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Twenty-Two Years

Twenty-Two Years

Causes and Consequences of Mental Retardation

Stephen A. Richardson, Helene Koller

ISBN 9780674212978

Publication date: 01/01/1997

Twenty-Two Years presents the results of a unique longitudinal study of the first 22 years in the lives of more than 200 young people with varying degrees of mental retardation. By following their paths through available services, job histories, leisure activities, friendships, and marriages, the authors provide objective information about the quality of life of young people with mental retardation.

The book makes a unique contribution by determining what factors in childhood predict who will and who will not require mental retardation services and, for those who disappear from services, why some fare better than others. Most important, the results help answer a question that haunts parents: "What will happen when my child grows up?"

This study expands on an internationally acclaimed clinical and epidemiological study of children with mental retardation published in 1970. It provides prevalence rates by severity of mental retardation, gender, social class, and family stability, and shows how these change over time.

The authors confirm the central role of biomedical factors in the etiology of severe mental retardation. For the etiology of mild mental retardation, the book examines the relative contributions of biomedical and intergenerational genetic factors as well as psychosocial adversity. The book should be of interest to a broad range of clinicians, researchers, and students, as well as the families of people with mental retardation, and it will serve as a model for future epidemiological and follow-up research.


  • This book offers a wealth of invaluable information on epidemiology and individual characteristics of young Scottish people with mental retardation. It is a unique follow-up study from the city of Aberdeen based on a representative series of 221 cases born between 1951 and 1955. The original ideas for the study were first concretized by Herbert Birch, Stephen Richardson and collaborators, and first published in 1970 in their well-known volume: Mental Subnormality in the Community: A Clinical and Epidemiological Study. [Richardson and Koller] now present the thoroughly collected and analysed follow-up data up to adult age… The volume undoubtedly is indispensable for all categories of researchers within the broad field of mental retardation projects. Above all, it is a brilliant reference book with advanced updated information, more so than a handbook, readily accessible for basic information. The authors’ knowledge and long professional experience, as well as their massive wealth of data presented and analysed, are all unique… The authors should be given special praise for the prevalence section, where the handling of controversial opinions between different schools is presented in a balanced way… This volume is highly recommended.

    —Bengt Hagberg, Acta Paediatrica


  • Stephen A. Richardson is Professor Emeritus, Departments of Pediatrics, Epidemiology, and Social Medicine, Albert Einstein College of Medicine, New York.
  • Helene Koller was Senior Associate in the Department of Pediatrics at Albert Einstein College of Medicine.

Book Details

  • 352 pages
  • 6-1/8 x 9-1/4 inches
  • Harvard University Press