Can IQ be Cultured?

Learning/Intellectual Disability (Mental Handicap)

Alan Challoner MA MChS

Research in this area has been going on for many years and thus the description of the
disability has changed with time. In order to avoid confusion and so as to steer clear
of using descriptions that were not used by the authors cited, I have kept the old
descriptions except where it has been possible to use a later one. In those cases it
seems sensible to use the current one — intellectual disability.

The term general learning disability has now been recommended in the UK to replace
terms such as mental handicap or mental retardation but it is referred to increasingly
as intellectual disability. A child with a general intellectual disability finds it more
difficult to learn, understand and do things compared to other children of the same
age. The degree of disability can vary greatly.

General learning disability must be differentiated from specific learning difficulty (e.g.
dyslexia) which means that the person has one difficulty such as in reading, writing or
understanding, but has no problem with learning in other areas.

CLASSIFICATION

• Mild learning disability: IQ 50-70, approximately 85% of cases; most can

lead normal lives except may need assistance in handling difficult
situations.
• Moderate: IQ 35-49, approximately 10% cases; use simple language when
talking but understand speech better. Patient can generally attend to the
basic tasks of life after training but more complex activities such as using
money usually require support within a special residential environment.
• Severe: IQ 20-34, approximately 3-4% cases: many able to look after
themselves with careful supervision.
• Profound: IQ less than 20, approximately 1-2% cases: development level of
one year old baby across a range of parameters and so require intensive
help and supervision in all activities.

EPIDEMIOLOGY

• Learning disability is common, affecting 1-2.5% of the general

population in the Western world. 1 .
• The number of people with intellectual disabilities increased by 53%
over the 35 year period from 1960 to 1995 (as a result of improved
socioeconomic conditions, intensive neonatal care and increasing
survival). 2

Psychometric tests which produce an intelligence quotient (IQ) are constructed such
that, theoretically, the population mean IQ is 100, with a standard deviation of 15
1
Gillberg C, Soderstrom H; Learning disability. Lancet. 2003 Sep
6;362(9386):811-21.
2
Cooper SA, Melville C, Morrison J; People with intellectual disabilities. BMJ.
2004 Aug 21;329(7463):414-5.

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(Weschler, 1992). The expected population mean of both verbal (VIQ) and performance
(PIQ) sub-tests is also 100, hence the expected discrepancy between sub-tests in a
large enough, normal, population is zero. Whereas an individual discrepancy of 9 ( p <
0.05 ) to 12 ( p < 0.01 ) is statistically significant, an individual discrepancy is not
usually considered clinically significant unless it is greater than 15 (Weschler, 1981;
Kaufman, 1990).

In putting dividing lines between the levels of learning disability at a notional level of
IQ 50, it should be stressed that this is essentially an administrative guidance tool.
Throughout the whole range of intellectual ability many intellectually disabled people
will have 'islets' of substantial ability, but other areas may well be very low. The
groupings therefore will be seen as artificial, and because in reality those who care for
such persons will make assessments at an individual level, there may be good cause to
phase out the system of IQ assessments as a means of labelling people. If such
assessments have a place they ought to be used as a means of gaining a better
understanding of the individuals' needs in terms of an educational curriculum and
social welfare.

It is accepted now, as described by Howells 3 that environmental problems can slow

the development of the young child, and premature birth, difficult delivery and low
Apgar scores compound the problem. Similarly a child who is deprived of learning
opportunities will not develop to its full potential. Inadequate parenting resulting from
separation from the mother, either physically or emotionally, may also give rise to
handicap.

Clarke and Clarke (1987) undertook a selective review of research on mental handicap,
which looked at the period 1957-1987.4 From this it became evident that although
many types of severe mental handicap were decreasing in prevalence, Down's
syndrome was increasing enough to make overall numbers of cases stable. Some
further research from Sweden indicated a reduction in the number of cases of mild
mental handicap which was seen as a reflection of the genuine secular trend for higher
intelligence arising from a highly developed social environment and a social welfare
state which was effective in tackling social disadvantage.

Clarke & Clarke [idem] mention work done by Richardson & Koller (1985) from which it
was possible to establish both the true and the administrative prevalence of
psychometric retardation in childhood. Epidemiology can be a powerful tool in this
field, and according to Clarke & Clarke, Fryers (1984)5 gives an excellent account of the
complex dynamics of prevalence, involving among other factors, incidence, mortality
and migration.

