8. THE TRAINABLE MENTALLY RETARDED Kirk (1972) defined the trainable mentally retarded child as one who, because of subnormal intelligence, is not capable of learning in classes for the educable mentally retarded but who does have potential for learning (1) self-care, (2) adjustment to the home or neighborhood, (3) economic usefulness in the home, a sheltered workshop, or an institution. Other terms used to denote the trainable child are "imbecile," "semi-independent," "severely retarded," "middle-grade defective," and "child with an IQ between about 25-50 (p. 221). Kirk (1957) surveyed programs provided for the trainable mentally retarded and found the following formulation which is widely accepted today for classifying this type of child. A trainable child is one who (1) is of school age; (2) developing at the rate of one-third to one- half that of the normal child; (3) of retarded mental development to such an extent that he is ineligible for classes for the educable mentally retarded but will not be custodial totally dependent or require nursing care throughout his life; (4) capable of learning self-care tasks; (5) capable of learning social adjustment in the home or in the neighborhood and learning to share, respect property of others, and cooperate in a family unit and with neighbors; (6) capable of learning economic usefulness in the home and neighborhood by assisting in chores around the house or in doing routine tasks in a sheltered environment under supervision, even though he will require some care and economic support throughout his life (p. 222). Three studies, (Coxe, 1956; State Department of Public Education, 1955; & Office of the Superintendent of Public Instruction; 1954) found that approximately two to four children of the trainable type are present in a population of 1000 school children in the United States. Birch et al (1970) reported a study made in Aberdeen, Scotland for children with IQ's below 50. His prevalence rate was 3.7 per 1000 school-age children. He compared his figures with other studies and found a surprising consistency in prevalence rates with previous studies in the British Isles and in the United States. He found no difference in prevalence rates between high and low socioeconomic levels for children with IQ's below 50, but found a marked relationship between socioeconomic levels and frequency of educable mentally retarded between 60 and 75 IQ. The prevalence rate for educable mentally retarded was 11.1 per 1000 school-age children for the highest social class, and 43.3 per 1000 for the lowest social class (p. 34). The original purpose of most of the institutions was to train the mentally retarded and return them to the community. Admissions to most of the public institutions consisted of children with all grades of mental defect. Goldstein (1959) tabulated the first admissions of individuals into institutions from 1900 to 1952 and found that from 1922 to 1939 the institutions admitted approximately 45 percent morons (educable), about 30 percent imbeciles (trainable), and approximately 17 percent idiots (totally dependent). By 1952 the picture had changed. The moron group had dropped to approximately 35 percent while the imbecile group had increased to 37 percent and the idiot admission to over 20 percent. Farber (1968) found that by 1963 the moron (educable) group of first admissions had dropped to 23.5 percent as compared to 45 percent earlier. The percentage of first admissions who were in the imbecile (trainable) group remained the same, while those classified as idiots (totally dependent) rose to 25.2 percent. These figures indicated that the residential institutions were gradually becoming less like training institutions, as they were originally intended to be, and more like hospitals or life-care institutions. As communities incorporated more retarded children into their schools the rate of commitment to institutions tended to decrease. Henderson (1957) found this tendency among educable mentally retarded children in Illinois institutions. He also found that the educable child who was sent to an institution from a community was usually dependent or delinquent. Controversy developed after WWII regarding how best to care for these children. Institution waiting lists became longer and longer, but the government was not willing to continue to build sufficient facilities to train all of them. Many parents began to keep their children at home instead of sending them away to institutions. During the 1950's parents who had continued to keep children at home became upset with the educational systems, and demanded that because they paid taxes, their children should be adequately taken care of by the system. The controversies of the 1950's, the activities of the National Association for Retarded Children, and Federal involvement in programs for the mentally retarded resulted in major community developments in the form of research and service to trainable mentally retarded children. Some of these were: 1. Public School classes. 2. Private Community Preschools. 3. Sheltered Workshops. 4. Diagnostic Evaluation clinics. 5. Comprehensive Community Facilities (Kirk, 1972, pp. 226-227). In 1970, the Federal Congress amended Public Law 88-164, changing the name from Mental Retardation Facilities and Mental Health Centers Construction Act of 1963 to Developmental Disabilities Services and Facilities Construction Act of 1970 (P- L 91-517). As criteria for admission became more clearly delineated and as the objectives were better understood, the programs became more meaningful. The admission requirements for school classes for trainable children have been formulated in many states. The following represent those generally in effect. 1. Admission age is 6. 2. The usual IQ range for these classes is between 30 or 35 and 50 or 55 and the IQ's are derived from such tests as the Stanford-Binet Intelligence Scale. 3. Most children admitted into the classes are required to have a medical examination to determine their physical ability to participate in the program. 4. Not all children with IQ's between 35 and 50 are admitted. Other criteria include the ability to take care of personal bodily needs and getting along with others. 5. Children must have minimum communication ability in the form of either speech or gestures. 6. The general procedure for admission is to have a committee composed of a psychologist, a social worker, teachers, and other school personnel accept or reject the children. The size of the classes varies from six to fifteen. Transportation is provided by the community for the children. Teachers in the past were not required to possess special qualifications, but in the past decade, this has changed considerably. The goals of the curriculum are: 1. Teach self-help, self-care. 2. Make adequate social adjustment in the home and neighborhood. 3. Become economically useful. Elements of the curriculum can include: 1. Modified reading. 2. Basic mathematics like counting. 3. Arts and Crafts. 4. Dramatization. 5. Physical hygiene. 6. Language. 7. Mental Development. 8. Practical Arts. 9. Motor Development. 10. Self-help. 11. Socialization. 12. Social studies. 13. Music. Kirk (1972) concluded that comprehensive community programs have not been in existence long enough for research to determine their overall effectiveness.