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We talked about coordination this morning and about the role of the mental retardation program board which became the Mental Retardation Program and Standards Advisory Board. Let me here have the freedom of stating a contrary opinion and, in turn, I give you the freedom to ignore it because I have my air ticket and I will be soon back home. But I think the idea of having somewhere in the departmental hierarchy a separate board that controls budgets of other agencies is preposterous; is amateurish. It violates the whole process of government. In sane states it would be literally unconstitutional, and, in any case, it goes against the whole structure of independent agencies.

Coordination of governmental agencies can be done only in one place and that is in the executive department. And control of budgets can be only done in one place and that is within the budget office of the executive department. And that is exactly what Massachusetts has done. The Bureau of Mental Retardation in the State of Massachusetts is in the Department of Administration and Finance. It is part of the budget office and, as such, controls budget to the extent the governor examines and controls departmental budgets as part of the legitimate governmental process. And the Department of Administration and Finance is at the same time -as is the Federal Bureau of the Budget) the planning agency of the State. Thus, both budget control, planning and coordination in mental retardation moves along in Massachusetts because they put the mechanism where it belongs -- at the executive level of government, above all the other departments.

You have kept on saying that your Board is going to coordinate all mental retardation activities. I never had the pleasure of meeting Max Rafferty, but I would just like to hear him when you say, "Max, we are going to coordinate your special education programs."

So when it comes to planning and coordination in mental retardation, you had better take a good, long look at what you really want to accomplish and then set about doing it the right way. But do not try and kid yourself with a paper organization. It just is not possible.

Now time is getting short and I cannot try to deal with more specific problems, problems you share with many other states. I only want to make over and over again this one comment: There are more smaller states in this country who do well in mental retardation than larger ones -- and some of our biggest problems and greatest retardation in retardation exist in our large states with the big sprawling bureaucracies which cannot really help themselves because they have so many builtin impediments.

But let me leave you with some thoughts of a little more general nature. I implied earlier that I certainly agreed with President Kennedy that there were some other countries in the world who, in this particular area, were far ahead of us; and as you know, the Scandinavian countries are countries where this is particularly the case. And from them has come to us a concept which only now we are beginning to really see more clearly, and I include myself most definitely in this "Me" although, as you know, I have some rather close ties over there and I have been visiting innumerable times in these countries, particularly in the area of mental retardation.

But only now I begin to see how terribly important is the concept to which they ascribe their entire mental retardation approach -- the concept of normalization. It is a concept that is elegant in its simplicity and parsimony. It can be readily understood by everyone and, at the same tine, it has really far-reaching implications. When you visit mental retardation services in Denmark or Sweden and, observing some things, ask "Why do you do this?", they most likely will just say "This is the normal way of doing things." That is why they have this kind of room for the mentally retarded; that is why they have this kind of schedule; that is why they have that kind of arrangement. It is the normal thing! Proceeding from that assumption, they only deny the normal situation, the normal furnishings, the normal food, the normal eating time, the normal bed time, the normal way of being addressed as a human being -- when there is some very compelling reason.

From my years of visiting institutions for the mentally retarded (although I started out at Letchworth Village thirty years ago, my intensive visiting only goes back 8-10 years), I would say we do the opposite; we simply take for granted the abnormal, and we extend the normal only as a privilege. Hence, this principle of normalization -- this insistence on thinking of people in a normal way -- is so very, very important, because it leads you to think more and more of people as human beings and to become more and more concerned about the harmful effect of categories and labeling, and categorical labelings.

The other day, I had to look up a letter I had written to Mr. Krause and just to show you that I do not just shoot off my mouth loudly in public, but I very often quietly shoot it off in correspondence, let me read what I wrote to him in June, 1967: "I have just seen the May bulletin of the Sacramento Association for the Retarded which states on page one that at Sonoma State Hospital, with a of population of 3,500, the number of nonambulatory patients has soared from 400 to almost 1,200. I am very much concerned about that statement because it implies a real danger in terms of official treatment policy toward these individuals. What does it mean that a patient is non-ambulatory? Do you realize that both my children were non-ambulatory, yet subsequently were able to go through college and even graduate school? As a matter of fact, I have heard that all children start out non-ambulatory. How old are these 1,200 non-ambulatory patients at Sonoma? What is their background? Why are they non-ambulatory? Is there a substantial number among them whose condition calls for orthopedic intervention? Is there a substantial number among them where ambulation will depend on intervention by intensive training programs? How many of them show an advanced degree of, e.g., hydrocephalus, which makes ambulation a physical improbability, if not impossibility?" I hope you see what I am trying to convey to you -- this illustrates the concept of normalization. You just cannot call 1,200 people non-ambulatory and then try to prescribe for them on that basis.