In the case notes accompanying the toy car pathology specimen implicated in the case of lead poisoning, the term ‘mental retardation’ is used as the original diagnosis attributed to the patient.

In 1963, when this case was first presented, ‘mental retardation’ was a specific clinical term used to describe a patient who had not
satisfactorily achieved a set of developmental and learning milestones.

Over time, a number of clinical terms, including mental retardation, came to be used pejoratively in some parts of wider society – most often this would be between schoolchildren and teenagers, but also sometimes by adults. Other clinical terms that have also been used in a derogatory fashion in lay society include ‘spasticity’, ‘cretinism’ and ‘mongolism’, to name a few.

The misuse of these clinical terms in this way was seen to have a negative and stigmatising impact on patients and also their loved ones, who may have encountered the terms in the context of their own diagnosis or clinical care.

In response to the potentially damaging effect on patients of misuse of certain clinical terms, over the years, clinicians have taken steps to find alternative descriptions of clinical conditions that are less susceptible to perjorative use.

For example, instead of using ‘spastic paralysis’ to describe a type of paralysis that is brought about when opposing muscle groups are contracted at the same time, clinicians now refer to ‘pyramidal paralysis’ in which ‘pyramidal’ describes a particular anatomical part of the brain in which this problem arises.

Similarly, ‘mental retardation’ these days would more likely be referred to as ‘learning disability’ and/or ‘developmental delay’.

Clearly, as language and use/abuse of language is continually evolving, it is likely to remain a challenge for clinicians to respond sensitively and appropriately to misuse of clinical language, whilst retaining as far as possible, clinically effective language.