Around the 1820s, amid a climate of enormous wealth in the growing industrial cities, a large number of rural and urban people were suffering from extreme poverty. During this age of rapid mechanical progress, industrialization, and scientific and medical achievement, people began to speak out on the conditions of persons with disabilities and others who were oppressed or neglected.

NEW CATEGORIES OF INTELLECTUAL DEFICIENCY

The first major change in the 19th century regarding the concept of intellectual deficiency came from Jean-Etienne Dominique Esquirol (1782-1840), a student of Pinel's and a famous psychiatrist in France. Esquirol divided intellectual deficiency into two levels: idiocy and imbecility. He defined "imbeciles" as "generally well formed, and their organization is nearly normal. They enjoy the use of the intellectual and affective faculties, but in less degree than the perfect man, and they can be developed only to a certain extent."

Esquirol defined "idiots" as persons with little or no intellectual functioning: "Incapable of attention, idiots cannot control their senses. They hear, but do not understand; they see, but do not regard. Having no ideas, and thinking not, they have nothing to desire; therefore have no need of signs, nor of speech." Esquirol's concept, though limiting, provided some consistency to the terminology used to describe persons with disabilities.

By the middle of the 19th century, society was much more aware of persons with disabilities. In an era of scientific and economic progress, social reformers alerted society to the often horrible living conditions of its many outcasts.

The Romantic poets Wordsworth, Keats, Byron, Shelly, and Coleridge, were influenced strongly by Rousseau's call to return to nature and celebrate the worth of the individual. The poets praised the restorative potential (clean air, fresh water, open spaces) of living a simple rural life. This rationale may have later justified locating institutions in the countryside.