^ 
 
 ^ 
 
 BACKWARD AND FEEBLE-MINDED 
 CHILDREN 

 
 WARWICK & YORK 
 Baltimore
 
 ( . ^(O 
 
 lE&Ufattnual PiUtrhnUnui itlintnnraplig 
 
 Backward and Feeble -Minded 
 
 Children 
 
 Clinical Studies in tlie Psychology of Defectives, witli a Syllabus 
 
 for the Clinical Examination and Testing 
 
 of Children 
 
 ::. . ■ J -.- ^. 
 
 BY 
 
 EDMUND BURKE HUEY, A.M., Ph.D. 
 
 Lecturer on Mental Development in The Johns Hopkins University, 
 
 Assistant in Psychiatry in the Phipps Clinic of the Johns Hopkins Hospital, 
 
 Author of The Psychology and Pedagogy of Reading 
 
 Sialtimmr 
 WARWICK AND YORK, INC. 
 
 1912
 
 Copyright, 1912 
 Bv WARWICK AND YORK, 
 
 INC.
 
 AC. 
 
 TO 
 
 Henry Herbert Goddard 
 
 Trusted and generous friend, whose own devotion to research 
 
 with defectives led me to undertake 
 
 these studies
 
 I'RKJACK. 
 
 The public scliorils receive ami ])artiall\ cniuri)l. for a time. 
 almost all of the indix-i'liials who will later trouiile society 
 as cleliiu|uenl> or dependenls. or who will 1x' troubled them- 
 selves b\ iu>auity or other foruis of mental disturbance. 
 Usualh' onK the lowest ij-rade of feeble-minded children fail 
 to find their wa\- to school. 
 
 Except in the case of infre(|uent offenders, and excepting" 
 also persons whose mental disturbance is due to s])ecific kinds 
 of poisonini;'. these individuals usually show excepti(^nal con- 
 duct even in their school ])eriod. and the_\- would be taken ac- 
 count of as children who need s])ecial attenti(»n, 1)\- an\i)ne 
 trained to and experienced in clinical observation. There is 
 here the possibilit}' of stuclyino- /// ndi'ancc the main sources 
 of social dauL^er and of indivi<lual misfit and shi])wreck. 
 There is equalh' the ])ossibilitv of forestalling- nian\- of the->e 
 ills and of taking- awa\" in advance the stiny' and smart from 
 many an unhappy life. Aside from the service to be rendered 
 to normal children (Hid teachers hy wise clinical oversight and 
 counsel, the recording- of exce])tional functionings and facts 
 in the case of these exceptional childien, the canvassin*;- of 
 their potentialities, favorable and unfavorable, would be of 
 inestimaljle service for the intelligent studx" of societ\'s ills 
 and for the solution (_)f the problems that these individuals 
 theniselves present. 
 
 ( )f most immediate need is the ])ro\-ision of special classes 
 for children who need a s])ecial pace or course or treatment 
 to enable them to win success at something useful in>tead of 
 failure at something useless. With this coiuo the planning
 
 X PREFACE. 
 
 and installing of manual and occupational courses by which 
 the most can be made of even slender resources. These 
 classes and courses will at once relieve teachers from the 
 worry of impossible discipline and from the dragging along 
 of the retarded. 
 
 Let us not delude ourselves witl: the hope that the de- 
 fectives are to be cared for in institutions. Existing institu- 
 tions cannot house one-tenth of the number. Alore institu- 
 tions should be built, but even then the most troublesome and 
 dangerous higher-grade children will only exceptionally 
 reach them. The cities must plan to manage these in situ; 
 must plan to exercise, through the schools especially, a per- 
 manent directive and educative control that will make self- 
 sup]Jorting and contented, if humble, citizens of thousands 
 who, without such oversight, become the unproductive, un- 
 happy dregs of perversion. A competent clinician-educator 
 in the schools can render at least the service of an institution 
 superintendent in organizing the activities of defectives ; and 
 far more, for he can really save the state the cost of main- 
 taining an additional institution for such cases. Of course, 
 the employment of one or another of the means proposed for 
 preventing procreation by defectives is presupposed for such 
 treatment /// situ. 
 
 Of even greater importance, we may find, will be the early 
 diagnosis of dangerous mental tendencies and habits, that 
 occur even in the brightest and best of school children. The 
 easing of adaptations in critical directions and periods, judi- 
 cious counsel to parents and others who mav direct the child 
 toward such levels of occupation and environment as will be 
 safest and most productive for him — these are services which 
 the history of cases of insanity teach us may be rendered to 
 thousands of threatened lives. The schools and institutions 
 are already beginning to look for men competent to do this 
 work, and psycliology aufl medicine are just beginning to
 
 I'KKl ACi:. XI 
 
 realize that thov nuist joiii hands willi cacli otlicr and with 
 sociology and education in traininL;" clinicians capalilc of 
 rendering" this service. 
 
 This little volume suggests hut a few of the possihilities 
 of such clinical work. The studies are of school children or 
 of persons who have heen school children. With normal 
 home conditions few, if anv of them, would have reached an 
 institution. They are just such e.\ce]Jtional children as one 
 meets in the schools of a Inindred cities, and they are of con- 
 siderabh- higher grade than very mau\- that one finds there. 
 If they could have heen studied in iheir home schools, I 
 should know a good deal more a])out them. I'.ut the pictures 
 of them here are as full and as true as circumstances per- 
 mitted me to make them. 
 
 Years ago at Heidelberg, Professor Kraejxdin told me, with 
 enthusiasm which I well remember, how much he thought 
 might come from an intensive clinical study of a group of 
 some thirt\- school children. ( )n ni}- way to Lincoln Dr. 
 .Adolf Meyer encouraged me to undertake some such 
 study in the Illinois institution. The results of a practice 
 try-out of the plan are here before the reader. There are 
 always limitations, methods were to be made, and of course 
 the studies are imperfect enongh. Hut whether f(~)r my de- 
 velopment as a psychologist and educator or for the render- 
 ing of m\ most useful service, I could hardly ask a better 
 opportunity than to repeat such a study in a jiublic or ]:)rivate 
 school, particularly if the sttidy could be made under the 
 auspices of a well-c(juipped universitv. 
 
 I'o Superintendent 11. (i. Ilardt, who had the foresight to 
 foiuid and support the department, and to the Illinois State 
 Board of .Vdministration. whose attitude has been one of 
 most cordial and intelligent co-operation, my best thanks are 
 due. I wish to acknowledge, as well, the effective assistance
 
 XU PREFACE. 
 
 of physicians, teachers, and attendants, and especially the 
 uniform courtesy and interest of the children themselves. 
 
 Dr. Goddard has been largel}' responsible for my under- 
 taking and continuing the work, and has aided me at every 
 point. JNIiss Julia A. Lathrop, of Hull House, and Dr. 
 William Healy, of the Juvenile Psychopathic Institute, have 
 given encouragement and assistance. Finally, the co-opera- 
 tion of my publisher has Ijeen most effective and cordial, and 
 has permitted the book to develop well beyond the original 
 plan. I regret only that other undertakings have prevented 
 my attending to certain details of literary expression whicli 
 may have needed modification in this change of plan. 
 
 E. B. H. 
 
 Baltimore, 
 
 Chi'istiiias. icjii.
 
 CONTENTS 
 
 CllAl'TliR 1. 
 
 PAGE 
 InTKODICI |().\ I 
 
 ciiAi'ri':R II. 
 
 Classification' \xn Ti'.km ixoi.cka' 5 
 
 CHAPTER III. 
 Clinical .Siri)ii:s oi- l>t)Ki)i-:K Casls 22 
 
 CH A PT I-: k i\. 
 
 Clinical Sicdils of Ijokdlk CasI':s 107 
 
 CHAPTER W 
 
 Taiu'lations ok Data, St'cicLsiLn (ikoi'ps. Lines of 
 Transition from Elfi;li:-M ini)i:i)N fss to Xox- 
 I'Fi:r,LL-MTxnKnNi:ss 157 
 
 CHAPTER \ 1. 
 
 A .S\ij,Aius i-DR I'Hi-: Clinical I^xam ina riox of Ciiil- 
 
 1 )Ri:.x 1 73 
 
 . CHAPTER \ II. 
 CoxcLL'sioN — Tmc .MiLxiAL ITxcrioxs lo ni-: Ti".STi:r> 
 
 AND ( )l!SLR\LD 2O3 
 
 Tlll'.LIOCRAI'FIV 209 
 
 In DFX OF Casks 217 
 
 Index of Scisjects axd X \mi:s 219
 
 BACKWARD AND FEEBLE-MINDED 
 CHILDREN 
 
 

 
 BACKWARD AND FEEBLE-MINDED 
 CHILDREN. 
 
 CIIAPTF.R I. 
 
 TXTRc:)])rrTir)\. 
 
 ( )t the poinilation of l^niL^land and Wales, il !ia> l)ecn 
 found that i in 24<S are feeble-minded, and that almost as 
 many, i in ly^^, are insane. It is prol:)able that we have 
 quite as many feeble-minded in Ameriea. V<~n- the most part 
 they are ]ivin!.i- in the families to whieh they !)el'ini:. Many 
 of the states have not i:)rovided institutions f(ir their care. 
 In none is there ])rovision for more than a mimir ])ercentag'e 
 of the total number, even if the institutions lioth ])u1)lic and 
 ])rivate were filled to their ca])acity, and the\- usually are so 
 filled. Dr. ( ioddard cjuotes Dr. I'^rnald as sayirij;- that "There 
 are at least 200,000 ])ronouncedly feeble-minded ])ersous in 
 the United States. ( )f these 16,000 are inmate> of alms- 
 houses, while only 18,000 are cared lor in .special institu- 
 tions." 
 
 The greater number of this vast army of defective'- are 
 for a part of their lives pupils in the public schools. Xearlv 
 43 per cent, (jf a year's C()nsecutive admissions to the Illinois 
 state institution had spent at least a year in the jniblic schools. 
 15ut of the far larger numbers who did not come to the in- 
 stitution, it is certain that the great majority are higher- 
 grade children who would l)e still more likel\- than the others 
 to spend some years in school. 
 
 The problem of the feeble-nn'nded is thus, at least at pres- 
 ent, a problem of the homes and of the ])ublic schools rather 
 than one of institutions. Indeed, it will long remain so. Xot
 
 2 BACKWARD AND FEIIBLE- MINDED CIIIEDREX. 
 
 only do parents love to cherish these maimed members of 
 their flock, but the hioher-2.-rade children usually find means 
 of avoiding detention in institutions, and spend their years in 
 their home localities or in wandering at large. Even so, they 
 are born to trouble anrl vexation of themselves and others. 
 Their presence and conduct subject their families to humilia- 
 tion ; they are an intolerable burden to the teacher and to the 
 schools ; they recruit the ranks of criminals, prostitutes, 
 vagrants, almstakcrs. and insane. Indeed, society is coming 
 to realize that all these latter conditions for the most part 
 proceed from the same source in weakened or tainted hmnan 
 stock ; and that the elimination of these classes is a matter 
 of the elimination of the causes o])erative in the degeneration 
 and reproduction of weak and tainted human stock. This 
 problem of prevention and elimination is the more funda- 
 nieiUal one, and there are already known means to its partial 
 solution which will become etTective just as fast as society 
 becomes better organized and more enlightened. 
 
 The presently pressing problem is one of the social adap- 
 tation, of this army of unfortunates, to an environment and to 
 a level of mental functioning which will make the most of 
 their scanty resources while assuring the protection of society 
 itself. To help in solving l)oth these problems the scientific 
 study of the feeble-minded is recentl\- being taken up with 
 enthusiasm, both in Europe and in America. 
 
 The case material for such study, while present in many 
 homes of ever}- neighborhood, is more accessible in the un- 
 graded or special classes that are more and more being or- 
 ganized in the public schools of cities and towns. The 
 Parental and Reform Schools have many such children, and 
 the schools for wayward girls as well. The Juvenile Court 
 has to do with many of them, and they are to be found in 
 jails, penitentiaries, almshouses, and hospitals for the insane. 
 
 On the whole, the institutions specially provided for the
 
 i.\ iKdiniriox. 3 
 
 feeble-minded offer the greatest advantage-; for sueli study. 
 J-"rom the courts and schools and aliu>house-~ and families 
 the children of all ty])es are sent on to the>e institutions, 
 which l)ccnme veritahle nuiseums of defect of every t}])e. to 
 h,e studied here at the student's will. Idiere i> the >iniile se- 
 rious disadvanta,L;e that the child is here sei)arated from his 
 native hal)itat, and thus the family and i)ersonal hi>tory is 
 often hard to obtain, and cannot be ()l)serve<l in its present .' ^ 
 effect upon the child. < )n the other hand, the child here liv(.s 
 in an environment which can be made au«i varied to order, 
 and the effect of various environmental and social factors can 
 be studied with almost laborator\- precision. This latter is an 
 o])portunity for experimeiUal pedaLioj.i'y which will doubtless 
 be taken advanta.ye of hv dei)arlments o\ education in state 
 universities, which ma_\- affiliate with psycholoj^y tlepartments 
 in the institutions. 
 
 The establishment of I )r. ( iocldard's laborator\- in the .\'ew 
 Jersey Trainiui;' School at \ ineland marked the bes^innin,^' 
 of a new era in the American stmly of the feeble-minded. 
 Followin.t^ the lead of the New Jersev school, the Illinois 
 state institution for the feel)le-minded. entitled the Lincoln 
 State School and Colony, was the first of the state institu- 
 tions to establish a psycholo,'^ical department. The ])reseut 
 voltmie presents some of the main results of the writer's work 
 in charge of this department for a year and a half from its 
 inception. 
 
 There were few traditions and no rules a- to what such 
 a department should do ov what studies should be under- 
 taken. As the work was actually done and as it is here re- 
 ported it consisted, first, in a provisional classification and 
 description of the membership of the institution as a whole 
 beginning with the new admissions, involving the adoption 
 of certain routine tests and of an official terminology in terms 
 of which classification could be made : Second, the clinical
 
 4 KACKWAKIJ AND FKl-:nr.E-.MI XDED CHILDREN. 
 
 study of thirt}-t\vo border cases of backwardness and feeble- 
 mindedness, made upon the highest-grade children of the in- 
 stitution : Third, a formulation of the methods of case study, 
 
 A CORNER OF THE LINCOLN LABORATORY. 
 
 and of suitable research tests for the mental functions in- 
 volved in mental defect. Without further j^reliminaries, the 
 work will be presented in this order.
 
 CIIAPri-R IF. 
 
 CLASSIFICATIOX AXD TERMINOLOGY. 
 
 A ])rc-Hniinary problem had to be settled early, that of a 
 classification system and a fixation of usage for the most 
 common terms. The words idiot, imbecile, and fccblc-mindcd 
 have been used in the most varied and contradictory senses, 
 even in the courts and in the institutions themselves, to sax- 
 nothing of the confusion of laymen. It had become abso- 
 lutely necessary to come to some agreement about them. 
 Then there are many forms oi each of these: manv causes 
 have operated and many types have Ix-en i)roduced. And a.-- 
 to the intelligence, there are, of course, many degrees to be 
 distinguished. 
 
 The possible groupings of the feeble-minded are thus 
 most various, such as into Mongolian, cretin, e])ileptic. etc. ; 
 into excitable and apathetic, congenital and acquired, trau- 
 matic, tuberculous, ad infliiituiii. All these are legitimate 
 groupings, and account should of course be taken of every 
 child in terms of them, as far as they applw P.ut for actual 
 handling- of the cases, for fitting them to work in school and 
 in occupations, a description and classification in terms of 
 mental capacity and character seemed certainly tc^ be what 
 was needed. 
 
 To make a satisfactory mental descrii)tion is one of the 
 most difficult of tasks ; and until very recently, if not even 
 now, the psychologists have been less able here than the 
 novelists and dramatists. To measure mental capacity, on 
 
 5
 
 O liACKWAKU AXU FEKIJLE-M I XDED CHILDREN. 
 
 the othtr hand, has usually been thought to be altoo^ether ini- 
 possible. ])Ut a beginning had to be made. Happily, it was 
 found that the Rnglish and iM-encli writers were tending to 
 a more or less common practice in the main lines of classi- 
 fication and in the tise of terms. In 1904 the English Royal 
 Commission recommended that the term fcchlc-uundcd 
 should include all mentally defective children who needed 
 institution care, in three ascending grades o f idi otj imbecile, 
 and fcchlc- mjiu icd j^roper. h'or the Fren^T-^rofessor Binet, 
 their most nVfluential adviser in these matters, makes three 
 grades similarly, lie delimits them more definitely in terms 
 of the amount of intellectual retardation as measured by a 
 scale of tests of the intelligence. 
 
 At Mneland and at Lincoln the P)inet classification and 
 tests were found usal^le and useful. The children were be- 
 fcjre us: and as no other system offered iialf so practicable a 
 means of bringing order into chaos, we proceeded to classify 
 in these terms and to use these tests for routine examinations. 
 Jn May, 1910, the Amc'rican Association f(jr the Study of the 
 Feeble-Minded met at Lincoln. After examining the work 
 of these two institutions, they took official action settling 
 at least tentatively, for .American i)ractice, the following" 
 ]:)oints. ])ractically an endorsement of what they found in 
 successful operation in these institutions: I. The term 
 "feeble-minded" is to be used generically to include all <le- 
 grees of mental defect due to arrested or imperfect mental 
 development, as result of which the ])erson so afifected is 
 incapable of competing on equal terms with his normal fel- 
 lows, or of managing himself or his aft'airs with ordinary 
 prudence. 2. The feeble-minded are divided into three 
 classes, viz. : 
 
 Idiots. — Those so defective that tlu- mental development 
 never exceeds that of a normal child of about two years. 
 
 Imbeciees. — Those whose deyelo])ment is higher than that
 
 CI.ASSIKJ CATION AM) ll^K M I .\( )l.()l iN'. 7 
 
 of an idiot, luil whose inlellit^'cncc docs not exceed that of a 
 norma] child of ahout. seven years. 
 
 AioRoN.s.— 'I'hosc whose mental dcA-clopment is ahove that 
 of an imbecile, but docs not exceed that of a normal child of 
 about twelve years. 
 
 They ftn-ther approve of the use of the older ])alholo-ical 
 terms, such as hydrocephalic, microce])halic. i)ara!vtic. etc. 
 
 Each of the three ,i>'rand divisions is sulidi\ided into loiv, 
 iiii(hil(\ and ///.i;7/. The use (jf the terms is illustrated in such 
 combinalioiis as "low MouL^'olian imbecile,"' "hi^h epileptic 
 moron." Moron, a new term. dis])laces the use of jcchlc- 
 uiindcd in the restricted sense, for the hi^hc'-t j^rade of the 
 feeble-minded. 
 
 I'inet uses the terms idiot, inihccilr. and drhilc i nearh' cor- 
 resi)ondini;" to moron), with no sti;4nia, and not to name 
 tirades of defect so much as decrees of intelligence, which 
 ma}' chan.::;e with ai;e, an. imbecile i)erhaps becoming' a moron. 
 J le wotdd not place children in the special school classes for 
 defectives, on account of mental retardation alone, unless 
 this retardation amounts to three years or more, or to at 
 lea.st two years if the child is imder nine. Presumably he 
 would not ai)])ly the terms idiot, imbecile, etc., for retarda- 
 tion alone, unless it amounts to as much as this, and not 
 necessarily even then. i'"or the still slis^hter de,qree> of re- 
 tardation he W'-()uld use the terms Hack:card for the merely 
 retarded and f/nstabic for the e([ually lar.^e number whose 
 instability is their most prominent cliaracteristic. We mav 
 conveniently (jualify these terms by any others that will fur- 
 ther define the condition, in such combination^ as "morally 
 imstable," "neurasthenically unstable," etc. 
 
 In spite of Binet's suggestion and ])ractici'. the terms 
 idiot, imbecile, moron, and feeble-minded will continue to be 
 thouglit of as terms of final diagnosis, and it is probably best 
 not to use them when the child gives i)romise of developin::;"
 
 8 IIACKWAKD AM) I-KKIW.I-:- M I Xi)i:U CHILDREN. 
 
 much 1)evoiKl the hmits of mental age impHed by the term in 
 question. This practice is especially advisable if the child 
 is quite vtning-. In these latter cases he should simply be 
 recorded as menially "Retarded"' in the degree found, with 
 such other terms as best describe his actual condition. 
 
 It will be ioimd that the term fccble-niiiidcd cannot always 
 be applied to children, especially to children under fifteen, 
 from the mere fact of their showing any given amount of in- 
 tellectual retardation as measured by any scale of tests. 
 Usuallv. it is true, when the child shows more than three 
 years of retardation it is feeble-minded. But there arc 
 cases in which the intelligence is inhibited even to this extent, 
 in functioning- or in development, from causes whose re- 
 moval permits the child to prove that he was never of the 
 feeble-minded kind. On the other hand, I shall later present 
 notes of many cases showing less than three years of retarda- 
 tion, but which are undoubtedly, and some of them very fun- 
 damentally, feeble-minded. As a matter of fact, all psy- 
 chiatrists know that feeble-mindedness, like insanity, involves 
 much more than the intelligence; and its correct diagnosis 
 often involves the expert consideration of various clinical 
 phases, and cannot be made by the automatic application of 
 any schema or scale. It is evident, however, that diagnosis 
 may be greatly facilitated and in the majority of cases may 
 be practically accomplished by a careful measurement of the 
 intelligence. 
 
 The ui)per limit of feeblemindedness was placed at twelve 
 years of mental age because observation and test, agreeing 
 completely at A'ineland and at Lincoln, showed that children 
 of any higher intellig;ence are able to "float" in society, and 
 insist on doing so. They manage to keep out of the institu- 
 tions or to get out when placed in them. In France the de- 
 fectives "float" at a still lower level; and indeed it will be
 
 ( I.ASSII' ICA riD.N AM) Ti;i<M 1 \(»l.(HiN'. 9 
 
 seen that the levels (jf eleven and twelve years of mental a.^e 
 have few representatives in the Illinois institution. 
 
 It must not he su])])ose(I that ahove the twelve-year level 
 we shall at once find the levels of normahtw We bci^iii to 
 find them here, if not even a little lower, in those small in- 
 telligences which <|uite sutitice to happily till some >im])le 
 sphere in which they may have had their evolution. l-"rom 
 this upward the successively higher levels of normality itself 
 are as manifold as are the degrees of difficult}- to he met by 
 individuals in a complex civilization. Xormality of intelli- 
 gence is not a fixed strength of intellect to he required of an 
 entire population. The various industrial and professional 
 •classes coiue to have intelligences that center about normals 
 of different heights. The tests for twelve _\ears of mental 
 age pass the candidate to service in the least exacting strata 
 of societv. 
 
 But the transition from feeble-mindedness is not merelv to 
 the lower levels of normality. The cases to lie presented will 
 best illustrate how feeble-mindedness blends, along most of 
 its upper margin, into the populous and turbulent zone of 
 the psycho-neuroses. 
 
 To return now to our system of classification : The use of 
 the Binet tests, while thought of in the adoption of the s\-.s- 
 tem, is by no means a necessity. 1 he Binet scale gives the 
 correct "idea" of a scale that is imfjiied, viz., a systematically 
 arranged table of norms for a variety of mental ])erforniances 
 normal to each age of childhood. W'e shall extend, exi)and. 
 or even displace the Ihnet scale just as fast as we determine 
 more of these successively developing capacities, llinet has 
 as least proved the possibility of measuring the advance in 
 mental efficiency that normally comes with increasing age. 
 
 The Binet scale, a condensed and revised statement of 
 which is given in a later chapter, is a series of some 64 tests 
 graduated in order of increasing difficulty and grouped in
 
 lO r.ACKWAKl) AND FliKliLK-.M I .\DI-:i) CIIII.DREN. 
 
 sets of five tests each, which can just be passed by the aver- 
 age normal child of the given age. The tests thus give a 
 scale of norms for the ages one year to twelve years inclu- 
 >ive. originall}' one to thirteen inclusive. The revised scale 
 provides further tests for fifteen years, and for the "adult" 
 intelligence of "above fifteen years." In being tested, the 
 child Ijcgins with tests that he can easily do, and tries pro- 
 gressively more dit^cult ones until he can do no more. His 
 mental age is then computed from the height reached in the 
 scale combined wilh the total number of tests passed. 
 
 There are three main results obtained b\- the use of the 
 scale: i. The child's intellectual level is measured. 2. Cer- 
 tain important practical data are obtained, concerning the 
 child's ability to read, write, draw, use language, use num- 
 bers, use money, do errands, imitate, etc. The original 
 scale as used in our Lincoln tests gave more of this in- 
 formation than does the revised scale, including, as it did. 
 tests for reading, writing, the memory f(~ir what is read, etc. 
 3. The tests o])en u]> the case for varied observation, giving' 
 the examiner o])portmnty to make supplementary notes of 
 the child's attitude, his emotional condition, his speech and 
 movements, and various other characteristics of his responses 
 and conduct. These notes all hei]:), along with the count 
 proper, to give a total picture and estimate of the child's men- 
 tal character and capacity. 
 
 Applying these methods and means of classification for .i 
 year and a half in the Illinois institution, I have selected the 
 consecutive admissions of one ])eriod of twelve months as 
 being approximatel) representative of what the institution 
 would show for its ])resent more tlian 1300 inmates. Ot 
 course, the death rate and the frecjuency of discharge and 
 parole are greater for some classes and degrees of defect 
 than for others. As a consequence, the percentages found 
 for new admissions dififer somewhat from those of a census of
 
 CI.ASSJI-ICAllOX AM) TICK M 1 N i )l.(); ,\- 
 
 II 
 
 NEW ADMISSIONS FOR ONE YEAR, 1303-10 
 
 lH-3 CASES. 
 
 No. OF 
 Cases 
 
 SPEECH 30 
 DEFECT 
 
 C0NVUL-J5 
 SIGNS 
 
 EP J7 
 
 MENIN-7? I 
 
 GITIsa ■ 
 
 MON- 6 ■ ■ 
 
 60LS| I I 
 
 VISDEFECT 
 
 6;SCH00L 
 
 iBlmHl I ] CRETIN 
 »/^.^/Z6 7.17 ^13 62d 100 ^^ r 2 ? 5%2 3.1 "" 
 
 I<'i,!,'. 2.
 
 12 
 
 l;.\C IvW AKU AND FKEULi:- MINDED CHILDREN. 
 
 population, l)ut in certain respects are of even greater value 
 than the latter. 
 
 The new admissions from November 17, 1909, to Novem- 
 ber 16, T910, numliered 147. l^g-. 2 presents some of the 
 more important general data concerning the 143 cases for 
 whom the data could be obtained. Fig. 5 tabulates the re- 
 suits of the mental examinations for 140 of these cases, seven 
 having failed of examination by early discharge, parole, or 
 death. 
 
 Reviewing the data presented in Fig. 2. it is noticeable 
 that the Mongolians, 4.2 per cent., and the cretins, two-thirds 
 of I per cent., though they are types which are much dis- 
 cussed and which are of much 
 interest to science, are of com- 
 parativt'ly rare occurrence. Dur- 
 ing the year the institution has 
 reported but fom- cretins from the 
 entire population, and one of 
 tliese has recently died. 
 
 11nis far the Mongolians have 
 tested prett}- uniformly to a men- 
 tal age of four or five years, both 
 at Lincoln and at \lneland. Of 
 course, many exceptions to this 
 will doubtless be found. The 
 .Mongolians are steady, docile, 
 and tractable, and are probably 
 more numerous than is indicated 
 l)y institution records, since they 
 can be easily managed at home. 
 They have a pretty high mortal- 
 itv as well, due to the generally "unfinished" condition of 
 their organs and tissues. 
 
 Twelve and a half per cent, or one-eighth of all new ad- 
 
 Fig. 3. — Typical cretin in 
 infancy. Orcat progress 
 since undor treatment 
 witli tliyroid extract.
 
 CI.ASSJI- 1( A riO.X AND IIIK M 1 XOI .()i : V. 
 
 13 
 
 missions, were stalrd in haw lia<l im'ninL;iti> <ir "l.raiii fever." 
 'J^hey form a .^rouj) of ca>es which iiMiall\- >ho\v svmptoms 
 ]:>eciiliar to ihis causation, and lhc\- make h'ttic' improvement. 
 They merit a lar^ei- share of atlcntion and >lnd\ llian thev 
 iiave nsnall_\- received. a> com])ared. for e.\am])le, with the 
 less numerons MoiiiioHan^ and cretin>. 
 
 Fig-. 4.— Kxliaustod l)y convulsions. .Mcnlnl iIcm 
 rested at 2i^ years li\ nicniimiiis. 
 
 >iniient ar- 
 
 Forty-one and three-tenths ])er cent are reported to have 
 had convulsions at one time or another, thonoh hnt J1.7 per 
 cent certainly are or have been epileptic, it is to be noted, 
 a.s well, that epileptics are not "supposed" to he admitted to
 
 14 I'.ACKWAKD AXI) FEETU.E-M I XDED CIlir.DREX. 
 
 this inslitution. TTowever, they are not provided for else- 
 wlierc in the slate. 
 
 Of tlie chil(h"en wliose intelligence made it possible to 
 measnre the visnal and auditory aonit}-, 58.2 per cent show 
 not more than two-thirds visiiMi in one or both eyes. I'esides, 
 there were many other cases of strabismus and of other 
 visual defects. Nine and (^ne-tenth per cent show auditorv 
 defect i^rave enough to l)e noticeable in the whis]:)cring" and 
 conv|:rsation tests for "jiractical" normality. A large per- 
 centage of the children tested have or have had disease of 
 the (^rs. 
 
 The comparative constancy with which sjieech defect ac- 
 companies mental defect is shown by the fact that nearly 
 63 per cent of all new admissions have persisting defects of 
 articulation, not counting those who have merely defective 
 grammatical usages or tendencies to confusion in speech. 
 
 The fact that 42.7 ])er cent, indeed the majority of all 
 l)ut the lowest idiots, had spent at least one vear in the 
 schools, gives food fnr ])edagogic reflection. Some of these 
 children had s]ient from five to eight years in the first or 
 first and second grades. 
 
