concept of social context. The social context of an event modifies its significance for the individual, and the social context of the individual has subtle effects on the impact of an event on the individual. The term "social supports" has been so readily and rapidly assimilated into clinical practice in psychiatry, and indeed into everyday discussion, that it is easy to forget that the research evidence underlying the concept, and the theoretical formulations, are confused and sometimes contradictory. Social class, which encompasses this concept but includes many others, has a significance which is even more difficult to disentangle from stereotypical beliefs. Golden and Barbara Dohrenwend offer in conclusion a path analytic model for testing a series of hypotheses regarding the action of st ressors, which are based on the preceding chapters. This is not the only analytic approach which could be used, and many may wish to skip the details of the model, but the ideas underlying the model are of great interest and could perhaps have been expanded. In an "afterword" Day ends with the optimistic hope that a better understanding of protective and vulnerability factors may lead to viable strategies for intervention. The application of stress models in child psychiatry is fraught with difficulties. Developmental issues are relevant to the child's understanding of stressful events, and to the child's repertoire of reactions. Stress may be mediated directly, or indirectly through the behavior of parents and other significant adults . Nevertheless, anyone who is interested in this topic would be well advised to read this volume closely, for it provides a more comprehensive review ofthe general issues than can be found anywhere else.
Reference
BOOK REVIEWS
Treatment Issues and Innovations in Mental Retardation. Edited by Johnny L. Matson and Frank Andrasik. New York: Plenum Press, 1983, 662 pp., $49.50.
for the deinstitutionalization of the mentally retarded. With each legal, social and behavioral advance, retarded individuals are being further integrated into the community. The volume edited by Matson and Andrasik gives a carefully detailed history of the legal cases which for the past decade have outlined the laws now providing this population with protected rights to education, deinstitutionalization and rehabilitation in the least restrictive environment. The philosophical position of this decade is that retarded individuals should, to the greatest degree possible, be treated as if they were of normal intelligence (Menolascino and Eaton, 1980). This volume examines the most recent experiences to fulfill these philosophical goals. There is a need for scientifically based data collection concerning behavioral modification techniques in an attempt to improve educational tactics and outcomes. Areas of educational neglect, i.e. human sexuality, need further exploration. Unified, careful research into the success of specific behavioral techniques, the training of educators and parents in those techniques and the inclusion of all areas of normal human functioning will be necessary for the successful integration of the retarded individual into the community. By the use of the term "curative" in the title of the Menolescino , Neman and Stark volume, the editors explain that they intend to associate optimism with a disorder that has been historically associated with irreversibility. Though none of the work being reviewed in this volume makes one think that a reversal of the syndrome is at hand, it does an excellent job of reviewing and applying to the area of mental retardation, the exciting and significant advances in neurodevelopmental biology. It examines many phases of the present research on the plasticity of the brain and includes other rapidly expanding basic science areas like genetics. The editors include summary pages for each chapter to help explain the sometimes too tech nical scientific discussions. In their summaries, Menolescino, Neman and Stark repeat their belief that with the genetic/neuroscience information explosion, treatment possibilities as well as further definition of the mechanism of retardation will.be found. This volume is significant in its accomplishment of applying basic science to this clinical
Curative A spects of Mental Retardation. Edited by
population who are now being rechanneled into the
Frank J ~ Menolescino , Ronald Neman and Jack A. Stark. Baltimore: Paul A. Brooks Publishing Compan y, 1983, 349 pp., $25.95. Reviewed by Marcia Litzinger, M.D. * The Wyatt V. Stickeny ruling in 1971 was responsible
community. Initially, institutionalization was society's answer to stopping the spread of a disorder whose cause was not understood and whose prognosis was gloomy. It will be fortuitous if the evolution of scientific understanding should parallel the social/legal maturation of the retarded individual.
* Dr. Lit zinger is a Medical Staff Fellow at the National Institute of Child Health and Human Development associated with the Laboratory of Developmental Neurobiology and the Human Genetics Section.
MENOLESCINO, F. J. & EATON, L. F. (1980), Future trends in mental ·retardation. Child Psychiat. Hum. Deuelpm ., 10:156-168.
has been given to locus of control as a factor in childhood depression. Matthews and Glass review the concept of type A behavior and its relation to stress and coronary heart disease. A large and very useful section, with chapters by Brown, Gore, Philips and Fischer, and Liem and Liem, covers t he difficult concept of social context. The social context of an event modifies its significance for the individual, and the social context of the individual has subtle effects on the impact of an event on the individual. The term "social supports" has been so readily and rapidly assimilated into clinical practice in psychiatry, and indeed into everyday discussion, that it is easy to forget that the research evidence underlying the concept, and the theoretical formulations, are confused and sometimes contradictory. Social class, which encompasses this concept but includes many others, has a significance which is even more difficult to disentangle from stereotypical beliefs. Golden and Barbara Dohrenwend offer in conclusion a path analytic model for testing a series of hypotheses regarding the action of st ressors, which are based on the preceding chapters. This is not the only analytic approach which could be used, and many may wish to skip the details of the model, but the ideas underlying the model are of great interest and could perhaps have been expanded. In an "afterword" Day ends with the optimistic hope that a better understanding of protective and vulnerability factors may lead to viable strategies for intervention. The application of stress models in child psychiatry is fraught with difficulties. Developmental issues are relevant to the child's understanding of stressful events, and to the child's repertoire of reactions. Stress may be mediated directly, or indirectly through the behavior of parents and other significant adults . Nevertheless, anyone who is interested in this topic would be well advised to read this volume closely, for it provides a more comprehensive review ofthe general issues than can be found anywhere else.
Reference