Now frankly, sir, the answer to your question is, "Yes." I think some of our scientists ought to immediately stop watching and treating the sick and go into a country where they are building finer thoroughbreds and find out how. I do not think we should spend another tax dime for patching up holes in the wall. With Federal funds we ought to get ahead of the man or condition that is making the holes. Isn't this the intelligent way to approach the problem? I think this is what the people in your district expected you to do when they sent you to Congress and paid your salary, take time to find out about these things and do this for the country as a whole.

Mr. O'BRIEN. Perhaps I might be a better judge of what my people in my district had in mind when they sent me to Congress and paid my salary, but I am very sure of one thing: If I were to report back to them tomorrow that I was supporting this bill in turn for a visit to the beautiful Utopia that you mentioned, they would have a new boy here.

Mr. MILLER. Mr. O'Brien, I did not recommend that you go. If you will check back in the record, I recommended that we send a qualified group of scientists, people who can evaluate this, send them in there to find out if the story is true to start with.

Art Linkletter gave national publicity to it, yet nothing was ever done by the Government. It seems to me that if we have the possibility of a country that could put 100 out of 100 of their boys when they became of military age into the military service because they all have a full set of teeth, they are mentally sound, they are good, strong men, they are not delinquent, they do not have a jail record. I frankly think your constituents would be delighted if you drew that to their attention.

Mr. O'BRIEN. I recall Mr. Linkletter was down here not too long ago in connection with the polio drive, I believe it was. I do not recall that he recommended at that time that we stop contributing to that fund and study why they did not have polio in this mythical kingdom. Mr. MILLER. Well, I am not defending Art Linkletter's application of the knowledge that was available to him, but I believe frankly that we should find out why they have no polio in Hunza.

Mr. ROBERTS. Gentlemen, I would like this to be pursued on some rainy afternoon. I have to help this very fine gentleman, Mr. Fitzpatrick, meet a train schedule.

Mr. MILLER. Thank you very much, Mr. Chairman.

Mr. ROBERTS. Mr. Fitzpatrick, I have a note from Mr. Nelsen who had to leave because of another commitment. He wanted to be here during the time you testified. There are certain communications which he left with the Chair with reference to your testimony which we will put in the record.

I understand you are up against a 5 o'clock train schedule. We will try to get you down there on time.

You may proceed with your statement, Mr. Fitzpatrick.

Mr. FITZPATRICK. I might say preliminarily to my statement that I am pleased to be before this committee. I know something of you, Mr. Chairman, from my friends in Alabama. I am particularly pleased to be before you. Of course I can't help saying that I like the name O'Brien, similarly. And a neighbor of mine is Mr. Nelsen.

STATEMENT OF DR. GUNNAR DYDWAD, EXECUTIVE DIRECTOR, NATIONAL ASSOCIATION FOR RETARDED CHILDREN, NEW YORK CITY, AND VINCENT J. FITZPATRICK, CHAIRMAN, GOVERNMENTAL AFFAIRS COMMITTEE

Mr. FITZPATRICK. On behalf of its more than 1,000 member associations throughout the country, the National Association for Retarded Children wishes to go on record in strong support of H.R. 3689, the Mental Retardation Facilities Construction Act of 1963, introduced February 11, 1963, by Representative Harris for the purpose of assisting States in combating mental retardation through construction of research centers and facilities for the mentally retarded. Since its inception, the National Association for Retarded Children has emphasized the need to develop and strengthen research in the area of mental retardation. In spite of the fact that at that time, in the early 1950's, there was everywhere in the country a crying need for services and facilities for the care, treatment, training, and education of the mentally retarded, the leadership of the national association recognized that, looking at the problem from a long-range viewpoint, an active program of research on causes and treatment could not be delayed.

Therefore, in 1953, the National Association for Retarded Children established a scientific Research Advisory Board, which became the first broad interdisciplinary mental retardation research body in the United States.

It was recognized that the immediate major concern was to stimulate interest in the problem of mental retardation on the part of leaders in the scientific community. Closely related was the task of assessing past and existing research efforts and of blueprinting mental retardation research needs.

