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The Mentally Handicapped Adolescent. The Slough Project of the National Society for Mentally Handicapped Children: an Experimental Step Towards Life in the Community PDF

182 Pages·1971·20.22 MB·English
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Frontispiece. National Hostels and Training Centre, Slough. The Mentally Handicapped Adolescent The Slough Project of the National Society for Mentally Handicapped Children An Experimental Step Towards Life in the Community EILEEN P. BARANYAY, B.A., Ph.D. With a Foreword by PROFESSOR GUNNAR DYBWAD AND DR. ROSEMARY DYBWAD PERGAMON PRESS OXFORD • NEW YORK • TORONTO SYDNEY • BRAUNSCHWEIG Pergamon Press Ltd., Headington Hill Hall, Oxford Pergamon Press Inc., Maxwell House, Fairview Park, Elmsford, New York 10523 Pergamon of Canada Ltd., 207 Queen's Quay West, Toronto 1 Pergamon Press (Aust.) Pty. Ltd., 19a Boundary Street, Rushcutters Bay, N.S.W. 2011, Australia Vieweg & Sohn GmbH, Burgplatz 1, Braunschweig Copyright © 1971 The National Society for Mentally Handicapped Children All Rights Reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission of Pergamon Press Ltd. First Edition 1971 Reprinted 1973 Library of Congress Catalog Card No. 70-135314 Printed in Great Britain by A. Wheaton & Co., Exeter and reprinted Lithographically by Hazell Watson & Viney Ltd, Aylesbury This book is sold subject to the condition that it shall not, by way of trade, be lent, resold, hired out, or otherwise disposed of without the publisher's consent, in any form of binding or cover other than that in which it is published. 08 016271 1 (hard cover) Foreword IN THE vastly expanding literature on mental retardation there are still far too few reports on innovative service projects in sufficient detail to be useful to programme planners. This history and analy- sis of the Slough experiment is an exception. During the period from 1964 to 1968 we were privileged to visit some thirty-five countries in different parts of the world, providing consultation on services for the mentally retarded. Without any doubt the visual aid which we used more frequently than any other teaching tool was a series of slides from the National Hostels and Training Workshop in Slough which we carried along on all our travels. Obviously the uses to which we put this material and the lessons we drew from it differed widely depending not only on the country but on the particular institution or service we were visiting. The great value of the slides and the interpretations to which they could be put was that they dealt with basic issues in mental retardation, basic life problems of the mentally retarded, and basic answers to these problems. Thus they could be used successfully in a wide range of situations. It seems to us that Dr. Eileen Baranyay's book has the same merit of broad usefulness. In this detailed account of the Slough Project she has furnished us with a careful documentation of its vii viii / Foreword inception, its growth, and the problems encountered along the way. Particularly significant and instructive are Dr. Baranyay's com- ments regarding the problems in administration, problems which may well be inevitable when a membership organization such as the National Society for Mentally Handicapped Children undertakes a demonstration project of this complexity. Indeed, it is astonishing that the Society managed to keep the project on an even keel for so long a period. Too often the attempt is made to cull data from an undertaking that has not been in existence long enough to permit evaluation. This is not so in the case of Slough, although one must regret, with Dr. Baranyay, that funds had not been available to set up, from the beginning, a rigorous on-going evaluation scheme including, in particular, follow-up of those who "graduated" from the training programme. Still Slough did not so much seek to explore new fron- tiers as to substantiate the pioneer research of Tizard, the Clarkes, O'Connor and, in particular, Gunzburg, whose guiding hand during the initial stages of the project contributed decisively to its level of achievement. One point which springs most clearly from Dr. Baranyay's account is the overriding importance of social training in any rehabilitation scheme for young people with severe intellectual defects. (This in no way contradicts our long-standing feeling that the great majority of such persons would have benefited from more adequate medical attention in early childhood to their secondary physical handicaps.) Dr. Baranyay quite correctly notes that at Slough the least progress was made by the most severely retarded. This, however, should not support their exclusion from future projects but, rather, should point to the need to develop for them a somewhat different type of group living and social and vocational training. Our own repeated observations of the programme over a period of 4 years definitely support the presence at Slough—on an ex- perimental basis—of some profoundly retarded individuals. While they were not able to participate, and thus to benefit sufficiently from the programme, they, none the less, proved as prejudicial the view held by so many that this most limited group among the mentally retarded would have to be cared for in the traditional institutional setting. Foreword / ix Perhaps that is what was most appealing about Slough. Even though it may not have reached all it set out to achieve, it clearly pointed out that there was a rich future way beyond its own circumscribed immediate objectives. Professional workers in mental retardation around the world are indebted to Dr. Eileen Baranyay for this documentation, and to the National Society for Mentally Handicapped Children for its initiative in carrying out this significant demonstration. GUNNAR AND ROSEMARY DYBWAD Preface THE following pages contain a review of the aims and achieve- ments of the Slough Project of the National Society for Mentally Handicapped Children. It is not a strictly scientific treatise but endeavours to investigate the workings of the scheme and to convey something of the atmosphere of Slough by including