LEND History

The Children’s Bureau

The Leadership Education in Neurodevelopmental and Related Disabilities (LEND) program has a rich and evolving history. This program, currently administered through the Maternal and Child Health Bureau (MCHB) has its beginnings in the Children’s Bureau, which was established in 1912. This Act gave a very broad grant of power to the Children’s Bureau. In 1921 the Children’s Bureau administered the Maternity and Infancy Act (Sheppard-Towner Act), the first national Maternal and Child Health program and the first significant federal grant-in-aid program in the health field.

Title V of the Social Security Act

In 1935, Congress enacted Title V of the Social Security Act, which authorized the Maternal and Child Health Services Programs and provided a foundation and structure for assuring the health of mothers and children. Title V established federal and state partnerships to promote maternal and child health, to provide a range of services for handicapped children, and to develop public child welfare services.

From the early to mid-1900s children with severe disabilities were institutionalized. Physicians explained that the children were burdens to their parents and it was believed they would be better off and happier in institutions. Parents went along with the recommendations of the physicians rather than disagree with them. Pearl S. Buck wrote a book in 1950, “The Child Who Never Grew,” about her daughter who had mental retardation. That same year, the first advocacy organization for people with mental retardation, the National Association for Retarded Citizens, was established.

Martha May Eliot, Chief of the Children’s Bureau, identified children with mental retardation as a Title V program priority in her report to Congress in the mid-1950s. By 1955, services for people with mental retardation were a priority within the federal government.

Maternal and Child Health Services Programs

In 1961 President John F. Kennedy, who had a sister with mental retardation, appointed a panel on mental retardation. The panel’s recommendation was to establish research centers to expand the knowledge base about mental retardation, construct University Affiliated Facilities to treat children and train providers, and provide money for training providers.

In 1963, P.L. 88-164, authorized construction of University Affiliated Facilities to “offer a complete range of services for the mentally retarded and to serve as a resource for the clinical training of physicians and other specialized personnel needed for research, diagnosis, training or care.” Amendments to Title V, in 1965, provided grants for the multidisciplinary training of specialists to work with children having handicapping conditions.

Today, Title V is administered by the Maternal and Child Health Bureau as part of the Health Resources and Services Administration, Public Health Service, US Department of Health and Human Services. LEND projects are funded by training grants authorized under the Maternal and Child Health Services Block Grant, Title V of the Social Security Act. They are located within Centers of Excellence in Developmental Disabilities, formerly referred to as University Affiliated Programs. LEND projects are dedicated to training interdisciplinary health professionals who will be leaders in efforts “to improve the health status of children with, or at risk for, neurodevelopmental and related disabilities, and their families.”

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