It is accepted, sociologically, that poverty and its sequelae create a greater prevalence
of handicap in its midst than does affluence. Therefore prime consideration should be
given to research and practice that affects the early experiences of handicapped
infants, so that as much progress as possible can be made towards developing their
social and intellectual competence. If we accept intellectual disability as a reason to
delay or omit the development of these competencies, then we deny the needs of
those children, and thereby exacerbate the conditions which will set them apart from
others.

3
Howells, Gwyn. 'The child with mental handicap'. In Howells, G. (ed) Primary care for
people with a mental handicap. RCGP, Nov. 1990.
4
Clarke, A. D. B. and Clarke, A. M. 'Research on Mental Handicap, 1957-1987: a
selective review'. Journal of Mental Def. Research, 1987, Vol. 31, pps.317-328.
5
Fryers, T. The Epidemiology of Severe Intellectual Impairment. 1984; Academic Press,
London.

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In recent years anthropolological concepts have been used to study the links between
poverty, ethnology, families and intellectual disability, as well as the nature of
intelligence and adaptation. Societies have developed accepted norms of appearance
and behaviour, and beyond these, individual cultural societies will accept or reject
divergences according to the tolerances that they perceive as normal. Within these
there will be sub-cultures which will develop their own levels of appearance and
behaviour (peer group approximation).

There is a need to focus on the meaning of culture and how it relates to the sense in
which it is used here. It hardly needs to be emphasized how much human behaviour is
affected by different cultural backgrounds. Culture is not passed on directly through
the genes, it has to be acquired by experience through contact and communication. It
is however partly to do with inherited instincts, and partly with the development of a
social identity. Generally this allows people from a variety of backgrounds to do things
together. These are consolidated into millions of tasks and transactions which fall into
practical patterns and spontaneous ritualizations which can be shared by all who are
able to fit into the pattern. However where a cultural development has been interfered
with, and an individual has been brought up in special circumstances, then the mould
is broken and a person who is 'different' emerges. This is most marked in people who
have been institutionalized (particularly if from an early age), but also in those who
have been otherwise segregated, and over-protected. Thus they are often seen to
exhibit behaviour which marks them out as being of a 'cultural divergence'.

This then brings about a certain ambiguity; for those who are affected by this cultural
divergence live in a handicapped world, whilst those who are endowed with a normal
existence have their experience in another. Their lives; as family, carers, nurses, etc.,
are part of the more general and accepted social culture. Whilst those who suffer this
cultural divergence are segregated, by whatever means, they are not faced with the
problems of this cultural conflict. When they are placed elsewhere for purposes of
rehabilitation, or naturally move into the world outside of their family, then they face
varying degrees of difficulty, as do the more normal people who are then around them,
because of the differences which are exhibited. This cultural ambiguity is not
necessarily completory, but its transition to a more acceptable state depends upon the
divergent cultures adapting each to the other, and if possible for them to reach an
acceptable coalescence.

Edgerton 6 reminds us that:

"...the heterogeneous nature of the population officially designated 'mentally retarded' is

seldom fully comprehended. Every conceivable kind and degree of cognitive impairment
occurs amongst these people. Some mentally retarded persons are so profoundly
retarded that they have no speech, no testable IQ, and must live vegetative lives under
medical supervision; others are so mildly retarded that they appear to have normal
intelligence until they are required to read or to perform mathematical calculations." [op
cit, p.28]

He argues that it is no longer disputed in social science that the IQ test performance is
largely a function of cultural experience; and that poor adaptive behaviour is based on
cultural judgement and sub-cultural values. He believes that when these judgements
and values are applied to any but the most severely retarded people, they are as
purely cultural as any diagnostic criterion could be. Carl Bereiter7 relates how the
intelligence test was originated by Alfred Binet, who had been asked by the French
education authorities to devise a system for identifying children who were considered
inappropriate for regular education facilities in French schools. He goes on to suggest

6
Edgerton, Robert, B. 'Anthropology and Mental Retardation: Research Approaches and
Opportunities'. Culture, Medicine and Psychiatry. 1984. 8: p.28.
7
Bereiter, Carl. Genetics and Educability. In Block, NJ; and Dworkin, G. (Eds.) The IQ
Controversy. Pantheon, New York, 1976. [p. 383]

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that if a different system had been established we might now have a different concept
of intelligence.

