When is a 'learning disability' a handicap?: When it confuses the public. Michael Durham reports

FELICITY FRYD has a 'learning disability'. That, at least, is how nursing staff describe her at the long-stay hospital where she lives. She is a thoughtful, good- natured woman of 53, who spends much of her time sitting on a heap of leaves at the bottom of the hospital garden, staring into space.

But to her family, calling her a 'person with a learning disability' is a travesty of the facts. Felicity cannot look after herself. She will never learn to hold an intelligent conversation. She is, and always will be, they say, 'mentally handicapped'.

'Learning disability?' queried her mother, Judy, with distaste. 'No - utterly wrong. It completely fails to match Felicity's condition. She has a great deal more wrong with her than the ability to learn.'

In the course of her life Felicity has been called backward, an imbecile, retarded and subnormal. Judy Fryd has always had strong views about how her daughter's condition should be described. She was the founder of Mencap in 1946, when it was first known as The National Association for the Parents of Backward Children. Eight years later, at her prompting, the group adopted the term 'mental handicap' and eventually became Mencap.

Yet now, in most social work offices, council chambers and health authority committee rooms the words 'mental handicap' are no longer uttered. They are regarded as insulting, misleading, bad for people's self-image and, ultimately, politically incorrect. In June last year, the term 'people with learning disabilities' was officially adopted by the Department of Health to describe the mentally handicapped. 'People with learning difficulties' has been widely used by education professionals for 10 years. But both terms are the subject of passionate debate.

This month Mencap, the leading charity for the mentally handicapped, will undertake a relaunch. Many of its younger supporters want the group to ban the old description, but a significant number of older traditionalists are adamant they want to stick with 'mental handicap'. Mencap will not, however, drop 'mental handicap' from its public appeals, nor change its name. The scene is set for the biggest row the world of mental disability has seen for many years.

The word 'handicap' derives from an ancient game of forfeits, in which the players dipped their hands into an upturned cap to retrieve objects. Later it became a horseracing term where, ironically, the most able horses were weighted down to give the slower ones a better chance. 'Handicap' first came to mean some kind of human physical impairment in the late 19th century. It is only in the last 30 years, as it has become associated with both physical and mental problems, that it has acquired any pejorative overtones.

Valerie Sinason, a psychotherapist who works with mentally handicapped adults and children at the Tavistock Clinic in London, has made a detailed study of euphemisms for mental handicap. She has identified 43 different terms, including dolt, blockhead, idiot, cretin, ninny, slow and stupid. Most, she believes, began as innocent descriptions but were corrupted over a period of time. Historically, euphemisms for mental handicap have usually lasted for about 30 years. 'Every new word is coined honourably,' she said. 'It is not deliberately created as a euphemism, but becomes one because of the painfulness of the subject.'

Ms Sinason believes the time span has become shorter because of mass communications, and words now last only five years. She has recently met normal eight-to-12 year old children who use 'LD', short for 'learning difficulty', as a term of playground abuse. 'It is only a matter of time before it will have to be changed to something else,' she said. In America, the birthplace of political correctness, the terminology is still on the move. Vogue terms are 'intellectually challenged' and 'intellectual disability' - in some areas this has given way to 'dysability', the 'y' in the prefix intended to defuse the negative.

Does what we call someone really affect the way society treats them? People First, a pressure group which is challenging Mencap, believes it does. At its small office in central London, the expression 'mental handicap' is regarded with horror. 'You don't use that term here,' warned Declan Treanor, the group's administrator. He is perhaps best described as a person without a learning difficulty; all the other employees do have, to some degree.

'It's up to the people affected themselves to decide what they want to be called,' said Mr Treanor. 'Staff here chose 'learning difficulties'. Nobody likes it, but it's better than what went before. Our slogan is 'label jars, not people'. At bottom it's not the terminology that needs changing, it's negative images. Altering the name is only the first step in changing public attitudes.'

'Handicapped is one of those words that isn't in our vocabulary any more,' said Simon, who has a learning difficulty, and works for People First as an adviser. 'It has a stigma and you are treated as a child, as if you can't do anything for yourself.'

Mencap, however, does not agree. It believes it can accentuate the positive without adopting jargon which is widely misunderstood by the public. 'The evidence is that most people don't know what 'learning difficulties' means,' said Steven Billington, fund-raising director. 'They think it's something to do with needing a bit of extra help with your Latin.'

Instead, Mencap is to relaunch with a 'positive images - positive action' approach. Old images of mental handicap which tug at the heart strings have been consigned to the dustbin, including 'Little Steven', the famous drawing of a sad-faced little boy. He will be replaced by new logos showing cheerful, smiling, active mentally handicapped people.

The approach may have financial consequences. Compared to shocking or pitiful images, soft or more positive advertising does not necessarily make people reach for their wallets. The result for Mencap could be that, while the public may be better educated, its coffers may be less full in future. 'The new images are not primarily designed to elicit public donations,' said Mr Billington. However, the harsh reality is that - for the time being at least - 'mental handicap' and doleful pictures may arouse more sympathy than political correctness.

(Photograph omitted)