 The mental examinations whose results are tabulated in 
 Fig. 5 show that of the }ear's new admissions thirty-three 
 were idiots, fifty-nine were imbeciles, and forty-eight were 
 morons, using these terms in the Kinet sense as indicating 
 merely the intelligence level actually attained. The females 
 numbered but sixty-one to the males seventv-nine. and were 
 not more numerous than the males at any mental age. Men- 
 tal defect is generally found to be more frequent among 
 males. It will be noted that there are more cases at a mental 
 age of two years than at any other. Probably this is because 
 these are the most helpless of the children who tend to live 
 for anv considerable time.
 
 t l.ASSl 1-UA'l ION AX!) TILKM 1 \<)\.i.)i\\. 
 
 l~^ 
 
 MENTAL AGE OE NEW ADMISSIONS.YEAR'03-IO, 
 
 S9 
 
 13 IDIOTS 
 
 MBECILES 
 
 ^MORONS 
 
 9 10 II 
 
 IZ 13 IH IS 
 
 _ TOTAL 
 
 NaoFCASEsyv 13 11 15 W 2 IS IS IZ 13 i H in 
 
 MALES/ 9 
 "V / »v FEMAL£S6i 
 
 Note. — Of the miiiilici-s iiidicMt iiij; mental a^c 1 means havinu a mentality 
 of 1 year or under. 2 means almve 1 year hnt not over 2 years, etc. Thus "a 
 child testing to ^Vz years is inchided with the lOyi'ar ^ronp.
 
 i6 
 
 I;ACJ<\\ ARD AND FEl£ULl-:-Ml XDIuD CIIII.DKKX. 
 
 Above the mental age of ten the number of admissions is 
 seen to he almost negligible. l''our of the eight who arrived 
 left within the year. Two of these were insane, and one, an 
 epileptic, was so complaining that his people soon removed 
 him. The fourth was a third-grade schoolbov. the l)utt of 
 
 Fig. 6.— T'nder ouo year of mental age. Tho child looking np is one of 
 tln-i'(> wlio showed the lea?t mentality of all the children tested. 
 
 his town, who stayed but a few weeks. Four were female 
 sex offenders. 
 
 The average age of the children classed here as idiots was 
 9.6 years ; of the imbeciles it was 12 years, and of the morons 
 14.9 years. But one idiot was over sixteen years of age : 
 but four imbeciles and four morons were over eighteen years. 
 The oldest moron was thirtv-six ; the oldest imbecile was
 
 CI ASSII-K AIIOX AND ll-k M I XOLOCV. 1/ 
 
 tort\-tiw, and the oldest idiot was l\\ cnly-scvcii. It is to 
 be noted that the institution discourages ai)plications for 
 cliildren that are over ei^liteen. interpreting' its fnnclion to 
 l)e that of a sc/iool for chihh'en in tlie formative ])eriod. I low- 
 ever, the state lias n(»t ])rovide(l elsewlTcrc for the older de- 
 fectives, who are very numerous and very dangerous to 
 society. 
 
 Eleven of the new admissions classed al)ove as m()rons 
 and nine of those classed as iml)ecilcs are of hioher ^rade 
 than those whom llinet would send to sjiecial classes on ac- 
 count of retardation, d^wo of these showed normal intelli- 
 gence, hut had serious speech defect in one case and weak 
 attention in the other. These two children were soon dis- 
 charged, and neither would have come at all hut for dis- 
 ru])tions in their families, h'ive of these cases are e])ileptic, 
 and thus tend to further retardation. Two others are stated 
 to have had convulsions. ( )ne child, with hut a vear of 
 retardation, is given to thieving, and had remained four 
 years in the first grade. Another, with Init a year of retarda- 
 tion, has a severe nervous affection. Another, retarded Init 
 two and a half years and already mentione<l as leaving 
 early, was ]3rematurely l)orn at seven mouths, was morallv 
 delinquent and an "easy mark" for his fellows. Still another 
 l)Oy, with hut one and a half \ears of retardation, was sent 
 ])}• a juvenile Court as being violent lo smaller children and 
 destructive. ITe is incontinent, and has spent tbri'e or l"our 
 }-ears in the first grade. Another, a colored girl of illegiti- 
 mate birth, defective in speech and vision, was retarded hni 
 one and a half years and was sent here for running aw aw 
 These are all, or ])racticall\- all, of moron grade. 
 
 (Jf these higher-grade admissions whose \'ounger \-ears 
 causes them to he classed as imbeciles, one is a bab\- i^irl of 
 three and a half )'ears. retarded but a year and defectix'e in 
 speech. Another, an or])han boy of eight, has defective
 
 l8 ISACKWAKD AND F.E1£BLE-MINDED CHILDREX. 
 
 vision and one and a half years of retardation. Another 
 orphan, retarded two and a half years, is defective in speech 
 and walk, is thieving and untruthful. The case of Harold 
 R., an aphasic boy with sensory defects and enuresis, will be 
 described later. Two twin girls with speech defect are 
 retarded very similarly to each other, and to the amount of 
 about one and a half years. A girl whose retardation 
 amounts to two and a half years had remained in the firsc 
 grade from her sixth to her ninth vear, and had an immoral 
 home with a mother who is feeble-minded. The last of 
 these cases is a girl of seven years who shows but a half 
 year of retardation in intelligence. She is an orphan who 
 was expelled from school for self-abuse. She is defective 
 in facial expression, is slovenly to an abnormal degree, has a 
 chaotic mental span, and shows marked para-functionings 
 in speech, writing, drawing, and general conduct. 
 
 In handling these cases I am impressed with the evident 
 fact that the amount of intellectual retardation may some- 
 times be very slight and yet the mental defect may be grave, 
 fundamental, and often incurable. Prognosis must some- 
 times be reserved, and a faithful description of the conditions 
 found is, of course, a better record than the affixing of any 
 formal labels. Some of these less-retarded cases are more 
 distinctly of the feeble-minded kind than some who show 
 three or more years of intellectual retardation. Of course, 
 they usually show marked retardation in functions other than 
 the intelligence. Probably, too, their intelligence itself will 
 seldom develop past the twelve-year limit of feeble-minded- 
 ness. 
 
 \\'hile. therefore, it may usually be best to apply the terms 
 idiot, imbecile, moron, and feeble-minded only to children 
 who show retardation of the intelligence amounting to ar 
 least three years, or to at least two years if they are under 
 nine, and while the safer rule for public school practice may
 
 CLASSlllCA'l'JO.N AXI) •I'I'.RM 1 .\(Jl.U( ;V, I9 
 
 be to ai)|)I\- these tenn> oiil) when there is more tliaii three 
 years {more tliaii two wht-n under nine), it should newrthe- 
 less be remenil)ered that the tise of tlu' terms is in eerlain 
 cases am])I\- jnstitied wlien the retardation is ot' less dej^ree, 
 and such children ma\'. with perfect warrant, be sent to insti- 
 tutions and confined tliere as loni^- as seems advisable. It 
 shotild l)e remembered, too, that iiiishihie children often can 
 be best cared for in s])ecial classes, sometimes even in in- 
 stitutions, when the intellectual retardation may be ver}- 
 slight. Binet fotmd that the imstiibles in the school classes 
 were tisually retarded hut one c>r two _\ears. 
 
 The chart in big. 5 shows a signiticant ,L;a]) for tlie men- 
 tal ages above ten years, and no admissions at all above a 
 mental age of twelve. Such children would be freel_\- ad- 
 mitted, but they did not ])resent themselves. There is no 
 doubt, however, that the higher-grade defectives are still 
 more numerous than the lower. Arrest occtirs at all stages 
 of growth to maturit}-, and even bcNond it, since there is a 
 growth c}-cle for the whole life-period. The English tallies 
 show" that the retarded become more ntimerous in ])ro])or- 
 tion as the clegree of retardation is slighter. Indeed, in 
 England the generalization has been made that in an\- coun- 
 tiy there is a certain degree of mental strength which is of 
 greatest frequency of occtirrence, from which as a mean 
 the curve representing the numbers who are bt'tter and 
 worse endowed falls awa_\- regtdarlv. At o])])osite extremes 
 of this curve occur the idiots and the men of great talent, 
 being fewest of all in numbers. '!'he defectives, according 
 to this formulati(_)n, are tints more numerous as in llieir men- 
 tal capacity they approach this normal mean. Tredgold'> 
 tables of frequency for idiots, imbeciles, and morons bear 
 this out in a general way. 
 
 Withotit insisting on this theoretical ])osition — and it will 
 evidently need revision — we know that tlu' zone of border
 
 20 IJACKWAKD AND FI-IEIJLE-.M IXDLlJ CHILDREN. 
 
 defectives is a very populous one. Not only that, but it is 
 pretty well agreed that here is our most dangerous class of 
 defectives, presenting to society the problems that are hard- 
 est to solve of all the problems of defect. Dr. Fernald even 
 identifies the whole class of instinctive criminals with the 
 high-grade defectives, and considers all of the latter to be 
 ])otential criminals. We know that prostitutes are recruitefi 
 by thousands from such defectives, and that the recipients 
 of public relief, as well as the ])etty trouble-makers that 
 pester comnnmities and courts, belong in large part to the 
 same classes. Above all, it is the zone of marriageable de- 
 fectives, often more fertile than normal ])ersons, who are 
 breeding tainted human stock, and who are helping largely 
 in the spread of our most terrible diseases. 
 
 Evidently, then, it is of first importance that we should 
 study the high-grade defective, and that we should obtain 
 good clinical pictures of the various ty])es of border cases. 
 One may begin with the normal and work down, or with the 
 feeble-minded and work up. In the P^aris clinics I had been 
 studying adults who showed various slighter degrees of 
 retardation in the forms of neurasthenia, hvsteria, epilepsy, 
 and sometimes of dementia i^raecox. At Lincoln T at once 
 selected thirty of the "brightest" children to be found in 
 the institution, for clinical observation and test. The school 
 principal and others who knew the children well co-operated 
 in making this selection : and while the search was not ex- 
 haustive, there is reason to believe that these children were 
 about as near to the normal as any group of approximately 
 school age that could readily be gathered from the 1300 
 inmates. A few substitutions were made as acquaintance pro- 
 gressed, and tile list was increased to thirtv-two. Several 
 have run away from the institution, or have been removed 
 In- friends. The majority have no homes or have abnormal 
 home conditions, or thev would not be here. However,
 
 ci-ASSJi'icA rio.x AM) •n:R.\ii.\oi.()L;\". 21 
 
 11k'\' ;irc ^ihkI i\'iircM.'nl;ili\(,'s ol )n>l [\\v t\i)r> that ai'c h> 
 be f()uii<I 111 i^rcal iiiiiiihrrs 111 liu' lioim-^ aii<! scIidoIs ami 
 liivcnilc ('(lurts (il the wholr ciinnti"\-. Twn ajihasic cases 
 hav^e been added Ironi tlie new a(h:iis>i()iis, and there is one 
 case from ihv Jolnis Monkiii^ 1 )isi)ensar\- ser\-ieL'. We shall 
 first present these tliirt\-hve ca^es in detaih and >liah then 
 tabulate some of the data obtained in the stud)' of them. 
 Reference ti; the latter tables ma\- ])c made as t!ie cases are 
 studied; and the >\llal)us of examination wliich was used 
 with these cases, with the description of the lliiiet tests. ma\' 
 well be looked o\'er betore th.e case studies are read. Thi - 
 s\dlal)us is printed in a later chai)ter. In usiiiL'; these stndie.- 
 the (lata obtaineil by oliservations and tests made at the in- 
 stitu.tion itselt are naturalh' more to be relie<l n])on. in most 
 cases, than the home record tnrnished bv ])arenls, guardians, 
 and others. 1 lowever, the application blanks which i^ivc 
 most ol the home record are signed b\- ])h\sicians in more 
 than <jC) per cent, of the cases, and whenever possible the 
 statements have Iseen checked b\- information obtained from 
 other sources. This part ot the data must l)e taken for 
 what it is considered to be we)rth.
 
 CHAPTER 111. 
 
 CLINICAL STUDIES OF BORDER CASES. 
 
 Fred J., Age T-c^'ciz'c and One-half Years. 
 
 Fred T-. who came to the instituti(in in ]\Iarch, 1905, at 
 the age of seven, is a typical and Uvely representative of the 
 unstable class. Of his j^eople we only know that his father 
 
 deserted the familv. his mother 
 died hefore Fred's admission 
 here, and the boy was taken care 
 of for two years by the Children's 
 Aid Society. They found him 
 quarrelsome and unreasonable, 
 ill-tempered and destructive ; and 
 reporting that he could not be 
 kept in the public schools turned 
 him over to Lincoln. 
 Physical examination shows Fred to be of about normal 
 weight and nearly an inch below in height, with cranial 
 measiu'ements that are very little below normal. He has a 
 normal strength of grip, but his lung capacity is 22 below 
 ilie no cu. in. normal to his age. He has 20/30 vision in 
 iiiC right eye and 20/25 in the left, with normal hearing'. 
 Flis head and face are fairly well formed though \\ith some 
 irregularity and asymmetry. The head tends to be held to 
 one side, the nervous control of the mouth is somewhat ab- 
 normal, and there is some shuffle in the walk. The medical 
 
 CASE 
 
 1. — Unstable 
 
 and 
 
 Quarrelsome. 
 
 Energet 
 
 ic and Coura- 
 
 geous. 
 
 Flighty At- 
 
 tention 
 
 except in 
 
 Band 
 
 Work. De- 
 
 fective 
 
 Motor Con- 
 
 trol. 
 
 
 22
 
 ciJNUAi. ,sTi:i)ii:s oi- noKui-R i:asi-:s. 
 
 23 
 
 record contains nutlimj^- ai^ainst Itl'cI cxccpl Imslcd ears 
 from plaxin^' out in all kinds dl weather. 
 
 In school I'" reel iTads onK' fairly in the second reader, 
 does sini])le additidn and snhtraction and is learning- tlie 
 tables, writes in a scrawled fashion, s])ells and draws only 
 fairh- and does inferior work in manual trainini^. 1 le dances 
 well and does fairl\- in calisthenics, Init produce> much dis- 
 turbance. Jn s^^eneral he dncs not care lor ""^rade work," 
 except that he loves drawing- and attends well thru the halt- 
 hour of this exercise. 
 
 In s])ite of such a record, k'red is a ma,gazine of ineri^-y 
 for work and for mischief, for 
 trouble and for service. Rest- 
 less, active, warm-heartedl\' de- 
 voted to those who are kind to 
 him and who interest him, he 
 is indififerent to others anrl to 
 all hum-drum tasks. 1 lis teach- 
 ers says that he punches the 
 other children and is even 
 "brutal t(» them." lie bosses, 
 teases, and terrorizes. "All the 
 boys knuckle to him." He can 
 whip any bo\- \vho is not a i^reat 
 deal larger than himself and he 
 promptly does so on occasion. 
 He is explosive in all that he 
 does, ordinaril) , and his worst 
 school fault, beside inattention, 
 is said to be "smartness" and 
 "feeling his own importance. ' 
 Kis teachers agree that when 
 
 any work is being given in class Fred is briefiv but intensely 
 interested and curious, then leaves it. ITe works, while inter- 
 
 FRED J.
 
 24 liACKWAKl) AND FEEBLK-MINDEI) Cll II DKRN. 
 
 ested, "twice as much as others." lie is intent on the 
 teacher until he gets what he thinks to be the main facts, 
 then will not attend to details or remainders. Left with a 
 task lie woiks till he gets the first problem, then leaves the 
 rest, and he has a "bad disposition ab(<ut the thing turned 
 down." 
 
 Music does some remarkable things to this explosive and 
 inattentive boy. In a year he has learned to play first cornet 
 regularly in the institution band, and is as steady and as sin^e 
 as a clock in taking his parts at the right time and in the 
 right manner. His inattention and explosiveness seem to 
 mellow into thoughtful seriousness and controlled adapta- 
 tion under the influence of harmonv and melodv. He is re- 
 liable and is continuously devoted to his music and to his 
 nmsical instructor, and makes entircK- normal progress in 
 this direction. His instructor states that he "will learn a 
 new selection as rapidly as a normal child of the same age" ; 
 and that Fred, with I-'elix N., George J., A incent C, David 
 1'"., and Casper H., "have learned to play such selections as 
 Marfha. ircddiiii^ of the Jl'iitds, Chiincs of Xoniwiid\, 
 and LJintcd Nation, with six rehearsals from Alondav to 
 Wednesday of the same week, half-hoiu- rehearsals daily at 
 8.30 A. M. and hour rehearsals dail\- at 2 P. AI." 
 
 In free i)lay in the gymnasiu.m b'red shows exceptional 
 s]5ontaneity and good intelligence in trying out and inventing 
 "stunts." and he is perhaps abnormallv courageous and dar- 
 ing in promptly taking any risk to carry out anvthing sug- 
 gested, seeming to be without self-consciousness, as well, in 
 the doing of it. 
 
 The Binet examination gave Fred a mental age of ten. 
 with a retardation of one and a half years. He showed a 
 weak attention span and was very distractible. He could 
 not repeat five numerals, could not make change for four 
 cents out of twenty-five, could only define by telling wdiat
 
 CI. I x iCAi. siri)ii;s ui- i;()Ki)i;k c \si-'.s. 25 
 
 thinj^s arc for, could iidt tell what one should do in any 
 situations that were not \-cr\- concrete, failed to construct 
 a sentence that would use three t^iven words, could not de- 
 tect the nonsense in sill\- statements, and was unable to rc- 
 arranfje sentences of ei^ht words when the words had heen 
 shuffled. Mis s])eech is (|uite clefeclive: lie ])ronounced 
 "exstrisity,'" for "electricit\ ." "twooly-woowal" for "trLdy 
 nu'al," "rawel" for "ro\al." "awis"" for "Irish." "hied" for 
 "bread," etc. l""or "She couldn't do that herself, could she, ' 
 Fred said "Couldn't do dat own-self, cou.ld 'em?" lie ])icl<s 
 up scissors and e\'er\thin^- in reach, to the delrimeiU of the 
 task in hand. 
 
 The written tests (see the tables with, descriplii m, follow- 
 iui^- the clinical studies) show a handwriting- that is irre^idai" 
 and infantile, but it can be read, riie lines are not ])arallel, 
 there are no ca])itals or punctuation marks, the i)a,L;e is ex- 
 tremely unpresentable and is apt to l)e scrawled with rude 
 drawings and other markinqs. d^dd the stor\ of "The 
 IvTarble Statue," lie showed interest and wrote 
 
 "One da\- a man side, 
 1 wold give 
 antler thin 
 in the wold 
 
 [f you was a live." 
 
 Told the story of "The Straw. Coal, and llean." he rc])ro- 
 duced some matter that had no connection with the sttnw, 
 and then added (_)nly "( )ne day 3 of then run a wax and the 
 clod (coal) fall in the Wdiit (water?)." Asked to write of 
 a tri|) in a flying machine, tlie snni total of the "stor\" was 
 that they were "glad to get home." Asked to mark all the 
 A's distributed at intervals in lists of printed capitals, he 
 made a very large number of oiuissions, biU showed good 
 improvement with ])ractice. .\sketl to write the o])posite 
 of eacii of twentv words, he succeeded with but four words
 
 26 BACKWARD AND FEEDLE-MIXDED CIIlLDKElSr. 
 
 in each of two dift'erent lists. Asked to write words siniilar, 
 in meaning', to twenty more, and given abundant illustra- 
 tions, he succeeded with two in one trial and nine in an- 
 other. He seemed unable to keep his mind on the conditions 
 of these problems, though trying- to give attention and un- 
 derstanding the directions. He would even himself suggest 
 illustrative examples and then fail in the test that followed. 
 As opposites he gave big — short, white — red, happy — mad, 
 like — love, war — cold, many — much, above — love, bad — day. 
 
 Asked to indicate the points of the compass, Fred marked 
 north correctly and then made inconsistent errors amounting 
 to one hundred degrees for east, seventy-four degrees for 
 south, and twent\-nine degrees for west. His errors for the 
 directions of Chicago. Springfield, the institution farm, and 
 the Lincc^ln Court House averaged twenty-four degrees and 
 were more consistent. Given the photographs of nine of the 
 best-known institution buildings and asked to place them 
 in their proper relative ])Ositions on a rectangular table-top 
 representing the institution grounds, he showed preliminary 
 confusion, but finally placed seven correctly. Asked tO' im- 
 mediately say the lirst word suggested by each of one hun- 
 dred selected words pronounced to him singly, fifty at a sit- 
 ting. I'red failed to react at all for thirty of the one hundred. 
 1diis seemed to be mainly due to his inability to attend for 
 the coming stimulus word. He woidd be full of something 
 else at the moment when the word was given, would wake 
 up and try his best to "think," then with a disappointed, 
 child-like little smile would wriggle and give it up. He 
 would grow progressively more restless, though trying his 
 liest, and I had to keep using devices to get his attention. 
 \\'hen his attention was sharp he usually reacted and the time 
 was then short, down to 1.2 second, while his median time 
 was two seconds. 
 
 But even when seeming to attend, sometimes, no word
 
 C'l.iNic Ai, s'rrnii'.s oi^' hordi'.r casks. 27 
 
 would cciinc. Merc, as often occurs with these children, the 
 attention was pnthaljly to ///(•. a i)ersoual attention, rather 
 than the prcjjcrceiitive wanniui;' up ol associative material 
 which would ha\e heen the essential of ade(|uate attentii)n to 
 the task. 
 
 Fiftv-scven of the se\ent\' reactions made were sini^le 
 words naturalK related to the stimulus word: seven showed 
 the inferior relationshi]) of mere sound, and six more showed 
 at least alliteration or similaritx' of endini^'. hOur were 
 merely usual associates in s])oken utterance. There was no 
 perseveration or stereot}'py. out of hearing- hein,^' "out of 
 mind'" for h'red. Not even a reminiscent constellation was 
 awakened. a]^])arcntly. 
 
 h'rcd evidentl}' fatigued (|uickd}- in these and in an\' exjjeri- 
 ments that involved attention to thino's at all ahstract. liis 
 extreme restlessness as the written tests ])rogTessed amounted 
 to contorsions and the most ludicrous devices to relieve him- 
 self, while still desiring- to keep my good oi)inion. lie sorted 
 fift_\- cards into five groups, hy colors, in eight) -two to ninety 
 seconds, keeping within these limits for four successive 
 trials. He made man\ minor errr)rs from haste and had 
 control. His form board time was successively 25.3, 2t,.^, 
 and 18.8 seconds. 
 
 On the ergog-raph he showed his tendencx- to earh' fatig-ue 
 hy making hut two-thirds of the normal record for one and a 
 half luinutes. I le did better witli the dynamometer, and in the 
 test for continue >us gri]) thru sixt\- seconds he displa_\ed 
 heroic fortitude, grittily permitting- only a step-wise, fairl\- 
 reg-ular descent from fifteen to nine kilogranis with the 
 right hand and a similar descent from fourteen to six kilo- 
 grams with the left. Jn tapping as fast as possible for thirty 
 seconds Fred fell eight short of norn-ial with the right hand 
 and nineteen short with the left. T.ut he showed remarkable 
 lack of control, drawing his face and bod_\ into all sorts of
 
 2^ UACKW ARiJ AM) FEEBLE-MIXDEU CIUEDRENT. 
 
 shapes, changing his method freciuentlx , tajjping so heavily 
 as to get the apparatus out of shape, and showing ahnost 
 choreic movements (hn-ing and after the ta])ping. 
 
 h>ed waits on table and makes himself useful in a variety 
 of wavs. lie has "run away" a time or two, but with no 
 effective plan. The institution as it is at present can scarcely 
 hold him many years. lUit he will always be defective and 
 in imperative need of guidance in the use of his super- 
 abundant energy. With his contempt for working at things 
 that do not strongly interest him, his tendencies to violence, 
 his restlessness and his fearlessness, and on the other hand 
 with his enthusiastic warm-hearted service when dominated 
 bv certain influences, he presents interesting possibilities if 
 wise direction can be permanently given, and dangerous 
 probabilities if it is not given. 
 
 The secret of his inattention, instability, and inaljility 
 t') submit to ordinary discipline lies with his defective neuro- 
 muscular control, so evident in the tapping experiments, 
 in the asxmmetrical mouth-tension of his recurring grin, 
 in the unbalance of holding the head to one side and shuffling 
 as he walks, in his ever-restless movements, and in the ex- 
 plosive character of his reactions genera' ly. This tendency 
 to explosive discharge masks the real iccakiicss of his nerve 
 centers, which are unaljle to inter-subordinate each other's 
 activitv, placing his organism wdioli\- at the mercy of what- 
 ever functioning "gets the floor" for the time. The repre- 
 sentations of past experience, of past injunctions and es- 
 peciallv of more or less abstract principles and rules of con- 
 duct, scantilv possible as these usuallv are in defectives, are 
 powerless even when brought to mind in the face of these 
 semi-convulsive reactions to present situations. The result 
 is conduct that cannot long be subordinated to ends, his own 
 or of others. 
 
 Such a life must have special conditions if its reactions
 
 CI. I. VIC. \i. sxrDTF.s oi-- r,oKi)i:R c.\ses. 29 
 
 arc ever Id lie linked up and co-ordinated inln effective 
 iniilics. ]"or frcd, one of these conditions seems to l)c musi- 
 cal feeling", wliirli seems able In hold its own in dominant 
 control, working; hehinil the scenes to niollil'\- and mo(hf\' 
 all reactions. Felt hannon\- and melodv are doubtless, on 
 their motor side, of the essence of synthesis itself, the ver\- 
 means and act of inter-subordination and imiti/,in<;- of other- 
 wise disruptive ftinctioniuQS. W'e need not tlu'U be sm*- 
 ])rised at the wonders the_\- sometimes work with the insane 
 and with defectives generally. 
 
 Another of these "feeling-charms" is the s])ell of stor\ - 
 telling. More ])otent still because more lasting is the ])o\\er 
 ui i)ersonal affection. The "I'.esoin de direction," whicii 
 Janet finds to be .so ftmdamental with the neurotic, res])onds 
 gratefully to the finding of the first real friend, be he breud- 
 ian ph_\sician, hypnotic cotmselor. or s\'mi)athetic nlu^ic- 
 master. 
 
 Manual work, a music-roll or sled or pair of shoes to make, 
 presents an outer. ])ersisting center of control which along 
 with the personalit}- of an efficient instructor tends to grad- 
 ually introduce more of unit\' and control into such lives. 
 (Jroup work in which the thought and work of twenty cen- 
 ter in the same line of conduct, often drowns the foibles of 
 individual fiightiness in a social attention and conduct that 
 has been the making of man\- a l)o\- in arm\- and navw and 
 that is effective in institution work. In sum. bred has strong- 
 hut ever-changing interests. To control them and him, he 
 needs ( 1 ) the removal or i)revention of the most serious dis- 
 tracting agencies, by provision of a selected environment: 
 (2) domination l)y personal friendship and interest, b\- grou]) 
 projects and exercises, by feeling-work in music, storv-tell- 
 ing, care of pets, etc.: (_:; ) work that centers in continuing 
 and interesting objects of construction: (4) the formation 
 of inveterate hahits of doing certain useful things in effi-
 
 30 UACKWARD AND FEEBLE- M I x\DED CUII.DKEX. 
 
 cient \\a\s at proper times. Such habits, once formed, 
 greatly lessen the need of attending, and help to direct the 
 attention when it is needed. The regularity possible in in- 
 stitution life may do much to steady such flighty natures. 
 ^\d^ether the nature itself can be permanently modified is a 
 problem to be solved by such institution experiments.
 
 CJ-iMCAL STL'Dii:s tU'" j;()KI)i:k casi;s. 
 
 31 
 
 CASE 2. 
 
 
 Unsta- 
 
 ble. Hered 
 
 ity 
 
 of Al- 
 
 coholism 
 
 and 
 
 Epi- 
 
 lepsy. Convulsions in | 
 
 Childhood. 
 
 Ta 
 
 iented 
 
 in Music, 
 
 whi 
 
 e De- 
 
 teriorating 
 
 in 
 
 Intel- 
 
 ligence. 
 
 
 
 I'chx A., .l^^c I'oiiytccn Ycar.^. 
 
 Felix N., anotlKT representative of the iinstal)le elass. is 
 a Ixn- (»t wlinm uv)>V eonnictin^- ()])ini<)ns have l)een formed: 
 from his musie instructor, wlio Ijelieved liim capaljle of he- 
 coming- an orcliestra (hrector, to 
 his attendant, w ho found him in- 
 ferior to bo}s who were evidently 
 feeble-minded. We shall see. 
 
 Now fourteen years of as^e, 
 Felix was admitted in July, 1 907, 
 from Chicago. His father is 
 stated to have been quite intem- 
 perate formerl)-. and his mother 
 is said to have been alcoholic. 
 
 epileptic, and immoral, her parents dying of tidierculosis and 
 heart disease. Five brothers and sisters died in infancv. at 
 least three dying of convulsi«ins. l-"elix was noticed to be 
 peculiar at two years, and had fre(|uent convulsions when 
 small l)ut fewer as he grew older, the last occurring nine 
 months before admission, lie also had "sliglu loss of con- 
 sciousness" by times. 1 le had an operation for abscess on 
 the head and three for injury to the knee with blood-poison- 
 ing. 
 
 Felix would neither stay at home nor go to school, ."^tartin^- 
 to school at seven xears, his school record was ver\ unfav- 
 orable. Placed in an imgraded room, he made no ])rog ress, 
 and his teachers considered that he could not be taught from 
 books. He was very fond of animals and very susce[)tible 
 to kindness. 1 Fe was with some boys when lhe\- stole some 
 beer; and as his home was unlit ihe juvenile C'ouri directed 
 him toward Lincoln. 
 
 Ph}-sical exann'nation fnids the bo\- six i)ounds abo\-e nor- 
 mal in weight and a good inch above in lu-igbt. liis cranial
 
 3-' 
 
 I'.ACKWAkl) AND FEEBLE-MINDED CHILDREN. 
 
 circumference is sixteen ninis. above the normal average 
 and he is well above in lung capacity and in grip of either 
 hand. Vision and hearing are normal. The forehead is a 
 little narrow and bulging, the face is not entirely symmetri- 
 cal and its ex])ression is asymmetrical, contracting une(|uallv 
 as he laughs. The palate is a little high, the ears are not 
 symmetrical, the skin is ])ale. The medical examination 
 
 records a little irregular- 
 ity of the heart and of 
 the right lung, with a 
 slightly enlarged spleen. 
 In school Felix reads 
 with dif^culty in th.e 
 third reader, is called 
 "very good" in spelling, •' 
 calisthenics and dancing, 
 but has difificulty with 
 the multiplication tables. 
 1 le attends normally 
 along the lines of his in- 
 terests only. lie uses 
 profane anrl obscene 
 language, and bullies 
 and is sometimes cruel 
 to other children. 
 
 It is in music that 
 Felix wins distinction. To (juote his instructor, he is "rather 
 a genius as a performer on the cornet. In two years he has 
 covered about live wears' work usually allotted to a cornet 
 student, has perfect control of embouchure, tones are sure. 
 velocity very rapid. Plays cadenzas from Bohemian Girl 
 with perfect ease and in an artistic manner. Plays a ballad 
 
 FKLLX N. 
 
