Introduction

There are limited data available to provide a comprehensive account on the development of services internationally for people with intellectual disabilities (ID). The historical study of intellectual disability is still in its infancy in many countries (particularly in the Third World), and generalization is made difficult by the substantial variations in the development of services between different countries (Holt et al., 2000; European Intellectual Disability Research Network, 2003). Nevertheless, some general trends have been observed in many societies: the introduction of humane forms of treatment in the nineteenth century, the move towards incarceration in total institutions towards the end of the century, and the reaction to institutional care in the later years of the twentieth century.

The development of humane forms of care

There are still debates about whether pre-modern societies had a concept similar to that of ‘intellectual disability’ (Goodey, 2003), and Jacobson (1999) noted that most writers date the Western history of intellectual disability from about 1790 (Meyers & Blacher, 1987). However, Jacobson noted that some specialist services did exist before that date. These included the founding of an asylum by St Vincent de Paul in Austria (Barr, 1904/1973); the establishment of a hospital in Cairo in the middle ages; a form of group care in thirteenth-century Gheel, Belgium; and residential programmes in the early seventeenth century in Thuringen, Bavaria, and Austria (Kane & Rojahn, 1981; Meyers & Blacher, 1987).