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Previous laws of the U.S. diminished persons with disabilities because society as a whole viewed such persons as a group of people to be pitied, mocked, rejected, and dreaded, or as objects of fascination. These early attitudes developed in Europe and followed American colonists to the U.S. The focus of the 17th and 18th centuries was on the simple goal of survival in the colonies. Persons with disabilities were seen as being reliant on others for care and incapable of contributing to survival. This dependency was often seen as unhealthy or defective.

Views of persons with disabilities originated in a combination of magic, religion, medicine, and science. For instance, an initial policy in the Massachusetts Bay Colony required a witchcraft-examination of the bodies of stillborn children. In relation to religion, disabilities were perceived as God’s punishment. People with mental illness were often persecuted and burned or hanged like witches. Disability was viewed as a moral problem, often bringing disgrace to families who had a disabled family member. By the 1800s, persons with disabilities were not only regarded as evil omens resulting from witchcraft or punishment to parents, but also as medical anomalies to be studied.

During the expansion era after the Revolutionary War, values and ideals such as individualism and self-reliance became prominent. Just like in the colonial period, each family was expected to care for its members who were ill or had a disability. When towns were developed and grew in population, minimal community services were provided to persons with disabilities. If families could not or would not provide support for their members who had disabilities, they were often placed in a jail or a home for the poor. Until the 19th century, there was no institution that cared for the needs of people with disabilities in America. This was viewed as acceptable due to societal attitudes during these periods, and was enforced through legal action and physical barriers. During the early nineteenth century, initial institutions were opened that focused on dealing with those with physical, developmental, emotional, and cognitive disabilities.

By 1830 almost every state had an almshouse following the model in England's poor laws. Conditions were terrible in these almshouses, and around the turn of the century they became very overcrowded. Governments blamed overcrowding on the rapid development of cities in the U.S. Physicians also thought that the noise and clamor of industrial life might be too stressful for some. As a result, state governments took control and relocated the people to the countryside, separating the individuals into different institutions under the same roof. However, this often proved to be negative for those afflicted with a disability, either physical or cognitive, as they were often placed in an asylum ward.

Throughout the Industrial Revolution, more hospitals were built and advancements were made in treating people with various illnesses. Industrial capitalism was aimed at healthy able-bodied people who could work long hours in mass production lines, which often resulted in the exclusion of people with mental and physical limitations. Industrialization also caused a new category of disability to emerge: injured workers. Workers who were injured on the job were usually fired if they could no longer produce. Workers compensation legislation did not yet exist, which left the workers no other option than to sue their employers. The first workers’ compensation legislation was passed in Germany in 1884, Hungary in 1887, Great Britain in 1897, and in the state of Maryland in the U.S. in 1902.

While early attempts at teaching or dealing with the disabled were forsaken in favor of more primitive responses such as incarceration or the banishment to poor houses, the 1700’s saw a turn of attitude in how to deal with the disabled. Originating in Europe, the “moral treatment” style involved a healing and understanding process with those afflicted, ditching the straight jackets and restraints that had come before and instead focusing on emotional well-being. The goal of treating the disabled humanely inspired Dr. Thomas Kirkbride to reshape the common idea of a hospital. Directing the Pennsylvania institute beginning in 1840, Kirkbride brought his ideal architecture of a hospital to life by separating patients into different wings based on need and care type. The hospital was surrounded by gardens and farmland that would be cared for by the patients who were deemed less at risk, giving them activities to mind their day with. The patients were able to both tend to the gardens and the farmland in order to better their emotional state, and the produce they farmed was used for food for themselves and other patients. Many other hospitals would follow suit and adopt this style of practice throughout the century.

In 1817, “The American Asylum, At Hartford, For The Education And Instruction Of The Deaf” was founded, providing the first school for children with disabilities in the Western Hemisphere. Established in Connecticut, this institution is still active today, operating under the name “The American School for the Deaf”. This institution facilitated the founding of institutions across the United States, allowing for more accepting and sympathetic societal attitudes towards people with disabilities. This included the creation of the St. Louis County Insane Asylum. Founded in 1869, this institution was intended to house the “indigent insane.” It formed on top of a large, expansive piece of land, and was initially designed to hold 250 patients. It has now expanded greatly, and is known as the St. Louis Psychiatric Rehabilitation Center. It has recently become a rehabilitation center, aiming to assist people living with mental illness, a large contrast from its initial purpose devoted to separating disabled people from society.

Institutionalization grew in popularity in the late nineteenth century, with the rise of the eugenics movement facilitating a growth in policies that funded institutions. This allowed for not only institutionalizing disabled people, but also forcing sterilization upon them. The term eugenics was coined by Englishman Francis Galton. It gained popularity throughout the late nineteenth century, with an overall aim at “improving the stock of humanity,” and pushed for compulsory sterilization and institutionalization. This eventually led to the forced institutionalized and sometimes sterilization of the disabled.

It was evident to many that the treatment of disabled people across the U.S. in the early nineteenth century was deplorable. Dorothea Dix, born in Hampden, 1802, began a revolution that brought change to how disabled people were treated across the country. Through her initial observations whilst visiting almshouses and jails across Massachusetts, Dix believed the conditions were deplorable, as the people being held were described as “criminals, retarded individuals, and the mentally ill.”. Through highlighting that it was normal to see people with disabilities being abused and neglected to an extreme extent, Dix appealed to her state legislature in an attempt to insight change. Through a series of speeches, Dix pressured Massachusetts legislation to revise state laws relating to the disabled, and begin providing appropriate funds for institutions assisting the disabled. This eventually escalated into Dix founding over thirty hospitals that provided treatment for the mentally ill.

African Americans also were heavily affected by disabilities. Southern plantation owners often viewed slaves with disabilities as useless, or worth less than their fully functional peers. Masters would still find ways for these slaves to perform tasks, although they were performed slower and mistakes would be more commonly made. Because of this, slaves with disabilities were more likely to be subject to abuse and even murder. Sometimes to avoid having to care for slaves with disabilities, Masters would abandon the slaves to avoid the laws of Manumission. These slaves would be sent to cabins or rooms in the woods without food or provisions to fend for themselves, left waiting to die. Occasionally disabled slaves were even murdered by their masters due to their lack of performance. Disabled slaves were valued at a lesser rate by their masters even if they were able to perform the tasks required for them, purely because of their disabilities and their master’s disdain for them. African Americans with disabilities often attributed to the stereotype of them being a lesser race, even though it was just as common among white people.