 *This means that he can learn a "spelling lesson" well 
 the e.xamples of his spelling in practice. 
 
 But note
 
 CI.IXICAI. SITlill'.S OI" IU)KI)1:k CASIiS. 33 
 
 with fceliiii;'." lie "will learn a new selectit^n as rapiillx 'is 
 a normal child of the same <iv;v." 
 
 Mental examination with Ihnel tests in January. P^io, 
 i^-ave h'elix a mental aj^e of ten and a halt' \e;:\rs. a retarda- 
 tion thns of two and a half \-ears. ive-examined in januir)-, 
 l{;ii, imder \er\ taNorahk' conditions and wiih much care, 
 he could onl\- earn a mental ai;e of nine and a half years, a 
 retardation then of four and a half years. This aii^rees with 
 the reports of hoth his attendant and his ])hysician. who hnrl 
 that Felix has heen "o-oing hack."' hecomiiiq- less intelligent 
 a--' time j^oes on. in spite of his evident iJroi^ress in hand 
 work. 
 
 In these tests VcA'w stated the month (j,nmar\ ) to he 
 Xovember or ( )ctober. lie showed almost comi)let(.' con- 
 fusion in tryinj;' to re|)ro(luce the ilinet niemorN ])assaL;e, 
 and at that he could mjt read the selection, which had to he 
 read to him. lie could not construct a sentence of three 
 given words, could not detect the nonsense in silK state- 
 ments, could not re])eat seven numerals or sentences of 
 twenty-six syllaliles. He could not define or distinguisii 
 abstract terms, nor dehne at all excej)! in terms of use. The 
 total later count shows that the number of tests passed was 
 less by five than the number passed a year before. 
 
 Jn the written tests lu's handwriting is infantile, llie lines 
 are of all lengths and with no ca])itals or ])uncuialiou marks. 
 His spelling is iuost fantastic, e. g. : .^tachal (statue). >ad 
 (said), cood (could), wone (i>ne). hat (hit). ])ri\iug 
 (present), shines (machine), arnalas (animals), derner 
 (dinner), pice (]Mece), bengan (began), a (and), ought 
 (out), they sawned ( re])eatedl\- for "the\- saw"'). 
 
 Interested in a stor\ of two cliildren who were allowed to 
 make a twd-da\- tri]) in a simpU' ll\ ing-machine gi\en tluMU 
 for a Xmas. present, and asked to write of what these chil- 
 dren would see and do. his stor\- was as follows: "Sow
 
 34 BACKWARD AND FEEBLE-MIXDED CIin.DREX. 
 
 day starting" of to see the world, so they was goging thay 
 sond (saw!) a hols and dichis horsas and anialas (animals!) 
 so thay start back so thay g-ot back home." Asked about 
 "sond" he repeated orally that "They sawnrl a whole lot 
 of dings," apparently considering both this spoken and writ- 
 ten form to be correct. His opposite for "bad" was "rud" 
 (rude), and when the test was further explained he could 
 only give "dirtv." His similar for "lightning" was "(lark- 
 ing." fjis total i)erformance was meager in all the written 
 tests, except that he shows regular improvement with prac- 
 tice in marking A's. 
 
 h^elix's control of his feelings and of their expression is 
 distinctly abnormal. In school or band he cries on slight 
 occasion. His manual training teacher reports that he has 
 "the most peculiar disposition of any boy she knows," that 
 he "gets mad" very easilv and then wants to fight, threatens, 
 "will kill after school," etc. : falls into a pout on slightest 
 occasion, or cries; does many "little simple things," with 
 "wavs of a three-}ear-old child." In testing him I noticed 
 his eyes fill with tears at an ill-success, but in a moment was 
 surprised at his Ijlurting out in laughter that was not en- 
 tirely apropos. He looks up brightly at me, by times, as 
 though he had an intelligent "idea." but his following sen- 
 tence does not show it. His whole manner as well as his 
 speech are most immature. He may, for instance, turn 
 awa}- with a childish grin when he should turn to you and 
 speak. 
 
 We have here an inhibition of intellectual and social 
 adaptations, with ]iersistence of infantile characteristics, 
 an emotional instabilit}', and an almost or quite aphasic diffi- 
 cult\ in self-expression, especially in writing and to some 
 extent in mimic. r)Ut in music this boy seems to find him- 
 self. His brain, under the dominance of rhythm and of 
 nuisical feeling, seems able to organize itself and to have
 
 CLIXICAL STUUIi:S OF UOKDICK CASES. 35 
 
 some (Icvelopmcnt for this class ui fiinciii)iiing's, even while 
 actually deterioralin^- in efficienc\- for the everyday work 
 of mind. The further history of this case will he watched 
 with interest. The latest word as I write is that his "teacher 
 reports marked improN-ement hoth in work and dis|)osition.'' 
 while his physician sa\s in effect that he is "not (|nite so re- 
 liable and cries at the least re])roof." 1 incline to fear the 
 persisting- effects of his years of convulsions, or of the still 
 operative tendency to detericjration which earlier expressed 
 itself in convulsions.
 
 36 
 
 r.ACKW ARD AND FEEBLE-MINDED CHILDREN. 
 
 PoU\ A., Age TJiirtccn Years. 
 
 CASE 3. - 
 
 — Unsta- 
 
 ble. 
 
 Family 
 
 Hi story 
 
 of 
 
 nsanity, 
 
 Alcohol- 
 
 ism 
 
 , and 
 
 Feeble- 
 
 Min 
 
 dedness. 
 
 Defect- 
 
 ive 
 
 Control 
 
 and Ten- 
 
 dencies to C 
 
 onfusion. 
 
 We make take as a third representative of the unstable 
 group Polly A., a rather clashing girl of thirteen, whose 
 sono-s and other parts in entertainments have made her well 
 
 known to all in the institution. 
 She was admitted in 1905 and 
 re-admitted in 1908 after a pe- 
 riod of absence. Her parents are 
 Hebrews, the father a Chicago 
 teamster in good health, the 
 mcther insane and stated to 
 have been a drunkard during the 
 gestation period. Two children 
 who died earlv are stated to have been neglected by th'' 
 mother and one of them is stated to have been deficient 
 mentally. 'Jdie three who are living are in the institution at 
 Lincoln. 
 
 d"he data aliout Polly's ])re-institution life are conflicting 
 and scanty, but she is stated to have had convulsions, the last 
 in 1904. She was in school several years with "no residt." 
 .She was irritable, did nor obev, talked foolishly, wanderC'l 
 awa}', and ])layed like a nnich vounger child. 
 
 Physically, she is nearly fifteen pounds above the normal 
 average in weight, is near the normal in height, and is well 
 above it in lung capacity and in strength of grip with right 
 and left haml. Her cranial girth is thirt}-eight mms. above 
 the normal averasje, the head beinc: abnormallv broad. Her 
 hearing is normal, but her vision is quite defective, one-fifth 
 in the right eve and four-sevenths in the left. TTer head is 
 fairly regular but is too broad in front of the ears, \\hile 
 the face is not of quite normal shape in its general efifect. 
 Tile ears are unlike, there is some incoordination of the eyes, 
 and the outstretched hands show lack of nervous control.
 
 CI. J NIC. \i. STi;i)ii':.s of i:oki)i:k (;.\.si-:s. 
 
 37 
 
 I'lu' iiic(li(-al examination fimls a. small ventral lieniia and a 
 condition of tlic genitals sni^'^cstixe of bad lial)ils. ( )iIut- 
 wise her plixsieal condition is said to he i^'ood. I ler liome 
 physician rcjxirted a "well ci )m])ensated mitral lesinn."" 
 
 In school l'oll_\- .^ives little tronhle nn the side of disci])line 
 and o-ets on well with others, tho she is loo hdoetx' to attend 
 well, and a ((nick tem])er is stated to he her "worst fanlt." 
 She reads rather wt'll in the fonrth reader, i^eneralK s])ells 
 well, has mnch ditiicnlt\' in doini;^ 1"",^' division, draws hadlx', 
 hnt with a certain dash that in- 
 terests sometimes. I ler hand- 
 writing is fair hnt shows had 
 motor control, she is a ^ood 
 sewer, dances fairly, hut is too 
 restless to succeed in calis- 
 thenics. She is studxing ele- 
 mentary histor)', geography, 
 and pliysiology, with onl\- \'erv 
 moderate ap])reciation and 
 progress, and she is taking 
 piano lessons. She was Loo 
 nervous to continue the earlier 
 piano lessons, using her limhs 
 too nnicli and heing unal)le to 
 concentrate even sutficienti}- for 
 counting or the observance of 
 rhythm. Later she has im- 
 ])rove(l. She has a goofl voice 
 for singing, though for talking- 
 it grows hoarse and weak, as with so man\ of the defectives. 
 Tn cantatas and other entertainments she takes her jjaris 
 with a charming abandon and self-forgetfulness. She has 
 a wild way of unconsciously taking series of attitudes due to 
 successive shiftings in her nervous balance, the efl'ect being 
 
 POI.IA' A.
 
 38 BACKWARD AND FEKBLR- M INDED CliH-DREN. 
 
 lo add interest to her manner. These shiftings may he of 
 a kind with a cHstinct fie of sighing which she shows from 
 time to time. 
 
 The mental examination shows a mental age of ten years 
 with a retardation of three years. The most significant 
 characteristic revealed by the various tests is the distinct 
 tendency t(3 more or less irrational responses, to replies and 
 acts that are only partialK- controlled by the demands of the 
 situation or by the notion of what the result should be. 
 Asked what "goodness" means she answers, "Fill this world 
 today — with people and like that — it's all right ain't it?" 
 She used the word "skeld" for "skeleton." Asked to dis- 
 tinguish wood from glass she said, "You can throw glass 
 on the floor and the wood can't." She says, "The number 
 of the death is 48," with satisfaction, meaning the "number 
 of the dead." She is "flighty" in giving reproductions of 
 stories, both in school and in the tests, weaving in masses 
 of material that was not given. ( )ccasionalh- she makes some 
 statement that she cannot "explicate" even to herself, a 
 result of temporary confusion of thought, as when she said 
 "That might be high," when I proposed taking her u])stairs 
 to weigh her and measure her height. Told to subtract 
 she may arrange the problem for division. The trouble 
 is not merely one of language: Dn the spirometer she can- 
 not blow slowly, she forgets and takes a second breath, 
 blows before her lungs are nearly full, and her movements 
 are reckless and badly controlled generally, though with best 
 intentions. With distinctly more than normal strength her 
 tapping rate falls well below normal with either hand. She 
 picked up the instruments at reckless random, nosed into 
 records, and generally did the wrong thing in irresponsible 
 ways. In general, as I have suggested, a question asked 
 or the terms of a situation to be met do not seem to remain 
 innervated to check out incongruities in her resultant speech
 
 Ci.ixuAi. s'i"L'i)li':s n\- luikDi'.k c.\si-:s. 3<j 
 
 or act, and IIk'sc lalU'r are iidt Icll as niaicliiii^' ov lailin,:^' 
 to matcli tlu' ideas that i)r()mpt tlieiii. I'lilike the neuras- 
 thenicall}' unstable >lie is ordinarily not at all troubled Ijy 
 this inconi;ruit_\-, l)iit niininiiniizes the importance of her mis- 
 takes. 'J1iis has the effect of distracting- attention from 
 them, and INjlly's personal charm and rather winnini^- ways, 
 with the devil-ma\-care dash of her \-er\ errors, pives, as Is 
 often tlie case, an impression of greater ahilitv than she 
 possesses. Besides, she does much l)etter at some times tlian 
 at others. 
 
 The written tests show a leg-il)le hut irregular and some- 
 what primitive handwriiiny. 1 ler mis-spellini^s are usually 
 such as "to" for "ttjo." "their"' for "there," "women" for 
 "woman," the omission of possessive marks, the use of the 
 infinitive for past tenses, and other such childish errors. 
 Except for her forgetting- to write certain words, her ])ara- 
 graphs make an ahridged sense, sketchil\- as a little child 
 talks or draws, and she sees no more in the stories told her 
 than a very little chilrl would see. IJer "flying- machine 
 story" is essentially: "I had tine time xx a good time xxx 
 was happy xx gave little ho}- a ride xx he enjoyed it verv 
 well XX thanked me and I was nice ahout it so he wi'ut home 
 I was happy all the time." It is totally colorless and "non- 
 specific." 
 
 Of her loo association reaction^ l)ut 24 arc found in the 
 list of all the words given hy 1000 normal persons. Sixl\- 
 eig-ht are phrases or sentences, heing her attem])ls to define 
 the word given in spite of cautions to react with hut a single 
 word. Fifteen of these "definitions" are entirely tautologi- 
 cal, many others are puerile, and there is little variet\- of 
 response. Note the following given in succession : — 
 
 20. Chair — What vou sit on.
 
 40 BACKWARD AXD FF.KP.LE-^riNDED CTllLDRF.NT. 
 
 21. Sweet — Nice. 
 
 22. Whistle — You blow. 
 22^. Woman — A lady. 
 
 24. Cold — Freeze. 
 
 25. Slow — Real slow. 
 
 26. Wish — You wish somebody something. 
 
 27. River — Water. 
 
 28. White — Nice and white. 
 
 29. Beautiful— -Purity. 
 
 30. Window — What }Ou close. 
 
 31. Rough — Not nice. 
 
 '}^2. Citizen — ( Xo reaction. Word unknown). 
 
 33. Foot — \i)\\ put a shoe on it. 
 
 34. Spider — What crawls. 
 
 Non-specific words and phrases, as "nice," "prettv," etc., 
 arc common and characteristic. The puerilitv and naivety 
 of the reactions were entirely in keeping with Polly's facial 
 expression as she looked at me in the experimenting. It 
 was to be noted, however, that none of the reactions were 
 entirely senseless or "bizarre." They were more or less 
 apropos to the stinuilus. and <)3 different reactions were 
 made in a total of 96. 
 
 Polly mis-placed seven of nine institution buildings when 
 asked to arange their ])hotographs, and she showed almost 
 no knowledge of directions. North and south were almost 
 interchanged, though she lives in "South Wing" as she well 
 knows. Such tests as the form board, or the sorting of 50 
 cards with backs of 5 colors, were carried out promptly, the 
 former in 21 to 2"^ seconds, the latter in 97 to 109 seconds. 
 T)Ut wherever the problem involves the manipulation of ideas 
 confusion is sure to appear. 
 
 More recently Pollv would seem to be deterioratino- some- 
 what : it is stated that she "forgets what she is to do" and
 
 CUNUAI. STi'DiKS OF i:okiii:r casks. 41 
 
 "sits rather stupidly." rtU'(;rlLiiialel}', too. niis-lcd 1)\ her 
 very superficial ' hri^htness." elTorts arc beini;' made to re- 
 move her from llie iiislilulion and to lia^-e her sliare the re- 
 sponsihihtics of home-keepiiii;-. 'J"he resuU can liardl\ he 
 other than disaslnms; and yet wlien a parent insists the in- 
 stitution is powerless.
 
 CASE 4.— 
 
 Dull 
 
 but 
 
 Pretty. A 
 
 Feeble- 1 
 
 Minded Family. 
 
 Col- 
 
 orless React 
 
 ions, 
 
 Fa- 
 
 cile Type. 
 
 Weak 1 
 
 Lungs. 
 
 
 
 42 llACKWARI) AXl) FKl-:ilLI->MlNDED ClI 1 [.I )klLN. 
 
 Winnie P.. Age Twcl-c'c and One-half )\^ars. 
 
 Winnie is nut at all unstable, but she does not know very 
 much. She is placed at the head of all the processions of 
 institution children because she looks so charming. .She is 
 
 actually a very good representa- 
 tive of the dull group. 
 
 Now I2j/j years of age, Win- 
 nie has been in the institution 
 since she was 7^/3. < ^f her hered- 
 it\- it is stated that both her 
 grandparents "drank some" and 
 that her mother's mother was 
 blind. Her own mother is blind in one eye, or nearly so. 
 and is !iot of strong mind, tho fairly healthy and earning her 
 living as a domestic, in separation from the father. ( )f the 
 seven children three were stillborn and four are feeble- 
 minded and are in the institution. 
 
 Winnie, the youngest, was late in learning to talk, showed 
 no interest in music and no mechanical ability, was good- 
 tempered and obeyed well but remembered poorly, and her 
 teacher reported that the child could not learn anything. 
 
 I^hysical examination at the institution shows Winnie to 
 be 1 1 pounds below in weight and nearly 5 inches below in 
 height, with a head that is 24 mms. below the normal girth. 
 She has a small lung capacity and her grip is somewhat lie- 
 low with the right hand, but is disproportionately strong 
 with the left, as occurs with very many of these children. 
 Tier hearing is good, but her vision is sub-acute. While her 
 head is fairly regular the face is not entirely symmetrical 
 and shows an luipleasant irregularity of expression about the 
 eves, seen also in the mother. The base of the nose is low 
 and broad, the palate is high and rather narrow, a lower 
 molar is almost crowded out Init otherwise the teeth are
 
 CI. I NIC. \i. s'ifi)ii:s OF i;ori)i:r cases. 
 
 43 
 
 iL;()()(l. Tlu' palpchi'al ti^snrc is lar^r, tlic lillle tin<4\r> >li!)\v 
 ap. abnoniuil cur\altirc, tlic skin is pale. Tlic cliild lia^ liad 
 pneumonia and severe l)rnnchitis Ijorderini;- on ])neumonia. 
 several limes, ."^lie shows a lendenc\- to tulierculosis and h 
 will ])r()l)a1)l\ lie diliicult to ])revenl some such earh eulmi- 
 nalion of her respiratory troul)le. 
 
 In scliool Winnie is still in kinderj^arten. .She does well 
 the simple child panics and exercises, i;x'ts on ver\- well with 
 the other children and is a fax-nrile with her teachers. She 
 tells little unlruths 
 1)\- times, in a \< mnj^- 
 child's fashion and 
 often to shield others 
 rather than herself. 
 She attends as well 
 as }-ouni;" normal 
 children, does not 
 do or sav sill\- or 
 absurd thint^'s, ex- 
 cels in f;\ mnasium 
 work, in danciuL;', 
 and in tlie sim])Ie 
 manual work of the 
 kindergarten. .S h e 
 has not been taught 
 reading-, wrilin;;", 
 spelling, or num- 
 
 liers, is sknv and inapt at dra\\'ing. and has had no other work 
 except in singing. .Slu' knows all the kindergarten songs, 
 but her voice is so weak and ]iusk\- that not much can lie 
 done with it. .She is without originalitv. takes everxthing 
 placidly, and her teachers state that her worst fatdt is 
 laziness. 
 
 The mental examination showed a mental age of 7 \ears 
 
 WINNIE D.
 
 44 r.ACKWARD AND FEEBLE-MINDED ClIIEDREN. 
 
 with a re'tar(lati(jn at that time <»f 4^ years. Her speech is 
 iKjrnial but fur tlie weak and hu>ky voice. She was unable 
 to put together again the two pieces of a visiting card that 
 had been cut in two diagonally. She did not know her age. 
 could nut copy writing so that it cnuld be read, failed to de- 
 scribe i)ictures, could not name cnmmon pieces of money or 
 make change of 4 cents from 25 cents. She is just mentally 
 dull and sluggish and is not troubled about it either, smiling 
 sweetly at me all the while. As she catmot write, the writ- 
 ten tests were beyond her. In the tests for orientation she 
 knew south and west, but made errors of nearly 90° for north 
 and east, and was quite at sea when asked to point in tlie 
 direction of well-known places. She mis-placed 6 of the 9 
 buildings. Her tapping rate was right 127, left 117, as com- 
 ])arecl with a normal 173 and 146. Her form board times 
 in successive trials were 39, 33, 28^, 2/. 26, 20^, 22^2 sec- 
 onds. In both ta])ping and form board tests she was "as 
 steady as a clock" with never a sign of confusion or hurry. 
 She used continuously the same gentle method, followed 
 directions well and made no breaks. Asking her to make 
 quicker time did not confuse her in the least. Hie steady 
 reduction in time in the form board tests iiulicates the readi- 
 ness with which her mental and ])hysical activities become 
 aiifoiiuillc rather than showing aljility to leant. The tend- 
 encies to automatism are i)erhaps the strongest that are to 
 l)e found in the feeble-minded generally. 
 
 Asked to "ive words similar in meaning- to 10 words Dro- 
 nounced to her. after the fullest explanation and with all the 
 time she wished she succeeded with but 2 of the 10. Given 
 too association words in two sittings, she could think of 
 nothing at all for 40 of them, tho knowing all of the 40 
 words except one. ()f the 60 reactions given, 42 were 
 single words naturally related to the stimulus words. In 9 
 reactions she showed perseveration, i. e., the repetition of
 
 t'l.i N icAi. s'iriiii:s oi- iu)Ki>i;k cAsi:s. 45 
 
 carlicM' reactions. Such words as "black." wliitc," would 
 kee]) recurring', luit imt >o dtlcn a,s lo cim^liliUt' tlk- >tcrcc)- 
 tvpv st) often foinid witli tlic-c cliildrcn. llcr median reac- 
 tion time was ver\- slow. 4.1 seconds, .^lie had too much 
 mental inertia to j^et the words out e\'en when the_\- did occur 
 to her, sometimes. At other times she would harel\- utter 
 them, colorless associalii ms at that, it all i.;a\e a \ivid ])ic- 
 ttire of a low-level. slu.i.i'L':ishly working' mind with ^reat 
 ])aucit\' of resources, and contentment withal. 
 
 It is the case of a child whose reactions are uniforml\- 
 without color, the reactions <if simple defect and ])assi\it_\- 
 coupled with the charm of a doll-like heautw Such a life 
 passes simi)l\' and ha])])il}' euou.i;h in an institution. I'.ut 
 nnfortunateh' she ai)])ears normal to the inol)ser\-ani and lo 
 those who do nut take accoiuit td' her a.^e. And ■-he is al- 
 most certain to attract some would-be philanthr(i])ist who 
 will take her out and eventuall_\- let her i)a-s intii the hands 
 of the elements in societx' that are ever on the lookout for 
 iust such facile twirls as this.
 
 CASE 5. — Dull, 
 Sluggish, and Docile. 
 Alcoholism in Fam- 
 ily. Weak Memory, 
 Thieving, but Gener- 
 ally Steady. 
 
 46 IJACKWARD AND FEECLIi-M IXDED CIIILDKF.X. 
 
 Jcrr\ H., Age Foitrtccn and Oiic-Jialf Years. 
 
 Jerrv is a typically dull boy, usually but not invariably 
 stable, who wins the affection of his teachers and is usually 
 over-rated.. Now 143^ years of age. he has been in the in- 
 stitution but a year, llis father 
 is stated to have been a periodi- 
 cal drinker and to have whipped 
 the boy in times of temper. It 
 is said that there is a brother 
 who is "not bright." jerry's 
 mental peculiarities arc said to 
 have been noted first when he 
 entered school, and the cause given was that he was "'al- 
 lowc'l to drink whisky until the age of 10 years." He was 
 "subject to sore eyes," l)ut with go-jcl health oiherwise. His 
 memory is stated to have l)een "very poor," but he was in- 
 terested in music and in mechanical construction, tho he had 
 a tendency to hide and destroy things and was not very good- 
 tempered or obedient. The mother died and Jerry lived in 
 an Orphans' Home, and makes vague statements about hav- 
 ing had some schooling there. 
 
 I'hvsically Jcrr\ is 18 pounds below normal in weight and 
 3.3 inches below in height. .His cranial girth is normal and 
 his strength of grip is nearly so, tho his left hand has a dis- 
 proportionate strength. In the spirometer test he falls 32 
 below. He has but two-thirds of the normal acuteness of 
 either e\e or either ear. The head is high behind and there 
 is slight asymmetry and irregularity of head and face. The 
 base and middle of the no.se are low and broad, the front 
 teeth below are impacted and abnormally long, but the teeth 
 are otherwise quite good. The hard palate is narrow and 
 perhaps a little high. The eyes are very prominent, the 
 mouth is open much, there is a slight drooping of the left
 
 CLINICAL STUDIES OV KOKDLR CASICS. 
 
 47 
 
 shoulder, the walk is slngg-ish. The medical examination 
 gave Jerry a clear hill of health, noting onl\- some fine ner- 
 vous tremors. 
 
 Tn school Jerry has a clean record on the side of morals 
 and discipline, gets on very well w ilh ihe other children, at- 
 tends "normally," does not make sill\ or incoherent replies, 
 is docile, amiable, the favorite 1)o\- in the room. Indeed lie 
 is a pet and trusted helper of his 
 teacher, who when asked for 
 Jerry's worst fault reports th.it 
 he "has none." 
 
 However, on the side of sch.ol- 
 arship, this box- of 14' _■ is ])lod- 
 ding with difficulty thru eas\- 
 tirst reader lessons, is just he- 
 ginning nniltiplication, and is 
 doing work in drawing ordina- 
 rily given to very much \-ounger 
 pupils. He does best in indus- 
 trial work, is learning to dance, 
 and some simple stor\- work and 
 calisthenics complete his sched- 
 ule. 
 
 The mental examination gises 
 Jerry a mental age of S^-j years 
 with a retardation of 51-2 years. 
 His speech shows primitive char- 
 acteristics, such as the use of 
 
 "(ley" for "they." "mudder" for "mother," etc., tho he can 
 articulate all the test-words given him. He could ue\-er 
 repeat five numerals, could not count the \'alue ot' si\' 
 stamps, coidd not count from 20 to o, could not co])\' a 
 phrase dictated, did not know the da_\' and tlate. could not 
 make change, failed to name some of the ordinary pieces of 
 
 JERKY H.
 
 48 BACKWARD AND FEECLE-M I XDED CUILDREX. 
 
 money, and could think of but 31 words in three minutes. 
 When there was read to him a short news item giving about 
 It) "details" about a fire and he was immediately asked to 
 tell of it, he could only recall that there was a "fire."' 
 Questioned then as to each detail he could recall a few, but 
 with inaccuracies. He tries honestly, but says, "It leaves 
 my mind." He tells me that he would go to the store for 
 articles, but would forget what he started for and would 
 have to return, tho he would keep repeating the name of the 
 article to help remember it. If he stopped saying it over 
 it "left his mind." He says that this often happened. 
 
 Jerry's responses show no absurdities, he gives good at- 
 tention and shows a fine spirit, with politeness and consid- 
 eration for the examiner. But he shows little energy, is 
 ■7rry slow to respond or to think, his mind seeming sluggish, 
 doing little and that little not too well. His eyes filled with 
 tears when I showed dissatisfaction at his recallin<>- so little 
 in the memory test, but he did not become active even in his 
 emotion and it quickly disappeared. He showed no signs 
 of nervousness, no twitching or excitement. By times he 
 would }awn or sit with mouth open, and no thoughts would 
 come. ( )n the play ground he can play well enough, but he 
 hangs back and does not think of things to do. Left to his 
 own resources, however, he sometimes shows spontaneity 
 and even imagination, as when I surprised him playing 
 "Ofiice" with another boy and using bits of paper for 
 "letters." 
 
 In the written tests he writes a fairly legible, child-like 
 hand, using no capitals or marks. He wrote nothing for the 
 first story or for the flying-machine test, sitting as if para- 
 lyzed. Trying to reproduce the "Straw, lican, and Coal 
 Sti)r\"." he wrote: "( )nce these nos olse tvonen to get stro\v 
 iill u i the fire cnel strow fell down and out and hean ju" 
 
 Tried with Burt's alphabet test, in which one complete
 
 ' CLINICAL sTiTDiics oi- I'.i )K'i)i^R rAsi:s. 49 
 
 iil])lial)ct is i)ickc(l in order from two shul'tlrd ;Ll])lialK'ts. 
 Jerry did nol know all the letters. \\\ showing; liini the form 
 of the letter needed he was ahle to do this test in 5 minutes, 
 lie sorted 50 eards to 5 i)ile> in times that were ])ro_q'res- 
 siveh' lowered from 120 to unS seeonds in six trials. Simi- 
 larly he made the (|uick form hoard limes of 20.2, 1O.4, 1O.7, 
 16, 15.2 seconds in successive trials, almost e(|ualin,L;- the ])e,"- 
 formance of an alert physician. Me ta])])eil \\ith equal 
 steadiness, the count heinp,- 172, 167, 165 with the ri^iit hand 
 and 140, 150, 150 with the left, the normal hein^- l\. 1S7 
 and L. 162. In the.se three latter tests he had the little intelli- 
 gence necessary to grasp the method, and seemed to do them 
 W'ith the automatic regularity of a clock and with as little 
 tendency to hecome ruffled or excited. 
 
 |err\' mis-])laced 4 of the 9 htiildings, and his errors foi" 
 north, south, east, and west. res])ectively 50", 124°. 2^\ and 
 15°, showed not onlv ignorance of direction, hut incongruitv 
 of thought, lie had little notion of the <lirection of known 
 points. The tests for similars and opposites seemed heyond 
 his ken. .Some "similars" written were love — pauta. tohacco 
 — stank, tent — knite, hig — like, lie came to do fairly well 
 in the .\-test, as atitomatic work was again in ])la\. 
 
 Given 100 association words he at first gave a numl)er of 
 intrchifcd words in times of 1 t(i 1 '^2 seconds, a])])arentl ■.• 
 misunderstanding the test and iustantl\- gi\'ing a word chosen 
 in advance. Later he gave i)hrase or sentence definitiuis 
 pretty uniformh- in spite of repeated cautions to react with 
 a single word. Thirteen of these were tautological and most 
 of the rest were colorless and over-sim])le, showing his 
 poverty of mental resources, hut with good attentiou alwaxs. 
 He showed some i)erseveration and some reactions that were 
 governed hv sound instead of meaning. .Some consecutive 
 reactions were as follows : 
 
 81. Ride — Ride a horse.
 
 50 UACKWAKD ANM) fi:i-:dle-imixi)i:u children. 
 
 82. Thirst — When you're thirsty. 
 
 83. Thumb — Means your thumb. 
 
 84. Til — Whenever you're cross. 
 
 85. Marriage — Whenever you get married. 
 
 86. Grandmother — Means whenever you got a grand- 
 
 mother. 
 