The relationship between socio-cultural mental handicap (i.e. where their is no organic
cause) and poverty has been made clear by, amongst others, Hurley8. Also Ramey et
al 9 have shown that it is possible to identify children who will need special educational
services (in USA) before or during grade school, solely by information available on
birth certificates, mother's race and education, the month pre-natal care began,
survival of other siblings, and the child's legitimacy. Children most at risk were male,
black, and born illegitimately to mothers of little formal education.

Of course there are many other factors that may be involved, such as: birth injuries,
maternal infections, toxins, poor nutrition, injury and disease. Some of these may also
occur to children born of mothers who are in a higher cultural or social class, but
Tarjan10 has estimated that a child born in the urban areas of the USA is fifteen times
more likely to be diagnosed mentally retarded than is a child born to middle-class
suburban parents. It is known that mothers of handicapped pre-school children show
significantly more psychiatric morbidity than mothers of healthy pre-school children11.

Success or failure in establishing the child in society may depend more on the
relationships between the child and its parents than on any other factor.[Howells 1990,
op cit] The early responses of the normal infant, help to 'release' appropriate
responses from the mother. By such abilities as sucking, rooting, grasping, turning his
head when his cheek is stroked, by eye to eye contact and a social smile he is able to
teach his mother how to respond to his needs. Not only may a handicapped child be
unable to do this but his very existence may produce in the mother feelings of grief,
shame, disgust, rage and disbelief. These feelings may, if not understood and dealt
with, lead to long-term rejection of the child and further decrease the ability of the
mother to meet his needs. Tinbergen12 tells us:

"Shortly after the Second World War, Bowlby (1951, 1969) traced back certain
disturbances of social behaviour to disruptions of the early phases of affiliation, of
bonding between mother and child. Bowlby saw straightforward deprivation of the
presence of the mother during longer or shorter periods as the primary cause of a failure
in children; first to form personal bonds with the mother, and subsequently of social
bonding of any kind. He argued that socialization comes about by a widening of the
circle of friends which is only possible if the first personal bond is successfully
established."

Research has shown13 that the communicative competence of adults with a mental
handicap and who were living in hospital was less than that of those who lived in
community settings. Van Der Gaag points to various research projects that have taken
place and which, firstly have underlined that adults with a mental handicap can no

8
Hurley, R L. Poverty and Mental Retardation: A causal relationship. Vintage Press, New
York, 1969.
9
Ramey, C T; Stedman, D J; Borders-Patterson, A; Mengel, W. 'Predicting school failure
from information available at birth'. Am. Jnl. Ment. Def. 1978, 82: 525-534
10
Tarjan, G. 'Some thoughts on socio-cultural retardation'. In Haywood, H C (ed.) Social-
Cultural Aspects of Mental Retardation. Appleton-Century Crofts, New York, 1970, pps.
745-758
11
Romans-Clarkson, S; Clarkson, E; Dittmer, I D; et al. Impact of a handicapped child
on mental health of parents. British Medical Journal, 1986, 293: 1395-1397.
12
Tinbergen, N; Functional ethology and the human sciences. In Halsey, A H. (Ed.)
Heredity & Environment. Methuen, 1977; [pps.79-80]
13
Van Der Gaag, A, D. The view from Walter's window: social environment and the
communicative competence of adults with a mental handicap. Jnl. Ment. Def. Res. 1989;
33: 221-227.

Page 4 of 11
longer be seen as 'children who have never grown up', and secondly, show that the
science of language in context, or pragmatics, has brought together experts from
differing disciplines, who have drawn attention to the communicative competence of
adults with a mental handicap.

Price Williams & Sabsay14 have divided 'communicative competence' into two parts;
pragmatic and linguistic. They have defined pragmatic competence as the ability to
use language; and linguistic competence as the ability to produce and interpret
syntactically and phonologically, well-formed sentences. It was further suggested by
them that the latter had received far more attention than the former. As a
consequence of this there has been an oversimplification of the 'communicative
competence' of adults. This view is confirmed by Calculator and Bedrosian15, who are
critical of the use of 'child standard tests' with adults because they concentrate on
linguistic comparisons which reveal nothing about pragmatic competence. Bedrosian
and Prutting16 found that the adults in their study could take part in a conversation
and utilize the same types of controversial controls and constraints as adults who had
no mental handicaps, despite the apparent differences in linguistic competence.
Studies of this sort indicate that adults with a mental handicap are more able to give
information than their formal linguistic abilities would suggest. [Van Der Gaag, op cit]

