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Dr. GALLAGHER. That is right. This example was for the mentally handicapped.

Senator YARBOROUGH. Would you tell us what some of these research projects are?

Dr. GALLAGHER. I might mention a few.

Senator YARBOROUGH. I would think it would be well to file a list with the committee. At least, file with the committee staff.

(The material referred to may be found in the files of the subcommittee.)

The CHAIRMAN. We will have that information. Just give us a few now, and you can submit the rest.

Dr. GALLAGHER. Well, there is one at the University of Illinois called "The Principles of Programed Learning Materials and Self-Instruction Devices for Mentally Retarded Children." This, in effect, means that the youngsters are able to use and know how to make use of materials that are on machines so the teachers are free to work individually with youngsters who need special help. These youngsters can go on and respond to a training program that is given on a console, like a television set. This project was to develop materials that would go on this set.

At North Carolina State they are doing a study on cognitive training with retarded children. One of the things we have found over the last couple of decades is that perhaps we have-maybe we have been too pessimistic about the degree to which the retarded youngster can respond to direct intellectual stimulation. So this project is for the development of materials that are designed particularly to study the intellectual abilities of the youngsters, not just to teach them in the area of social studies or arithmetic, but actually to stimulate the basic intellectual processes themselves. This is a long-range project, which attempts to develop materials which are put in sequence so the teachers can give these youngsters special training.

We have another kind of study, comparisons of the differences in abilities between children with normal and defective hearing.

Senator MURPHY. Incidently, I have a friend in New York that I have known for, I guess, 7 years, and I did not know that he had been stone deaf from birth. He was president of a very important bank in New York, and he had a frightful time because he could tell all the conversation in the room.

The CHAIRMAN. You had to be very careful what you said about him. Senator MURPHY. He came one time-there was a contest between two banking organizations and Paramount Pictures, and they said do not worry, he can't hear. Little did they know; it is amazing.

Dr. GALLAGHER. We have some others which would investigate the ability of blind students to listen and to use their hearing apparatus most effectively. An interesting study concerns the possibility of stimulating new visual abilities of children educated as though they have no vision-children who read Braille. We have, as you know, many youngsters who are called blind but who still have residual vision which has been virtually unusable. It is an interesting thing for us to investigate as to what extent they can use the vision that remains. The same can be said for youngsters who are deaf. That does not mean that they cannot receive some sounds and might be able to profit from education using new kinds of amplification devices. This is trying to

stimulate the usable remainder of ability which has been damaged, as well as trying to compensate by developing other organs.

Senator YARBOROUGH. Dr. Gallagher, I assume you already have developed or are developing tests to measure the degree of mental retardation?

Dr. GALLAGHER. Yes, in addition to the usual methods of measuring intelligence, we have some research which allows us to look more thoroughly at the particular ways the retarded child is hampered in learning, such as memory, or perceiving relationships, and so forth. Dr. LEE. There is another important aspect to this, Senator Yarborough, in many of the projects that the Office of Education has supported, and that is building an evaluation component so they can evaluate the effectiveness of one method versus another and determine in these new research areas which methods we need to continue and disseminate widely and apply which are not successful. A very good friend of mine is involved in such a project in the District this summer, and they are now extending it. They got the idea of using art would be a way to reach the kids with apparently normal intelligence but impaired learning for a variety of reasons, and this is now very carefully evaluated to see if this approach, which is a very wise and neat one, is the way to interest this intellectual process to capture the imagination and stimulate it so that they can then learn in other areas. I think that this is just one example of a very important element in many of these projects. This is just research for the sake of research and is carefully evaluated to find the most effective means of doing the job. Senator YARBOROUGH. I think that is very valuable, Doctor, and I congratulate you on this evaluation. I think this research into the degrees of deafness and of how and to what degree vision is impaired is important. I think it is valuable to have in the record a report of the research being conducted. There is too great a tendency today to subjugate all of our vital domestic endeavors to the involvement in Vietnam. In the last 10 years we have made a good start in many important areas, including health, but now some are ready to destroy that start by withholding necessary money. Frankly, I think it is more important to build America than to destroy Vietnam.

I have no further questions.

The CHAIRMAN. Do you have any further questions?
Senator MURPHY. I have no further questions.

The CHAIRMAN. We want to thank you all very much.
Dr. Martin, from Alabama, that includes you, too.

This is very fine testimony.

Now, Dr. Charles D. Barnett, deputy commissioner, Mental Retardation Services, and secretary, National Association of State Coordinators of Programs for the Mentally Retarded.