details of trainees at work and leisure. The indefinable quality that marked Slough in action and that was remarked upon by many who visited it, also led the writer to undertake this account. Apologies for any shortcomings must be made to those who were directly involved in the Project. It is hoped that in spite of inadequacies this analysis may increase that concern for the care of the mentally handicapped in the community which was exem- plified by the National Society at Slough. Thanks are due to many for their interest and co-operation. The National Society has given support throughout not only in making available the necessary material and supplying excellent photographs, but also, through the General Secretary of the Society (Mr. George Lee) and his staff, giving generously of time for dis- cussion. Mr. James Cummings and the staff at Slough have shown endless patience in dealing with questions and in general discussion over a long period. The regional officers of the Society have given xi xii / Preface valuable assistance with the follow-up of trainees. The National Association of Mental Health afforded encouragement throughout especially at the final stage. Thanks should also be given to that cross-section of visitors who spared time to revive their memories of Slough and provided useful comment. Many parents generously assisted the survey by affording first-hand information, while the trainees themselves were at all times co-operative and friendly. (Throughout the study fictitious names have been used in all situations concerning the trainees in residence.) The time given to useful discussion by many with experience in the field of mental retardation has been greatly appreciated. It has not been possible to enumerate these, but particular mention should be made of the support so readily given by Dr. M. A. Charrett, Area Medical Officer of Health for South Buckingham- shire and Medical Officer of Health for the Borough of Slough, and of the time generously afforded by Dr. Kenneth Rouse, Head of the Department of Psychology, Goldsmith's College, University of London, in providing constructive criticisms. Finally, the facilities afforded by Dr. H. C. Gunzburg, Consultant Psycholo- gist, Monyhull Hospital, in the shape of his research findings and relevant publications, were greatly appreciated. London EILEEN BARANYAY I Slough in Prospect AN INEVITABLE consequence of a strong personality, we are told, is the support of ardent admirers and the hostility of strong oppo- nents. In this light, the National Society's Project at Slough must have had singularly strong characteristics. The Project was concerned with community care of mentally retarded adolescents with IQs between 30 and 50 as measured by the Terman Merrill Revision of the Stanford-Binet Intelligence Scale. Critics of the Project include those who see it as near perfection and those who regard it as of questionable value. For a balanced judgement, therefore, a right sense of perspective must be sought. There is greater likelihood of obtaining this if Slough is looked upon as "a child of its time,\ Viewed from that angle, the aims of the planners can be more fully appreciated and also the extent to which these aims have been realized. To understand the particular concern of the National Society for Mentally Handicapped Children for community care of the mentally handicapped adolescent at this particular point in time, it is necessary to review the contemporary scene. A variety of forces combined to promote the desirable social climate for the emergence of the Slough Project. Philosophical, psychological, and sociological developments 1 2 / The Mentally Handicapped Adolescent have jointly effected a change of attitude towards the problem of mental handicap. Few will query the statement that each generation must define afresh the nature, direction, and aims of education: as a philosophy underlying work with the mentally handicapped, these words have deep significance. Changes in circumstance and knowledge have afforded opportunities for research and experiment in the sphere of mental handicap. Many of the important discoveries concern the mental growth of the individual and are usefully referred to by Bruner(1) as "Profound reorientations in developmental theory in the last generation—changes that have been hastened by studies of normal and pathological growth, by analyses of effects of different types of early environments, by studies of the development of language and its impact on thought.'' Bruner further indicates that not only have we somewhat clearer understanding of the process of learning but that, most obviously, the rate of the society in which we live forces us to redefine how we shall educate a new generation. For the mentally handicapped this reorientation of thought has opened up possibilities of development of potential and fulfilment of personality to a degree previously inconceivable. Pioneers of research in the area of mental subnormality such as Earl, O'Con- nor, A. M. Clarke, A. D. Clarke, Hermelin, Hilliard, Kirman, Gunzburg, Tizard—amongst others—have laid the foundation of a progressive outlook in contrast to the finality of earlier unen- lightenment. Acceptance of the theory of the interrelatedness of all aspects of personality—physical, intellectual, emotional, and social —has given weight to the teaching of Earl(2) that we need to regard the severely subnormal as a person, not merely as repre- senting a cognitive deficiency. A wider interpretation of the term "education" and greater understanding of the forces that influence the learning process have come about as the result of recent research into the crippling effects of emotional and social deprivation. A corollary to this has been the evidence of the compensatory benefits that can be obtained by "replacement therapies" as, for example, by an enriched environment. Dr. Kellmer Pringle(3) makes reference to this as follows: "That rehabilitation and recovery can take place during late adolescence and adulthood has been convincingly demonstrated in recent years, notably by the work of Clarke and

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