Guyette17 describes the 'communication environment', by which is meant the actual

demands that are placed on the individual and the opportunities they are given to
communicate. This communication environment is created by those who are involved
in caring for the individual person. If they do not establish an adequate communication
environment then the appropriateness of that environment will be reduced. The degree
to which this environment is established will inevitably affect the communicative
competence of the individual person. Patients on wards in hospitals for the mentally
handicapped, and others who were segregated into groups of a similar disability, did
not have the same opportunities to develop communicative competence. Other
studies show how the expectations of non-handicapped individuals can have an
important influence on the communication skills that the handicapped person actually
uses. This point is well illustrated in the novel by Cook 18; 'Walter was aware that he
should be doing something, but did not know what, and rather than do something
wrong...he thought it wiser to do nothing'. [p.165]

It would seem therefore that this communication environment is related to the

communicative competence of adults with a intellectual disability. Van Der Gaag [op
cit] shows, by comparing two similar groups that were differentiated only by their living
environment, that those who lived in the community achieved higher scores on
pragmatic competence, than did those who resided in hospital. These findings were
not precise or clear cut, and he reports some overlapping between the two groups
which led him to believe that there were also other environmental factors which will
influence the person's communicative response, e.g. learning, health, and emotional
environments.

He believes that the differences were partly related to the levels of linguistic
competence, and that this together with the communication environment will affect

14
Price Williams, D; & Sabsay, S. Communicative competence among severely retarded
persons. Semiotica; 1979, 26: 35-63.
15
Calculator, S N; & Bedrosian, J L. Communication Assessment and Intervention for
Adults with Mental Retardation. 1988; Taylor & Francis, London.
16
Bedrosian, J L; & Prutting, C A. Communicative performance of mentally retarded
adults in four conversational settings. Jnl. Speech Hearing Res. 1976; 21: 79-95.
17
Guyette, T W. 'A discussion of the use of the environmental approach to developing
communication intervention programmes with the mentally retarded'. 1978, unpublished
ms: Univ. Kansas.
18
Cook, D. Walter. 1978; Penguin Books, London.

Page 5 of 11
pragmatic competence. It is vital therefore that there should be the provision of
appropriate settings of demand, expectation and opportunity for each individual.
Often the lack of appropriate levels of this demand in the hospital setting was a
variable factor in the limitation of attainment of language skills.

That said, the problem with poor communication environment is not restricted to those
who are severely intellectually disabled, nor to those who were in mental handicap
hospitals. Most of the one million people who are assessed as being moderately
intellectually disabled, will be resident in the community, never having been in
hospital, and probably not having spent very much time outside the immediate family
circle. Indeed their very handicap might well be centred on lack of communication.

Learning is a continuous experience, and with very young children this will usually be
on an entirely informal basis. Right from the moment of birth, the more fortunate
children will be parented in an atmosphere of communication. Both mother and father
will spend time talking to their infant, and even if at that stage it does not understand
the words, it will slowly be absorbing the sounds, the tone of voice and the associated
expressions on the face of the speaker.

'Communication' from the Latin communicare is closely related to communitas, which

means not only community, but also fellowship and justice in men's dealings with one
another. Society is based on the possibility of people working together for common
ends, in a word, co-operation.

Without proper communication, co-operation may well be reduced. Equally, without

proper communication between parents, siblings and the new infant, there will be a
lack of learning, an absence of shared knowledge, information and experience. This
will in turn lead to a deficient personality; for delays in learning may never
subsequently be made up, and this will reduce the quality of personhood in the
individual.

Where this has happened, consideration needs to be given to the realisation of some
equality by artificial means. It is unlikely that help will be at hand in the family in
which this situation has developed. Therefore some form of personal advocacy will be
necessary to assist the handicapped person forward, and to allow that person to take
an appropriate place in society without the developmental deficiencies reducing the
quality of life below an acceptable level. This should be judged by the individual, if
possible; or by those closest to that person, again if possible and appropriate. Failing
those possibilities then it will need to be assessed by society at large, though this will
probably be undertaken by those who have a statutory responsibility for that person if
there is no one closer.

To the extent that good communication skills are not allowed to develop, then there
will also be enormous cultural divergencies between the handicapped person and his
fellows. This will contribute markedly to the subsequent ambiguity and how that
person fits into his local community, and his acceptance by it.

