This volume reports on the fifth nationwide survey of trends in mental retardation (MR) and developmental disabilities (DD). It begins with four chapters summarizing trends in the nation as a whole. The first chapter is "Mental Retardation and Developmental Disabilities: Historical and Contemporary Perspectives" (David Braddock). This chapter reviews etiology, history, and innovation in the states, especially as it concerns supported community living. Chapter 2, "The State of the States in Developmental Disabilities: Summary of the Study" (David Braddock, Richard Hemp, Susan Parish, James Westrich, and HyeJung Park) describes the survey's data collection procedures and provides tables and graphs showing trends such as closures of state-operated mental retardation institutions, daily costs per resident in public institutions, and public spending for developmental disabilities by state and year. Chapter 3, "Toward Family and Community: Mental Retardation Services in Massachusetts and New England" (David Braddock and Richard Hemp), compares services in Massachusetts to New England as a whole. Chapter 4, "Medicaid, Managed Care, and Developmental Disabilities" (Richard Hemp, David Braddock, and James Westrich), identifies key issues in Medicaid and managed care pertaining to persons with developmental disabilities. The remainder of the book presents detailed graphs and tables for each state showing community services, institutional services, trends in spending for MR/DD institutional and community services, trends in total developmental disabilities spending and fiscal effort, trends in Medicaid and Medicaid components spending, individual and family support services, and expenditure details. These graphs and tables are also provided for the United States as a whole. (DB)