The Good Word

The “R” Word

How do you avoid saying “retarded”?

We’ve been hearing an awful lot about retarded people lately. More precisely, we’ve been hearing about a certain subset of mentally retarded people who live on death row. The recent interest in the fate of mentally retarded convicts has launched a bevy of headlines like this from the New York Times in June: “Jeb Bush Signs Bill Barring Executing the Retarded.” On television, we’ve heard Ed Bradley, filling in for Dan Rather on the CBS Evening News earlier this month, refer to “retarded killer Johnny Penry” and “retarded criminals.”

What’s striking about all this attention is that the word “retarded” has fallen from favor—and not just among the PC crowd. Though it’s still a clinical term used, somewhat begrudgingly, by psychologists to describe people who score lower than 70 on IQ tests, almost everyone in the developmental-disability field thinks it’s demeaning and wants a new word. Just last May, for instance, the American Association on Mental Retardation, the leading advocacy group for the, um, mentally retarded, voted to change its name. But no one could agree on the replacement, so the group simply pledged to change it to something better—less pejorative, less likely to bring schoolyard epithets to mind. And in August at the American Psychological Association’s annual convention, the group’s panel on Mental Retardation and Developmental Disabilities (called Division 33), will likely drop the “R” word from its name. “There will be a discussion,” says Philip Davidson, Division 33’s president-elect, “and I suspect it will be put to a vote and that it will pass.” The smart bets for an eventual successor are on “intellectual disability,” the term used in Europe. But competitors abound (many dislike the word “disability”), and the issue is far from settled.

“I don’t think there are any questions about the moral and ethical side to this,” says Davidson. “I think everyone recognizes that mentally retarded is a negative term.” Of course, it’s a step up from “moron,” “imbecile,” or “idiot,” which were actually codified as appropriate technical terms in 1910 by the AAMR, then known as the Association of Medical Officers of American Institutions for Idiots and Feeble-Minded Persons. (Morons were the brightest, followed by idiots and imbeciles.) The AAMR replaced those terms with “mild,” “moderate,” and “severe” retardation in 1959, but the old words did not go quietly: Davidson recalls attending a guest lecture in graduate school in the 1970s where the speaker, an esteemed professor in the field, discoursed on “low-grade imbeciles.” (The professor was not invited back.)

There are fine gradations of usage when it comes to the term “mental retardation,” and some are more cringe-inducing than others. The lowest of the low is the simple “retard.” You will never hear Ed Bradley say, “Jeb Bush signed a bill barring the execution of retards.” The least worrisome version is the abstract: “the mentally retarded” or “mental retardation.” Activists and physicians also prefer what they call “People First Language,” which is supposed to emphasize a person’s individuality: People aren’t mentally retarded, they are individuals with mental retardation. Yet these subtleties still tend to escape even advocates on behalf of people with mental retardation. Davidson recently consulted on an amicus curiae brief the American Psychological Association has filed with the Supreme Court in the case of a mentally retarded North Carolina death-row inmate named Ernest P. McCarver. “In the McCarver brief, every single time the lawyers referred to developmental disability, they said ‘the mentally retarded,’ ” he says. “I said, ‘Come on guys, you gotta change this.’ And they did.”

If everybody hates the word, why is it still around? Is anybody pounding on the table in support of “retarded”? Well, yes. Changing the name, many point out, could create problems for the government programs that serve the mentally retarded. For instance, people who have been diagnosed as mentally retarded currently qualify for Supplemental Security Income. Will they still qualify if their doctor changes the diagnosis to intellectual disability? “I don’t think we’re going to accomplish anything other than screw[ing] up our public programs that help these people,” says James A. Mulick, an Ohio State University pediatrics professor and Division 33 member who opposes changing the name. The APA’s Davidson supports getting rid of “retarded” in popular parlance, but wants to continue using the word in diagnostic circles for the same reason. ” ‘What’s intellectual disability?’ ” he says, impersonating a hypothetical HMO executive. ” ‘We only cover mental retardation.’ “

Three years ago, organizations involved in serving the needs of the mentally retarded, including the AAMR, Division 33, and the Social Security Administration, formed an ad hoc committee—rather creepily called the Consortium on Language, Image, and Public Education—to hash out just such issues and come up with a plan for moving away from “retarded.” The group announced in May that, for the time being, there’s no better clinical term than “mental retardation,” but that “retarded” should be dropped from popular parlance and replaced with something better (a particular term, not surprisingly, is not forthcoming). The consortium is now devising a media campaign to persuade two crucial consituencies—pre-teens and copy editors—to strike “retarded” from the insult registries and stylebooks.

But any psychologist will point out that changing the name is, in the end, folly. Whatever new term comes into favor today will seem insensitive, or worse, tomorrow. A nation of 10-year-olds has pretty much exhausted the pejorative power of “retarded” and is eagerly awaiting a new state-of-the-art insult. (The AAMR actually went through this before: In 1973, it switched its name from the American Association on Mental Deficiency to its current appellation because “deficiency” implied, well, deficiency. And retarded, at the time, did not.) The current frontrunner, “intellectual disability,” even contracts nicely to ID, which can become a cousin of LD (for learning disability), which served as a choice epithet among the circles I ran in in fifth grade. Steven Warren, the president of the soon-to-be-differently-named AAMR, admits that whatever term his organization comes up with, all the little boys who have crushes on little girls and so call them “retarded” will be quick on its heels. In other words, the AAMR will almost certainly be going through an identity crisis again in 20 years, just to stay ahead of the game.