The National Association for Retarded Children, with assistance from private foundations and Federal agencies, requested the Scientific Research Advisory Board to initiate a 3-year study. It was conducted by Doctors Masland, Sarason, and Gladwin during the years 1955 to 1957, and the results were published in 1958 in the volume "Mental Subnormality," which has since became a landmark in this field.

Following the publication of this 3-year study, the National Association for Retarded Children established the NARC Research Fund, and in line with the needs pointed out by the study, the fund concentrated on the establishment of research professorships in a variety of university centers.

I have sketched out this history, Mr. Chairman, not only to indicate our longstanding interest in the area of research, but also to emphasize that a stage of development has now been reached where we must move on to more comprehensive efforts involving larger, multidisciplinary research teams as well as more adequate laboratory and clinical facilities.

It is for this reason that we consider as particularly timely the provision of title I of H.R. 3689 pertaining to grants for construction of centers for research on mental retardation and related aspects of human development. Once again we hope Congress can take action which will break new paths in this so long neglected field.

The past several years have seen exciting new scientific developments in the field of mental retardation. A few years ago, talk of a preventive program in mental retardation would have been considered visionary. Today, preventive practices in mental retardation are firmly established the question is how far our growing knowledge will take us and how fast a rate of progress we can achieve.

At this very time, with funds of the U.S. Children's Bureau, an extensive program of testing newborn babies for phenylketonuria (PKU) is in process in a large number of States. In Massachusetts, where the State health department has gained the full cooperation of all private and public hospitals, during the course of the past several months eight infants have been detected as suffering from PKU and by prompt application of the diet which effectively curbs this dread disease, these eight infants have been saved from serious mental retardation.

It is of particular satisfaction to us that one of the grants which supported Dr. Robert Guthrie in the development of this new screening test came from the Research Fund of the National Association for Retarded Children. Dr. Guthrie is presently engaged in exploring how the principle used in this new test may be used to develop other tests to detect other types of metabolic disorders which also lead to severe mental retardation.

Equally remarkable has been the discovery of deviations in the chromosome structure of persons afflicted with Downs syndrome (Mongolism), another serious form of mental retardation. However, as yet, the new information merely affords us a better understanding of the causes of this affliction but there is good reason for hope that eventually we will find leads which will make prevention possible as specifically as is already the case with regard to PKU.

Other important new scientific discoveries have been in the area of the peculiar ways of learning characteristic of mental retardates and of the disturbances in their perceptual processes.

These striking advances underline that we no longer can be contented with support of the individual research scientist. The magnitude of the problem of retardation and the range of related research efforts it requires demand establishment of research centers so that maximum benefit may be secured by the interplay of the biological and social sciences.

Thus, Mr. Chairman, the program of Federal grants this bill foresees is indeed the next essential step. Much as we hope to gain the interest and cooperation of many of our State and private institutions of higher learning, and other research centers, they obviously will need financial aid to establish in this new field of inquiry that kind of appropriately designed, staffed, and equipped research facility deemed essential.

I might say, parenthetically, that I was very much heartened that the report of the President's Panel on Mental Retardation recommended that high priority should be given to developing research centers on mental retardation, not only at strategically located universities but also at institutions for the retarded.

As president of the board of trustees of the Hamburg State School and Hospital, a Pennsylvania State institution for the retarded, I very much welcome this reference to institutions. It is my hope that

this subcommittee agrees that the language of section 721, title I, of H.R. 3689 includes among possible recipients of grants selected institutions for the retarded that have developed an effective research program under the direction of competent scientific investigators. If we want to create better, more effective institutions, if we want to change them from mere storage houses to centers of treatment and prevention and rehabilitation, then we must make it possible for these institutions to attract outstanding professional personnel. Incorporating research facilities into our institutions will have that result. Likewise, we are grateful, Mr. Chairman, that title I includes social and behavorial research along with biological research and medical studies. The President's Panel on Mental Retardation has presented ample evidence as to what extent mental retardation is linked to nonmedical causes and to what extent we need to establish, on a scientific basis, new approaches to the education and vocational and social adjustment of the retarded. The availability of Federal grants will be particularly welcome in these fields where we have far fewer established research centers than in the biological sciences.

