In the early 1970s, one of the authors of this chapter, Richard MacNeil, was working in the vocational rehabilitation department of a large Massachusetts institution, designed for the care of individuals with developmental disabilities. At this time, the philosophies of deinstitutionalization and mainstreaming were beginning to be emphasized. As a result, the institution staff’s efforts were directed toward preparing clients to adjust to a life outside our facility. As part of their preparation, our clients received rigorous training that emphasized vocational competence and independent living skills, and focused upon activities of daily living (i.e., grooming, cooking, shopping, etc.).