In the mid-1800s, emerging services and supports for individuals with intellectual and developmental disabilities were grounded in education and training. Within a few decades, as demand for services increased, services shifted from education to warehousing people in large institutional settings. The early educators in this field were replaced by staff who provided custodial care. One hundred years later, following years of advocacy by parents and later by individuals with disabilities, services began to be offered in community settings. Custodial staff in institutions were replaced by committed direct support workers who did far more than caregiving. Today, most supports to individuals with IDD are provided in the community and made possible by trained direct support professionals. 


Visual timeline – 1800 – 1850

Scales of Justice with the word Good and Bad. One word on each scale

The moral model

Under the moral model, disability is viewed as good or bad, and people with disabilities are either sinners or saints. Services are provided out of charity or pity.

Images of doctors with patients and text describing the medical model.

The medical model

Under the medical model, disability is a problem that needs to be fixed. People with disabilities are patients needing to be studied and cured. Professionals are in control. This model continues today.

Judging people with disabilities image with two books from that time in history.

Judging people with disabilities

Judging people with disabilities as good or bad, deserving or not deserving of support, is not limited to the past.

Early 1800s

Few services available

Prior to the 1850s, there were few services available for people with disabilities. Custodial shelters like poor farms, almshouses, and asylums were the only option for those who were considered deviant.

1843

drawing of people in small stalls.

Poor living conditions

Social reformer Dorothea Dix visited jails, almshouses, poorhouses, and asylums across the United States and was appalled by the living conditions of the inmates. She pleaded with the Massachusetts legislature for better facilities.

1848

Headshot image of Dorothea Dix

Dorothea Dix Quote

“Man is not made better by being degraded; he is seldom restrained from crime by harsh measures, except the principle of fear predominates in his character; and then he is never made radically better for its influence.”

– Dorothea Dix

1848

Dr. Hervey Wilbur's house where he started a small school.

Small school opens

Dr. Hervey Wilbur started a small school in his New York home to teach children with intellectual disability. Another private school was opened in Massachusetts. These early training schools sought to educate students and provide schooling, assistance with self-care tasks, and physical training