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Society's willingness to help people with a disability has been determined largely by the perceived causes of the disability, existing medical knowledge, and general economic conditions. Ancient and modern religious faiths (including Christianity) have at times been an aid and at other times a detriment to viewing those with a disability as people. The early Greeks promoted the philosophy of the unity of body and soul, with a blemish on one signifying a blemish on the other. This philosophy led to a negative attitude toward those with a disability. Centuries later, the Romans also put to death some people with a disability who were considered unproductive. In ancient history, there were almost no organized efforts to meet the needs of people with a cognitive disability. In early Greece and in the Roman Empire, mental illness was seen as stemming from demons entering the body, with exorcism being the primary treatment.
During the Middle Ages, disabilities were seen either as the result of demonic possession or as God's punishment. Modern Judeo-Christian values of charity and humanitarian treatment were generally absent during this period, partly as a result of poor economic conditions. About the only employment provided by feudal lords for people with a disability was that of court jester, a position considered suitable for those with a cognitive or physical disability. The mentally ill continued to be viewed as possessed by demons, and cruelty was advocated and used to punish and drive out the demons. In early colonial America, conditions were not yet suitable for the development of rehabilitation programs.
In the 19th century, gradual recognition was given to the needs of people with a disability in the United States. The first programs to help these people were developed around that time. Cognitive disability, before and during the early part of the 19th century, was thought to be inherited and therefore incurable. In the first half of the 1800s, most people with a cognitive disability were relegated to lunatic asylums, poorhouses, almshouses, or local jails. Unfortunately, the orientation toward people with a cognitive disability in the latter half of the 19th century switched from one of education and training to one of custodial care. People with a cognitive disability were viewed as having defective genetic strains; as a result, sterilization was used extensively at the end of the 19th century. Until the latter half of the 19th century, people with a physical disability were either taken care of by their family or placed in almshouses. Toward the end of the 19th century, these people began to benefit from medical advances: antiseptic surgery, orthopedic surgery, heat and water therapy, braces, and exercise programs. Around that same time, public funds began to be used for the education and training of children with a disability.
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