Interesting Essay from WebMD


Well-Known Member
I just read this and found it very interesting and provocative. I'm a straight shooter when it comes to health care concerns so this sort of thinking from doctors upsets me. I'd rather know the facts now and learn to deal with them now rather than find out something was sugar coated along the way. But that's just me, lol! I thought I'd share:

"Developmental Delay" or "Mentally Retarded?" Getting Off the Euphemism Treadmill

It was an all too common story in our School Achievement Clinic: 12-year-old Bertie was doing terribly in school and had just failed 6th grade. Her parents believed it was because she was "lazy" and because the school had lousy teachers.

On formal testing, Bertie's IQ was in the high 60s, meaning she had scored in the "mild mental retardation" range. So it was no mystery to us why school was so difficult for her.

But it was to her parents. "Mentally retarded!?" they exclaimed, incredulously and angrily. "We have known she was developmentally delayed since she was 3 years old, but no one ever said anything about mental retardation."


This is one example of a pediatric euphemism that was taken too far and used for too long, which then created misunderstandings, inappropriate expectations, and insufficient therapeutic services. Mea culpa.

I know why this happens so often. Nice guys and compassionate to a fault, we pediatric providers hate to give bad news and avoid it when we can. We want to keep hope alive (even if it isn't particularly justified) and, at the same time, avoid our own discomfort with not being able to cure a problem. We think we are doing the family a favor: doesn't "developmentally delayed" sound so much more hopeful, so much nicer, than "mentally retarded?"

One reason is that "developmental delay" implies that the child's developmental functioning may some day catch up to her peers. After all, a delayed train eventually reaches its destination. But after a certain point - different for every child - it becomes clear that she will not catch up, that her intelligence will always lag well behind her peers, that she is, in fact, retarded and will remain so, no matter what her educational program provides.

By avoiding straight talk, by sugarcoating what is really going on, we pediatricians don't allow parents to understand their child's true potential. How are they then to provide the best possible environment to meet the unnamed developmental challenges?


A euphemism is "a word or expression intended to be less offensive and troubling to the listener." In some cases - such as pet words for a child's genitals or excretions - it's a way to avoid a word that is embarrassing to the speaker. I think this sort of thing is harmless and most families have funny pet names for their child's wee-wee and poop. No harm, no foul.

But other times, a euphemism is meant to lessen the emotional hurtfulness inherent to some terms. That's why we pediatricians have now been advised not call kids "obese," but "overweight" or "at-risk for overweight." That's another reason we prefer "developmentally delayed" to "mentally retarded."

Why? What's so bad about the word "obese?" Well, people have negative associations with "obesity," so it's felt that a kinder, gentler word will dispel that hurtful emotional baggage and perhaps even serve to change our attitudes towards obese kids. Thus is born "political correctness," wherein absurd word acrobatics are mandated, that we might soften our prejudices.

One slight problem: it doesn't work. The negative connotations of a word come not from the word itself, but from people's pre-existing prejudices. Changing the offending words is a stop-gap non-solution, because eventually the politically correct euphemism acquires the same negative baggage as the old word. This called the "euphemism treadmill" by Steven Pinker, the neuropsychologist. (A patient of mine was recently ridiculed by a bunch of kids on the playground who pointed and hollered, "Overweight! Overweight!" Do you think he thinks the word "overweight" is kinder than "obese?").


Nowhere has the euphemism treadmill been clearer - and more heartbreakingly ineffective - than the terms we use for people with developmental disabilities. In 1900, the terms "imbecile," "moron," and "idiot" were introduced to more precisely define the developmental level of the person. These terms were seen as a great advance. But, since our society doesn't take kindly to folks with disabilities, these terms - initially devoid of offense -- became insults and had to be dropped.

New terms came and went ("lame," "crippled," "handicapped," "disabled," "retarded") on the treadmill, until someone decided that even implying a problem was dehumanizing, and thus the term "differently-abled" was created. Aside from its absurdity and its insensitive trivialization of what is really a hard road to hoe on many levels, the politically correct crowd actually thinks such a term will improve our attitudes. Would that it were so easy. I shudder to think what term will come next, after "differently-abled" becomes an unacceptable insult.