 87. Rich — Whenever you got lots of money. 
 
 88. Bad — Whenever you're bad in school. 
 
 Jerry's attendant re])orts him to be "the greatest thief on 
 the ward," perhaps an exaggeration, and says that Jerry 
 keeps a particular place to hide things taken. He adds that 
 one cannot believe anything the boy says and that he semi- 
 occasionally says foolish things, as when having a blood-shot 
 eye, he told the doctor that he got shot in the eye. In spite 
 of his general mildness he has occasional outbreaks of tem- 
 per, and one caimot always count on the stability of even 
 these most "stable" children. The type, however, appears 
 in the data given.
 
 I 1,1 NIC. \l. STT'DII'.S Ol' r,OKI)|-.K CASKS. 
 
 51 
 
 Bcrtliii ./., .li^^c Thirteen )'ears. 
 
 CASE 6.— Dull and 
 Docile. Mild Emo- 
 tionalism, Paucity of 
 Ideas. Most Grace- 
 ful Dancer. 
 
 Bertha i> another of tlic ty|)ically (hill children with little 
 that is positive mentally or morally. l)ul with a hue sense of 
 what is graceful in physical movement, and a readiness to 
 learn in this direction only. ( )f 
 T'.ertha's family nothiniL;' has been 
 learned. She was for a time in 
 an industrial school for j^irl-, 
 and has been at Lincoln since 
 1904. 
 
 Phvsically she is of normal 
 height and C) pounds above in 
 
 weie'ht. with a head that is of nearl\- normal jjirth but that 
 is abnormallv narrow in proportion to its length. Her lung 
 capacity is 13 above, her strength of gri]) is good but is great- 
 est with the left hand. lier hearing is normal, visual acuity 
 is one-half in the right eye and two-fifths in the left. The 
 head and face are regularh- forme(l, the lower jaw is rather 
 undeveloped. The skin is much freckled and of a peculiar 
 pallor. She w'as anaemic a couple of years ago, but has im- 
 proved, and her health is considered good. 
 
 In school Bertha gives no trouble in morals or discii)line, 
 gets on well with others, attends well, does not do sill\- things 
 or make absurd replies. She reads only fairly well in the 
 third reader, spells satisfactorily, adds and subtracts two- 
 place numbers w ith difficulty, and is learning the easier lines 
 of multiplication. Besides she takes only music, jihxsical 
 exercises, and the simple manual work of the kindergarten. 
 In the calisthenic and gymnasium work she is most grace- 
 ful and is even a leader. She learns the exercises readily 
 and remembers them well, .^he is perha])s the uKist gracelnl 
 dancer in the institution and seems to have a real tho in- 
 articulate sense of the "poetry of ])h}sical movement." An
 
 52 
 
 BACKWARD AND FEEBLE-MINDED CHILDREN. 
 
 earlier teacher of drawing found her "artistic" in her at- 
 tempts at free hand drawing as well. Her piano teacher re- 
 ports her to be a promising pupil in music. 
 
 Mentally she tests to a mental age of 9. with 3 or 4 vears 
 of retardation. .*^he could not count from 20 to o, could not 
 tell the day and date, could not make change or name the 
 commoner pieces of money, etc. In the written tests her 
 handwriting is neat and legible, but like that of a little child. 
 
 Asked to reproduce the story of "The 
 ATarble .Statue," which she had just 
 heard, she writes : — "A young man 
 made a studeyu out of sund and it sude 
 on gnmd and it was a perttry girl." 
 
 In the other tests she showed a simi- 
 lar paucity of resources and of expres- 
 sion. She could give scarcely any op- 
 posites or similars even when tested 
 orally and alone. In the A-test she first 
 failed entirely, then omitted 45 while 
 crossing 38 in the two minutes. In the 
 orientation tests she had little notion of 
 the direction of known points, made a 
 uniform displacement of 90 degrees for 
 points of the compass and mis-placed 
 7 of the 9 buildings, 6 being placed at 
 points distant from the correct loca- 
 tions. 
 
 In 100 association tests she remained 
 meekly silent for 27. and did not know the meaning of 
 mutton, citizen, and justice. Perseveration occurred four 
 times and stereoty])y was shown in six repetitions of the 
 word dress. The tendency to drop into an automatic 
 '"tempo" of reaction was shown by giving 10 reactions at her 
 median reaction time, 2.4 seconds. Her associations are 
 
 BERTHA A.
 
 Ci.lNICAL STUDIKS OF I:<)KI)|;k CASICS. 53 
 
 characterized h\ the now famih'ar lack of colcir and ])overiy 
 of resource. 
 
 Tn school and elsewhere it is to he noted that I'ertha does 
 not volunteer rejdies. She is a])t to sit stupidly with no 
 thought hut to do automatically the thing expected hy her 
 teacher. She seldom raises her eyes from her hook or slate, 
 confined in the ver\- little world of the half-dozen things that 
 she knows to do at her desk, and apparently never thinking 
 beyond these. With all her apparent stabilit\- her teachers 
 state that her worst fault is that she "cries too nuich." one 
 teacher saving that she "can hardly speak to her without her 
 crying." r)Ut the emotions are mild and fleeting, and the 
 child is the same from dav to dav.
 
 54 
 
 BACKWARD AND FEKBLE-M IXDED CHir,I)REN. 
 
 Robert P., Age Fifteen Years. 
 
 CASE 7. 
 
 — Dull. 
 
 Unstable. 
 
 Family 
 
 History of 
 
 Alcohol- 
 
 ism and 
 
 Insanity. 
 
 Premature 
 
 Birth. 
 
 Convulsions 
 
 until 
 
 Admission. 
 
 Flighty 
 
 Attention. 
 
 Agraphia 
 
 Mis-spelling 
 
 s. 
 
 Any one who sees Rol^ert managing a ball game, rushing 
 liither and thither all in a perspiration and dazzling his 
 oddly-assorted team with the lingo of an accomplished "fan," 
 
 would be certain that the boy 
 w^as unstable. We shall see that 
 he is equally dull. 
 
 Robert's father is stated to 
 have l)eeu very intemperate, and 
 a brother was insane. Robert 
 was born prematurely at 7 
 months, was sickly then and 
 "never had good health." He 
 had convulsions three or four 
 times a week, the last occurring 
 in ]\Iay, 1907, shortly before his admission to Lincoln. He 
 was considered to l)e epileptic. He did not begin to talk 
 until more than two and a half years of age, and had typhoid- 
 pneumonia, measles, and scarlet fever. He went to school 
 one year and was said to be a truant. 
 
 Physically the boy is of about normal height and weight, 
 but with a cranial girth that is 25 mms. below normal, the 
 head being 12 mms. too short, but normal in witlth. He is 
 normal in lung capacity and in strength of grip, except that 
 the left hand is disproportionately strong. He has two- 
 thirds vision in either eye, with some strabismus, and his 
 hearing is quite defective at the left. The forehead is re- 
 ceding, palate a little high, uvula small, ears very large, 
 separate from the head and asymmetrically placed. His 
 fingers are very unstead}- when extended, he perspires with 
 extreme readiness, etc. 
 
 Medical examination records that he has had chronic dis- 
 charge from his ear, that his tonsils are enlarged and that
 
 n.ixTc \i, sTci)ii-:s o]- i;()kI)i:r casks. 
 
 ^0 
 
 since enterini^ llic in.stitulidii lu- lias had broucluj-pncuuKMiia. 
 measles, and dtitis media. I \c has no record of convulsions 
 since conniii- to I .inc^ln. 
 
 Kor.KUT 1'. AND 1)AV11> F. 
 
 Tn school l\i)hert reads fairl\- in the first reader or.'v, 
 does some addition and subtraction, hut failed on 5 X - and 
 4X 1- Ht' does well in calisthenics and likes to "lerid.'" 
 He is also good at dancing- and in Ijasketry. in manual work 
 he is generally quite unsatisfactory, only working h\- fits 
 and starts, tho occasionall\- he turns in and works hard for a 
 time. He does not work accurately and "complains of being 
 tired all the time." In other school work he is said to be 
 a "hard worker for a time," "when interested in something," 
 like iM'ed 1. He coidd learn band work, but after three
 
 56 P.ACKWARD AND FEEBLE-MINDED CHlr.DREN. 
 
 iiKjnths' trial he had to be dropped for laziness and inatten- 
 tion, lie would forget to come in at the right place with 
 his part or at the right time for his lesson. In playing ball 
 with him I note that while he can play well enough his energy 
 and interest soon run down, he keeps throwing too low from 
 sheer laziness, with no enthusiasm. He is generally found 
 to be inattentive and liable to distraction. 
 
 Mentally Robert shows an intelligence of nine years with 
 a retardation of ^y? years. His speech is nasal, but he can 
 articulate normally. He could repeat 5 numerals but once in 
 7 trials, could not count from 20 to o, nor make change of 
 4 cents from 2~^, name the months, detect nonsense in sen- 
 tences, or give C) of the 19 details about the "lire." He seemed 
 to be bored with the trouble of thinking. He did not make 
 absurd replies, but was merelv weak in his adaptations and 
 at the same time rather self-satisfied with them. "Not very 
 hard" was his characteristic reply after itftriiy failing to re- 
 arrange the shuffled words of a sentence, upon my saying" 
 "That's pretty hard, isn't it?" Asked to try further he made 
 the words up into some other jargon and was satisfied. 
 
 In the written tests the work is very weak both in quantity 
 and quality. His handwriting is irregular almost to scrib- 
 bling, tho large and therefore moderately legible. His mis- 
 spellings, as in some of the other cases, suggest a form of 
 agraphia. Examples are: \Vaunts (once), feiyend mon- 
 shewn (fixing machine), worild (world), that (they), wenet 
 (twenty or fifty), dooler (dollar), woomen (woman), hose 
 (house), she shad (she had), bencis (beans), frie (fire), 
 strae (straw), heir (her), cold (coal), sue (saw), sad 
 (said), goe (go), a crose (across), stache (statue), uch 
 (wish), aand (and), chiikes (cheeks), rud (red), treind 
 (turned), buteuring (beautiful). There are many others. 
 Robert occasionally omits words needed to connect his 
 thoughts, apparently from carelessness or forgetfulness as
 
 '''^ 
 
 CLINICAL S'lLblKS Ol' l!Okl)i:K CASES. 57 
 
 lli^ llidUi^lit sliuws loi^ical CDiilimiilx tliriKmt. I'.nt there is 
 scantiness of nieinorx and of j^xMieral resonrces. Me sini])li- 
 fies the stcries to the merest sketches ami dlteii misses essen- 
 tials, giving- the ini])ressi<)ns ol' a very yonn^- child. I he 
 povert\' (if his ima,t>er\ i> shnwn in his story of the tlyinj^'- 
 machine tri|): "'riiey had a ])<>[ with some cotiee." went 
 "out to see the world,"" and "had a hn<.' time,"' covers it all. 
 Robert's child-like e.^'otism is well seen in the hall i;ames. 
 where he makes himself the shininj^- h_L;'ure amont;- his still 
 less gifted mates, and ])lays with tremendous swagger and 
 noise. llajipilN' he has become enamored of shoemaking, 
 and has been sticking prettx' well to tlie learning of this 
 trade. At such an occui)ation and under wise direction this 
 bov mav be haliituated to a life of useful and luore or less 
 contented service. lUU he is trickw an<l if left to shift foi- 
 himself would attain to very different results.
 
 CASE 8. — Dull, 
 Unstable. Feeble 
 Mental Span. Adapt- 
 ed to Institution Life. 
 
 58 P.ACKWAUn AXn FI-:RnrJ-> MINDED CHILDREN. 
 
 Dora J/., Age T7vciity-lico Years. 
 
 In her neat nniform Dora is often taken for a steady-go- 
 ing attendant. She is a good example of the wa\- in which 
 manv of tlie more stable higher-grade children may grow 
 
 into the ser\'ice of the institu- 
 tion. Unfortunately her stabil- 
 it\' disappears in the presence of 
 the opposite sex, and her dullness 
 is evident whenever her routine 
 of life is varied. Xow 22 years 
 of age. she was admitted 9 years 
 ago. She had lived in Chicago, her parents were dead, she 
 had been at school, was very nervous at times, forgot things 
 readih'. was untruthful and "careless of herself." No more 
 is known. 
 
 Phvsicallv she is 24 ]wunds above in weight and an inch 
 above in height, iler head is 12 mms. below the normal 
 girth, being abnormally short for its width. Her lung ca- 
 pacitv is 45 cu, in. above, and in vision, hearing, and strength 
 of grip with either hand she is normal. The palate is rather 
 high, but there is no other abnormality worthy of note unless 
 it be a slight strabismus. She is subject to tonsilitis and at 
 one time had some little trouble with the left lung. Usually 
 she is in fair health and able for her work. 
 
 In school Dora now takes only calisthenics, manual work, 
 and music : but she had had grade work, has read in the 
 fourth reader, and can now read a newspaper with mod- 
 erate fluencv, tho her reading is nevertheless illiterate and 
 abnormal in character. For instance, she was utterably un- 
 able to pronounce experience, gaily, charitable, correclional, 
 juvenile, purpose, and was unable to read long numbers. 
 She can multiply and divide only with the smaller digits, 
 and fractions are quite beyond her. She could not tell the
 
 ct i.\i( Ai. S'i-ri)ii:s OF i:()K!)i:r casi-:s. 
 
 5<) 
 
 cost of four appk's at i ' _- cents apiece. She m"i\es her teach- 
 ers no trouble on the side of morals or (lisci])line, i^ets on well 
 with others, and attends well to teachers and tasks. She 
 sews well and rajiidly. and makes man\- of her own clothes. 
 She is a s^'ood dancer, and sometimes leads the calisthenics 
 class thru their exercises. .She is a satisfactory pu])il on the 
 ]>iano. reads her music well, and ])lays eas_\- selections as 
 part of the i)roj.iram of entertainments. 
 
 The Rinet tests ^ixe Dora a mental ai^e of lo'/i \ears, a 
 retardation of i i ' _> years. .She will ])rol)ahl\- ne\er have an 
 appreciabl}- Ijetter nn'nd. lier 
 mental "span" is childishK- weak, 
 not sufficient for the re])etition 
 of 5 ninnerals, which is a ta.sk 
 normal to a 7-year-old, nor for 
 a i6-syllable sentence, normal in 
 a 6-year-old, Asked to sa\ all 
 the words she could think of in 
 3 minutes, she "ran out"' com- 
 pletely in I) J miiuUes. Abstrac- 
 tions are quite be\on(l her. Ask- 
 ed what charity is she said, 
 "Avren't they the i)eo])le that 
 come here to look after thinq-s?" 
 'AVhat is goodness?" "Someone 
 is kind to you." She did not 
 know the word jtisficc at all. 
 Asked about a picture of a man a)id bov pulliui^ a cart, she 
 said "The humans have to i)ull the waj^dn." 
 
 The written tests show a noi-mal and verv fair handw rit- 
 ins.^" and spelling". She occasionally- omits a word, causing' 
 her sentence to make ridictilous sense. Except for this 
 her composition is very fair. A few phrases such as "on 
 her returned," "became in love," surprise the reader. In 
 
 lioK.V M.
 
 6o BACKWARD AND FEEBLE-MINDED CHILDREN. 
 
 her story of the flying-machine trip all that is "new" is 
 "and we indeed delighted and we seen some beautiful sigh.ts 
 on are trip." Her total output is very meager indeed in all 
 the tests, except that she progressively reduced the marking 
 of A's to automatism, with good final output. 
 
 The tendency to automatic functioning was also shown in 
 making 13 of 100 association reactions in 1.7 seconds each, 
 this being her median time. Eighty-three of the one hundred 
 reactions were single words normallv related to the stimulus 
 word, 75 of these being found in Kent and RosanoiT's table 
 of words given b\- normal persons. She shows some tend- 
 ency to give words suggested by sound rather than by mean- 
 ing, and this appears also in giving opposites and similars. 
 Note tall — tell, thin — then, war — warm, many — any, ' for 
 opposites, and tent — ten, feel — fell, winter — win, big — pig, 
 snow — now, run — ran, for similars. 
 
 She made no error in indicating the points of the compass 
 or in representing the location of nine buildings, and had a 
 fair general notion of the direction of known points. 
 
 On the ward Dora is a trusted and useful helper in the 
 storeroom, caring for the children's clothing, helping to 
 wash and iron the finer things, waiting on table and having 
 the privilege, for the latter service, of wearing a special uni- 
 form. She is talkative and lively, but gets disgusted and 
 angry by times and then pouts and says she "has the blues." 
 Her sewing teacher reports that Dora does not always act 
 normal!}- in the expression of her feelings, and that occa- 
 sionally she breaks out laughing without apparent cause. 
 
 Generally she is satisfied and contented, and in the very 
 simple conditions of her work and life she conducts herself 
 normally and correctly. But the tests show a fatal weak- 
 ness of mental control, tendencies to confusion, to "losing 
 her head" whenever circumstances are a little complex, or 
 under strain and stress. With her instincts well developed
 
 ei.JMi Ai. sri :i)ii-,.s (»i- i;(»ki)i:k CASiis. 6i 
 
 \vc should expect to inul just what general ohservatioii 
 shows, a girl wIki is euiolii >nal1\ unstable, at the mere\- of 
 her sexual instinct, aljsurdlx- over-conscious of herself in 
 the presence of men and having to he watched carefull} 
 when the latter are ahnnl. She was taken out of the insti- 
 tution and cared for in a family for a while. I hit thi> in>ta- 
 liilit}- made it necessar}- to return her t(j to the institution 
 for safety. Even here she gets into "disgrace as the result 
 of flirting." 
 
 Here is a striking instance of a nsefid and coniparati\el\- 
 hap])_\- life l)eing realized in an institution, 1)\ suiting th ■ 
 conditions of environment, work, and stress to the girl's nu'n- 
 tal level, in the case of a girl who if she lix'ed at large would 
 certainly he a menace to societv and to herself.
 
 02 
 
 l:.\C KWARI) AXn FKlCr.LE-.MIXDKD CI1II.DKEN. 
 
 CASE 9.— Neuras- 
 thenically Unstable. 
 Epilepsy and Cancer 
 in the Family. Quar- 
 relsome, Complain- 
 ing, Thieving. Reads 
 Much, and Intelli- 
 gence Fair. 
 
 iicorgc /., Age Sixteen and One-half \'ears. 
 
 George is about the brightest boy that I have tested in the 
 instittition. and he is ahnost as unstable as any. lUit his in- 
 stabihty shows some special characteristics which perhaps 
 
 warrant us in classing hin: as 
 nenrasthenicallx unstable. 
 
 Admitted three years ago. he 
 comes of Polish parents who 
 lived in Chicago. His father was 
 an epileptic who died of cancer. 
 His mother died of pneumonia, 
 and he has a brother with de- 
 fective hearing. George had 
 slight losses of consciousness or 
 "fainting spells." but was not thought to be an epileptic. 
 He was "extremelv nervous." did not sleep very well, smoked 
 cigarettes and chewed tobacco, was addicted to running 
 away, was very ill-tempered and disobedient, continually 
 quarreled with the other children and at times threatened them 
 with a knife. He was at school seven years from the age 
 of six. Later he was a short time in an orphan asylum 
 where he ct)uld not l)e retained on account of vicious habits, 
 and so was brought to Lincoln. 
 
 Physically he is about 15 pounds below in weight and two 
 inches below in height, with a head that is 14 mms. below 
 in circumference, being too sh.ort for its width. He is 
 somewhat below in lung capacity and is distinctly inferior 
 in strength of either hand. He has not more than one-half 
 vision in either eye, l)ut his hearing is normal. The upper 
 incisors are separate, Init the teeth arc good. His skin is 
 ])alish and the nutrition is not ver\- good. The neck shows 
 some goitre, the tonsils are somewhat enlarged and the 
 cervical glands as well, and he is recorded a^ having a chronic
 
 ci.i.N JCAi, siiDii'.s ()i- i;()kiji:R casi^s. C)T, 
 
 adenitis. Jii meeting- one's ya/.e the facial expression is not 
 normal. 
 
 In school Georg'e reads readil}-, iho with man\ errors, 
 and he takes man\- hooks from the lihrarv. readin:.;' some- 
 times even when marching- in the line-u]) for meals. Me 
 made glaring- mis-])ronunciations of iwistciice, occasion^, 
 ancestor, cojifracts. etc.. hnt read on untronhled. lie does 
 simjilc division, not long division, and he can work die \-er\- 
 sim])lest problems in fractions, hnt all with a strong lend- 
 ency to confusion and inaccurac\-. lie does not (■(//■(■ about 
 being accurate, and gets bored with tests that call for ac- 
 curac\-. In general he attends badU- and tends to leave or 
 slight his work. Manual work is well executed while the 
 teacher is "right there,"" but is deserted when the teacher 
 leaves. He sometimes uses good intelligence in inventing 
 puzzles and games not connected with his work. The boys 
 in the manual room seem to cater to him. recognizing, as 
 they often do. an intelligence superior to their own. I lis 
 manual teacher sa^s that (leorge "talks more intelligentl\- 
 than any boy in the roon-i. about history and stories and own 
 experiences." tho telling a good man\ things that are not 
 true, l)Ut owning up when caught, lie excels in drawing, 
 but iinds this eas\- and has little incentive to tr\- hard. 
 
 George"s bandmaster buds that this boy learns music 
 just about as a normal child. In a _\ear he has learned to 
 play the cornet in treble clef and the baritone in bass clef. 
 and in one month after starting with the clarionet he could 
 play several easy beginner's pieces and had learned the 
 chromatic fingering of the clarionet. All this was within 
 the year of band work. 
 
 The I'linet exaiuination shows a mental age of ii'j 
 years, a retardation of 41-2 >ears at the time the tests were 
 made. His speech is slightly defective. ]M-onouncing "d"' 
 for "til," etc., iho the trouble would seem to be largeh' func-
 
 64 BACKWARD AND FEEBLE-MINDED CillLDREX. 
 
 tional. He finds an abnormal amount of difficulty in usini; 
 language to express his thoughts, illustrated, for instance, 
 when he said "in a several weeks," and again "I didn't in- 
 terfere much with — I didn't monkey around much with 
 medicine and tilings like that," his reply wdien asked to name 
 certain smell substances. He followed this by saying, "Yon 
 know half the time I didn't try things like that." For "His 
 neighbor died" he said. "The death reached his neighbor." 
 Asked how he felt he said, "For last two years Fve been 
 feelin' as good as a fish." In the manual room when 
 he was asked w hy he made certain silly movements and clap- 
 pings, he said he was "ha]opv because the world is going 
 around." Of course these errors show a troubled thought 
 that is perhaps one ^\ ith the troul^led language. 
 
 The written tests show a fairly legible handwriting, tho 
 the letters and syllables are often widely separated. Capi- 
 tals and punctuation marks are often omitted or incorrect, 
 and words and letters are omitted by times. He spells 
 dindt (didn't), rite (right), jest, (just), slipt (slipped), 
 siad (always for said), through, thrue and true (threw), 
 tialler (tailor), enouhg (enough), mountians. Separations 
 such as the 11. g rceii, p asf. pas s iiij^, occur frequently. 
 Fxcept for his forgetting to write an occasional word his 
 composition shows logical normal sequences thruout. His 
 invented story of a trip in a fiying-machine dramatizes the 
 initial situation, quoting the speakers : They went past 
 fields like a bird, saw cows in pasture, farmers in the fields, 
 all so small. A forest looked lovely, like, green carpet. 
 Then the mountains, where great birds followed them. Then 
 a camp for the night, a good time next forenoon, and home 
 again by evening. 
 
 In 100 association tests he gave 89 normally related single
 
 ci-JNU Ai. siTT)ii:s oi' i;()RI)i;r CASiis. 0^ 
 
 
 
 words, ()4 different rcacti(m>. ami 4 failures Xo re-act, with 
 l)iit one sc'iilcnce or ])lirasc. Ilis nu'dian time was 1.7 sec- 
 onds and Ins maximum time was _v,^ seconds. 
 
 In \\\v orientation tests hut one hnildin^- was mis-placed, 
 and his errors as to directions were not tar from normal. 
 He ^i^ave similars correcth' for each of 20 words in two trials, 
 and II and lo oii])osites in two trials of one mimtte each. 
 In three ti'ials he ])roi^ressed to an outi)ut of (;5 A's crossed 
 with no omissions. To 10 words L;"i\'en orally he re>])onded 
 with correct similars in rt-aclions of 1 .( ) to 3 seconds. In 
 three repetitions of the same "'similar" list, on diilerent days, 
 he made a nimiher of variations, hut no errors. Ilis form 
 board times were sticcessivel\- J 1.3, -'4.3, K) seconds, alter 
 two practice trials. 
 
 Georo-e shows "nerve"' and s^rit when ijtioyed up l)_\- social 
 approval, as in the L;"\-mnasiimi w here he i^rittiiy carried thru 
 "stunts" that w'ere almost heNund him, because he thought 
 that 1 expected them of him. Me s])eaks to me with a self- 
 conscious and soniewhat ceremonious air, looks to see if i)eo- 
 ple watch him as he pla\> in the band, and is at all times 
 abnormall}- self-conscious, lie tisuall\- wears a dejeclefl, 
 wronged expression. com])lains a ij'reat deal and is always 
 dissatisfied. His self-consciousness and his fundamental 
 al>oulia aiLjQravate his troubles with lani^tiai^e. which reall\ 
 rest on a dit'hculu of synthesis. The social adaptation in- 
 volved in talkiuiL^- with me, the sinudlaneous sxiithesis of va- 
 rious factors social and linguistic, are too much for his 
 weakly-constituted brain-mechanism. The hner adjtist- 
 ments clog-, and using the coarser ones he 1)lurts otit what 
 conies, feeling that he lias done badl_\ and \et not doing the 
 utterly irrational things; for he is checked and controlled, 
 ;;/ tlic lari^c, b)- the representations of the results of his ac-
 
 66 DACKWARn AXD FEEBLE-MINDED CHILDREN. 
 
 tions. He is therefore by no means irresponsible; but feel- 
 ing- his unceasingly bad outcomes he is perforce one of the 
 unsatisfied, as neurasthenics constitutionally are. 
 
 He complicates the situation by lying and especially bv 
 thieving. One of his teachers says that George steals from 
 people that he "has it in for," and not from certain others. 
 He is easily "smitten," and is said to have stolen perfume 
 and "everything- he could gets his hands on" to lavish on 
 one of the institution girls. Last year he ran away, but 
 after enduring- severe hardships was returned by the police. 
 He is still determined to get away, tho a teacher recently 
 reports a "wonderful improvement in both work and dis- 
 position," and that he is now "always smiling and pleasant.'"' 
 
 Here we have one of those difficult natures more often 
 classed as neurotic than defective, but who are much of 
 both. Gifted with all the mental functions necessary for 
 life in society, these functions work so frailly and incom- 
 pletely that these individuals are always in trouble and are 
 always making trouble. George's brains will doubtless float 
 him out into society sooner or later, and we await with in- 
 terest the additions to his record.
 
 ci.iMCAr. s'rri)ii:s oi" i;()K1)i:r casics. 
 
 67 
 
 Ucslcr ./., Ai^^c Eii^htccii and One-half Vrar. 
 
 CASE 
 
 10. 
 
 — Hyster- 
 
 ically 
 
 U n 
 
 stable. 
 
 Pse udo 
 
 - E 
 
 pi le pt ic 
 
 Convuls 
 
 ons 
 
 Asso- 
 
 ciations 
 
 by 
 
 Sound. 
 
 Hester's attractive voice, lier ])rMmineiice in scIkkiI eiiler- 
 tainiiients, and tlir in'olilcniatical cliaracter of lier '■convul- 
 sions" make lier the center of much attention, .she has been 
 in the institution since i<jt)5. 
 
 Her mother cookcl on a 
 dredg'e-boat and is stated to have 
 been intem])erate. The father 
 died of pneumonia, and the chiM 
 had measles. scarlet fever, 
 nium])s, ])neumonia. and malaria. 
 She had a bad tem];er, destroxed 
 
 clothing, was "s!_\l\- disobedient." had bad sex habits, and 
 was a great talker. She was in an ( )ri)hans' J lome for a 
 short time, and was in the .State Industrial ."School lor ( lirls 
 for some years liefore being sent to Lincoln. W bile in the 
 Industrial School she attended school for three \ears, but 
 reached only the 2(1 grade. She ^a\s that she had >onie sort 
 of "spells" when still with her mother. 
 
 Physically Hester is 3 pounds al)ove in weight and 1.2 
 inches below in height, with a cranial girth that is 34 mnis. 
 below normal. She is 40 cti. in. above in lung ca])acit\'. ami 
 of more than average strength in gri]) of either hand, i fer 
 hearing is normal, but her visual acuitv is but one-half in 
 each eye. Her uvula is diminutive, her hands and fingers 
 take abnormal positions when extended, the thyroid shows 
 an over-fullness and she states that she was formerly treated 
 for goitre. 
 
 In school Hester takes work in the sewing-room onl\'. 
 She writes a good hand and reads ordinarx matter with 
 readiness, bitl with illiterate mis-pronunciations. 
 
 The mental examinati(_)n gi\es her a mental age of 10J/2 
 \ears with a retardation of S \ears. She could not cbausj'c
 
 68 
 
 BACKWARD AND FEEBLE-MINDED CHILDREN. 
 
 4 cents from 25, defined only in terms of use, could not re- 
 call 6 of the 19 details in the memory passage, could think 
 of but 49 words in 3 minutes, giving () successive words 
 which ended in -ing. She was never able to rearrange the 
 shuffled words of sentences nor to repeat 7 numerals or sen- 
 tences of 26 syllables. 
 
 In the written tests she is very weak in capitals and marks. 
 
 and occasionally forgets to 
 write a word intended. 
 ( )nce she writes "We got 
 a fifty dollars." Usually 
 her ])apers are neatly ])ut 
 up. with regular lines of 
 even length. Her repro- 
 ductions of stories are mod- 
 erately full and correct, but 
 her invention for the flying- 
 machine trip gives only : 
 "Where do you think it 
 took us to — we saw a laut 
 of pretty things on our 
 wa}'." A nuff (enough), 
 laut (lot), whean (when), 
 one ( on ) , are practically all 
 the mis-spellings to be 
 found in her written work. 
 In the orientation tests 
 she mis-placed 4 of the 9 buildings, and her errors for the 
 direction of compass points and known points averaged 68 
 and 54 degrees respectively. She could give but 6 of 20 
 opposites, but gave similars for 16 of 20 words. 
 
 The association tests at once revealed certain character- 
 istic tendencies. In 24 instances she failed to react at all, 
 partly due to the emotional or reminiscent appeal made by 
 
 II E.ST KK A.
 
 ( I.I.XU AL STL'D1I-:S (>1~ l'.(jklJl-:R CASES. Gj 
 
 the slinuilus wmd or 1)\- sonic i)i"ccc(ling' word. I'^njni tlie 
 same causes many of her reaclions were much dchiNed in 
 time. 
 
