Generalized dependency handicap

The principal global social disadvantage (handicap) is dependency, measured by scales of dependency or maladaption. It varies in individuals, environments, and cultures.

If an IQ below 50 is the sole criterion for categories of learning disability or dependency handicap, they are, in reality, severe intellectual impairment. In practice, categories of learning disability use legal and administrative criteria that do not approximate to categories of intellectual impairment. Children and adults with learning disabilities do not necessarily have especially low intelligence, and not all persons with the same level of IQ share the same degree of generalized learning disability. Current terms such as 'special needs' and 'learning difficulties', in a school context, are proxies for learning disabilities. In other contexts, they are usually proxies for dependency handicap. Socially acceptable terms used in different societies (mentally retarded, mentally handicapped, developmentally disabled, etc.) without standard measures of intelligence, are in reality describing generalized dependency handicap.

Factors influencing who is labelled mentally retarded (or whatever) in any community include clinical, personal, social, cultural, legal, and organizational criteria, some recognized, some not. They operate differently in different communities and at different times, so the number selected is very variable. Since such factors are rarely stated, there is no sound basis for comparing studies.

Discriminating between global impairment, disability, and handicap in mental retardation encourages clear thinking and rigorous research. For example, causes of intellectual impairment are largely organic brain syndromes. Causes of learning disability also include other clinical conditions, especially those affecting communication (e.g. cerebral palsy) and social factors. Causes of dependency handicap (related to intellectual impairment) add family, social, and environmental factors (e.g. society's demand for universal literacy handicaps many who might otherwise fare well).

Partial categories

Persons with intellectual impairment may experience any disease or disability, but it is useful only to identify those 'partial categories' whose defining features are commonly though not exclusively related to mental retardation. Investigation of prevalence or causes in these groups requires studies of total human populations, not only of groups exhibiting intellectual impairment or selected as mentally retarded. Prevalence of specific conditions within an ill-defined group of mentally retarded persons in a service system is not very interesting, though commonly published.

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