Another problem with euphemisms is that they afford undue negative impact and power to the old, banished term. If "retarded" is now an unmentionable insult, it wounds even more when hurled at your child.

Finally, euphemisms are confusing for kids. So your dead doggie "went to sleep." That's so much less harsh than "died", right? But explain that to the five-year-old who then is afraid to fall asleep, lest she meet the same fate as Rover.


Go ahead and use euphemisms all you want with your kids. But, remember, when the stakes are high, avoiding explaining to your child about politically incorrect, hurtful words only furthers the power of those words to hurt your child. In that case, it's OK to embrace the simple, direct unambiguous terms, to teach your vulnerable child that "sticks and stones may break my bones but names can never hurt me," and to teach all your kids that wounding others with bad words is unacceptable in your family.

But don't count on clear, unambiguous words from your pediatrician, because we are forever developmentally delayed at not always giving you the unvarnished truth. Excuse me, I'd like to write more, but I have to go perform a not entirely benign procedure on a patient.


New Member
I agree - even doctors are somewhat "easy child" with their words. I, too, would rather know the score than go along for years in a state of mild denial.

thanks for posting this!


Well-Known Member
I agree! Developmental delay, speech delay, cognitive delay not otherwise specified, Sensory Integration Disorder (SID), etc. all meant Autism Spectrum Disorders (ASD) for my son, but many professionals don't want to alarm parents by saying "autism" so they sugarcoat it with a laundry list of other things. That doesn't help our kids get services and it deludes the parents into thinking that the child will someday grow into "normal." It also enables those in denial.I'm for shooting straight. Good article.
On the funny side of things, George Carlin did a bit on this, talking about how ridiculous all this "easy child" talk is. He compared toilet paper to bathroom tissue, the dump to the landfill, and old people to senior citizens, to name a few.

Great article.


Active Member
And yet a developmental delay , can be what it is a developmental delay. An accurate description of what is going on needs a multi-disciplinary approach also looking at the compatibilty and responsiveness of caregivers to a kid's difficulties. Research today shows that nurture can alter nature , that behaviors can be viewed as learning disabilities.
In the past all the parents here who take some sort of medication, anti-depressant would be considered ' mentally ill ', or maybe I prefer the euphemism - stressed out



Active Member
The problems arise when the newer term can have added meaning. I agree Allan, I'd always seen "developmental delay" as having a subtly different meaning to "retarded".

difficult child 3 was given a label of "significant language delay" which I took to mean that he was simply not as far along the language path as he should have been. I certainly didn't see it as a sentence of permanent inability to use language - it may have been intended that way perhaps, but I never saw it that way thank goodness, or maybe I wouldn't have worked so hard with him to help him "catch up".

At about the same time, the first big multi-disciplinary assessment of difficult child 3 (which also gave us the label "mild to moderate autism spectrum disorder") gave his first "psychometric assessment" (not IQ test, of course) results as "borderline". They never did tell us WHAT was borderline. I actually asked and they would not answer specifically, just told me that he would never be able to attend a normal school but in a few years time could be enrolled in a "special school". Again, no further specifics.

I grew up with accepted terms like "retarded" being used appropriately, certainly not as playground insults. The relevant insult was "dummy". And it was never used to the girl who clearly WAS retarded. Mind you, we did keep asking her why she was retarded but we never got the same answer twice and her big sister would refuse to answer. Hey, I was only 6 at the time. Kids want to know things, they aren't automatically easy child.
My older sister had a friend who was retarded. The term was used openly, frankly, no disgrace. Mary grew up, got married and had a baby (we were amazed). She needed a lot of support but I still remember her visiting my sister, with the baby. Mary and my sister were very good friends. I remember being told Mary's IQ was about 80. My sister was 145. But they understood one another.

