Early on, people with special needs and disabilities were placed into institutions for the insane by their families because they did not know how take care of them and did not want them to embarrass the family. These institutions were dirty, overcrowded and unregulated. While there was no education happening in these asylums, there was electroshock therapy, hydrotherapy (extended exposure to extreme temperatures of water) and eugenics (forced sterilization) taking place in the 1800s and 1900s. In some circumstances, doctors performed lobotomies which was when they cut connections between parts of the brain, resulting in comas.

By 1930 child guidance clinics and counseling services were relatively common features of major cities, and by 1950 special education had become an identifiable part of urban public education in nearly every school district. By 1960 special educators were instructing their students in a continuum of settings that included hospital schools for those with the most severe disabilities, specialized day schools for students with severe disabilities who were able to live at home, and special classes in regular public schools for students whose disabilities could be managed in small groups. During this period special educators also began to take on the role of consultant, assisting other teachers in instructing students with disabilities. Thus, by 1970 the field of special education was offering a variety of educational placements to students with varying disabilities and needs; however, public schools were not yet required to educate all students regardless of their disabilities.