 Of 2\ selected extra words interspersed in tlie Kent- 
 RosanofF hst of loo, the word coimilsioiis caused nuicli con- 
 fusion and a reaction time of lo seconds, the reaction heini^ 
 "Can't explain any." ddie word escape, ( slie had tried lo 
 run away), ,q"a\'e no reaction. Spasm ^ave no reaction hut 
 a thoughtful look. "Make l)e!ieve," succeeding- this, wa> 
 simply repeated with a laugh, time 5^/2 seconds. ( )thcr re- 
 actions showing similar characteristics had a sexual refer- 
 ence. While she showed herself ahle to react in i ' _- seconds, 
 her median time was 3 seconds, showing the fre(|uent occur- 
 rence of the ahove or other disturhing inrtuences. Hut 17 
 of the 100 Kent-Rosanoff words called forth words found 
 in these authors' list of reactions given hy 1000 normal ])er- 
 siMis. ]*)Ut 22 reactions in all showed a nattu'al (^r usual re- 
 lationship of nicaniii!^. to the given word. In 42 instances, 
 on the other hand, the word given was ohviously suggested 
 hy its similarit}' of sound. Examples are deep — steep, moim- 
 tain — fountain, house — horse, mutlon — l)utton, hand — hand, 
 short — stork, hutterfly — butter, sweet — heat, whistle — fistle. 
 The last is one of the five neologisms, or coined words, fotmd 
 in her reactions. In three instances she merely repeated the 
 stimulus word. These inferior tyi)es of reaction are supple- 
 mented bv others stich as dream — train, ( iirls' Cottage — 
 Cot, with long reaction times and apparently connected with 
 repressed constellations. 
 
 IVIy attention was first called to llester 1)\' tiuding that, 
 tho not considered an epileptic, she had stiddenly commenced 
 having a series of frequent and severe convtilsions regularly 
 reported as epileptic in character. There was the hitteu 
 tongue and every appearance of the convulsions heing gen- 
 uine, and on one occasion she was rei)orted to have l)een
 
 70 BACKWARD AND FEEr.LE-MINDED CHILDREN. 
 
 uiicoiisciuus for ijvcr Iwo hours and to have had as many as 
 21 convulsions in one day. It was noticeable that she did not 
 injure herself much in falling, that she showed areas of 
 anesthesia, and that the attacks could l)e made to cease by 
 threats, or by changing the girl to another building. 
 
 On investigation I found that some weeks previous to the 
 beginning of all the attacks she had a fist-fight and hair- 
 pulling with another girl, had quarreled and called names a 
 good deal, and had struck an attendant. As a punishment 
 she was kept from the institution pictiu'e-show and dance. 
 .She grew very angry, escaped to the distant "Girls' Cot- 
 tage," and violentl}' resisted return. Allowed to remain 
 here in the epile])tic ward, she commenced having the con- 
 vulsions, which continued when she was transferred to the 
 hospital, but which ceased when she was allowed to return 
 to her original quarters and standing. There has been no 
 recurrence after many months. 
 
 Beside local anesthesias noticeable at limes, Hester shows 
 a self-conscious and abstracted manner, with nervous twitch- 
 ings under excitement, and a considerable narrowing of the 
 field of vision. She showed susceptibility to at least light 
 h\])nosis, and the indications irom the association tests, 
 with the other symptoms, point to a condition of hysteria. 
 She was finall\' induced to talk frankly about her "spells," 
 and her statement was essentially "I put them on," "I did it 
 to be mean." She claims that, sleeping and eating with the 
 epileptics, she "caught" the convlusions as slie feared she 
 would; and that her first attack was when an epileptic in a 
 convulsion jumped on Hester's bed and frightened her. She 
 claims not to remember what she did in the attacks. 
 
 This case illustrates the possibility of even trained phys- 
 icians, familiar with epilepsy, being deceived b\ the symptoms 
 of an hysterical patient who is herself familiar with epileptic
 
 fr.Txir.\r. STiiniF.s of noRni-.N casks. 
 
 7> 
 
 nianifcslalions. TIktc is of course llic remote |)ossil)ility 
 of genuine epileptic seizures Ijciiii;' occasioned 1)\- sucli su.l;- 
 gestion, l)ut the couditiiin of Insleria llial is actualK indi- 
 cated seems sufficient to account for the ])iienomena re- 
 ported. The latest reports are that tlie girl continues to 
 do well, and that much of the trouljle mav have been due 
 to lier not haN'ini'- enough of mental occui)ation.
 
 7^ 
 
 ■.ACKWAKD AND FKKRLE-.MI XDED CHILDREN. 
 
 Miiiiiir C Ai^c Sci'Ciifceii ]'cars. 
 
 CASE 11 
 
 — N 
 
 euras- 
 
 thenically 
 
 Un 
 
 stable 
 
 with Tendenc 
 
 es to 
 
 Hysteria. 
 
 Urt 
 
 icaria, 
 
 incontinence 
 
 with 
 
 Cystitis, 
 
 Tu 
 
 bercu- 
 
 losis. 
 
 
 
 Minnie is one of those neurasthenically constructed indi- 
 viduals who Iiecome hysterical on occasion, and whose de- 
 fective growth has been at the bottom of her liiuitations of 
 
 body and intelligence on the one 
 hand and of her neurotic disposi- 
 tion on the other. She came to 
 the institution in November, 190:-), 
 from Chicago, with little of fam- 
 ily and personal record beyond 
 the statement that her mother 
 was dead, that Minnie had al- 
 ways been incontinent and was so 
 still, that she had disease of the ears and some trouble with 
 the skin since having di])htheria al the age of six, and that 
 she had reached the fourth grade in school. 
 
 Phvsicallx' Minnie is 4.4 pounds below in weight and 3.4 
 inches above in height, with a head that is nearly normal in 
 girth, but that is abnormally short for its breadth. She is 
 well al)ove in the spirometer test but a little below in strength 
 of gri]), has but one-half visual acuity in the right eye and 
 very defective hearing in the right ear. The face shows some 
 irregularitv, the uvula is diminutive, the nails are very short, 
 the chest is sunken, the l)ack is constantly l)ent, and there is 
 a general unbalance of the bod_\- with the lung? cramped by 
 her crouching positions. Tier walk is stooped and defective. 
 There is poor peripheral circulation and the nutrition is not 
 good. The vaso-motor system is unstable, with marked lo- 
 cal variations of heat and cold. There is irregular occurrence 
 of the reflexes and there are areas of h\po- and hyper-esthe- 
 sia. The medical examination shows a condition of pulmo- 
 nary tuberculosis with chronic myo-carditis and an "exceed- 
 ingly unstalile nervous condition." There has been found, as
 
 CLINICAL Sll'l)ll-:.S (JL l;OKI)i:k CASES. 
 
 /.•) 
 
 well, a c\slili> which resists liX'atiiK-nl and which doiihtlcss 
 aj^g;ravatcs ihc enuresis, ."^hc has also had a i>eculiar and 
 variable skin affeclinn diagnosed as factitious urticaria. 
 
 .Minnie's school work" has been limited to the sewinj^'-rooiiL 
 where she is l)ecomin,i4 (|uite co]ni)etent in sewing' and em- 
 broider\-. .^he attends nonnall\, i^ets on well enouj";!! with 
 otliers. l)ut is abnonnalK sensitive to re])roof. She reads 
 with ease any ordinar\- 
 printed matter, but has 
 never learned to ninltiply 
 and (li\-ide. .She writes a 
 ver\- fair and normal hand. 
 
 The IHnet tests ^ive A I in 
 nie a mental age of i i ' - 
 years with a retardation of 
 4J/ years. She thout^bt of 
 and named i l i W(Mds in 
 three minutes, told the time 
 which clock hands would in- 
 dicate if intercbanj^ed at a 
 given time, gave rh_\mes to 
 given words and conld usu- 
 ally tell what to do when 
 asked about a variety ot 
 emergency situations. She 
 said "iM-iendsbip is a per- 
 son wlio is kind to one an- 
 other." Apologizing for an 
 
 incorrect drawing she said, "I'm not a yery good straighter. 
 of course." She showed al)normal fearfulness and "edgi- 
 ness" about anv unusual occurrence, and extreme suggesti- 
 bilitv. After some trouble widi a test she broke out with 
 "Sometimes I get so stui)id I don"t know what to do." 
 
 Tn the written tests she crossed 81 and t)8 .\"s in two two- 
 
 MLWII': o.
 
 74 HACKWARD AND FEEBLE-MINDED CHILDREN. 
 
 minute trials, and succeeded with 17 of 20 "similars" in one 
 trial but did luidly in another and in die tests for opposites. 
 and .yave rather weak reproductions of the stories. Punc- 
 tuation marks are absent and capitals are usually in the wrono- 
 place or omitted. She causes breaks in the composition b\- 
 omitting- words that were probably present to her thought and 
 would be expressed if she were talking. She also writes the 
 wrong word by times, apparently from distraction. When 
 she has to write of happenings that are at all complex she 
 breaks down and simplifies the matter in semi-incoherent 
 statements. But her thought generally progresses thru the 
 story in sequence as things occurred, and her frequent errors 
 in expression seem to be phenomena of confusion and of 
 frail power of synthesis. She seldom mis-spells, the onl\- ex- 
 amples being fithy (fifty), on (one), and way (away). 
 
 Minnie's intelligence would suffice for better results than 
 those tabulated if she were not so fearful of doing badly and 
 so markedly introspective and easily confused. She grieves 
 over the fear that she may be feeble-minded and that our 
 tests may prove this. By times she breaks out with infantile 
 expressions of afl:'ection for those about her. Unfortunately 
 she has fallen into bad sex habits and does not have a good 
 influence on the younger children with whom she preferably 
 associates. • She has a habit of complaining and tends to a 
 condition of hypochondriacal neurasthenia with tendencies 
 to hysterical dissociation, and without sufficient strength of 
 intelligence to furnish the needed correctives. Her physical 
 condition is most serious and demands permanent institu- 
 tional care. If her body were strong, her intelligence, tho de- 
 fective, would doubtless suffice to float her in society as well 
 as does that of many another of the host of the neurotics.
 
 CLIMCAI. STUDIKS OF llOKDllk CASES. 
 
 /O 
 
 Jn'iihi/i X., Age I'ijtccii )'cays. 
 
 CASE 
 
 12.- 
 
 — Epilep- 
 
 tic, Defective Emo- 
 
 tional and 
 
 Motor 
 
 Control. 
 
 Gossipy and 
 
 Over - 
 
 Re 
 
 i g i us. 
 
 Writes 
 
 C 
 
 reditable 
 
 Stories. 
 
 
 
 r.eiilali is a ratluT lyi)iral (.■])ik-|)lic, l)ut she -hows soiiil- 
 phenomena of hysteria as well, and withal has the flistinoliim 
 of bein,^- a story-writer. She came to the institution in I'eh- 
 ruary, 1909. 'i'he home record 
 states that the father was intem- 
 perate and ran awa_\- when the 
 child was a baby. The mother 
 died of diphtheria and heart 
 trouble. A brother who died at 
 three years of age is said by Beu- 
 lah to have had s])asnis. The lat- 
 ter was kept at an Orphan's 
 
 Home until brought to Lincoln. She had measles and scar- 
 let fever followed by mastoid trouble. She also had epileptic 
 convtilsions which are said tn have increased in frequency 
 since an operation for mastoiditis in August, 1907. She at- 
 tended the regular sessions of school while at the Orphan's 
 Home. 
 
 Physically Beulah is 6j>^ pounds above in weight and ,2 
 inches above in height, with a hea<l that is 10 mms. too small 
 in girth. 1 ler lung capacit}' is 38 cu. in. above, she is some- 
 what dehcient in strength of either hand, has but two-fifths 
 vision in either eye and has very defective hearing in the ear 
 that was operated ui)on. 
 
 The face is rather infantile and shows some irregularity, 
 l)robably a result of asymmetrical muscular ccMitraction. 
 The teeth show some irregularit\- of position and the lower 
 teeth are much crowded. The jaw has an irregular shape 
 and there is a diminutive-uvula and a high ])alatal arch. The 
 ears are defective, the fingers are al)normally tapered and 
 the second fingers arc turned strongly outward. The fingers 
 show convulsive movements when extended and spread.
 
 76 
 
 BACKWARD AND FEEBLE-MINDED CHILDREN. 
 
 The medical record shows that I'eulah is not considered 
 strong, having tendencies to bronchitis and gastritis. She 
 has right hmiljar scohosis and "shght lung and heart in- 
 volvement. " She continues to have severe convulsions, and 
 there is at least a temporary partial paralysis of the right 
 side of the face, the right eye being abnormality open while 
 the month and lower chin are drawn to the left. 
 
 In school Beulah reads fairly in the 
 fourth reader, works problems in divi- 
 sion and simple fractions, does not 
 s]x'll well, is fairl} original in drawing 
 but does not finish her work well. She 
 does poorly in basketry and irregularly 
 in clay modeling, showing originality 
 in the latter but lacking persistence in 
 the face of difficulty. She does badly 
 i'l calisthenics and dancing, is original 
 in story-writing and tells stories well. 
 She also studies history, physiology, 
 and geography, but with less than nor- 
 mal ])rogress. She is "very cjuick to 
 see thru a prolilem," attends well to 
 her teacher and to certain tasks, but 
 often stojxs and ''looks into space," 
 ])erhaps"making up stories," her teach- 
 er suggests. On the whole her teacher 
 llhnks she attends fairly well "with al- 
 lowance for dreams." She gets on well 
 with other childreiL and gives much time and interest to the 
 Ihble. She is decidedly inclined to gossip, to over-confiding, 
 and to mild complaining and criticism. 
 
 The mental examination gives Beulah an intelligence of at 
 least 12 years, a retardation thus of not more than 2^ years. 
 Asked what to do before undertakinig an important afifair 
 
 IJEULAU X.
 
 ci.iNK'Ai. sTUDii'LS OF i!()ki)i:r casi-:s. 'J'J 
 
 she answers, "Pray and think." Clidrily is "hniiililc' and ri^ht 
 Hke Christ." She gives too words in _^ minutes. I Icr mental 
 span is too weak for 7 nnmcral> nr lor sentences of 26 S}'1- 
 lal)les. and she cainioi (hslingnisli between abstract terms. 
 But her \-i\-id imagination enal)lc^ her to succeed in the first 
 of the pa])er-cutting ex]KM-iment> ruid to maisc jirogress witli 
 the other one, and lier inter])retatii mi o) ])ictures was normah 
 During 2j/> hours of Ihnet toting her con\'ersation and ac- 
 ti(Mis were sensible and natural ihniout, exce])ling tor three 
 or four incorrect or ])eculiar uses ot words and excepting that 
 she showed a marked tendenc\- to gossi]). to over-confide, and 
 to talk rclii^ioa. There was also some abnormal contusion 
 of memories. "Revolution is when the man r.uig the Liberty 
 Bell." Jt is "where they make a big racket, but I don't guess 
 they do either." "It's where the soldiers meet together to 
 tell over their old times and talk about the revolution." 
 "What I thought was when that little boy called M\ing, 
 father, ring,' or was it Paul Revere's ride?" She once asked 
 her teacher what the capital of Chicago was. 
 
 On another occasion she tells me that she wants '"to be 
 some place where 1 can mind the Pible," and grows (|uhe in- 
 tense as she complains that now she cannot "sa\- my pi-a\ers 
 with all my heart," as formerly. She says, "I think its awful 
 that they ever crucified Christ that way, don't you."" She 
 wants to be a "Catholic Sister," tho unt a Catholic now. After 
 rambling on in gossip aliout the institution, she wants to talk 
 of sex matters, and says she would tell of the dirt}' things the 
 girls say. "if voti were not a man." She claims tliat she will 
 not listen to these things herself. She showed distinct sexual 
 excitement at various times and in the ])resence of other men. 
 She is easily influenced even to mean conduct, by certain 
 girls, and her disposition and mentality are (piite different on 
 different day.s. 
 
 Another of Benlah's characteristics which she shares with
 
 78 BACKWARD AND FEEBLE-MINDED CHILDREN. 
 
 Other epileptics is her inchnation to talk ahout her '"spasms" 
 and otlier ailments. Incidentall}' her talks with me about her 
 convulsions throw more or less real light on their character. 
 Some of her convulsions have been recorded as epileptic and 
 others as hysterical. As a matter of fact some of them evi- 
 dently have both characters. Sometimes she has been "talked 
 out" of "having an attack" by the assurance that she would 
 not have it. Sometimes she can avoid them by telling the 
 girls to "come and play with me." Sometimes she does not 
 lose consciousness in the attack and then she feels so dread- 
 fully that she tries to reach the unconscious condition to es- 
 cape the torment, and thus may sometimes seem to ''put it 
 on." She would always rather "lose conscience" than to 
 know what is going on in the attack. Ordinarily, in a con- 
 vulsion, she is onlv aware of her head's initial turning to one 
 side. vShe has been a sleep-walker, and tells of recent in- 
 stances in which her sleep-walking was the expression of a 
 dream. She is reported by her teacher and others to have 
 had attacks in which she would become "nervous" and 
 "faint " without losing consciousness or falling, and to have 
 had other attacks that were "markedly hysterical." 
 
 In tapping as fast as possible, in the first 30-second test 
 Ueulah pounded the key somewhat and was quite irregular 
 in rate. In the second trial she hammered as if she would 
 pound the instrument to pieces, even pounding with her el- 
 1)ow. clawing with painful tenseness, and growing red in 
 the face. In the third test it was painful to watch her, the 
 movement was so beyond her control that her fingers could 
 scarcely hit the key. In the fourth test her movements were 
 "wild." and fearing a general convulsion the testing was not 
 carried fiu"ther. 
 
 In the written tests P>eulah shows many errors and a rather 
 variable performance, apparently doing well but for distrac- 
 tion. Her story of the trip in a flying-machine, while show-
 
 CLINICAL STUDIES OF I'.OKDl'K CASi;S. 79 
 
 iui;' iiiuii^iiiativc aljility, is spoilcMl l)y "t;r(i\\n ii])" im iraliziii^'. 
 Her haiidwritinii' is tliat of a iiuicli youiij^cr child and she 
 omits most of the ])iinctuation marks. She occasionally mis- 
 spells, examples bein^" staches (statue), nx'sy (rosy), hear 
 (hair), been (bean), die (they), ti) (two and too). 
 
 I'eulah writes very smooth hji^iish and shows a. ])retl\' 
 originality of thought and si)ri<;htliness of iniaii'ination in 
 making up little stories, onu at least of which has been 
 printed in a newspaper. 1 (juote the first ])art of another, cjf 
 the many that she has written for me: 
 
 THE LIUERTV BELL. 
 
 "I was dug out of the gromid all rnst an<l dirty, and in 
 little tiny pieces. 1 was sent to a big manufacture and put 
 into a ver\- hot oven. I stayed there so long that I went to 
 something runny like water. And then 1 was ])ouned till 
 I thought there was going to be nothing left of me at all. Ihu 
 when they stopped, wdiat do you think T was? W h\', 1 was 
 a big bell. 
 
 And I was so heavy that it took a good many men to lift 
 tue. They put me in a very dark car and 1 had a long ride. 
 The car stoped many times, lint no one came to take me <~»ut. 
 I'ut at last four men took me out and ])ut me in a big tower 
 and rang me many times. 
 
 One day a very old man eaiue and stood by \vc a long 
 time. Pretty soon I heard a boy cry. ring grandpa, ring and 
 it is said he rang me so hartl that T cracked."' 
 
 Her "Story of a Pennw" "Story of a Xeedle," and most of 
 her other stories are built on much the same simple model 
 suggested by her school lessons : and 1 fear that there may be 
 even here the ten Ienc\- to automatic woodeiuiess of imita- 
 tion so conunou in the deteriorations of epile])sy. Hut she 
 has had little instruction or syiupathetic encouragement in
 
 8o BACKWARD AND FEEBLE-MINDED CHILDREN. 
 
 this story-writing-, a t^ift which niight well be utilized to the 
 advantage of the girl and of the school. 
 
 The case is one of those sad ones in which along with a 
 streak of genuine al^ility there is mild but unmistakable de- 
 fect of both intelligence and emotions, with incipient psy- 
 choses characteristic of epileptic deterioration. It woidd be 
 a fatal mistake iov l')eulah to attem]jt living at her own di- 
 rection outside of the institution. As I write, the latest report 
 comes that she "continues bright and original, but makes no 
 more progress in school work."
 
 ci.iNiCAi. srrj)ii:.s ()!• r.oKUER c.\si-:s. 
 
 8i 
 
 Marsliall P.., Age Thirty-six Years. 
 
 CASE 13.— Mildly 
 Insane, while Feebie- 
 Minded. Semi-Delu- 
 sions, Automatisms, 
 Grandiloquence. Re- 
 ligious Mania and 
 Moralizing. 
 
 Marshall is one of tlic (iIcUt ■■children." bnl all of ihe 
 feeble-miiKk'd rniiaiii l)n\> and skirls for life, lie is a good 
 example of an intermediate condition between feeble-mind- 
 edness and insanity, and is often 
 thought to he too wise for either. 
 We shall see. 
 
 Of his famil)- it is stated that 
 the mother died insane and the 
 father of alcoholism. Previously 
 to 1891 the bo}' was for some 
 time in a Catholic school and it 
 is commonly said that he was 
 
 "studying to be a priest." In 1891 he was adjudged insane 
 in Cook Co.. Illinois, and was sent to a hos])ital for the in- 
 sane. Two months later he was sent to Lincoln where he 
 has since remamed. 
 
 At present he is a man of average weight and 2.4 inches 
 below the average height. His head is 22 nims. lielow the 
 normal in circumference and is shorter than the average by 
 10 mms. The forehead has depressions a1)ove the orl)its, 
 the jaws are well forward, the wings of the nose are wide, 
 the lips thick, the tongue over-large, the teeth and jaw irreg- 
 ular and the palate a little high. 
 
 There occurs a verv fref|uent and marked contraction of 
 the muscles snrrounding and closing the eyes, with winking 
 and drawing down of the evebrows. The eyeballs themselves 
 are rolled by times and show marked incoordination, espe- 
 cially when excited as wlien ])k'ning tlie horn in the liand. 
 The eyes will not steadily follow a moving object. 
 
 The fingers and h.ands are large and chubb}-. tlic shoulders 
 are held unequally, and the bodilx- carriage and walk are un- 
 toned and stooping. The lung ca])acity is considerably above
 
 82 
 
 BACKWARD AND FEEULE-MlNDliD CHILDKEX. 
 
 the normal average, while his strength of grip is somewhat 
 below. The right eye has 1)ut two-thirds of normal vision. 
 Hearing is normal. The physicians do not report any serious 
 physical disturbances beyond some troubles with digestion. 
 At a little distance Marshall's stooped and peculiar walk 
 
 and his decrepit and unkempt 
 appearance suggest a rapidly 
 aging- little old man instead 
 of a "youth" of 36. Seen 
 more nearly he will be found 
 to be talking to himself or 
 others. He will probably 
 have a policeman's club or 
 some substitute for it ; and 
 from one to three police- 
 man's stars, actual or imi- 
 tated, will be pinned on his 
 chest tho perhaps partially 
 concealed from sight. At in- 
 tervals, and frequently when 
 absorbed in conversation, he 
 makes a stereotyped move- 
 ment with one hand, striking 
 it against his lower chest. 
 The movement is so habitual 
 as to wear his shirt away. 
 Questioned about it he says 
 it is a "little way of mine." 
 His garrulity is remarkable, 
 and is marked by a cere- 
 monious use of gestures and pet phrases. Scholastically, 
 Marshall is reported to know tlu'ee or four languages and to 
 give other bookish evidence of deserving a place outside. As 
 
 MARSHALL E.
 
 ci.iN'iCAi. .STi'j:)iKs ()!•" i'.()ki)i:R fASiiS. 83 
 
 a matter ui fact lie can say the I'aler Xoster and some oilier 
 clmrch pieces in Latin, is really al)le to converse somewhat in 
 Clermaii, and has somcwliere ac(|nired a very su]ieriicial 
 ac(|iiaintance with a little JM-ench. I \v exploits these furbelows 
 to the dismay of the uninitiated, and (|uoles dates with an air 
 of exactness that tends to conceal their fre(|Uent inaccuracy. 
 He rehashes stock nidralizin^s in L;randilo(|uent lan£>uage and 
 st}le, and with much punning- and joking. 
 
 Brought to task with numbers, however, he is utterly un- 
 able to multi])ly nv dix'idc 1)_\- two digits, and shows general 
 confusion in handling nunil)ers ; when asked to divide he did 
 the sum by adding, and incorrectly at that. Asked how 
 many apples at 3c each he could buy ^\■ith 45c, he fumbles, 
 counts on his fingers, and says: "I'd get 45 apples at 3c a 
 piece and I'd lie left 89c total." His handwriting is ver\' 
 scrawled, irregular, and angular, but is more legible than 
 it appears. He is punctilious with his s]3elling, the 590 words 
 written in three tests showing no real mis-spellings except 
 that of pedestal, tho he occasionally neglects to write some 
 letter. He can read the local paper with ease but does not 
 do very much reading. His articulation shows a recurring- 
 difficulty in sounding "th", and there is a thickness of speech 
 as of a person semi-intoxicated. 
 
 In the band Marshall plays the V> lib bass horn, lie is a 
 poor reader but very musical. He will learn to play o])eratic 
 selections in a few rehearsals, but reads and ]^lays very auto- 
 matically. For instance, he cannot start to play anywhere 
 except at the beginning of a strain. 
 
 The mental examination finds Marshall to have but ti 
 years of mental age. He showed a frail memory span for 
 numerals and sentences, and en-ibellished his account fif the 
 memory passage with masses of incorrect data stated in 
 "pretty big words but then there's a meaning," as he ob- 
 served.
 
 84 BACKWARD AND FEEBLE-MINDED CHILDREN. 
 
 In the written tests he reprockiced stories quite well, but 
 no test shows any productive imagination. He crossed 
 A's rapidly but with irregular accuracy, and was able to 
 write similars and opposites for most of the test words given. 
 One hundred association tests gave but 12 normal single 
 word reactions. 86 being sentences or phrases used to define. 
 The stimulus word was repeated 13 times. In twelve reac- 
 tions he made a gesture as his first or a prominent part of his 
 first response to the stimulus. His definitions are often ex- 
 cellent but for their wordy and ceremonious form. His tend- 
 ency to automatism appears in his adherence to a fixed 
 tempo adopted for these reactions, 37 of the 100 reactions 
 being within one-fifth second of his quick median time of 
 1.7 seconds. He used this same tempo on another occasion 
 when reacting with the similars of given words. 
 
 Marshall is reputed to be honest and generally trustwor- 
 thy. He gets on well with the boys, helps with odd jobs, and 
 spends much time with his music. He delights in having 
 children about him and they are fond of him. He is a de- 
 voted Catholic, talking much of religion and attending as 
 many church services and funerals as possible. He has occa- 
 sionally shown mild delusions of persecution, these even be- 
 coming "pronounced" at one time. He only half believes 
 that he is a policeman, but he persists in acting the part. 
 When excited in reading or talking he "lays it ofif" in ges- 
 tures, rolling his eyes and contracting his facial muscles. 
 
 Marshall's speech and writing abound in high-sounding 
 but hollow strings of words, ceremonious statements, stock 
 expressions, and examples of mental automatism and stereo- 
 tyjiy that are of a kind with his formal and incessant gestur- 
 ing and his automatic movements. Some of this is illustrated 
 in the following extracts from one of his letters. "I've got
 
 CLINICAL STUDIES OF BOKDI'.R CASES. 85 
 
 no show i)ush ];ull l)ackinL;' nor slamliii;^' '■'' '''■'' I'm a jjoor 
 homeless rehitioiiless. deslitute lad " '■'' I'm for all and I'm 
 not I'relentions Pernicious Sui)t'r>tili(iu-- 1 )ecei)live n(ir of 
 the chslikin<;- kind of L'cople. I'm not huilt that way I'm like 
 the Hon Henry Geor,c:e and his ^reat 5 ct cii^ar. he says he 
 and his cigars are l)olh for man hut the chief one is Jesus 
 Christ mine and _\"our Savor so there you are aUhoUL;h I'm 
 a sinner I declare to goodness 1 look things s(|uare right 
 Justly and I hjuestl}' in the face as so sliDuld he ma_\' l)e and 
 must be the case." 
 
 He is another classic example of llighty attention. Too 
 many things occur to be said, directive control is lacking, 
 and the normal sequences are broken. In writing he con- 
 stantly slips from his j)oint and starts with some unrelated 
 topic that has caught his attention. His frail mental span 
 fails to hold what is just past until it ma_\- exercise its blend- 
 ing control upon what is coming. If some one brings iiim 
 back to the circumstances his intelligence usua!l\' suffices to 
 meet the situation. Asked to compare two given words he 
 finds it impossible to hold them apart and examine eacii 
 singly. .\s he writes, some of the letters and words intended 
 drop out of the functioning mental span before the\- can be 
 written, and thoughts as quickly leave his mind as he talks, 
 so that some of his sequences are as bizarre as those of cer- 
 tain dementia praecox cases. PUit except for this weakness 
 of mental span his thought seems to go forward with a fair 
 sort of logical sequence. He falls l^ack on a domination by 
 sound-sequences and symbolism, rounding out and expand- 
 ing his adjectives and phrases in tiresome jM'olixity and tau- 
 tology. 
 
 .'\11 this is of course more symptomatic of insanity than of 
 feeble-mindedness. Rut there are as well the evident stig-
 
 86 BACKWARD AND FEEliLE-MINDED CHILDKEN. 
 
 niata of defective growtli in body and in mind. A nature 
 badl)' formed would seem to liave nevertheless pushed on to 
 a further stage of intelligence than is commonly reached even 
 In' the high-grade feeble-minded, but only to be thrown back 
 in some of the deteriorations that so often mark dementia 
 prsecox. It is unfortunate that we do not yet have a history 
 of Marshall's earlv adolescence.
 
 rr.TN'lrAr. sicnip.s of ik^rih'.r r.\SF.s. 
 
 ^7 
 
 Corhiii C, Age lliirtccii Years. 
 
 CASE 14.— Menin- 
 
 gitic Feeble-Minded- 
 
 ness. Violence to 
 
 Playmates, Confused 
 
 Substitutions for 
 
 Acts Intended. Ex- 
 
 citable and Noisy. 
 