difficult child 3 is quite comfortable with the autism label. He will openly tell total strangers that he's autistic, if there is even the slightest indication in the conversation. For example, "Why are you not in school?" would bring difficult child 3's reply, "I do Distance Education because I'm autistic and don't manage as well in a normal school."
Sometimes a person he's talking to will comment that difficult child 3 seems very smart. "That's because I'm autistic," he tells them.
A young friend of ours is a very smart kid. difficult child 3 asked her mother, "Is Debbie autistic?"
The mother was a bit taken aback and said, "No, of course not. Why would you think that?"
"Because she's very clever, one of the smartest kids I know," he told the mother.
I've explained to difficult child 3 that you can be clever without being autistic, and some autistic kids may be clever but have too many problems to use that clever brain properly. It's just that kids who are autistic need to learn in a different way and have problems sometimes where other kids cope. It's not always easy for them but there is a reason for that and there are often ways to work around a problem, as we are doing.
We have a young neighbour whose autism is quite severe. He's non-verbal and in many ways, like a 2 year old. difficult child 3 can accept that his autism is more severe but also sees that this boy can continue to improve. He doesn't understand that he will probably never be able to cope as well as difficult child 3 can. But we can't play cutesy with the language, we have to tell it like it is (and then try to convince difficult child 3 to be tactful - doesn't come easily!)

Political correctness is alien to autistic kids. difficult child 3 gave me a hug one day and said, "I love you, Mum. I don't care at all that you're fat."
Hmm. I hugged him back and thanked him, but tried to explain that saying things about someone being fat isn't polite. His reply - "But surely, Mum, you did know you're fat, didn't you? I wasn't saying anything you didn't already know?"

Maybe we should put autistic people in charge of the language use police.



Well-Known Member
Development delay has a MUCH different meaning than mentally retarded to me. It implies the child may catch up, and it's good to be optimistic, in my opinion. What isn't good, again in my opinion, is to see a disorder and refuse to label it, at least in the U.S.A. Without the label you don't get the help. I had to fight tooth and nail for every bit of autism therapy my son go because nobody would give him the label. What is cognitive delay not otherwise specified, speech delay not otherwise specified, Sensory Integration Disorder (SID), speech delay, social delay, etc. if not Autism Spectrum Disorders (ASD)? My son, now that he is older, is OBVIOUSLY Autism Spectrum Disorders (ASD) and had we not thought that he had it, and fought for the interventions without the label, I don't believe he ever would be functioning as well as he is. It's kind of like calling childhood bipolar the labels of ADHD/ODD and putting them on stimulants. I think some psychiatrists just like to soften the blow, and I don't feel it's useful. If you have cancer, do you want to hear tumor not otherwise specified? How can you get help if you can talk yourself into thinking, "Well, not as bad as I thought." Again, though, I like to hear it straight, no matter what it is. Then, and only then, can I attack it. I'm not a fan of easy child terms or softening the blow. I'd rather do much intervention and find it wasn't needed than not enough and find that more WAS needed.


That doesn't help our kids get services and it deludes the parents into thinking that the child will someday grow into "normal."

Amen. Misinformation is a disservice to parents and the child.


New Member
I think that, particularly when professionals are attempting to diagnose a child that is only 2 or 3 years old, it would be very premature to tell parents that the child is mentally retarded. Mental retardation diagnosis is, I believe, measured with the use of IQ tests, none of which can be used very reliably with that age group. Developmental delay, on the other hand, indicates that the child is behind peers in the types of things that a 2 or 3 year old should be doing. I think it is a very useful label, and not a euphemism at all, at least in that context.

My son was diagnosed with a "developmental delay"--quite accurately given what he could and couldn't do--at the age of 2 years and 4 months. But when his IQ could be tested accurately at age 6, it was normal to high-normal. Had we been told he was retarded when he was 2 years and 4 months old, who knows what kind of difficulties that misinformation could have caused?


Well-Known Member
I think developmental delay can be fine with a toddler, depending on whether or not the professional clearly sees other red flags, however, when a kid is six and you're still getting "developmental delays" or "cognitive disorder not otherwise specified" (like we did) they're quite often just being timid about saying a word that could have made our lives A LOT easier. My son's IQ has tested all over the place, from 85 50 107. I put more stock in what he can do, which is a lot more than we dreamed (due to his interventions), however there are things he doesn't do well, even at fourteen. And he most certainly does NOT have only ADHD, another label that in my opinion is often misused in order to sugarcoat what may be wrong. Not always, but sometimes. JMO