Gratified as we are at the prospect of mental retardation research centers, funds for this purpose will be of little avail unless sufficient appropriations under existing statutory authority to the various agencies of the Department of Health, Education, and Welfare are available to help in manning these centers in the various States. Indeed, the question may well be raised whether title I of the bill under discussion here would not have been vastly more effective if it would have provided not just for construction grants but also for core staff, much as H.R. 3688 provides for this in the grant to community mental health centers. I want to thank you, Mr. Chairman, for your com

ment.

In summary, then, we feel that title I with its relatively small grant program of $30 million, spread over a 5-year period, will pay substantial dividends in accelerating the probing of a vast area in mental retardation where we have as yet only the most meager clues as to causes or methods of detection and prevention.

President Kennedy in his message to Congress of February 5, 1963, highlighted the tremendous economic burden which mental retardation imposes on the Nation. Considering the high cost of maintaining the severely retarded individual over his lifetime, it is indeed quite feasible to say that if, for each year the title I program is in effect, 100 new cases of severe retardation can be prevented, Mr. Chairmanjust two cases for each of the 50 States-you will have recouped your investment.

TITLE II-GRANTS FOR CONSTRUCTION OF FACILITIES FOR THE MENTALLY

RETARDED

Many of the institutions where retarded children and adults receive care are obsolete, having been constructed in an era when there was insufficient knowledge of proper methods of care, education, training, and treatment of these individuals.

For the severely and moderately retarded who reside in the community, the situation is even more serious because in most parts of our country there is an almost total lack of facilities, let alone adequate

ones.

The National Association for Retarded Children is grateful that title II of H.R. 3689 makes broad provision for grants supporting construction of needed facilities for the mentally retarded. It is to be hoped that the actual appropriation under this bill will be substantial enough to permit a large number, if not all of the States, to avail themselves of this badly needed assistance.

We welcome in particular that in section 204 (a), item 7, provision is made for minimum standards (to be fixed at the discretion of the State) for the maintenance and operation of facilities receiving Federal aid under this title, and we hope that this shall be interpreted to include standards for staffing.

We also welcome, in section 203 (c) the provision that the Federal Hospital Council shall prescribe by regulation for facilities of different classes and in different types of locations, general standards of construction and equipment. This provision should remedy the source of many complaints that under the Hill-Burton Act administration, many mental retardation facilities were strait-jacketed by insistence on Federal regulatory requirements that did not fit the needs of the mentally retarded, no matter how appropriately they were when first issued.

Here, as in other areas, it must be emphasized and reemphasized that the needs of the mentally retarded differ in many and substantial ways from the needs of the mentally ill. Federal and State planning and regulations must reflect this difference.

One can no longer permit mentally retarded children and adults to be cared for under programs once designed for the mentally ill but by no means appropriate for the mentally retarded. It is fortunate indeed that H.R. 3689 recognizes that expertness in the field of mental illness does not necessarily include expertness in mental retardation.

We would also like to express our appreciation that this bill provides for consumer representation, that is, inclusion of parents of retarded children on both the Federal Hospital Council (section 212(a)) and the proposed State advisory councils (section 204 (a)). Certainly the great achievement of hundreds of associations for retarded children across the country in demonstrating effective new methods of training and treatment of the mentally retarded suggests that their advice and counsel be sought.

A good feature of title II of H.R. 3689 is the provision for combining specified portions of allotments of one or more States with another State to make possible construction of a facility these States can use jointly. For our less populated States, this feature will be most useful in implementing needed, small, specialized services (section 202(b)).

While in general our association is wholeheartedly in support of this bill, there are two parts to which we have to raise specific objections:

Section 211(b) lists "custodial care" as one of the purposes for which funds under this bill would be available. The National Association for Retarded Children does not believe that the relatively limited amount of money to be made available through H.R. 3689 should be used for custodial care. While we realize that in many of our States we can expect only a rather slow discontinuation of this