 Corbin C. is a Baltimore boy wbom I examined at tbe 
 Jobns Ilojjkins Hosijital. lie is typical of a class of cases, 
 numbering' one-eighth of a year's admissions at I^incoln. who 
 are usually reported to have had 
 meningitis or "brain fever," most 
 often in infancy. 
 
 Corbin's family seem normal, 
 except that a younger brotlier is 
 a deaf-nnite. a condition said to 
 be sequent to a severe burn of 
 three years ago, but probably of 
 more fundamental origin. Cor- 
 bin's birth was normal, and up to the age of fifteen month-^ 
 he is reported to have develoj^ed normally, learning to wallc 
 ami making progress with talking, etc. At that age he is 
 said to have had a severe fall, striking upon his forehead. 
 A few weeks later he suffered a severe attack of meningitis 
 and is said to have had spasms. After this he never acted 
 like other children, and did not re-learn talking or walking 
 until three and a half years subsequently. 1 le always acted 
 "wild." would yell loudly as if "hysterical,'' indulged in all 
 sorts of mischief and was extremely destructive, breaking 
 dolls, tearing clothes, etc. He is said to be fond of playing 
 "Indian." His mother 'claims that he is absolutely beyond 
 correction. 
 
 Corbin attended school four years, begiiming with his 
 sixth year. He never advanced beyond the lowest grade, and 
 for the past two years his mother has kept him away from 
 school. He would not return, from schocjl until late in the 
 evening, and would wander away from home. At night he 
 sleeps 1)ut little and then has somnambulisms, wandering
 
 88 
 
 r.ACKWARD AND l-'EEBLE-MINDED CHILDREN. 
 
 aliout tile Iiouse in api^arcnt fright and talking constantly, 
 sometimes jumping upon chairs. 
 
 He has hts of unprovoked anger, and if other children do 
 not do as he wishes he threatens them witli any available 
 weapon. A week before examination he struck a playmate 
 with a hammer, and he once stabbed his brother in the fore- 
 head with a bread-knife, 
 tho sorrowful about it after- 
 ward. He is extremely nerv- 
 ous and is constantly at va- 
 riance with other children. 
 ( )n visiting" the family re- 
 cenllv the mother told me 
 she had to constantly 
 "watch him if he had a 
 knife." He is unable to 
 dress himself or to tie a 
 "how-knot". 
 
 The ph}'sical examination 
 records nothing especially 
 almormal except slight 
 exophthalmos, some anae- 
 mia, and mouth-breathing'. 
 He is below the normal 
 weight and height but data 
 for a full physical descrip- 
 tion are not at hand. He is 
 markedly defective in facial 
 expression, with twitchings 
 and asymmetrical contractions of the facial muscles. 
 The mental examination finds Corbin to have a mental ag;e 
 of yYi years with 5^2 years of retardation. He was unable 
 to distinguish right and left or forenoon from afternoon. 
 There were 4 fingers in each hand but only 5 in all. He 
 
 CORBIN C.
 
 CLlXirAT, STI'niES OI- r.ORDKR fASES. 89 
 
 could ill it ri'i)c;it fi\c nuiiuTals, confused 5 and lo-ccul ])ieces. 
 could not "change"" 4 cents from 23 ccnt>. and was unable ti) 
 count I) cents' worth of stamps or backwards from 20 to o. 
 ] le could not name in order the days of the week or months 
 of the year, nor i^ive the date even approximately. 
 
 Corbin copied written matter, tho hadly. I'ul when asked 
 to write "The ])retty little girls" Ik- wrote "sais." ap])arently 
 supposing that this was correct. Asked to write various 
 single letters and numerals he wduld write something en- 
 tirely other than what was called for. tho seeming anxious to 
 do as directed. He could not read a first reader selection con- 
 tinuouslv. hut would make out some words and then jump at 
 wrong conclusions about the others. lie Icnded to become 
 excited and would then say bizarre things. Confused in try- 
 ing to name nickels and dimes, he commenced to sav "five 
 cents, ten cents, hfteen cents," lieconiing m.jre excited and 
 wanting to write these words at the blackboard. In trying 
 to count the value of stamps he talked confusedly of getting 
 "two for a cent, and red ones vou get three for a cent." The 
 days of the week were "Sunday, Monday. Palm Sunday, it's 
 two Sundays before." etc. When he could l)e kc^t cahii he 
 talked readily, descriliing pictures j^romptly and with some 
 fullness, carr)ing out commissions, etc. 
 
 We have here a child whose ]iermauently injured brain 
 makes him extremely liable to states of uncontrolled excite- 
 ment, these states being attended bv conditions of anger, fear, 
 anxiety, with aphasia and apraxia, according to circum- 
 stances. The bizarre responses, the paraphasia and para- 
 kinesia that occur so frequentl\- in the testing of these cases, 
 are probably of a kind with the hammering and cutting of 
 playmates ; and this characteristic of their mental function- 
 ings causes some of them to be very dangerous members of 
 society. Still others, while harmless. Ijreak out with ill-timed 
 fits of laughter, with jumping, yelling, or what not, misunder-
 
 90 BACKWARD AND FEIiBLE- MINDED CHILDREN. 
 
 stand directions, etc. One little girl persisted in trying to 
 put the window ///>, in her earnest attempt to carry out my 
 request and my obvious endeavor to put it dozen. Many of 
 these children are deficient in facial expression or in its nor- 
 mal control, while many others look far more intelligent 
 than they are, the features not having been marred by pri- 
 iiiary degenerative tendencies in growth. As a rule it is ex- 
 tremely difficult for these children to profit by the normal 
 or usual methods of learning. In the case of Corbin the child 
 will certainly escape much trouble by being placed in a good 
 institution, and societv will be the safer for it.
 
 ci.iMCAi. S'irDii:s nv \)uk\)\'.r casks. 
 
 91 
 
 CASE 15.- 
 
 -Aphasia 
 
 with Defecti 
 
 ve Facial 
 
 Expression. 
 
 Enure- 
 
 sis. Good Int 
 
 elligence 
 
 shown in IN 
 
 r m a 1 
 
 Play. 
 
 
 JJaruld K., .li^c Si.v years. 
 
 The two followin.u cases from the year's admissions al F.in- 
 coln are prc)l)ably to be classed with the ])rece(hn^- case as 
 ilhistratini;' th.e varied, effects that l)rain lesions ma_\- have in 
 children that are ])riniarily ^.vell 
 endowed. 
 
 Harold R., a sober-faced little 
 l)oy estimated to be of the age of 
 six. dropped in from nowhere 
 one Jnly day in 1910, and noth- 
 ing;- has been learned of his fam- 
 ily or ])ersonal history. The 
 
 boy's weight was 32 jjonnds and his height was 2,7 /-^ inches. 
 Ills walk was mirmal bnt his speech was limited to a lew 
 words imi)erfectl_\- nttered, and his hearing seemed to be 
 qnite defective on either side. His vision seemed to be of 
 fair acnitv in spite of severe strabismns. At least it enabled 
 him to tie threads and to deal with small objects. He was 
 found to be troubled with enuresis. The medical examina- 
 tion found no additional abnormalities but classed him as 
 an "idiot." and to everyday observation he hardly gave 
 promise of more than this. 
 
 Tried with the I'.inet tests the boy's inability to talk pre- 
 vented his going nnicli further than the tests for two years 
 of mental age. As usual in such cases I improvised souie 
 tests with objects such as would tend to call forth the higher 
 levels of reaction if there might be any. 1 lere is what hap- 
 pened with this uni)romising-looking "idiot": (liven my 
 bunch of keys he went to the laborator\- door and tried in 
 its lock onlv the key whose size seemed to f^roiitisr a fit. 
 He tried the latch too, tinkering with the more ])ronhsing 
 parts. b"inall\- he turned the knob of the ui)per lock' and 
 //('/(/ // .s-o till he could simultaneousl}' turn the lower knob,
 
 92 
 
 BACKWARD AND FEEBLE-MINDED CHILDREN. 
 
 and thus o]icn the door. He very evidently foresaw the ne- 
 cessit}- of operating- l:)oth locks simultaneously, as was 
 proved by his repeating this combined procedure until he 
 could get it to work. Having been told that he could get 
 out lie worked at this task for a long time, hesitating only 
 
 with an occasional 
 tan t. 
 (iiven a box of 
 blocks he sat mo- 
 tionless before 
 them for ten min- 
 utes, probably 
 thinking that I 
 meant them to be 
 let alone. Assured 
 then that he might 
 play with them, he 
 immediately took 
 them out one by 
 one //: order of she 
 and arranged them 
 in a long row from 
 smallest to largest. 
 He expressed his 
 enjoyment of this, 
 and called my at- 
 tention to his 
 "finds" of various 
 kinds of blocks. He 
 searched continu- 
 ously till he found all the cones that would lit the holes in 
 certain blocks. The T-square was next rested on three 
 four-legged blocks to form a trestle, and he varied the dis- 
 tances between the trestle's supports, with much enjoyment. 
 
 HAROLD R. AND MORTON W.
 
 CrJNICAL ST'JniF.S OF l'.()R!)l-.R CASES. 93 
 
 Tn ^ucli \\a\s Iil' ]'la\<--(l on 1)\ the hour, unaiilcfl and \vith- 
 out (listurhiniL;.- nic, humming a sort of melody for awhile 
 hut usually (|uiet. 
 
 I showed him the furm hoard and ])laced each hlock in 
 its place. When ihey were removed he i)roni])lly accei)ted 
 the prohlem and ])laced each hlock in some place, hut at 
 random. Then for fom" (rials T calie(l his mis-placements 
 wrong and placed them right. In the lifth he succeeded in 
 221 seconds, heli)ed In- one hint. Next time his time was 
 130 seconds, unaided. The next was nuich ijuicker hut for 
 an accident. He did the next in 58 seconds, and crowed 
 with delight, lie would never allow that it was "done" til! 
 every piece was properly in idace. 
 
 ^\'hen shown the card-sorting tra)' with 50 square cards 
 in its central com]iartment, he at once joined with me in 
 turning over each to see its color hefore i>lacing it in the 
 proper compartment for this color. Xext time he did it un- 
 aided, sorting all to the five trays without an error, in (>[■_> 
 minutes. He enjoyed it thoroly. 
 
 These and other tests and further ohservation ot' his ])lays 
 showed that he had normal spontaneitx' and the ahility to 
 learn progressivelv from his exjjeriences. Ills j^ower of 
 will and attcn-tion, as shown in ])crsistent tho not automatic 
 application to the task in hand, are even ahove thai usually 
 found in a 6-year-old. His use of make-l)elie\-e and his imi- 
 tative acting out of past ex])eriences. and tlie inlelligence w itli 
 which he chose his ends and means and ada])te(l these to 
 each other, would also he creditahle to most hoys ol (). 
 
 We evidently have here an ai)hasic child who hut for the 
 disturhance of hearing and of speech, of mimic, and perhaps 
 of still other of the normal means of ex])ression, would he 
 able to do the mental work normal to his age. It will he in-
 
 94 UACKWAKD AND FEEBLE- MINDED CJ[]LD1<EN. 
 
 teresting at some later time to record the result of a sys- 
 tematic examination for aphasia, which I hope may he car- 
 ried out later. The psychologist now resident at Lincoln 
 writes me that this is "the only child who has asked me 
 'why' instead of trying to do what I asked."
 
 CIJNlCAr. STllOIi:.S Ol'- nOUDliR CASliS. 
 
 95 
 
 Morion //'., Ai^c Seven Years. 
 
 CASE 
 
 16. — Menin- 
 
 gitis and 
 
 Other Dis- 
 
 eases in 
 
 1 n f a n cy. 
 
 Aphasia, 
 
 with Defect- 
 
 ive Fac 
 
 al Expres- 
 
 sion and 
 
 Motor Con- 
 
 trol. Good Intelli- 
 
 gence an 
 
 d Volition. 
 
 Mortdii, like llarold. lookccl uiijJroniisiniL;' enough when 
 admitted! in that same July. I'.ut "hrains will ull." And the 
 natural ])la\- and work soon revealcMl 1)\- ihoe two little 
 boys refreshinoiv reminded iis 
 that there were levels of l)al)y- 
 land whieh the institution was 
 sadly used to being without. 
 
 Morton had lost his father and 
 mother, tiie former tlvinp- of he- 
 l^atic abscess, the latter of loco- 
 motor ataxia. There was defect- 
 ive hearing in the father's fam- 
 ily. One child was stillborn and 
 
 another died at 8 months. Diu-ing the ]XM-iod before Morton's 
 birth the mother was malarial and mentally troubled. There 
 was difficult labor, and the child had severe icterus for tliree 
 months with no gain in weight. Some da_\s after birth he 
 went into a condition in which his head was retracted and 
 he had sligiit spasms. It has been sui^posed that he had 
 meningitis. At i() months he had measles followed by 
 chorea. At 3// years he had scarlet fever folJDWcd b\- left 
 otitis media. There was some left ])aral\sis in infancy, and 
 the child stood first at 2X months and walked at three years, 
 lie was described as industrious, cheerful, neat, ill-tem])ere'!, 
 and excitable, and had not been to school. 
 
 TMiysically Morton weighs 451-2 pounds and is 45 'j inches 
 in height, with large and well formed head, fair \ision, 
 and hearing that is (juite defective as orJinarily iiicasnrcJ. 
 Some but I think not all of the hearing defect seems to be 
 due to "mental deafness." His walk is defective and his 
 .speech is even more so, tho he talks .somewdiat and under- 
 stand.? what is said, but with difficulty. His facial expres-
 
 Cj6 BACKWARD AND FEEBLE-MINDED CHILDREN. 
 
 sion is laro'cly wanting and is apt to be abnormal when it oc- 
 curs, and the carriage of the liead is abnormal. No medical 
 record is obtainable. 
 
 Alorton's difficulty whh language rendered impossible any 
 rating with the liinet scale. As in the case of Harold we fell 
 back on ol'servation of the child's play, his manipulation of 
 tools and other objects, and his readiness to meet various 
 objective situations not involving speech : Turned loose to 
 play in the laboratory he quickly showed the spontaneous ac- 
 tivities of which his brain was capable. Spools, rubber rings, 
 blocks, the T-square, etc., were promptly utilized in the con- 
 struction of a railroad and trains. A derrick was rigged up, 
 with pulleys. He foraged in drawers and cupboards and 
 boxes for the necessary strings, blocks, and other pieces, 
 and formed definite plans of construction which he persisted 
 in carrying out, intelligently choosing and adapting resources 
 to the realization of these plans. 
 
 To illustrate his conduct in the face of difficulty: He 
 opened a heavy drawer full of sundries, to tind playthings, 
 but was told to close it. Demurring slightly, he then tried 
 several times but the drawer caught at the sides and he 
 called my attention to this fact. I insisted and he then 
 jiushed alternately at either end, moving it thus each time 
 the very little distance that it would go. Again he called my 
 attention to the unpleasant difficulty ; but seeing now that I 
 must have it closed, he tugged away with at least fifteen 
 l)ushes regularl}- alternating at either end, and with a good 
 many at the middle whicli help;.'d a little, till half-inch by 
 half-inch the drawer was completely closed, tho not easing 
 up at any time. He had to push with all his might to budge 
 it at all, and there was nothing apparent to make this any- 
 thing but the very disagreeable and uninteresting task that 
 we usually find it. Yet he showed no emotion or sign of im-
 
 CLINICAL STUDIES OF BUKDER CASES. 97 
 
 patience, nor did he even look aroinid for commendation 
 when he was at last successful. 
 
 Asked to l)ntl<»n the eleven huttons of a lon^" testins;' strip 
 of cloth, his motor coordination was seen lo he poor and at 
 first he failed on the first hutton and dennu'red, sayin;;' 
 "Hard." Then he lahorionsly did this one; and then one hy 
 one h(^ laljored with the others till all were done, denun'rin_^' 
 hut three times and sayint^ "Hard" a time or two. I Te showed 
 that he thoroly disliked the joh, as it was very difticnit f<M' 
 him and occnpied 7 minutes and 40 seconds. I'.ut there was 
 no whining or show' of emotion, and he worked on steadily. 
 At the end he seemed satisfied, hut witliout emotion, not 
 even snn'ling'. He made a gradual reduction of the time per 
 button thrnout the test. In the test for threading needles, 
 after much difficulty resolutely faced he finally succeeded by 
 ch(m<:iu'^ ends of the thread, with evident intention. 
 
 Morton showed uniform good nature thruout all the hours 
 of our testing. Even wdien urged to do difficult tasks that he 
 
 disliked he never showed anger or whining. He would very 
 briefly demur and would then attempt the task. Tho rarely 
 smiling, his busy, unruffled way of meeting difiiculties indi- 
 cates a cheery attitude of content w'ith people and with 
 things. He enjoys a little teasing, and his laugh at a joke 
 was hearty and apropos. His laugh, while almost uproar- 
 ious in its heartiness, shows some abnormality of sound and 
 of nervous control, and its facial expression is gross in char- 
 acter and not sensitively varied. T have not seen him smile 
 in response to the smile of another, .or mimic any facial 
 expression of others. Nor have I seen his face show ap- 
 preciation of other's approval, even when success h.ad 
 crowned struggles that were really heroic. 
 
 Here again we have a case of aphasia, showing difficulty 
 of auditory appreciation along with difficulty of speech, 
 mimic, and emotional expression, and with some general
 
 (jS LACKWARU AND FKliHLE-M IXDED CHILDKEX. 
 
 motor incoordination. But the evident retardation of these 
 functions has left essentially intact the intelligence, the will 
 as persistent attention and application to the task in hand, 
 and mental spontaneity and liveliness, with a normal utiliza- 
 tion of the experiences of past and j)resent. Morton's difh- 
 cult\- is a matter of the means of communication with his nor- 
 mal fellows and teachers; and unless given very special and 
 most intelligent attention he will remain comparatively imde- 
 veloped and with certain inevitable perversions, just as oc- 
 curs with neglected sense defectives.
 
 CLiMCAi. s'iri)ii-:s of I'.okni-.k cases. 
 
 99 
 
 rnidcncc S., Age lilcicii and Onc-halj Wuirs. 
 
 I he iiistilulion c(»ntaiiis a \ery few children who arc of 
 approxinialcly normal inlclli^cncc. and who arc here in 
 some cases because an im])ro])t'r en\ironnienl lia> ])re\-ented 
 iheir having- pro])er care and de- 
 velopment, in other cases because 
 physical or sensorv detects have 
 caused them to need institutional 
 care. A typical case is Prudence 
 S., sister of Toll)- .\. already <le- 
 scribed. The reader will recall 
 the family history of insanitv, in- 
 temperance, and feeble-minded- 
 ness. Prudence was admitted two 
 
 CASE 17.— Insan- 
 ity and Feeble-Mind- 
 edness in the Family. 
 Convulsions before 
 Admission. Intelli- 
 gence Normal when 
 Conditions are Fa- 
 vorable. Frail Body 
 and Defective Vision. 
 
 years ago. It is stated that she 
 
 did not talk until 3 years of age 
 
 and that she had convulsions until near tlie time of adniissinn. 
 
 She has had none since. 
 
 Physically she is about 7' _> ])ound> a])ove weight and ^j/j 
 inches above in height, with a normal cranial circumference, 
 almost normal lung capacity, and above the average strength 
 of grip, ller hearing is normal but she has l)ut one-hft!i 
 vision in either eye. with strabismus, ller ears are abnor- 
 mally sha])ed and jjrojecl mark'edly, the palatal arch is 
 rather high, the skin is ])ale. chest is narrow, and the bands 
 show irregularities of nervous control. The girl is i>hysi- 
 cally frail, needing medical attention for various slight ail- 
 ments, }-et usually able to attend school. 
 
 In school rrudence is ,'i model i)U])i!, alwavs ^en■^Il)le, over- 
 serious, rather "old-maidish" in her ten(U'nc\- to correct and 
 mother others, and over-scruimlous and finical in the ])er- 
 formance of tasks. .She reads the third reader with exnres-
 
 lOO BACKWARD AND FEEBLE-MINDED CHILDREN. 
 
 sion and understanding, does simple problems in division but 
 is not strong in number work, excels in spelling, drawing, 
 manual and calisthenics work and in dancing. She makes 
 good progress with piano lessons, but her aggravated myopia 
 interferes with this as with other school work. 
 
 Mentally the Binet examination credits her with an intel- 
 ligence normal to her years. She gave persistent and pa- 
 tient attention to the various tasks, and when circumstances 
 remained very favorable her reactions in the tests were nor- 
 mal. There is, however, a latent instability with peculiarly 
 strong tendency to confusion. For instance, in trying to re- 
 produce a simple news item she made absurd errors, and also 
 in trying to count by twos beyond a certain point. 
 
 The written tests show a normally legible handwriting. 
 Capitals and punctuation marks rarely occur correctly or at 
 all. She spells twiil (twelve), were (where), lik (like), flor 
 (floor), contry (country), wish (which), brige (bridge), 
 wile (while), oppen (open), and makes 7 or 8 other more 
 usual mis-spellings in the three story tests. Her story repro- 
 ductions give a fluent, connected story, much simplified but 
 always progressing naturally. The total output is not large 
 and the imagination shown is rather meager. She gives such 
 "opposites" as tall-little, happy-mad, false-flys, like-love, 
 glad-happy, thin-narrow, war-new, many-lots, above-down, 
 friend-chum. Her weak showing in the A-test may be due 
 in part to poor vision. 
 
 The tapping test revealed a peculiar weakness in the con- 
 trol of the left hand, a weakness not shown by the dynamo- 
 meter. At first she was quite unable to tap at all with the 
 left, and this hand had to have many times more preliminary 
 practice than the right to reach a representative performance. 
 When obtained the ratios to the normal were 149/169 with 
 the right and 90/139 with the left. These experiments need 
 to be repeated, as such a local weakening, whether temporary
 
 CLINICAL STUDIES OF BORDER CASES. lOI 
 
 or pennancnl, is sii^iiilicant cspeciall}' in one who has had 
 convulsions. 
 
 General observation in the institution finds Prudence to be 
 steady, stal)le, and intellio'ent a'/zr// fliiiii^^s ,<;o "a'cl!^ 1)ut tend- 
 ing;" to "o'o to pieces" when circumstances l)ecome difficuU nr 
 unusual, as on the occurrence of minor accidents. 1 ler phys- 
 ical frailness is ])aralleled by a latent but real mental weak- 
 ness wdiich only a kindlv and favorable environment can ])re- 
 vent from develoi)in^'. Ideally, Prudence should be spared 
 the "stigma" of life in an institution for the feeble-minded. 
 Actually, she will fare best in the institution unless she can 
 be furnished a permanent home which w'ill shield her from 
 the stress of guiding her own fortunes
 
 I02 DACKWARD AND FEEBLE-MINDED CIIILDREX. 
 
 /■/('/(/ //., J^t' T-j^'ciity-tlirCi- (uui Oiic-Juilf ]\'ars. 
 
 Somewhat similar to the last is the case of \'iola H., a 
 frail diminutive young woman who has been in the institu- 
 tion for yy2 years. Her father and father's parents are all 
 
 dead of tuberculosis. Her only 
 brother died in infancy and her 
 only sister is dead. Her mother 
 is a seamstress and is very poor, 
 but \'iola was kept in the Chi- 
 cago public schools until she 
 
 CASE 18.— Tuber- 
 culous Family. Frail 
 Physique. Weak 
 Mental Span. Intelli- 
 gence Normal to a 
 Simple Environment. 
 
 reached the sixth grade. 
 
 Physically, Viola is about 20J/S 
 pounds below the normal in weight and 2^ inches below in 
 height, with a cranial girth that is 16 mms. below. Her 
 lung capacity is too small by t,t, cu. in., and her strength 
 of grip is about half what it should be, tho disproportion- 
 ately stronger with the left hand. She has but one-fifth 
 vision in either eye, with normal hearing. 
 
 Viola's face is asymmetrical, the lips are thick and are 
 drawn markedly to the left, the chin is little developed and 
 the mouth remains open, exposing the impacted and irregu- 
 lar teeth. The hard palate is very narrow and high, the left 
 ear is placed considerably higher than the right, the head 
 tends to be held to the right and the walk is rather peculiar. 
 The nutrition is poor, with cold hands and feet. From time 
 to time she has had to have recuperative treatment in the 
 hospital, and shows decided tendencies to tuberculosis. 
 
 In school A'iola reads fluently and with good pronuncia- 
 tion and intelligence, spells and writes well and composes 
 letters normall}-. She does long division readily and cor- 
 rectly, and also some very simple problems in fractions. 
 Her music teacher states that Viola is "slow but willing, 
 takes an endless amount of practice and then is not sure,"
 
 xicAi, sirnii'S ni-- i;(>ki)|-;k casi-:?. 
 
 '<'3 
 
 l)ul si'c'm> 1(1 cii]()\ liiitli |ir;u'licc' ami K'Smhin. She is \cr\' 
 j4()()(l in l)askc'tr\'. inakiii,:; liiTuwii (k'sis^ns and sha])c.s. She 
 has slmwii rather e\ce])ti< nial a])litu<le I'M' wurk in lUi xK'Hn::;' 
 and ])i)Uer\-. (k>ini4' tlii.s work with un(kTslan(hn,L;' tho not 
 capahle of ])ri>(hieini^ much, ol herself. She is "easily dis- 
 coura_^ed and expects much hel])." She allends well ti > work 
 that she likes, hut is inclined to he ])ee\-ish in calisthenics 
 and "•yninastics. .She has an only moderate amount of t;en- 
 eral information, hut talks intelligently ahoul t^eneral affairs. 
 
 \ ioki ijasses all the liinet tests 
 thru 12 years, except the repeti- 
 tion of 7 numerals. I'esides she 
 was ahle to state "differences he- 
 tween ahstract terms of similar 
 sound or meaniiiL;'.'" Mer mental 
 .--pan was frail, iisinilly insufficient 
 for even 5 numerals or 2() syllahles. 
 In the written tests she used 
 ca])ital> and marks correcth' ex- 
 ce])t within her ])ara^ra])hs, where 
 the\- were usualK' omitted. I'rac- 
 ticall\- her nnh' mis-si)ellin|t;s were 
 inadvertent omissions or trans- 
 ])ositions of letters. 1 ler com- 
 ])ositic)n "makes sense" always and 
 normall)-. harrin^' an unusual state- 
 ment or two. I Icr re])rodnctious 
 of stories show no variations from 
 the te.xt that would snq^est imagination or construct i\e 
 tendency, but they are ordinarily full reproductions with 
 only an occasional mis-statement. Her tlying-machiue stor\ 
 of 131 words shows a little real imaginative ahility : She 
 flew low so she could see things, and saw cliildren coasting 
 on their Xmas. sleds. ( )ne was tr\ing out \\\> ]\v\\ dog for 
 
 vior>A If.
 
 I04 BACKWARD AND FEEBLE-MINDED CHILDREN. 
 
 a horse. She compares coasting with flying, etc. Her re- 
 sults in the written tests are rather superior to those of all 
 the other children. The frequent "omissions" in crossing 
 A's arose from her attempt to make one mark serve for 
 several A's when found together. Her tapping rate is near 
 the normal, with little irregularity of performance except 
 that the left hand was hadly controlled. 
 
 In all the tests Viola's replies and conversation were en- 
 tirely normal and sensible, and she showed a normal appre- 
 ciation of wherein she failed. She gave evidence of having 
 an intelligence that worked normally within the simple 
 sphere in which she is at home, and when no very difficult 
 tasks were to be performed. But she gives evidence of 
 frailty and ivcakness in her mental as in her physical con- 
 dition, and this weakness appears in lack of control when 
 under mental stress. Her home physician reported that her 
 moral nature was "weak" on the side of sex, and that "if 
 not restrained she was sure to get into trouble.'' Her low 
 vitality and plain appearance of course lessen the latter 
 danger. Viola will continue to need constant medical super- 
 vision, and it is again the case of a girl of relatively normal 
 but frail intelligence and weak physique who should con- 
 tinue to find a home in the institution unless adequate and 
 permanent home care and direction can be assured her else- 
 where.
 
 cr.lxlcAL STdnlKS of t-ordrr Cases. 
 
 105 
 
 Clarence ./.. .h'c Y'lCr/rr Years. 
 
 CASE 19. 
 
 — Morally 
 
 Unstable. 
 
 Intelli- 
 
 gence near 
 
 y Normal. 
 
 Thieving, 
 
 Stubborn- 
 
 ness, and 
 
 Fits of 
 
 Temper. A Case for 
 
 Parental D 
 
 iscipline. 
 
 Tlu' "moral iiiil)ccik'" is rci^ularly a incntal inihccile as 
 well, and abnonna! iiKjral perversity is ii'»t fmind in isola- 
 tion in anv ease thai 1 lia\e found at I .ineoln or that I have 
 studied auywliere. it is to he re- 
 membered, liowever, that ehil- 
 dren who are not detieient iiieii- 
 tally will ordinarily not arrive 
 at sueh an institution, whatever 
 their morals. The (|uestion, 
 therefore, of the possible isola- 
 tion of moral perversion is pre- 
 judged for such institutions, and 
 
 demands more thoro clinical study elsewhere than it has 
 hitherto received. 
 
 Clarence A. is one of otu- thirty-two selected "bright" 
 children who is notable mainly for petty thieving and for 
 truancy. Admitted in August, 1908, his home record shows 
 that there has l)een some paralysis, heart disease, and ner- 
 vous instability in his near ancestry. The father was intem- 
 perate and his mother's health was poor before the child's 
 birth. Clarence is said to have been peculiar from birth, 
 not sleeping well and having fainting spells and great dis- 
 plays of temper. He was ])rononnced feeble-minded l)y a 
 physician. He had ear trouble, bad sex habits, and is said 
 to have been destructive and stubborn and not to care for 
 or fear anything. He began school very early, l)Ut "did 
 not seem to learn." 
 
 Physically Clarence is over 8 pounds belcjw in weight and 
 nearly 2 inches below in height. His cranial circumference 
 is 18 mms. below and he is somewdiat inferior in strength 
 of grip and in lung capacity, but with normal vision and 
 hearing. His tonsils were somewhat enlarged and there
 
 Io6 liACKWARD AND in:i-:r.Ll':-.M IXDED Cini.DREN*. 
 
 were iKTvous movements of the hands when extended. Idle 
 medical examination fonnd nothing noteworthy. 
 
 In school Clarence reads well and with understanding- in 
 the third reader, and knows the tahles hut does not divide, 
 tho he can do some simple prohlems in fractions. Me spells 
 and draws well, was "oriijinal" in kindergarten work, and 
 did well in calisthenics and dancing. He attends normally 
 Intt gets on only fairly with others, being very stubborn. 
 As his "worst faults" are mentioned "temper and stealing." 
 