These views may not be shared by the romantic nativists however.19 Their assertion
that the infant is born with unspoken wisdom, an awareness and feelings which just
simply need to be allowed to grow, may have to be questioned. Others who believe
infants are endowed with problem-solving tendencies and rational awareness, have to
vie with those who believe that infants have nothing but reflex powers of integration.
The most recent research however has determined that children:

19
Note: Chomsky's arguments that natural human languages are based on a common
'deep structure', which is inherited, is at variance with Piaget who subscribes to 'a model
of development through active adaptation' which underlines the importance of the
person's actual life experiences.

Page 6 of 11
 "...refine their reactions to particular events and formulate specialized skills within a
coherent general ability to perceive...and are born with several complementary forms of
knowing, and they use these to develop experience of the particular world they are in,
assisted by communicating." 20

The epigenesis of identity has an importance for everyone, the intellectually disabled
person included. In a particularly telling chapter of his book on Identity, Erikson 21
presents human growth from the point of view of the conflicts, inner and outer, which
the vital (healthy) personality weathers. In speaking of this 'vital' personality he refers
to the criteria presented by Marie Jahoda 22, according to which a healthy personality
actively masters his environment, shows a certain unity of personality, and is able to
perceive the world and himself correctly. In considering that all of these criteria are
relative to a child's cognitive and social development, we may look upon childhood, by
definition, as having an initial absence of such criteria, and of developing them in
complex steps of increasing differentiation.

This epigenetic principle is derived from the growth of organisms in utero. It states that
the growth of living organisms follows a pattern or plan. As this plan proceeds and
unfolds there arises individual parts which eventually will form the functioning whole.

The ascendance of these parts also has a critical phase where there is a particular
danger of defect. In addition to these, and following birth, the baby enters the system
of his society and will proceed to develop his capacity to meet the opportunities of his
culture. How well he succeeds in this will depend upon any genetic defect, damage
that was sustained in utero or subsequent to birth; or to the effects of his environment
and the nature of parental influences. There will be inner conflicts to be met and these
idiosyncratic developments will determine how and in what manner the individual
becomes a distinct personality.

Epigenesis is governed by 'the proper rate and the proper sequence', but nevertheless
varies from culture to culture. The child who is healthy, in Erikson's sense, and who is
given appropriate guidance can be 'trusted' to obey the inner laws of development.
These laws ensure a series of 'potentialities for significant interaction' with those who
will parent him and the society which responds to him. So we have the force from
within and the interaction from without, and these two will allow for the development
of personality over a period of time. This time may often be contained mainly within
the first seven years of life; or it may extend further in certain circumstances.

What is worth considering is how these forces and interactions vary. Not only in
normal, healthy children but in those who are handicapped or who have a potential for
becoming handicapped. Erikson [op cit] writes of a paradox in which the child, having
instinctual energy (the genetic endowment of developmental potential), is also
vulnerable; and whilst this vulnerability is always present in some respects, the child
is also completely oblivious and insensitive in others, and yet remains unbelievably
persistent in the same respects in which he is vulnerable. If the child is to grow up
'normal' the family must reorient itself to accommodate his presence and they must
grow together as a group. 'A family can bring up a baby only by being brought up by
him. His growth consists of a series of challenges to them to serve his newly
developing potentialities for social interaction.' [p.96]

20
Trevarthen, Colwyn. In Oxford Companion to the Mind. R L Gregory (ed), OUP, 1987.
[p.363]
21
Erikson, E H. Identity; Youth and Crisis. 1974; Faber, 91-144.
22
Jahoda, Marie. 'Towards a Social Psychology of Mental Health; Symposium on the
Healthy Personality', supplement II; Problems of Infancy and Childhood, Transaction of
Fourth Conference, March 1950, MJE Benn (ed.), New York: Josiah Macy Fndtn. 1950.

Page 7 of 11
If however the baby's instinctive responsiveness is damaged in some way, or if his
parental or societal environment is deficient, then this situation has the possibility of
creating a damaged personality, which in itself may be the basis of a handicap, or at
least contribute to causing the handicap to be visible because the child becomes
socially unacceptable due to the differences from the norm that are exhibited by him.

To pursue this development of identity I mention here the important division between
the two basic types of intellectual disability. They are the genetic and the brain
damaged who although distinct are usually severely handicapped; and the mildly
handicapped who are in this state, largely, because of environmental factors that gain
influence from familial low intelligence, poor maternal pre-conceptual care, and a lack
of nurturing associated with a progressive lack of basic 'trust' [Erikson, op cit, p.102]
or 'confidence' [Benedek, vide Erikson op cit, p.102]. According to Erikson, these
latter, at a level of infantile experience, do not seem to depend on quantities of food or
demonstrations of love, but rather on the quality of the maternal relationship.

