This work reports upon a 1990 questionnaire survey of 16 Pakistani leaders in the field of mental handicap. Results are compared with those of a similar survey conducted in 1982. Most respondents reported that services in this field have increased both in quantity and quality. Differing views were expressed concerning: ease or difficulty of fundraising; terminology and the level of public awareness of mental handicap and ability to differentiate it from mental illness; involvement with self advocacy and parents' movements; effectiveness of services reaching rural and slum populations; access to published books/journals on mental handicap and special education; level of mutual cooperation between voluntary and government agencies; and issues of skill shortage, of environmental design, of equipment availability and of daily transport. Respondents also varied greatly on whether there is a suitable blend of Western and Pakistani ideas and methods, or excessive domination of foreign ideas. Appendices include summaries of development reports written from 1980 through 1988, a paper on the problems of definition and categorization, a discussion of past and future mental handicap studies, and a proposal for planning for mentally handicapped people. (86 references) (Author/DB)