Regarding labels, I thought a little personal history might be helpful, especially since as these are adult clients they might have through the "system" I would have done, if I hadn't had parents that made damned sure I didn't.

I have CP, and back in the '60's mental retardation was considered the norm, rather than the exception for this condition. So when I was 2, the hospital asked my parents to bring me in for psychological testng.

We were all three in the waiting room, my parents were seated facing the door, and I was seated facing them, and we were all engaged in a conversation. Then the nurse came in, said hello to my parents, grabbed hold of the back of my stroller, and, without saying a single word to me, spun me around wheeled me into another room, where a psychologist came in and started asking me questions, and asking me to do things with blocks, and such.

Now, at two, I was still shy of strangers, had no idea why I was there, or who this person was, and so I just sat there, and didn't do anything. Well, the doctor was very concerned and called my mother in, ready to break the news to my mother that I was severely retarded.

My mother was furious at how the nurse had treated me, and so to keep herself from going off on a tyrade, decided that she would only answer the doctor's questions with "Yes," "No," or "I don't know". She came in, sat down next to me and smiled at me.

Well, with Mom there, I was instantly at ease, so when the doctor asked me the questions over again, to show her how really slow I was, I answered all of them perfectly.

The doctor took "retarded" off my diagnosis, but he wrote that she was "Hostile and manipulative" (hostile to him, and manipulative of me, because I would only perform in her presence).

I go a little icy inside when I think what my fate might have been if my parents (my mother especially) had been cowed by the "expert" diagnosis that I was severely retarded, if, instead of insisting that I be mainstreamed in school from kindergarten on (and this was decades before ADA and IDEA [Individuals with Disabilities Education Act]), they agreed that it would be best if that I go to a "special" school with "children of my own kind" where kids are lumped together regardless of their mental capacity.

She had to make that fight twice, btw. When I graduated from 6th grade, the public school wanted to put me in such a "special program" because the high school building was even less accessible than the elementary building had been. That's when my parents decided to send me to private school instead (as Mom said to me at the time, she told the school officials that I get a "d" in balance, but an "a" in intellect, and she wasn't going to sacrifice that).

(Years later, my mother went back to that public school for a community meeting of some sort. The walls were covered with art work by students from kindergarten through high school -- and it was all exactly alike. When the principal [I think it was] said: "Ann can come back now, because our high school is accessible!" my mom declined the offer ;-))