 The Ijinet tests give ( 'larcnce a mental age of 1 1 years, 
 showing but one year of retardation. He could not tell the 
 time from a watch or clock, but distinguished line-lengths 
 that differed by only one millimeter. I le thought of and gave 
 71 words in three minutes, Ijut al)out half of these words 
 were suggested by similarities of sound. His responses and 
 conduct during the testing showed intelligence, but he lacked 
 energy in speech and action. He is ]>olite and genteel in 
 manner, with something even of the "aristocrat" in his l)ear- 
 ins:. He learns readih' in starting with band work, and can 
 doubtless go consideral)l\ further wdth school work. Un- 
 fortunatelv for our study the boy was early removed to his 
 home. 
 
 This bov's thieving was inveterate, and this moral insta- 
 bility comes nearer to being isolated or the main feature in 
 this case than in any other of the cases that were specially 
 observed. lUit there is also the usual slight retardation of 
 intelligence, and besides there is the truancy and marked 
 stubbornness with tits of temper. It is a case of slight men- 
 tal backwardness with moral instability, the whole amount- 
 ino- to hardlv more than an extreme variation of normal 
 childhood, and calling for adjustment by parental discipline 
 with the intelligent co-operation of the trained teacher of a 
 special class.
 
 ( I.IX ICAI. SI'l'DII-'.S 0|- r.OR|)I".R CASF.S. 
 
 to; 
 
 CllAI'Ti:i< 1\'. 
 
 CLixic \i. s'rrnii'.s ( )!• i;oui)1-:r casI'.s. 
 
 W'c have now sUidicd (HU' or nmro rci)rcseiitatives of eac'ii 
 of llic main '\i;ri)Ui)s'" to wliicli ihc thirly-fivc selected cases 
 !na\' Ijc tlion.<;ht of as l^elon^ini:-. ilioe qronps Ijein^- bri.'Hy 
 characterized in ('hai)tcr \'. The remainder of the cases, 
 as presented in llie ])resfnt clia])ter. fnrther ilhistrate the 
 various i)hases of defect. The somewhat fnU i)resentation 
 of man\- of tlie i)rece(Hn;4- cases, selected as more or less 
 ty])icaK makes it necessar\ , in the following-, to discuss rather 
 l)riell\- some children \\ho woidd (|uite repay fuller stud>. 
 
 Stanley !K. .l_:^c lildcii and Oiic-lialf ]'cars. 
 
 Stanlev I)., a little Chica^'o hoy who has been at Lincoln 
 a year, is t\picall\- unstable morall\- and mentally. .Xothin,:^' 
 especiallv unfavorable is known of his h.eredity. but Stanle\' 
 is said to have been j^eculiar from 
 birth and "was not acting- ri^ht 
 from early childhood on." II is 
 head a])peared small and fore- 
 head low, he did not talk until 
 three vears of ai^e. and early be- 
 gan to lie and steal. He would 
 also tr\ to ru)i away. lie at- 
 tended schcx)! more or k'ss since his seventh year. 
 
 Plnsicallv. .^lanle\- is 4 pounds above in weiL^ht and is 
 nearh' normal in heig-ht. His cranial girth is below normal 
 to the significant extent of ?; mms. and the forehead is low 
 with the hair encroaching u])on it. The forehead is deeply 
 wrinkled and the face has an expression that suggests cruelty 
 or at least unrest. The medical examination showed no 
 
 CASE 
 
 20.— Unsta- 
 
 ble Mentally and j 
 
 Morally 
 
 . Thieving, 
 
 Lying, an 
 
 d Violence. 
 
 Defective 
 
 Motor Con- 
 
 trol. 

 
 Io8 BACKWARD AND FEEBLE-MINDED CHILDREN. 
 
 physical stigmata except an adherent foreskin and a con- 
 dition of bronchitis. He has later had a chronic purulent 
 otorrhea on the right side, with discharge. He walks with 
 head down as if concerned about things, has a peculiar scowl 
 or frown by times, and seems over-serious generally. 
 
 In school Stanley reads monotonously in the second reader, 
 can scarcely multiply by small digits, is awkward and unin- 
 terested in calisthenics, and is poor at dancing. Pie is said 
 to be inattentive, but he makes an appearance of keeping 
 busily down to work. 
 
 The Binet tests give him a mental age of loy^ years, an- 
 other case of but one year of retardation. He could never 
 repeat five numerals and could not count the value of stamps 
 or "make change." He could detect none of the nonsense in 
 sentences, and could make no definitions except in simple 
 terms of use. 
 
 From time to time Stanley has been in trouble for steal- 
 ing and Ivino-. He has also run away at least once. More 
 serious still, on two occasions he has struck playmates with 
 rocks, on one occasion injuring considerably the eye of the 
 boy knocked down by the stone. Questioned about the 
 latter experience he first denied it variously, then admitted 
 it ; but in trying to tell why he did it he convinced me that 
 he did not know himself. The boys had been playing "cow- 
 boy," and Stanley was excited and threw wildly. The other 
 boy, he says, had hit him on the legs with a switch, "and it 
 hurt." The boy who was struck says that Stanley did not 
 mean to injure him, that he looked around suddenly or the 
 stone would not have struck his eye. 
 
 It seems that lack of motor control rather than vicious- 
 ness may be back of Stanley's violence, and indeed he seems 
 to lack control of his imagination as of his actions. His 
 facial expression is under no better management. He looks 
 me in the eves with a strained appearance of earnestness
 
 CI.INICAI. STUDII-'.S or I'.ORDI^R CASKS. lOQ 
 
 wliicli does not vary willi my own expression and witli 
 tile demands of the situation. 1 look u]) at him with a smile 
 of relief from the fatigue of writing", l)ut he meets my gaze 
 with not even a faint smile in response. His over-serious 
 faee shows marked over-action of the frontal muscles, and 
 a tortuous sort of corrugation seen especiall}' when he tries 
 to do mental work. 
 
 Further tests and ohservations were prevented hy the 
 family's removing the boy from the institution. Tho hut a 
 year retarded, Stanley's instability of neuro-muscular con- 
 trol will probably continue to put him at variance with 
 society.
 
 1 lO 
 
 BACKWARD AAD i'EKCLIi- AllXDELi CllILDRKX 
 
 MUtoii J ., Age Thirteen and One-half Years. 
 
 CASE 21.— Unsta- 
 ble. Truancy, Vag- 
 rancy, and Thieving. 
 Deficient in IVlotor 
 Control and in Mimic. 
 
 Milton is a typical truant and vagrant. Admitted in April, 
 T()io, he is stated to be of alcoholic parentage on one side,^ 
 with feeble-niindedness and tuberculosis in the family. The 
 
 child is said to have wandered 
 away since his third year. He 
 was sent to school from his sixth 
 year, but was a truant, was at a 
 reform school later as a delin- 
 (|uent, and was there finally pro- 
 nounced defective and sent to 
 Linc(^ln. liis mother states that 
 the boy would "play hookey" instead of going to school and 
 would stay away several days, apparently sleeping out when 
 it was not too cold. She states that he went off continually, 
 school or no school, and that "no one will keep him over 
 night any more." He always looked up the worst boys he 
 could find, and "won't work for nol^^dy" as she ])ut it. "As 
 soon as he gets his breakfast he walks off and don't return 
 till eight or nine o'clock." lie craves toliacco and has 
 chewed it since he was (|uite small. 
 
 Physicallx' Milton is near the normal in weight and height, 
 
 with a head that is over-large by i() mms. of circumference. 
 
 rile head is developed mainly in the back and to the left, 
 
 causing a marked asymmetry, kle is a little below normal 
 
 in strength of grip and in lung capacity. 
 
 The mouth is unusually small, the palate a little high, the 
 ears are unlike and the right ear is pointed sharply. The 
 fingers take distorted sha])es when s]^read apart, contracting 
 variously without his control or apjiarcnt knowledge. The 
 visual acuity is normal, the hearing is quite defective in the 
 left ear. f'.eyond a hospital record from i)neumonia the 
 medical fin<lings are not important.
 
 CLIXICAI. SlL'l)li:S Ol' IK )K1)I;K CASKS. Ill 
 
 Jn scliDul Milluii is inaUcntive iu liis work and U) his 
 teacher, lie can read only the sini])lest second reader selec- 
 tions, with elTort and fre(|uenl ermrs. lie does sim])le addi- 
 tion and suhlraclion, hut is j)raclicall\' heljjlo^ beyond this, 
 lie is ver\- inisatisl'actor_\- in manual training. a> Ik' will not 
 stick to or finish an\' task'. Mis drawini;- teacher was able 
 to g'et some fair work from him, and he does well in calis- 
 thenics but re<|uires hrm control, lie could name no state 
 other than Illinois, liesidcs die Revolutionary War. he 
 stated, the I'niled States had the I'.lack Hawk War and the 
 "Civilized War.'" lie does not know "'what country they 
 did fight last with." 
 
 Mentalh' .Milton earns a rating ot i i \ears of mental age, 
 with a retardation of 2^^ years. When asked to write from 
 dictation "'fhe ])rett>' little girls," he wrote it "The pettr}' 
 Ittle girles." I le was weak on re])roducing numerals. Thru- 
 out the testing his attention and interest were unfailing. I le 
 staid faithfully by his tasks. i'\-en when these re(|uired con- 
 siderable effort, and he tried to ])lease and accommodate. 
 His talk was sensible and showed many marks of intelligence. 
 In playing ball with me later he disregarded the pain of in- 
 jtired fingers, and ])la\ed with enio\-ment tho with less \ im 
 and energ}- than is shown In- most normal boys, lie made 
 many commonplace remarks but no absurdities. 1 le likes to 
 "captain" the calisthenics class and does well on such occa- 
 sions. At other times he is a])t to keep the rocjm in an uj)- 
 roar. 
 
 The secret of Milton's dissatisfaction with school and of 
 his restless wanderings seems to lie in his defective motor 
 control. In school T noted that when he was interested he 
 kept making slight choreiform twitching^. All his move- 
 ments seem to lack normal control. The\- begin and end 
 suddenly. There is no gradual warming nj) or slowing 
 down, but the look is sudden, the mo\ement of hand or foot
 
 112 BACKWARD AND FEEBLE-MINDED CHILDREN. 
 
 starts and ceases without warning. His eyes have an odd 
 look, and their furtive movements suggest those of a fox 
 or wolf. Their expression does not respond normally to 
 the gaze of another, is out of accord with the other's look 
 and with the given situation. He looks either too fixedly or 
 too shyly, with slight incoordination of the eyes and with a 
 half-fearful expression. The facial expression is too sober 
 and strained, and is badly inter-coordinated : The smile of 
 the mouth may be apropos enough while the eye looks star- 
 ing and cold. The incoordination of facial movements shows 
 markedly when he is asked to watch an object moved before 
 the eyes. 
 
 When reading or when writing dictation Milton was never 
 still. To quote from my original observations, his "eyes 
 close a little, head turns slightly to side, body straightens, 
 eyes wink several times in succession," etc., typical of a 
 stream of quick movements going on constantly, while he 
 made errors at every line, backing up and trying it again 
 with difficulty but with good effort. One can see that this 
 must be fatiguing, and in the end work that is thus subject 
 to constant error must bore the best of pupils. 
 
 Further observation and tests and the study of his con- 
 tinued thieving propensities were prevented by Milton's run- 
 ning away from the institution, and no more has been heard 
 of him. It is an interesting case of an unstable child with 
 strong tendency to vagrancy associated with criminality. The 
 mal-coordinations and the kaleidoscopic shiftings of neuro- 
 muscular equilibrium have correlated with them an inability 
 to persist in at least the school kinds of work, with a restless- 
 ness that must have its expression.
 
 CM MCAI, STIMHRS Ol' r.ORDFR CASl^.S. I T^ 
 
 Ihlda li., L'olorc'd, Age Twelve Years. 
 
 I lilda I'"., at the institution since I'"el)ruarv, KjOQ, is oi im- 
 
 known L'hicago parentage. Deserted by lier mother she was 
 
 placed in the care of the Juvenile Tourt. and thus reached 
 
 TJncoln. She was stated to have 
 
 bad sex habits, to have a record I 
 
 of stealing, and to have been I CASE 22.— Unsta- 
 , , '^ ,, ., ble. Fighting, Steal- 
 
 treated for specihc U'ltis m an • j^g^ Lying. Deficient 
 
 eye and ear infirmary. Control of Temper 
 
 „, . , . " . , and Movement. Kera- 
 
 -rnysical examniation shows tjtjs_ 
 
 1 lilda to be about normal in 
 weight, height, cranial measure- 
 ments, and strength of gri]). but distinctly below in lung ca- 
 ])acit\'. 1 ler head has some irregularities, with forehead nar- 
 row and rather low and receding, and with the scalp thick 
 and fleshy in front. The nose is low and broad, palate rather 
 high, obliquity of the eyes not quite normal, ears small and 
 abnormally formed. jMedical examination has found noth- 
 ing abnormal except "an acute keratitis of left e\e. ]irobably 
 specific." This has become chronic and seriously threatens 
 her sight, tho she still has one-half vision in the right eye 
 and two-thirds in the left eye. Hearing is normal. 
 
 In school Hilda reads poorl\- in the hr>t reader, adds and 
 subtracts a very little, is "poor" in spelling, writing, and in- 
 dustrial work. l)ut dances well. She gives only momentary 
 attention to anything, gets on only fairly with others, and her 
 worst school fault is stated to be her insistence on iK-ing the 
 center of attraction. She is most restless, and "alwa_\s sits 
 on one leg or twisted around in her seat." She appears 
 bright and lively, even spontaneous, but she does not get the 
 work done. vShe is over-demonstrative of her affection for 
 persons whom she likes. 
 
 The Binet tests give her a mental age of 8^ years, a retard-
 
 114 UACKVVAKD AND FEKULIC-.M INDKL) CHILDREN. 
 
 ation of 2 years. She coiikl not repeat 16 syllables, could not 
 count stamps nor backward from 20 to o, could not write a 
 four-word phrase when heard, could not give the date even 
 approximately, nor make change, name the months, or ar- 
 range weights. 
 
 Hilda has learned to write with moderate legibility, but 
 cannot use waiting to any purpose. In trying to reproduce 
 stories I and IT and to write of a trip in a flying-machine, 
 
 she wrote 9. 6, and 4 lines re- 
 spectively, being a hotch potch 
 such as "a fat pig a hoig to 
 leand a good heven Cand a 
 sometime cand," etc. Instead 
 of writing similars and oppo- 
 sites. in the tests for these, she 
 either copied the words with 
 strange transpositions and 
 changes, or occasionally wrote 
 some apparently imrelated 
 word or series of letters. She 
 crossed 49 and yy A's in two 
 minutes each, with no errors. 
 I Icr tapping record counted to 
 nearly normal, but she showed 
 exceedingly poor control, tens- 
 ing her fingers into knots, 
 hammering the key, etc. She 
 somelimes became so awkward and her muscles would be- 
 come so tensely knotted that she could hardly continue tap- 
 ping even when coaclied. 
 
 Of a kind with these results of the tests for motor con- 
 trol is Hilda's conduct when crossed or angry. The attend- 
 ants report that she has violent fits of temper in which she 
 throws herself on the ground and butts her head, and she 
 
 
 / 
 
 n 
 
 HILDA E.
 
 ci.iNiCAi. srri)ii;s oi- i'.nKi)i;R tasks. 1 15 
 
 sonictiiiics kicks ])laymalcs severcl}' and (Ido thciii tnhcr 
 violence. She continues lier record of fighting and also of 
 stealing and lying. 
 
 We have, then, a case of tmstahlc motor and menial con- 
 trol shown in the almost convnlsi\'c manifestations in the 
 motor tests and in the fits of tc'm])cr and of viok'nct' : shown 
 equally in her restlessness and weak attention, and pi^ssihU- in 
 her inability to mentally direct her movements oi writing. 
 ^^'ith the deep-seated infection shown in tlic keratitis, with 
 her bad habits sexual and otherwise and her inal)ilil\- to ])rolit 
 by instruction, she is evidently best cared for in an institution. 
 in spite of the small amount of intelligence retardation.
 
 Il6 UACKWAKD AXD FEEBLE-MINDED CHILDREN. 
 
 JVilda C, Age Thirteen Years. 
 
 The home record of Wilda C, who was admitted in Jan- 
 uary, 1909, shows that eight of her brothers or sisters have 
 died from causes not stated, and that two, with her mother 
 
 and grandfather have died of tu- 
 
 CASE 23. — Emo- 
 tionally Unstable. 
 Tuberculous Hered- 
 ity and Condition. 
 Keratitis. Fair In- 
 telligence. 
 
 berculosis. There is httle else 
 reported of her. 
 
 Wilda is above the normal by 
 nearly 1 1 pounds in weight and 
 2.8 inches in height, but is slight- 
 ly below in cranial girth, strength 
 of grip, and lung capacity. She 
 has but one-fifth vision in the right eye and two-thirds in the 
 left, with normal hearing. Her forehead is rather low, the 
 eyebrows are high arched and unite low on the nose, giving 
 a ])eculiar oblique effect to the face. The two upper in- 
 cisors are separate but well developed, the tooth on each side 
 being poorly developed and small. The medical examination 
 shows a poorly nourished body, oral breathing, narrow chest, 
 and weak lungs. There is slight cnlargenient of the heart 
 and some abnormality of its action. She was considered to 
 have tuberculosis of the lung, with "corneal ulcer, probably 
 tubercular." The latter condition is one of chronic keratitis 
 which has clouded and caused irregularities of the cornea. 
 
 In school Wilda reads well in the fourth reader, does long 
 division and addition and subtraction of fractions, and is 
 said to spell well and to draw "normally." .She is a little 
 awkward in calisthenics and does but fairly in dancing. Be- 
 sides she is making a little progress with history, physiology, 
 and music, but finds geography difficult. She "attends" as 
 well as normal children, gets on well with others, and her 
 worst school fault is stated to be that she "likes to be made 
 over" and "is jealous about getting her share of smiles,"
 
 cr.iNicAr. STuniF.s of noRDi'.R cases. 
 
 1 T' 
 
 The lliiK't c.\;uiiiiiati(iii .ui\cs W'ilda a mental a.L;c of il. a 
 retardation thus <if hut n\]v year. It was noiieeahle that she 
 could not c-lian,L;e 4e from 25c, could not rt'])roducc 6 of 19 
 details read to hei\ nor delect inconi^ruities in sentences. She 
 could not construct a sentence of ,^ !L;i\-en words and failed 
 to rearran,<4e the shuffled words of sentences. She volunteers 
 a good <leal of information learned in school, stating- it cor- 
 rectly. 
 
 Wilda's good showing in the re]M-odnctious of stories T and 
 II and especially in story invention, also in the .\-test and in 
 the giving of similars, corresi)onds to the 
 findings with the Ihnet scale hut would 
 after all be weak for a normal child. The 
 stor)' invented, however, does show some 
 imaginative ahilit)- and some power of us- 
 ing images to a purpose. 
 
 Her writing is legible hut ])rimitive. 
 She omits or misuses ])unctuation marks, 
 uses the infinitive for the past tense, etc. 
 Her composition is child-like, with primi- 
 tive couplings up and rei)etitions of 
 "and", and the occasional omission of a 
 word apparently from distraction. Her 
 spelling is normal hut careless. Her 
 thought is generally natural in its se- 
 quences, tho she made the statement "P 
 begins with prevent and E begins with event," when asked 
 to distinguish these words. 
 
 The tapping tests showed a normal total with the left anl 
 26 below with the right. T>ut the work was irregular, and 
 showed defective control in the frequent knocking and ham- 
 mering. 
 
 Wilda's actions in the presence of the opposite sex indi- 
 cate that she has an abnormal deficiency of control of her 
 
 WILD A c.
 
 Il8 BACKWARD AND FEEBLE-MINDED CHILDREN. 
 
 sexual nature, and she would seem to have bad sexual habits. 
 Her attendant says emphatically that Wilda is ''very fond of 
 the boys" and that she is not ver}- promising. She shows 
 facile emotional reactions to boys and men, and tendencies 
 to over-fondness in general. Her face becomes soft and 
 without character as she looks up with an ever-ready smile 
 which bespeaks notice and commendation. 
 
 \\'e have here the case of a mentally backward girl with 
 verv moderate mental furnishings, but sufificient perhaps for 
 a normal if simple life in society. But there is more to be 
 considered than the intelligence. There is an abnormal lack 
 of emotional control and an over-tendency to the things of 
 sex, with little development of will or foresight. When one 
 adds to this the tuberculous history and condition, and the 
 deep-seated affection of the eyes which will long need medical 
 attention even if it should spare her vision, it is seen that in 
 spite of the small amount of intelligence retardation this 
 girl, too, is well placed in an institution. My latest report 
 received as I write states that she is ''doing well but daily 
 growing to be more of a flirt."
 
 CT.iNncAi, sTUniKs ni- p.oi^df.r cask?;. 
 
 no 
 
 /■aiiiiic If.. .Ij^c I'Diirlcrii ]'cnrs. 
 
 CASE 24. — 
 
 ■ Dull, 
 
 but 
 
 Well Ba 
 
 anced 
 
 and 
 
 Pleasing. 
 
 Ap- 
 
 pears 
 
 Normal. 
 
 1 
 
 Fannie li. lias a ijrctly face and an c\eT-rca(l\- smile, and 
 these are proliahly lier strongest assets, often ser\'ini^- lier as 
 snbstitntes for thinking;. She came to tlie institnlion in 
 October, njc/). and was re-ad- 
 mitted in .\])ril, \<}\o. l'>orn in 
 Germany, she (Wd not talk till 
 three years of ai^e, had a habit 
 of hidinj;- thin<;s and of rnnnini;- 
 away, and was accused of "'want- 
 ing- to eat all the time." She was 
 
 said to have ^iven trouble when with her famih and they 
 washed to be rid of her, but little more is known of her liome 
 record. 
 
 Physicall}- Fannie has lao-g-ed behind her years in weight. 
 heig-Jit, and strens^th of ,qrip. but is of normal cranial and 
 lung- capacity, and indeed is in rolnist ])h\sical condition as 
 shown in her medical examination and to general observa- 
 tion, lier vision is good, the hearing was dull in one ear 
 when the test was made, luid home conditions ma\- haw; 
 caused the lagging in growth, as it was noted that after .i 
 prolonged stay with her liome i)eople she returned ill-cared 
 for and much reduced in desh. 
 
 In school 1^'annie reads "fairly" in the second reader, is 
 "subtracting," and is doing fairly in industrial work, dancing, 
 and calisthenics, tho awkward in the latter and in walking. 
 She "attends" normally, "lias a good o])inion of herself," 
 and her worst fault is stated to be "stubbornness." 
 
 The I'.inet tests showed a mental age of 9^2, a retardation 
 of 4 years. An}- problems involving any use of abstract con- 
 ceptions or the ideating of abstract situations were (piite 
 l)eyond her. She lacked ideas and was easily confused in 
 handling what she di<l have. In general she seemed bored
 
 I20 
 
 BACKWARD AND FEEBLE-MINDED CHILDREN. 
 
 at thinking, but would look up sweetly at me instead of mak- 
 ing a try whenever some intellectual effort was called for. 
 In the written tests her writing is very irregular, but can 
 be read. The lines are of all lengths, with capitals and punc- 
 tuation marks at random. She wrote but little, showing no 
 imaginative construction and making most trivial state- 
 ments. She spells "ho" for "who," 
 "lift" for "lived," "gard" for "gar- 
 den," "bouj" for "boy," "brig" for 
 "bridge," "dint" for "didn't," "siad" 
 for "said," "spreank felte" for 
 "S])ringfield." Reproducing "The 
 children knew how to work the fly- 
 ing-machine," she writes, "And 
 they new How too Work on the 
 Mashin." The A-test showed many 
 errors, and the tests for similars and 
 o]iposites seemed beyond her com- 
 prehension. She showed one-third 
 less than the normal rate of tapping. 
 The Binet finding of 4 years of 
 retardation is thus confirmed by her 
 lamentable failures in most other 
 mental tests and by her very slow 
 progress in school studies. Even 
 if her age should not have been cor- 
 rectly stated by her people, her 
 power to do mental work evidently 
 lags well behind even her physio- 
 logical development. But this little girl is pretty evenly 
 balanced as far as she goes, and is able to make the most of 
 her rather scantv resources. Whatever she attempts to do 
 is performed with fair ef^ciency and promptness, and one 
 does not note that she attempts but little. There is nothing 
 
 FANNIE H.
 
 CLINICAL STUDIES OF liOkDLR CASES. 121 
 
 to altract unfavorable attention in her ordinary l)ehavior, 
 as she is soeialh' eonijjanionahle ami ready to lie more or less 
 helpful, tlio prrhaiJS a little lazy. And it is thus not sur- 
 prisini>- that w ith her winning- faee and ever-ready sniile she 
 is often thoui^iit to l)e ([uite normal and to belong- outside. 
 As a matter of faet. if she had a .qood home she would cer- 
 tainlv be eared for in it. and ])roi)erIy jjerhaps. With o-,)o<l 
 home conditions from the iirst she mig-ht have shown less 
 of mental retardation. I hit as things are. while on the ph\s- 
 ieal side l^'annie has reacted well to proper hygiene, mentally 
 she has not made much ])rog-ress; and I am inclined to con- 
 sider this a case of fundamental defect of mild degree, show- 
 ing mainlv as mental dullness and inaptitude for any think- 
 ing- that involves representations of the absent. 
 
 SocialK', the danger of leaving- such a girl without the 
 supervision of an institution or of adequate home directi<tn. 
 with her winning ways, her physical vigor, and lu'r marked 
 incapacitv for taking- thought, is evident enough. And her 
 "normality" is that of a much younger child, judged even 
 then bv the standard of the few things that she attempts 
 rather than l)v that of th.e varied activities needed to live 
 normallv at her age.
 
 122 EACKWAttD AXt) FEEr.LK-.MlNDED CHILDREN. 
 
 Nura L.. Ai^c Tliirfccii Years. 
 
 Nora L., of whose home o^nditions ahnost nothing is 
 known, was brought to Lincohi in February, 1906. A tall, 
 slender girl, she is weak physically, dull mentally, and has 
 
 an over-seriousness of manner 
 and seclusiveness of attitude that 
 would seem to make of her life 
 a sad monotony. 
 
 Nora is a little below normal 
 in weight and i >'2 inches above 
 in height. Her head is 7 mms. 
 
 CASE 25. — Dull. 
 
 Poor 
 
 Physique and 
 
 Vision 
 
 Over-Serious. 
 
 Mildly 
 
 Emotional. 
 
 't> 
 
 below in girth, 10 below in l)readth and 6 above in length, 
 giving a noticeable disproportion. The head is narrow in 
 front, with the forehead appearing more prominent at the 
 rio-ht. The lins curve downward, middle incisors are sepa- 
 rate, palate is rather high, ears asymmetrical, skin pale, and 
 nutrition poor. There is considerable strabismus and an un- 
 diagnosed affection of the cornea, with a deforming promi- 
 nence of the left eye and vision of but one-fifth in either eye. 
 The hearing is normal. Two years ago she was quite frail 
 and was placed on tonic treatment for tuberculosis. .She has 
 improved physically, but is still frail and is probably tuber- 
 culous. 
 
 In .school Nora reads well in the third reader, multiplies 
 bv two digits and divides by but one. spells satisfactorily, 
 does "good" work in drawing and "very well" in calisthenics 
 and dancing. Her defective vision prevents her doing well 
 in sewing. She practices faithfully at piano lessons and 
 takes various parts in the entertainments. 
 
 The Binet examination gives Nora a mental age of 10^2
 
 CI-INICAI- S'l Ul)Ii:S OK IIOKDI'.K CASES. 
 
 123 
 
 Acars, a i-ctardalioii of 2 years. The written lest^ sliow a 
 liandwritiiiL;- that is irregular, willi crooked words and lines 
 and ratlier infantile eharacteristics. There is rarely a capi- 
 tal or ])nncttiation mark. The niis-spellinos. tho not frc- 
 <|uent. are of interest: stad (statue), thonth nhoni.;iit), 
 g-randen ( iiarcUn ) , enntli (enough), filed (fell), prise 
 (present). Besides, she tends to tise the infin.itive or parti- 
 ci])le forms of the verh everywhere. Her thought seems to 
 progress normally, 
 tho simply, hut she 
 cannot readily put 
 what she thinks 
 into written sen- 
 tences. The total 
 output in these 
 tests is very mea- 
 oer, rather below 
 what the Binet tests 
 would indicate. 
 
 In tapping Nora 
 is ij below with 
 the right hand and 
 I 1 above with the 
 left. being- left- 
 handed. In this 
 test as in others she 
 was ])assi\e, calm, 
 with no facial ten- 
 sions. With the 
 more dif^cult of the 
 Binet tests she ^^^^^ l 
 
 tended to remain 
 silent, trving- but "stuck, "' her mind seeming i)aralyzed and
 
 124 BACKWARD AND FEEBLE-MINDED CHILDREN. 
 
 inactive, her eyes filling with tears and her lip quivering. 
 This was repeated over and over. 
 
 The poor physical condition, very weak vision, and paucity 
 of mental resources, with the over-seriousness of demeanor, 
 render this case rather unpromising, tho recent school re- 
 l)orts show some progress.
 
 cr.ixicAi. s'irrMi:s of t.ordf.r cases. 
 
 \2- 
 
 Harriet (/., Ai^c Eleven Years. 
 
 CASE 
 
 26. 
 
 — Insan- 
 
 ity and 
 
 Fee 
 
 ble-M 
 
 nd- 
 
 edness in th 
 
 e Fam 
 
 ily. 
 
 Keratitis. 
 
 Pneumo- 
 
 nia. Bri 
 
 qht 
 
 and 
 
 At- 
 
 tractive. 
 
 
 
 
 llarricl is a really brij^lit and sweet little ^iv\, a star at 
 the school entertainments and a favorite with ever\()ne. 
 The question as to her normality has often been discussed. 
 Admitted at the age of six or 
 seven, her family record is un- 
 promising^. A grandmother of 
 weak intelligence, a mother in- 
 sane since adolescence, a father 
 reported to have been "simple" 
 and worthless, and the child her- 
 self apparently born out of mar- 
 riage and brotight to the in-^titntion after a severe attack 
 of typhoid, — this sums u|) the stor\ . 
 
