Disability treatments have varied widely over time in the United States, and can vary widely between disabilities, and between individuals.
Throughout the Industrial Revolution many disabled people would still end up in asylums, especially if they were mentally disabled, as those were considered completely untreatable. Though during this time schools for the deaf and the blind would begin to open as people found ways to remedy physical disabilities. Eugenic movements during the late 1800s stalled treatment progress due to a "survival of the fittest" mindset taking place, going back to the same ideas held by the Romans and the Greeks.
During the 20th century, eugenic ideas began to fall out of fashion and progress towards understanding what caused disabilities was made. During this time the U.S. also expanded rehabilitation facilities and the independent living movement would begin, the independent living movement would advocate that rather than the person in question being considered a patient at the whims of an all-knowing doctor, the person would rather be considered a consumer, who is now instead presented with options instead of an option. Being informed of alternatives to choose what is best for them by themselves and ultimately in control of their welfare. The program advocates for ideas such as self-help and advocacy, peer counseling from others in a similar situation, and the removal of environmental obstacles and societal attitudes. This attitude would be considered radical during the mid-20th century when it was proposed, however over the decades and into the 21st century attitudes about this would also begin to change, leading to today where this is a much more normal thing and consumers are increasingly being consulted in their rehabilitation.
16th–17th centuries In the Thirteen Colonies, people carried on the tradition of thinking that the disabled were witches, often being burned or hanged. Others viewed disabilities as God's disapproval of the colonists, and overall, people thought of disabled people as a disgrace to their families and communities. Once again holding on to the belief that disability was connected to God and administered as punishment. Disabled members of wealthy families were, if nonviolent, kept at home, if not they were sent to an asylum and treated as criminals.
Treatment progress would be made in the early United States upon the opening of the first colonial hospital in Philadelphia in 1752, though the quality of care was lacking. A second hospital would open in New York in 1791 and in addition, the first 3 medical schools in the United States would open between 1760 and 1780, training 3,000 doctors in the process.
Industrial Revolution During the Industrial Revolution, the changes in lives of those with disabilities changed due to urbanization and the growth of factories, more hospitals were built but due to the working conditions of factories requiring strong and able-bodied people, those with disabilities were often excluded from participating in factory work at all. The quality of life for disabled individuals continued to improve, with the first U.S. school for teaching the deaf opening in 1817 in Hartford, Connecticut. Though great progress was made in aiding those with physical disabilities, those afflicted with mental disabilities didn't fare as well, as many were still institutionalized with little to no treatment administered, as people during this period believed that mental disabilities couldn't be cured. However, thanks to the research of Dorothea Dix, light was shed on this mistreatment and more humane treatments would soon come into effect. During the industrial revolution, another school of thought started to form: eugenics. After Charles Darwin published his 1859 book "Origin of Species" a survival of the fittest type doctrine began to form, where people argued against any kind of welfare for not only the disabled but the poor should be forbidden to exterminate the "weaker" members of the human race, "saving" it as a result.
18th century In 18th-century America, disabled individuals were frequently subject to similar marginalization as groups like criminals, which upheld the unfavorable public view of the developmentally as well as physically disabled. The 18th Century was a time of new understanding and philosophical curiosity of the disabled; and a shift of the public's common view of disability. This new approach paved the way for future medical treatments, scientific discovery, and new physiatric institutions which brought about beneficial as well as unethical medical treatment. These institutions of the developmentally disabled would continue to grow in popularity up to the present day, with many alterations and new understandings of how to treat disability. Before this period in time, the general public's opinion of Disability was often referred to as a "Time of confusion", reflecting the lack of understanding and scientific approaches to classifying and treating both mental and physical disabilities. Accurate classifications for Developmental disabilities at the time were limited, resulting in there being no distinction between what is considered to be mental illness in the 21st century and "intellectual disability" during the 18th century.
