Several traditional terms denoting varying degrees of mental deficiency long predate psychiatry, but have since been subject to the euphemism treadmill. In common usage they are simple forms of abuse. Their now-obsolete use as psychiatric technical definitions is of purely historical interest. They are often encountered in old documents such as books, academic papers, and census forms (for example, the British census of 1901 has a column heading including the terms imbecile and feeble-minded).
There have been some efforts made among mental health professionals to discourage use of these terms. Nevertheless their use persists. In addition to the terms below, the abbreviation retard or tard is still used as a generic insult. A BBC survey in 2003 ranked retard as the most offensive disability-related word, ahead of terms such as spastic (not considered offensive in America) and mong.
Cretin is the oldest and comes from a dialectal French word for Christian. The implication was that people with significant intellectual or developmental disabilities were “still human” (or “still Christian”) and deserved to be treated with basic human dignity. Individuals with condition were considered to be incapable of sinning, thus “christ-like” in their disposition. This term is not used in scientific endeavors since the middle of the 20th century and is generally considered a term of abuse: notably, in the 1964 movie Becket, King Henry II calls his son and heir a “cretin.” “Cretinism” is also used as an obsolescent term to refer to the condition of congenital hypothyroidism, in which there is some degree of mental retardation.
Amentia has a long history, mostly associated with dementia. The difference between amentia and dementia was originally defined by time of onset. Amentia was the term used to describe an individual who developed deficits in mental functioning early in life, while dementia described individuals who develop mental deficiencies as adults. During the 1890s, amentia was used to describe someone who was born with mental deficiencies. By 1912, ament was a classification lumping “idiots, imbeciles, and feeble minded” individuals in a category separate from a dement classification, in which the onset is later in life.
Idiot indicated the greatest degree of intellectual disability, where the mental age is two years or less, and the person cannot guard himself or herself against common physical dangers. The term was gradually replaced by the term profound mental retardation.
Imbecile indicated an intellectual disability less extreme than idiocy and not necessarily inherited. It is now usually subdivided into two categories, known as severe mental retardation and moderate mental retardation.
Moron was defined by the American Association for the Study of the Feeble-minded in 1910, following work by Henry H. Goddard, as the term for an adult with a mental age between eight and twelve; mild mental retardation is now the term for this condition. Alternative definitions of these terms based on IQ were also used. This group was known in UK law from 1911 to 1959/60 as “feeble-minded”.
Mongolism was a medical term used to identify someone with Down syndrome. For obvious reasons, the Mongolian People’s Republic requested that the medical community cease use of the term as a description of mental retardation. Their request was granted in the 1960s, when the World Health Organization agreed that the term should cease being used within the medical community.
In the field of special education, educable (or “educable mentally retarded”) refers to MR students with IQs of approximately 50-75 who can progress academically to a late elementary level. Trainable (or “trainable mentally retarded”) refers to students whose IQs fall below 50 but who are still capable of learning personal hygiene and other living skills in a sheltered setting, such as a group home. In many areas, these terms have been replaced by use of “severe” and “moderate” mental retardation. While the names change, the meaning stays roughly the same in practice.
Retarded comes from the Latin retardare, “to make slow, delay, keep back, or hinder.” The term was recorded in 1426 as a “fact or action of making slower in movement or time.” The first record of retarded in relation to being mentally slow was in 1895. The term retarded was used to replace terms like idiot, moron, and imbecile because it was not a derogatory term. By the 1960s, however, the term had taken on a partially derogatory meaning as well. The noun “retard” is particularly seen as pejorative; as of 2010, the Special Olympics, Best Buddies and over 100 other organizations are striving to help eliminate the use of the “r-word” (analogous to the “n-word”) in everyday conversation.
Perhaps the negative connotations associated with these numerous terms for mental retardation reflect society’s attitude about the condition. There are competing desires among elements of society, some of whom seek neutral medical terms, and others who want to use such terms as weapons with which to abuse people.
Today, the term “retarded” is slowly being replaced by new words like “special” or “challenged.” The term “developmental delay” is rapidly gaining popularity among caretakers and parents of individuals with mental retardation. Using the word “delay” is preferred over “disability” by many people, because that term (delay) encapsulates the core deficit that creates mental retardation in the first place. Delay suggests that a person has been held back from their potential, rather than someone who has been disabled.
Usage has changed over the years, and differed from country to country, which needs to be borne in mind when looking at older books and papers. For example, “mental retardation” in some contexts covers the whole field, but previously applied to what is now the mild MR group. “Feeble-minded” used to mean mild MR in the UK, and once applied in the US to the whole field. “Borderline MR” is not currently defined, but the term may be used to apply to people with IQs in the 70s. People with IQs of 70 to 85 used to be eligible for special consideration in the US public education system on grounds of mental retardation.
Along with the changes in terminology, and the downward drift in acceptability of the old terms, institutions of all kinds have had to repeatedly change their names. This affects the names of schools, hospitals, societies, government departments, and academic journals. For example, the Midlands Institute of Mental Subnormality became the British Institute of Mental Handicap and is now the British Institute of Learning Disability. This phenomenon is shared with mental health and motor disabilities, and seen to a lesser degree in sensory disabilities.