Senator YARBOROUGH. Mr. Chairman, I would like to note that my State is fortunate not only to claim this witness as a Texan, but also in the fact that under the Hogg Foundation at the University of Texas work has long been going on in this field of mental retardation under a grant left by the family of Gov. James Hogg, who was rated as one of the two greatest Governors of Texas. Some historians say that Governor Hogg and Sam Houston were the two greatest in history. Certainly, they were preeminent, Hogg having been Governor in the early 1900's at the time of the great populist movement in the United

States. After he retired from the governorship, he farmed the gulf coast, struck oil and left an immense fortune. His children left this fortune to the University of Texas for a foundation to be concerned primarily with mental retardation.

So, under this grant, Texas is one of the early States to work in this field, and we are proud of the fact that Dr. Barnett comes here so highly qualified representing one field in which we feel our State has made a fine contribution.

The CHAIRMAN. All right, Doctor, go ahead.


Dr. BARNETT. I appreciate Senator Yarborough's kind remarks. As I look around the room here, I would like to have in the recordand, of course, I speak from a little different point of view than the people who preceded me. We are the implementers of the legislation and the resources that the legislature makes available to the States. We have been very deeply appreciative of this and very grateful for the excellent leadership that is being given and has been given at the Federal agency level, and I would be remiss if I did not point out the honestly good work that Miss Switzer is doing now and has done in the past; and Dr. Robert Jaslow, who is here, and all of his staff, and certainly Dr. Gallagher's office, and all the agencies that we deal with through our regional offices.

I might also say that we are fortunate in Texas to have a very fine regional office in Dallas.

In order to have some perspective on what this legislation means to a State, and Texas in particular; I would like to comment just briefly. and I have submitted to the committee an official statement.

I would like to comment as to some of the points here.

The CHAIRMAN. We have your statement. You may make such comments as you see fit.

Dr. BARNETT. I think, by any measure, I would like to comment or this.

(The prepared statement of Dr. Barnett follows:)


Mr. Chairman, distinguished Committee members, my name is Charles D. Barnett, and I am Deputy Commissioner for Mental Retardation Services in the Texas Department of Mental Health and Mental Retardation, Austin, Texas. It is my pleasure to represent our Commissioner, John Kinross-Wright, M.D., and the Chairman of our Board, Horace E. Cromer, M.D., in basic support of H.R. 6430, the "Mental Retardation Amendments of 1967." Additionally, and in the capacity of Secretary, I have the honor of representing the National Association of State Coordinators of Mental Retardation Programs, Bert W. Schmickel of Hartford. Connecticut, President. The National Association of State Mental Retardation Program Coordinators also supports H.R. 6430, and in the comments that I shall now make, I represent both this Association and the Texas Department of Mental

Health and Mental Retardation. Although most of my comments will be directed to H.R. 6430, I will also comment briefly on S. 1099 (Hill) and S. 389 (Javits), since I feel these companion bills both offer specific points of considerable merit. From almost any vantage point, Texas has a king-size mental retardation problem. It is estimated that approximately three percent of the State's population is directly affected by this condition which means, theoretically at least, that there are some 300,000 individuals in our State who are afflicted with mental retardation. If we consider the numbers who are both directly affected as well as those immediate family members who are intimately involved with the mental retardation, the total number swells to an estimated ten percent of the population, or over one million persons. As we look at the various Texas State agencies having responsibilities for programming for the mentally retarded-and these include our Texas Education Agency, Texas State Department of Health, Texas Department of Mental Health and Mental Retardation, and the Texas Department of Public Welfare-an enumeration of known mentally retarded individuals being served by these various agencies reveals that only about fifteen to twenty percent of the estimated 300,000 individuals who are thought to be retarded are now being served in ongoing programs of one type or another. Even if one concludes that the three percent figure is high and that in actuality some smaller percentage of the retarded population in our State, or in any State for that matter, actually requires special services, we would still have to conclude that a sizeable portion of those mentally retarded individuals who are in need of services are not receiving them at this time. There are undoubtedly many reasons for this state of affairs, but probably one of the most prominent is simply the fact that Texas, like many states, until recent years has focused primarily upon the institutional approach to meeting the problems of the retarded. However, the experience of recent years has shown that such an approach is undesirable from a humanitarian point of view, uneconomical from a fiscal point of view, and is virtually impossible from a logistical point of view. In short, we have come to realize that the continued construction of institutional beds can never adequately and fully deal with the mental retardation problem but, rather, that increased emphasis on the development of a broad array of services for the retarded and their families at the community level is required. Such an approach does not place the residential institution in a polar position with community programs but views the residential center as an integral and catalytic part of the "continuum of care" which the retarded and their families require.

