Nielsen begins Chapter 3 by discussing the ways in which people dealt with psychological and physical disabilities in the late colonial era. Using anecdotes to cite specific cases, she explains that “first and foremost, families provided care” for individuals with disabilities (31), but people with disabilities became the responsibility of their village or town when families could not or would not provide support. In the cases of revolutionary hero James Otis, Jr., the wife of Patrick Henry, and the sister of Thomas Jefferson, all of whom had psychological disabilities, their families provided care, but in cases in which individuals had no family, people with disabilities frequently entered the domain of “poor laws” (35). While confinement of those exhibiting “madness” was rare and done only when absolutely necessary, by the end of colonial period, people with disabilities regularly resided in almshouses (36). Almshouses not only served as correctional institutions but also were “a general dumping ground for all those unable to support themselves financially” (37). Concerning physical disabilities, Nielsen writes that although bodily variations were routine, the general lack of discussion and institutional acknowledgement of them suggests that “they simply were not noteworthy among communities of European colonists in the period before the Revolution” (39).