Erikson explains this as follows:

"Parents must not only have certain ways of guiding by prohibition and permission, they
must also be able to represent to the child a deep, almost somatic (heartfelt) conviction
that there is a meaning in what they are doing. In this sense a(ny) traditional system of
child care can be said to be a factor making for trust, even where certain items of that
tradition, taken singly, may seem arbitrary or unnecessarily cruel - or lenient. Here
much depends on whether such items are inflicted on the child by the parent in the firm
traditional belief that this is the only way to do things or whether the parent misuses his
administration of the baby and the child in order to work off anger, alleviate fear, or win
an argument, either with the child himself or with somebody else..." [op cit, p.103]

In differentiating between these two divisions of intellectual disability, there will be,
on the part of the severely handicapped person, a delay in reaching the goals of
identity (some of which might never be reached); and on the part of the mildly
handicapped a more natural progression, but one that is warped by deprivation of one
sort or another.

The landmarks in the formation of identity from birth, as outlined by Erikson [ibid],
apart from aspects of physical growth, are:

1. The expanding libidinal needs of the developing being and, with them, new
possibilities of satisfaction, of frustration, and of sublimation.
2. The widening social radius, i.e. the number and kinds of people to whom he can
respond meaningfully on the basis of his ever more highly differentiated capacities.
3. The developmental crisis evoked by the necessity to manage new encounters within
a given time allowance.
4. 5. A new sense of estrangement awakened along with the awareness of new
dependences and new familiarities (e.g., in early infancy, the sense of
abandonment).
5. A specifically new psycho-social strength (here a favourable ratio of trust over
mistrust) which is a foundation for all future strengths. [pps.104-105]

He considers that the earliest and most undifferentiated 'sense of identity' arises out of
the encounter of maternal person and small infant, an encounter which is one of
mutual trustworthiness and mutual recognition. This, he says, is in all its infantile
simplicity, the first experience of what later reoccurrences in love and admiration and
can be called a sense of 'hallowed presence', the need for which remains basic in man.
Its absence or impairment can dangerously limit the capacity to feel identical, when
adolescent growth makes it incumbent on the person to abandon his childhood and to
trust adulthood and, with it, the search for self-chosen loves and incentives.

Page 8 of 11
Deprivation of the maternal 'goodwill' in any or all of the above aspects will so
compound the basic deficits of the infant that the degree of handicap can be
intensified. This not only sets the child apart from his family, causing in some cases
infantile depression and subsequent withdrawal, but begins the process of
accentuating the difference that handicap imparts, and draws a greater gap between
the individual and the society of which that person is part.

Lomasky 23
makes some interesting comments on the upbringing of children when he
writes:

"One who is thoroughly servile is not a project pursuer...For if the enterprise is such a
total failure that the child is left attitudeless and valueless, and thus can only be moved
to action by the projects of others, then the child has been severely harmed." [p.185]

If the environment is changed there is evidence that the force of such change can be
beneficial as has been indicated in studies in France where children from deprived
backgrounds, who were fostered or adopted at four to six years of age, and who had
an initial IQ of 77, subsequently some five to 12 years later, were recorded as having
IQs of over 100 in a quarter of the cases. 24

It is worth pointing out, in connection with persons who are mildly intellectually
disabled - and for whom it might be said that they had spent some of their developing
years in a deprived (in any sense) environment, that when it has been possible to
improve their environment, there has often been a substantial improvement in IQ. In
these circumstances it might also be said by some observers that variation in teaching
methods might also have some effect on ability to comprehend, and therefore on IQ.

My main concern here is not to denigrate families, teachers or society in general, but
to look at possibilities whereby any person who has learning difficulties can be
monitored, assessed and offered whatever services are required, to improve his
chances of an increased potential in both educational and social skills. However where
mild intellectual disability is exhibited by a person who suffers from no obvious
environmental inadequacies, then there may be other factors that need attention.
These may include a change in teaching methods, psychological assessment, and a
check on any health problems.