Mental and developmental disabilities
Institutions and asylums
In the period of Colonial America as well as the early Industrial Revolution, a new medical treatment for the "clinically insane" or "mentally retarded"; medical classifications that are not used in present-day psychiatry, emerged. During the 1760s–1780s, multiple medical schools were built; becoming the first medical schools in the United States. An increasing interest in medical treatments and medicine can be observed during this time. The Eastern State Hospital in Williamsburg, Virginia formed in 1773 was an example of this interest. This hospital is commemorated for being the First public Institution in the United States formed with the sole purpose of caring for the mentally disabled, and those facing what would be considered Mental illness in the Modern day. Before this hospital was built, institutions such as the Pennsylvania Hospital formed in 1751 by Dr. Thomas Bond and Benjamin Franklin, were further examples of psychiatric and medical progress in the United States. Most medical Institutions at the time for the "clinically insane" were lacking in proper medical care; reflecting the evolution of psychiatric care during the 18th century Terminology in the 18th and early 19th century
Hangings and persecution Intellectually disabled people in the Early American Colonies were persecuted in most areas of life. The intellectually disabled who were born into wealthy families usually had a different experience in life than those who were not born into wealth, although it depended on their family's choices which affected their quality of life. For those born into wealth, most of the intellectually disabled or those with mental illness lived inside their homes almost exclusively. If a mentally ill or disabled person exhibited violent behaviors, they were generally treated the same way as criminals were, with imprisonment being a common punishment for this behavior. The average public opinion of disability at the time was that their mental challenges or disability was God's punishment, and disability was considered disgraceful if a family member exhibited such behaviors. Being burned or hung on a stake as "witches" had been in earlier times like the Salem witch trials in 1692, were common. In a similar fashion, exorcisms occurred mainly in the later centuries. Exorcisms which is the process of expelling demons from a person's body, became popular in later years. The lack of distinction between religious and scientific beliefs resulted in further persecution of disabled individuals.
Medical treatments
Although institutions for the mentally ill and intellectually disabled had started to gain popularity, continuing in the 19th century; there were also new innovative forms of treatment for those with disabilities during this time. Despite the medical innovation during the 18th century, a lot of medical professionals did not have adequate training; or were self-trained in their field of work. Because of this, medical procedures such as bloodletting, where a person was intentionally bled from a part of their body to cure illness or insanity, were common. Medical procedures such as bloodletting were typical in medieval Europe but were also evident in the 18th-century United States. The "Tranquilizing chair" invented by Dr. Benjamin Rush in the late 1700s was a new form of treatment for the "clinically insane." This chair was built to regulate blood circulation in the brain, which was believed to positively affect "insanity" levels in patients. Unlike previous scholars' beliefs that disability and demonic possession were connected, Dr. Benjamin Rush advocated for treating the intellectually disabled or mentally ill as disordered, rather than viewing the relationship through a superstitious and religious lens.
Physical disabilities
Injured workers Beginning with the Industrial Revolution of 1760, the strenuous and long working hours resulted in many people becoming injured while working. Some of these injuries resulted in disability; or an inability in this case to effectively continue their job. Moreover, the majority of the now disabled "injured workers" were fired from their jobs. Workers compensation acts passed in the late 1900s provided compensation and assistance in returning to work if a person receives an injury at their place of employment. Without this act, newly disabled workers in the late 1700s to early 1800s did not receive any compensation for their employment-related injuries. In most cases, the employers would win if a lawsuit was filed because of the "contributory negligence" and "assumption of risk" laws that existed. These laws stated that a person was at fault for their injury because their negligence resulted in the injury, as well as that they knew the potential dangers of the working conditions.
Evolution of education The American Enlightenment brought about new and innovative ideas regarding disability. Philosophers such as Jean Jacques Rousseau promoted the notion that children's education is most effective if they learn at their own pace, with minimal intervention. Along with these new ideas about education, was an emerging education for the deaf and blind. This trend would continue up until the present day, most notably in the 19th century with major educational reform for the deaf and blind. Although not much is known about education for the deaf and blind prior to the 1800s, instances of deaf and blind students learning to communicate through hand signs on their arms can be observed as early as the 15th century.
19th century Attitudes toward disability in 19th-century America shifted due to a reclassification of criteria for a disability that began in Europe with Jean-Etienne Dominique Esquirol, as well as the effects of the Second Great Awakening, a Protestant religious revival that produced reforms on several fronts, which included the treatment of the disabled in America. Disability expanded in the public view in America during this time beyond its former visibility, leading to scrutiny of the treatment of the disabled and prompting the rise of "moral treatment," which involved more humane care and led to the rise of asylums.
Mental and developmental disabilities