Let me cite some specific figures to assist in more clearly defining the problem that we are facing in Texas, and then I would like to mention briefly some of the approaches that we believe to be possible in coping with the situation. During the seven-year period of 1960 to 1966, the Texas Department of Mental Health and Mental Retardation received 10,767 applications for admission to its then existing six residential facilities or Special Schools as we call them in Texas. During this same period we actually admitted some 7,000 individuals to our institutions, this being largely made possible by an intensive construction program which added new beds at a number of locations throughout the State. Despite this increased admission activity, new applications continue to come into our Department at a rate of 1,200 to 1,500 annually, and we currently find ourselves with a waiting list of 1,500 completed applications, with another 400 applications pending completion. Based on our present care and treatment cost, we conservatively estimate that every eight admissions to a residential facility will eventually commit the Texas taxpayer to approximately $1 million in long-term support and maintenance expenses. This means, for example, that the 7,000 individuals admitted during the period 1960 to 1966 will eventually cost the State of Texas in the neighborhood of $875,000,000, and it means that the current waiting list of 1,500 represents an additional investment of over $200,000,000. One quickly notes that the total potential commitment entailed by the 7,000 admissions in the period 1960 to 1966, plus the waiting list population as it now stands, represents a total commitment of the Texas taxpayer of in excess of $1 billion—an awesome sum, to say the least.

Yet, recent studies conducted by our Department indicate that beyond a shadow of a doubt there are many individuals coming into our institutions who simply do not need to be there. For example, approximately fifty-three percent of the 876 applications to the Austin State School last year involved individuals whose intellectual functioning fell in the mild to moderate range of retardation. These individuals can and ordinarily should be cared for in their respective communities in proximity to their family and homes if (1) an adequate array of services is

available; (2) if these services and programs are staffed by a sufficient number of professional and technical-level personnel who are adequately trained to carry out their assignments; and (3) if there is available a continuing and stable source of support monies. The necessary services I refer to include diagnosis, parent counseling, day care programs, preschool training, special education, prevocational training, sheltered employment, and a host of other individualized services which, depending upon the retarded individual's age and needs, can be brought to bear on his situation. All three prerequisites for the development of community programs are directly related to and are supported by the “Mental Retardation Amendments of 1967."

This year the Texas Department of Mental Health and Mental Retardation will spend in the neighborhood of $25,000,000 on its programs for the mentally retarded. These programs include direct services to some 11,000 residents of six existing Special Schools, along with an array of commitments to an evolving network of community programs. As such, the Department is the official mental retardation authority in the State of Texas, and we are the agency which administers the mental retardation facilities construction monies. Additionally, we presumably would be the agency which would administer any mental retardation staffing monies that might be forthcoming. As an agency, we are deeply committed to and strongly believe in the partnership arrangement whereby local serv ices and programs are initiated and funded through the cooperation of and interaction between local, state, and federal resources. We have enjoyed an excellent and productive relationship with our Region VII HEW Office in Dallas and especially with Dr. Robert Jaslow's Mental Retardation Division in the new Social and Rehabilitative Service Agency here in Washington. We have been amazed and grateful for the outstanding leadership role played by these key mental retardation groups, despite severe staffing and program support limitations.

Essentially, the Department has five chief means of delivering services to the retarded and their families or for participating in the catalyzation process which leads to the services being rendered. The media for providing these services include: (1) the provision of direct services by various programs operated out of our central administration in Austin; (2) the provision of direct services as may be provided by our various residential centers either on a direct basis or through numerous satellite programs; (3) contractual arrangements with various private and public organizations, agencies, and individuals for specific service programs; (4) a system of State grants-in-aid to locally organized and established boards of mental health and mental retardation; and (5) the administration of available federal support programs, such as community facilities construction and staffing. You will have to pardon me for sounding like a Texan, but please believe me when I say that the problem of delivering services to a State with 254 counties and in which almost two-thirds of the total State's population reside in twenty-one urban areas separated, for example, by such distances as 864 miles between El Paso and Texarkana or the 658 miles from Amarillo to Port Arthur, is no small chore. Nor is there any single approach which can be identified as the most effective for all areas and for all populations. A customized approach is called for, and this is true in all states. Yet, certain commonalities and similarities do exist in both problems and approaches; hence, H.R. 6430 does have certain projected benefits for all of our states. Obviously, a combination of approaches is called for.

Since time will not permit any further elaboration on these points, let me summarize thus far by saying that the primary thrust of mental retardation programs in all states is to the community level and that the provisions of the "Mental Retardation Amendments of 1967" will significantly enhance the movement toward realization of strengthened programming at the community level. I would now like to comment brifely on several of the specific sections of H.R. 6430, and in so doing, point up several specific amendments that the Texas Department of Mental Health and Mental Retardation as well as the National Association of State Program Coordinates for the Mentally Retarded feel are worthy of your consideration.

Relative to Part B of H.R. 6430, Project Grants for Construction of UniversityAffiliated Facilities for the Mentally Retarded, we applaud the extension of this program and the proposed increase in funds for fiscal years 1969 and 1970. It seems clear that, if we are to meet adequately the mental retardation problem and if we are to progress to the point of developing an adequate array of services at the community level, a significant number of new manpower training

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