Intelligence skills are epigenetic, that is they are not innate, but develop in the course
of time. Experience and developing cognitive abilities accrete, but are also affected by
genetic factors, and the influence of adaptability to the environmental circumstances.
Culture therefore plays an important part in the development (or lack of development)
of intelligence. Separation from normal cultural standards may well influence the
abilities of individuals to relate to others in that culture, and may therefore interfere
with the epigenesis of intelligence.

To complete even a small picture of these circumstances it is necessary to show the

possibility expressed by such as Carl Bereiter who says:

"...culture may not only influence the phenotypic expression of inherited traits but may
also, through selection pressures, influence the distribution of genes within cultural
groups, and that cultural differences may represent not only adaptations to
environmental conditions but also to distributional genetic differences between groups,
with the result that culture and heredity are intimately interconnected." [op cit, p.404]

23
Lomasky, Loren E. Persons, Rights and the Moral Community. OUP, New York, 1987.
24
Duyme, M. & Dunmaret, A. 'La Reversabilité de la Débilité Légère: une thérapeutique
sans Thérapeute'. 1986, CNAMS-INSERM, Vol. 144, pp 553-62. [For a summary in
English, see Clarke A M.; Clarke, A.D.B.; & Berg, J.M. (eds.) Mental Deficiency: the
changing outlook. 1985, Methuen, London. pps.458-9.]

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He suggests (ibid) that findings on child-rearing antecedents of behaviour must be
regarded as ambiguous, and that causal hypotheses must be more fully tested in order
to ascertain if they have any credibility.

In practice, at the coal-face so to speak, teachers are dealing with practical issues and
these in the main are to do with environmental matters and teaching methods in the
context of individuals. Thus efforts to improve situations for each child should
concentrate in these areas rather than be overly concerned with genetic inheritance.

Bereiter is concerned that the education of children is based on abilities to use abstract
thought and verbal cognition. [ibid, p.385] Those who are unable to grasp these
concepts are measured as failures by the IQ system, which is then seen as a self-
fulfilling prophecy. Those children who are unable to make progress in this type of an
education system, and whose difficulties are categorized as being brought about by
developmental delays or impairments, should not be considered uneducable (albeit
that some classes may be unproductive of progress). Steps should be taken to
establish what areas of learning are possible for these children, and under what
circumstances. These should then be part of the curriculum for them, and this
teaching should be located alongside that given to others in normal schools, if
integrated classes are not possible.

Education has a social content as well as an intellectual one. It is important that this is
not denied to intellectually disabled children by using their lack of normal abilities as a
reason to segregate them. Bereiter's approach has been, 'a matter of trying to locate
the underlying sources of difficulty in grasping various concepts and operations, and
then trying to devise ways to overcome them.' [ibid, p.386] He believes that
educational systems should not place 'unnecessary thinking difficulties into the path of
learning', which he sees as discriminatory. [ibid, p.388]

However he does see the problems of this approach, and wonders if the lack of deep
understanding may limit their ability to apply knowledge in new situations, which
might damage their self-confidence. This is a challenge for those who are charged
with the education and support of persons with an intellectual disability. Having
established a policy of community care, it is the duty of all concerned to allow progress
towards integration, which in turn demands appropriate support in areas of actual or
potential fallibility.

It is of course speculative to consider how changed circumstances and environmental

conditions would affect the development of an individual. Some circumstances,
however, are self-evidently the cause of low achievement, and it is important that
these are at least discovered at an early stage, before the lack of intellectual
development brings about potential (further) deprivation and possibly handicap. One
such case that I came across personally some years ago related to a young boy from
Hong Kong, who had followed his father to the UK with the rest of his family. He
arrived here at about the age of five, not being able to speak English, not having an
understanding of the British culture, and almost immediately was placed in a normal
English-speaking school. Not surprisingly he soon became educationally 'lost'.
Eventually, at about the age of 17 he arrived at an education centre for mentally
handicapped young adults, and it soon became obvious to us that his lack of
educational development was entirely due to his cultural difficulties which were
compounded by his inadequacies in local language. It took several years for him to do
the necessary catching up that allowed him to take his place in normal society.

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REFERENCES
Bowlby, J. The nature of the child’s tie to his mother. Internat. Jnl. Psychoanal. 39;
[pp., 350-373], 1951.
Bowlby, J. Attachment and Loss. (Vol. 1); Attachment. Hogarth Press, 1969.
Richardson, S.A; Koller, H.; Katz, M. Relationship of upbringing to later behaviour
disturbance of mildly mentally retarded young people. Am. J. Ment. Def.; 90:
[pp., 1-8.];1985.

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