Abstract
History on PWID indicates influence of various psycho-social, biological, religious and educational factors for the existence of stereotypical attitudes towards PWID. Across the world until the mid-80's they were a marginalized group of people who were discriminated from others' who considered themselves as “normal”. But since the early part of the 21st century significant efforts have been reported across countries in integrating and mainstreaming the PWID in the community at large. To attain this challenging milestone attitude plays a very significant role. Families of PWID undergo high levels of stress and emotional reactions resulting from daily care demands, emotional distress, interpersonal difficulties (family discord), financial hardships as well as social isolation which call for intervention not just for the intellectually disabled but also with the family members. Positive attitude among the health and all professionals with humane qualities such as empathy, genuineness, unconditional positive regard towards the PWID leads to positive expectation and better outcome. Interestingly in developing countries stereotypes are based on ignorance and families find it extremely difficult to disclose the presence of Intellectual Disability (ID) as it is considered to be a ‘loss of face'' and is believed to tarnish the family reputation. Hence, families often adopt strategies to hide the existence of a disability, which in turn delays the treatment, and rehabilitation of PWID. Along with parents and family members other stakeholders like siblings and relatives, teachers, educationists, health professionals and general public's attitudes towards them are highly influential factors for their rehabilitation and integration in the mainstream community. Hence, this chapter is an attempt to focus on the importance of attitude that determines the course towards acceptance of PWID. The authors' focus is on the various perceptions towards intellectual disability and the implications of the favorable and unfavorable attitudes towards PWID since the Egyptian era in developed and developing nations. Further, the recommendations provided are for the policymakers and stakeholders to design intervention programs to alter people's attitude towards acceptance and compassion towards PWID. This is believed to help in their rehabilitation, and integration into the society at all levels and thereby reduces the prejudice and discrimination towards them.
TopAttitudes Towards People With Intellectual Disabilities (Pwid) In The Earliest Centuries
Egyptian Papyrus of Thebes in 1552 B.C. (Harris 2006) was the first to refer to ID. Attitudes in the earlier times were delimited by religious and spiritual explanations. The ancient Greeks and Romans before 18th century believed children with ID are the cause of curse by god who were allowed to die while some societies in Rome did allow some form of protection to children with ID who were born to the wealthy, by allowing them with right to property and also to have guardians (Beirne-Smith et al. 2006; Harris, 2006). Traditionally, in Indian context mental retardation (MR) or intellectual disabilities (ID) has been referred by Charaka and Susruta in Ayurvedaas as ‘manasmandyam’ (weak head) caused by genetic, nutritional and environmental factors and is influenced by ‘Graha’ (planetary influences). In the current scenario the past, present and future are attributed to supernatural powers and there is a strong belief in ‘karma’. Hence, disabilities have been considered punishments for sins committed in a previous life by the individual or their family members (Schlossar, 2004). Interestingly before the 18th century, societies differed in conceptualization of intellectual disability. Those with mild ID who were socially competent never received special identification or treatment, and those with more severe conditions received protective care from their families or in monasteries while few societies believed people with more severe ID to be capable of receiving divine revelation (Beirne-Smith et al. 2006; Harris 2006).
Jean-Marc Itard in 1799, first developed systematic and documented program of intervention for ID in France. Seguin elaborated on Itard’s methods and formulated a systematic program to educate the “feebleminded” at Salpetrière Hospital in Paris. Henceforth, the stakeholders in Europe worked towards educating PWID which received recognition and subsequently began to spread to other developed and developing countries. In the U.S., and other developed countries there was an initial optimism about rehabilitating, training, and reintegrating PWID into “normal” life. Positive attitudes prevailed and reformers like Dorthea Dix advocated improving treatment of people who were living in asylums, poorhouses, country homes, and almshouses in the mid-1800s. Samuel Howe in 1848 established the first public training facility in the U.S. for PWID and in the same year Hervey Wilbur established in his home the first private institution for PWID (Beirne-Smith et al. 2006) at Massachusetts. There were favorable attitudes during those times towards the PWID as mainstream education was the goal.