 Physically Harriet is somewhat above normal in weight 
 and height, slightly below in cranial girth, ({uite inferior in 
 lung capacity, and nearly normal in strength of gri]). There 
 are no bodily stign.iata and the head and face are well de- 
 veloped, but the front teeth show a rather inferior develo])- 
 ment. For several years Harriet has had serious trouble 
 with her eyes, diagnosed as interstitial keratitis. This causes 
 some corneal opacity and irregularity and at times threatens 
 the sight of one or both e)es. Her vision is less than one- 
 fifth in either eye. vShe also has "snuffles" continualK and 
 breathes thru her mouth, btU has had no exploratory exami- 
 nation for adenoids. She has very frec|uent colds, gets in- 
 fected easily in toe nails, fingers, etc., and shows low vitalit\-. 
 She is subject to gastric disttirbances and sudden high tem- 
 peratures, and worst of all has had severe attacks of acute 
 bronchitis and pneumonia. 
 
 In school Harriet reads (|uite well in the third reader, 
 does addition and sul)traction and some of the tables, is not 
 careful or neat in industrial work, but is graceful in calls-
 
 126 
 
 BACKWARD AND FEEBLE-MINDED CHILDREN. 
 
 tlienics and dancing. She attends well to her teachers, but 
 not so well to her work, of which she soon tires. Little 
 wonder, in trying to do near work with less than one-fifth 
 vision and no glasses ! She gets on well with others and is 
 not credited with any special faults or with any special 
 abilities. 
 
 The Binet examination gives Harriet a mental age of 
 ()]/>, while her age. based only on the estimate made when 
 she was admitted, is between lo and ii, most probably the 
 latter. She was unable to name common pieces of money, 
 could not change 4 cents from 25 cents, defined horse as 
 "What you ride on. what rides a bugg}-, its got legs," and 
 could n(jt define any words in other terms than use. She 
 
 could not tell the time from watch or 
 clock. She attends well and makes nor- 
 mal ada])tati()ns so far as she attempts 
 an\-, biU tends to silence if the question 
 is difficult and is over-mild and inag- 
 gressive in manner. Even when emo- 
 tion occurs it is nu'ldl}' expressed. 
 
 In the written tests Harriet's writing 
 is irregular and primitive, often illeg- 
 ible. She uses no capitals or punctua- 
 tion marks, and obscures her meaning 
 by omitting words and letters, making 
 also some illiterate mis-spellings. How- 
 ever, her simple sentences show speecii 
 habits that are normal for a young 
 child, and it may be mentioned that she 
 talks a great deal when well acquainted, 
 though bashful otherwise. She repro- 
 duced correctly 22 and 2C1 details of stories I and H, but could 
 think of nothing iov the tlying-machine trip. She crossed 
 ]/ and then 51 A"s in successive tests of 2 minutes each, 
 
 HARRIET G.
 
 CLJixicAL sri'Diis oi' i;(ii<i)i:i< (■asi-:s. 127 
 
 with iKj crrii)">. Ten similars were correct ami j, incurrect, 
 12 0])po.sites correct and 1 incorrect, in tlic 1 1 -minute tests 
 for these, in tapping- she went a little bcNond the normal 
 rate. 
 
 On tlie whole the mental tests establish the fad of a 
 certain amount of UH'Ul.al hackw anhu'ss, not aiuountin^-, 
 however, to teehle-mindedness. In jud^in^- turtlu'r of such 
 a case, we have to consider it in its collective aspects. There 
 is first an exceediuf^ly bad heredity back-<7round, and we are 
 told of a mother fairlv brijT^-ht (j^ettin^- "^-ood marks'" in 
 school) till adolescence and then failin;;-. Then there is ver\' 
 defective vision. And while this does account for some if 
 the j^edagoj^ical retardation, the visual defect is based ou 
 deep-seated disease and will continue to be a retarding- fac- 
 tor with ])ossible blindness as an outcome'. There is a res|)ir- 
 atory system already weakened b\ re])ealed attacks, and a 
 distinct tendency to Iuuq- involvement. There is an intelli- 
 gence that is at best frail and distinctly laggino-. and there 
 is, also, an evident lack of self-assertion and self-direction. 
 the child being entirely too easy-going and dependent, and 
 giving little promise of being able to face the world for her- 
 self. ()n the physical, mental, and social sides it seems clear 
 that this attractive child, little retarded as she a])i)ears to be. 
 will long be in need of kindly directive control b\- an insti- 
 tution or other social agent, ller meu.lal dex'clopuient will 
 hardly continue very much further and her dangers will 
 increase man\- f(_)ld.
 
 CASE 
 
 27.- 
 
 -Dull 
 
 and Lazy 
 
 Steady-go- 
 
 ing, but 
 
 Lack 
 
 ng in 
 
 Mental 
 
 Resources. 
 
 Chorea 
 
 i/vith 
 
 Heart 
 
 Trouble. 
 
 
 
 128 BACKWARD AND FEEBLE-MINDED CHILDREN. 
 
 Delia //., /Igc F iff ecu and One-half Years. 
 
 Delia impresses one with her placid countenance in spite 
 of its occasional choreic movements. A Chicago girl ad- 
 mitted in August, 1909, she has a history of having been 
 
 picked up as a foundling, and 
 was reared by a city family. 
 Nothing is known of her own 
 family. The child had nervous 
 twitchings from infancy, and 
 this was assigned as a cause of 
 mental deficiency. She became 
 addicted to self-abuse, and was 
 notably lazy and gluttonous, would hide and destroy things, 
 and would "run away from school and lie about it." Four 
 years before coming to Lincoln she "lost the use of her limbs 
 for a while, but recovered." She had measles, scarlet fever, 
 and an operation for tonsil itis. but was generally considered 
 to be healthy. 
 
 Physical examination shows her to be nearly 2-^ pounds 
 above in weight and slightly above in height. Her head is 
 36 mms. belt^w in circumference, being more deficient in 
 length than in breadth. She tests well above on the spirom- 
 eter, and in strength of grip is normal with the right hand 
 and disproportionately strong w ith the left. Her vision and 
 hearing are normal. The palate is narrow and high, the lips 
 are deepl}- creased vertically, the teeth are a little separated 
 and not very well developed, the right ear has the Darwin- 
 ian tubercle prominent. The shoulders are of unequal 
 height and the bodily carriage and walk are slovenly. 
 
 Medical examination records a jerky and irregular respira- 
 tion and a condition of the lungs that is otherwise not wholly 
 satisfactory. The heart is enlarged and she has mitral 
 regurgitation and chorea. INIensti'uation is irregular.
 
 CMxicAi. STri)ii:s oi" i;()ki)1".r casks. 129 
 
 Delia reads satisfaclnriK in llir fmirth rcadeT and does 
 ver\' simple pr()l)lenis in divisidn. Slie can draw siin])le 
 designs for C'hristnias cards. l)ul is slf)venl\- in cla\ modeling;", 
 laz\ in industrial work and calisthenics, and awkward in 
 dancin,^'. her chorea seeinini; to interfere with the* lattc. 
 MowCNcr. I have seen the choreic movements disa])|)c-ar 
 completeh as slie ])la\ed the \ii)lin. tho they usually l)ecome 
 more vii)lent when >he makes an effort. I ler \-iolin teacher 
 thinks that her "nervousness"' does not interfere with her 
 music, hut that she is lazw tho a rather satisfactory 
 l)U])il, ncN'ertheless. She studies elemcntarx history, ])liysi<>l- 
 oe\', and j^reoeraphv, and learns these lessons rather (luicklw 
 
 The r.inet tests s^ive Delia a mental age of i 1 ' _> years, 
 with a retardation of 3' 2 years. Her speech is normal. 
 She could ni)t rei)resent to herself social situations suiij^ested 
 hv the tests, and could do little with ahstractions. "lustier 
 is to do ri^ht. Ain't jiishCi- frccddiu too.'" dcodiu'ss is 
 "When Ndu're ^ood." (.'hantx was unknown. .She does 
 not get e.xcited and does not show an\- s])ecial tendencx' to 
 confusion. To the limit of her resources she kejit adapted, 
 hut the resources were not extensive. 1he choreic mo\e- 
 ments did not seem ag-!.;ravated hy the tests. In actual ihink- 
 iuL;' the\- sometimes ceased, or were ])artiall_\- replaced hy 
 bulirinu' of the forehead muscles, etc. 
 
 The written tests show les^ihle hut childdike handw i-itin^. 
 ( )ccasionall_\' there is ver\ had use of cai)itals. marks, and 
 ])aragraphs, and some l)ad spellini.i'. I'suall} her comixtsition 
 shows smooth and grammatical l-'n^lish. lmat;inalion was 
 hut little in evidence, and her tl\ in^-machine tri]) showed 
 her onl\- some children skating', snow -balling', and coasting. 
 and ])eo])le taking children out on sleds. 
 
 Delia makes a nearly perfect record in the te.sts for asso-
 
 130 l!At■K^VAKI) AXD FKIiCLE-.M IXDED CIIU.DREN. 
 
 ciation by similars and opposites. and she crossed 87 and 
 then TOO A's with but one partial error, in tests of 2 minutes 
 each. 
 
 Takini^- all the data together we find prognosis difficult 
 from the lack of knowledge about the child's heredity and 
 development. The ap])arent paralysis of five years ago is 
 suggestive of trouble later, but may be incorrectly reported. 
 The chorea, heart lesion, and weak lungs mark her as a girl 
 that will always need medical attention. The laziness seems 
 to be constitutional, perhaps part and parcel with the phys- 
 ical condition. She has such a ]:)aucity of mental resources 
 as makes her one of the mildly dull feeble-minded. ( )n the 
 other hand her emotional steadiness and rather equable dis- 
 position make of her a girl who, with wise parental control 
 and some careful attention to her bad sex habits, might 
 ordinarily fit fairly well into home conditions. Such adjust- 
 ment will not l)e wise until societ\- renders impossible mar- 
 riage or at least the bearing of children by such defectives. 
 For the present Delia should be trained to useful activities 
 in the instituticjn.
 
 ci.ixKAL sruDii:.s OF i;oki)i:r casics. 
 
 'of 
 
 Jrcn.dy /.. .-/f't' Tiy'Ciify Vrars. 
 
 CASE 
 
 28. — 
 
 Dull, 
 
 with Occasiona 
 
 1 Out- 
 
 breaks. 
 
 Excel 
 
 s in 
 
 Lace - Making 
 
 and 
 
 House-W 
 
 ork. 
 
 
 W'ciuly, imw a rather ])rc-U_\- ^irl of 20. came to the insti- 
 tution 11 \ears aj^o. .Xothinj^- is known of htT fainil\- or 
 personal hislor\' except that when aihnilted there were staled 
 to l)e two l)rothers an<l a sister 
 ah\-e and nientah}- sound. 
 
 1 MusicalK' sIk' is nearl\' four 
 pounds aho\e in weight ami 1.3 
 inches l)elow in liei.Li'ht, with a 
 cranial circumference that i^ 24 
 mms. Ijclow normal and a cranial 
 leni>tli that is i(> mms. helow. The 
 
 chin is receding- and the thyroid is somewhat enlarLivd. l)ut 
 there is nothins;" else worth} of note and her physical health 
 is considered i^'ood. 
 
 in school Wendy reads with fair fluenc}' any reading.; mat- 
 ter that is comparatively sim])le. She does <»nl\- the very 
 simplest addition and suhtraction, almost always failini^- in 
 multiplication and she is quite unahle to divide. Mer music 
 is like her arithmetic, she simply cannot learn it. After ])rac- 
 ticing for months at an easy violin selection, a simjilest be- 
 ginner's series of measures, and having lessons all tliis time, 
 she was still (|uite unable t<) i)la}- it. It is in the manual room 
 that W'endv excels. Fiere she makes beautiful lace with ihc 
 lace machine. She is a little slow but is ver}' neat and satis- 
 factory in this work, always leaves the bobbins arranged 
 "iust so," and seems contented here. The girls in the man- 
 ual room are said to "look u]) to her a good deal." -She usu- 
 ally attends as well as normal children and gets on well with 
 the girls and with her teachers, except for an occasion.al out- 
 break of stubborn resistance. 
 
 Mentally \\'endy shows an intelligence age of 10/j years, 
 a retardation of ()]/> vears. She could not define or distill-
 
 1 3-' 
 
 BACKWARD AND Fr-:EBLE-MINDED CHILDREN. 
 
 guish terms, could not make change or arrange weights, and 
 could not detect the nonsense in silly statements. She was 
 shv and timid, with an unreadiness to undertake and a tend- 
 ency to give up that is characteristic of the typically dull 
 children. There was, too, the topical scantiness of mental 
 
 res(nn'ces, and there were no 
 reactions that showed any 
 sfrcir^fii of intelligence, but 
 rather the tendency to win 
 with a smile a way around 
 the ]:)rohlems that needed 
 mental grip for their solu- 
 tion. Abstractions were 
 meaningless, and the ordi- 
 nary grade work of a school 
 would lie for this girl a per- 
 ])etual monotony and waste 
 of time. 
 
 The written tests show a 
 handwriting that is very leg- 
 ible, though somewhat irreg- 
 ular and undeveloped. Capi- 
 tals and punctuation marks 
 are usuall\' omitted. She for- 
 gets some needed words and 
 loses track of what precedes 
 as she writes further, though 
 apparently her inner speech 
 WENDY o. "^^'3^ 'ill the time proceeding 
 
 in normal sequences. Her 
 story reproductions are extremely simplified, sketchy state- 
 ments, omitting most of what should be given. Of ''The 
 .Straw. Coal, and liean" she writes: 'Tn the vill live a lady 
 one day she out to the garden to pict some beans for dinner
 
 c'f.i.MfA! sTri)ii:.s ()|- I!()RI)i:k casi-is. 133 
 
 the starw sli]) out of Ikt tin^'crs and fcld lo the tloor She put 
 the beans in llu' put one uf ilic lican said it hickinL;' I feld I 
 wouhl ha\x- been cook to death if she I'Ul in with rest oi' them 
 l)rett}- soon a tarlor come and saw what a [)oor fix the l)ean 
 in." 
 
 1 ler out])iit in the tests !^eneran_\' is \er\' niea^'er. tlioni;h a 
 ])erformance which i-nnld lie rednce(l to automatism, .-nch as 
 the A-test. could soon he faiid\- well done. 
 
 1 have spoken of \\'end_\"s occasional ohstinacw At rare 
 intervals this has manifested itself a^ downright \-iciousness, 
 as when with two other .s^'irls she deliherateh' ])lanned to c;ive 
 a third i^irl a j^ood kicking', and hrutalK' carried, it nut. A dull 
 mind is not hy that fact a harmless mind, and outbreaks like 
 the above are much less expensively adjudicated in an insti- 
 tution than in o])en society. Those who have Ioul: had charge 
 of Wendy say she would never be able to live safeh' outside. 
 -And _\et only recently an etiort was made to remove her. b\- 
 some one. it is stated at the institution, who is not heivself 
 of over-strono- mentality. 
 
 ( )n the other hand Wendy has won a rei)utation for neat 
 bed-makiuQ- and other work on the ward, and the success 
 with whicli she has learned to do woman's hand work- and 
 housekeeping- duties, with the contentment and ri-ht ideals 
 that she is showin;^- in these tasks, su^ijests wdiere the em- 
 phasis should ])v placed in training these dull skirls.
 
 CASE 29. — Dull 
 and Infantile. Weak 
 Heredity. Defective 
 Motor and Emotional 
 Control. 
 
 134 I'.ACKWARD AND FEEBLE-MINDED CHILDREN. 
 
 Casf^cr H., Age Thirfccii or Fourtecu Years. 
 
 Casper is still another of the dull ehildren who have little 
 mental or moral coloring'. The admission data are meager 
 and do not state his age. lie has been in the institution since 
 
 1902. and was evidently as much 
 as six }-ears of age when admit- 
 ted, according to the statements 
 of those wdio knew him then. His 
 mother is said to have been men- 
 tally defective and "stupid as a 
 worker,"" and the family was de- 
 pendent, the boy being cared for 
 in one of Chicago's charitable institutions. 
 
 Casper is slightlv above in weight and below in height, 
 with a head that is a tritle larger and longer than the normal 
 average. His performance with the spirometer and dyna- 
 mometer is not quite up to par but he is disproportionately 
 strong with the left hand. He has but two-thirds vision with 
 the right eye and two-hfths with the left. His hearing is 
 normal. 
 
 His upper incisors are separate but the teeth are fairly 
 regular and good. The uvula is small and the palate rather 
 high. The ears have large Darwinian tubercles. There is 
 a general unbalance and lack of tone in the bodily carriage. 
 In school Casper gives no trouble on the side of discipline 
 or morals, and gets on well with the t)ther children. He is 
 docile and especially amiable, a general favorite ^vith his 
 teachers, whom he assists in a variety of ways. However, 
 he attends badly, is very distractible, and his "worst fault'" 
 is stated to be laziness and great restlessness. He sometimes 
 "says little silly things" and is quite "babyish." fie reads 
 fairly in the third reader, spells well such words as occur in 
 his reader, and is one of the three best in his class iii simple
 
 ci.ixK Ai. SI ri)ii-:s oi' iioudi;!.; ('.\si-:s. 133 
 
 <lra\\iiij4 work. I Ir iiiaiia^'o lo \si irk xmic pri il)k'iii^ in kin|L;- 
 (livi^iiin, l)iil i)c\'L'i"llu'less conkl not (li\-i(U- \nv[\- 1)\- six or 
 twenty ])\ four, when tc^tcil. In hiIut scliool work lie shows 
 no s])ccial ahilit\' or (K't'icicnew I fear thai much of his learn- 
 inj;' is rather wooden. W lien a^ked lo read onlinariK eas\- 
 matter not tound in the rcader.s he could not ])ronomice 
 course. Tancii . provided, consists, conrciiicut . iiiciiihcrs. at- 
 tached, etc., and needed constant assistance to ,m't through 
 at all. Asked what is the capital tjf Indiana he answered 
 "Minnesota." Asked what year this is he answers "Winter." 
 
 Casper plays second clarionet in the hand, reads the music 
 readily, plays well and learns selections with normal rapid- 
 ity; Init his musical ability is "below normal." and he lacks 
 attention and is very distractil)le here as elsewhere. 
 
 The mental examination shows an intellij..;ence a.^e of nine 
 and a half }ears. with a retardation of as much as three and 
 more probably of four years. His s])eech shows such errors 
 of articulation as trick for creek, free for three, de for the. 
 and some others, widi very incorrect rji<.;lish in y'eneral. 
 
 The written tests show a handwriting^' that is infantile and 
 irregular, but that can be read. The lines are at all angles, 
 with no capitals or ])unctuation marks. Some of his numer- 
 ous mis-spelling"s are a ])on ( upon ), sone ( some), an ( and ). 
 Hore (floor), coa (coal), where (were), watch (which), 
 brig ( bridg'e ) , acro.se ( across ) , taler ( tailor ) , svede 1 se\ve(l ) , 
 warl (worhh, eiift (enough), slaj (sleigh), titying (fight- 
 ing), settch (statue), dad (dav), sed (said), women 
 (warm), niaber (marble). 
 
 He omits whole phrases that ai)i)arently were more or less 
 present in his thought, as in the following exaiiiple> : "( )nce 
 a pon (a time) an old lad_\- ;" ".She was ])utting ( be.ans in a 
 pot when) a straw fell:" "( )nce a (artist) works for _\-ears;" 
 "Every bean had scar on them." 
 
 His otitput is ver_\- meager for all the written tests and
 
 136 BACKWARD AND FEEBLE-MINDED CHILDREN. 
 
 he shows a paucity of mental resources and a skiggish move- 
 ment of thought. He could do fairly well in the orientation 
 tests, but seemed too inexpressibly lazy and lacking in tone 
 and energy to make more than the most necessary move- 
 ments. His tapping rate was sixteen below with the right 
 hand and twenty-nine below with the left. He alternated 
 between a lazy tapping with a single linger, against which 
 he had to be cautioned repeatedly, and a hammering method 
 which several times deranged the instrument. 
 
 (General observation shows Casper to be shy and un-aggres- 
 sive, with a tendency to take refuge in infantile reactions. 
 Jle has doubtless been "babied" a great deal, and does not 
 seem to have thought of taking any other attitude. He cries 
 readily when reproved, sits or walks with little tone in his 
 carriage, and shows a constantly' recurring shift and s(|uirm 
 of bodily and facial i^osition and expression, causing various 
 observers to call him restless, babyish, shy, nervous, imstable, 
 etc. Some of this is merely bad habit. More of it seems to 
 be the manifestations of a nervous system that has not grown 
 to normal .strength and stability and that gives him an un- 
 toned carriage, a weak-willed, lazy attitude, and a mentality 
 that would answer for a much younger boy, that has even 
 been thought normal by some who have known him, but that 
 has lagged well behind his years.
 
 CT.IXir.M. STI'Dll'.S <)\' I'.ORDF.U CASKS. 
 
 1 '•" 
 ' .1/ 
 
 S\iiiiiicl J., .li^c Ten yciir.s 
 
 CASE 
 
 30. - 
 
 - E n- 
 
 larged Thyroi 
 
 d with 
 
 Exophtha 
 
 m s . 
 
 Dreamer 
 
 and 
 
 Joker, 
 
 who m a 
 
 kes 
 
 Little 
 
 Progress 
 
 in School. 
 
 This is a curious and iiitcrcslin^' case which could have 
 l)Ut httic stuch' as the child \\a^ early taken to hi^ home. Ad- 
 mitted in i<K)'). Samuel^ fauuh' would seem to ])v healthy. 
 The\' are of Polish, nationality. 
 Samuel was "peculiar from 
 hirtli," had one convulsion at 
 three \ears of a,u'e, did not l)eL;in 
 to talk till his ftjurth year and 
 was late in fretting' his teeth. 1 ie 
 did not learn to dress and undress 
 or to tie a shoe-lace, and he "ran 
 
 away every chance he ,^<it." lie showed an early tendency 
 to l>lay jokes, as when he is said to have climl)ed on the roof 
 and stc:>ppe(;l hoth chimneys. Me was sent to school "several 
 times but always ran away." 
 
 Physically Samuel is considerably below normal in wei,i.iht 
 and hcig'ht, and is moderatel)' deficient in strenj^th ot L^rip. 
 I lis head is of about normal size but shows some asymmetr}-. 
 'idle teeth are notched and the l)ack teeth are mostly absent. 
 The mouth is small, palate hii^h. e\'es exo])htha]mic, ears 
 larg"e with Darwinian tubercle ])rominent in tiie lelt. There 
 is marked tremor of the tonL;ue and the hands take abnormal 
 positions on extension. The skin is pale and the muscles and 
 i^'enitals are not well dex'eloped. X'ision is but one-halt in 
 either eye and his hearing- is slii^htly defective on both sides. 
 
 Medical exanhnation shows enlarged thxroid. with exoi)h- 
 thalmos and marked irregularity of ]niise rh\thm. There is 
 some cyanosis of the finger ti])s and the heart-sounds arc not 
 normal. 
 
 In school Samuel has never learned to read, ^'pell, u.se num- 
 bers, or draw. He is not neat in kindergarten work- and 
 "dreams" to nuich to do well in calisthenics, lie attends to
 
 138 I'.ACKWAKl) AM) FEEULE-MINDKL) CIIir.DREN. 
 
 his teacher but seldom to his task, lie gets on weU with the 
 other children and his worst fault is stated to be his "dreami- 
 ness". 
 
 The Ijinet examination gives Samuel a mental age of 
 seven years, with a retardation of three vears. He could not 
 tell which was his right hand, did not know his age, could 
 not copy a diamond shape nor give correctly two details of 
 a news item read to him. He was unable to coiuit stamps, 
 or backwards from twenty. lie makes infantile expressions, 
 as when he said. "Rags can't tore, have to cut 'em," and 
 "You can't tore rag's." His articulation is somewhat defec- 
 tive. 
 
 He could not Ije taught to use the si)irometer, because of 
 his "fooling" and hi> ignorance together. Then he sat down 
 with me and suddenly broke out with a vivid description of 
 his mother cooking nice |)ork and cabbage, at home, and of 
 the nice fire there with lots of coal ; and his eyes brightened 
 and he grew intelligently enthusiastic about these home 
 scenes. This was all done, however, in a ((uiet, dreamy sort 
 of way. In school he sits "dreaming" instead of working. 
 I note that he watches me with interest when he thinks he 
 is unnoticed. He seems to see the fun that there is in things, 
 in his simple way, but he does not have normal control of his 
 laug^hter. 
 
 In this case of mental and ])hysical retardation associated 
 with th_\roid mis-functioning we find some interesting" s\'mp- 
 toms and trails (|uite other than those of the ordinar\' dull 
 child. It is til be hripcd that Samuel may come urider further 
 observation.
 
 n IXICAI. SITDIl'S Ol" I'.ORni"!^ CASI'.S. 
 
 139 
 
 Kcjiih'lli ,1/., . ! '^c Sti'citlccii ]'car. 
 
 CASE 31.. — .Dull 
 and Infantile. Dwarf- 
 ed Physically and 
 Mentally. Premature 
 Senescence. 
 
 Kc'iiiR'th is a liltlf i'uli^li dwarf wlm lias l)cen at llie insti- 
 tution since .Marcli. n>0')- -^^ 'i*-' ^'^s at his desk in >ch()(il 
 he would he mistaken for a hoy of nine years. ( )ntdoors his 
 l)eculiar walk, his wrinkled, wiz- 
 ened face and "old" manner, ^.^ive 
 him the ajipearanee of a little old 
 man. 
 
 1 lis father is hut slightly over 
 five feet in height and the mother 
 is still shorter. The}- are sim])le, 
 mild-mannered "peasant" folk, 
 
 and api)ear to he healthy, as does Kenneth's brother, an a])- 
 ]Kirentlv intelligent ho}-. Kenneth weighed but four pounds at 
 birth and was ill most of the time till his tenth x'ear. 1 le "did 
 not grow," did not liegin to talk until his fourth year, and had 
 diphtheria severely at hve years. At seven years his mental 
 peculiarit\- was first noted in his lack of memory and of com- 
 prehension. I le spent alii>ut seven years in school, with little 
 progress. 
 
 Phvsically the bo}' weighs but forty-nine ])ounds and is 
 three feet eight and a half inches tall, llis hea<l is twenty- 
 eight mms. below the normal in girth and twenty-one mms. 
 below in length, l)Ut exceeds the normal breadth by seven 
 mms. llis strength of gri]) and lung capacity are those of a 
 small child, and his rate of tapping is ])roporti()nately slow, 
 llis vision is defective in both eyes, his hearing is normal. 
 
 lie has a very broad face, small mouth, irregular lower 
 jaw anfl a uvula that is diminuti\e or wanting. Mis eyes 
 are widelv sei)arate and seem small, |)robably the ])alpebral 
 fissure is short. The skin is somewhat wrinkled and leath- 
 ery. He is pot-bellied, the genitals are al)normall_\- small, and 
 there is a small right inguinal hernia.
 
 140 
 
 llACKWARI) AND FEEBLE-. M I NDKD CHILDREN. 
 
 Tn school Kennetli reads fairly in the third reader, adds 
 and subtracts, and in other subjects does about the work of a 
 
 KENNKTIT AL AXI> PETER A. 
 
 ten-year-old boy. He attends well, j^ets on well with (Others, 
 and is not credited with haviiii;' anv "faults". Every one 
 notes his bashfulness. He jdays second cornet in the insti- 
 tution l)and and his instructor states that in nine months' 
 work he has only fallen about one month behind the normal 
 progress, but that he is sliiihtK- below normal in musical 
 ability. 
 
 Tn the I'inet examination Kenneth earns a mental age of 
 nine with a retardation of seven and a half }ears. He was 
 interminably slow and hesitant in his reactions, and infantile 
 in his speech and manner. His responses are weak, with lit- 
 tle spontaneit} or self-assertion. He is extremely sensitive,
 
 ci-i\ic.\r, STi'DTEs oi" I!(»ui>i-:k ("ASKS. 141 
 
 and is about as frail iiu'iilall}- a^ he is insii^iiirK-ai)l boclil}-. 
 I lis iiKMilal ways as well as his ai)i)earanee and walk impress 
 nie as do those of a feehle old man who is not ver}- sure of 
 himself in an\thing". 
 
 The attempts at stor\ reprocjuction and invention and at 
 g'ivin.t;' o])i)osites and similar> >how the same feel)leness of 
 ]XM-fornianee. He writes (|uite as a little child draws, givini;- 
 onlv some main lines of his thou,L;ht with i^iarin^- omissions 
 as viewed from aii}" loi^ical stand] )oint, just as in children's 
 drawing's. What he writes is hut a sketchim;- aiciniipiinimcut 
 to his thought, simplified to the last degree, but suggesting 
 after all that his tluuii!^ht has had a natural se(|uence. In- 
 deed the latter is the case more often than would a])pcar trom 
 hastv glances at these children's compositions. 
 
 His spelling is fantastic. I^xam])les are -u'aiiDn for z^'oiinin. 
 fO!j;catcr for foj^cthcr, z^'cttcr for -c^'utcr. s faces for stuliic. cha! 
 for checks, bci:;crf for lh\i:,(.iii, c/iidrcii for children, tr^dif Un- 
 iii^aiit, ■K'heiit for -u'Ciit. lie uses few cai)itals or punctuation 
 marks, and these are mis-placed. 
 
 Further inter|)retation of this as of man}' of the other 
 cases is advisedly postponed to a later time. We nvcd to 
 have man}' careful studies of similar cases, and the observa- 
 tions should be continued through a tenu of }ears. \\ hat is 
 the uatm-al life C}cle of such a child as this? What of the 
 man\' lives that seem l)orn to run a brief and "telescoped" 
 course, ])h\'sicall}' and mentall}', amounting even to juvenile 
 senescence? What of the "going back" so often reported 
 in the institutions and not always a matter of e])ile])tic de- 
 terioration? We shall hope that the life-courses of t\pical 
 cases will be studied and followed with care, for it is onl}' 
 from such bases that valid conclusions are to be drawn.
 
 142 
 
 DACKWAKD AND F1-:K1!LE-M I NDED CHll.DKKK. 
 
 Frit:: A., A^^c Tivclvc Years. 
 
 CASE 
 
 32. — D 
 
 ull 
 
 and 
 
 Infa 
 
 ntile. Th 
 
 iev- 
 
 ing 
 
 and 
 
 Lying, 
 
 but 
 
 with 
 
 out 
 
 Malice. 
 
 
 Fritz is a slender, dark-eyed boy who meets you with a 
 peculiar, fixed gaze that seems to express the deepest interest, 
 but is i)robably rather of the nature of an automatism. He 
 
 belongs to the dull group ; but 
 his voice for singing, his interest 
 in hearing and re-telling stories, 
 and his petty thieving tend to 
 give color to the case. 
 
 Me has been in the institution 
 for two years, coming from Chi- 
 cago. His heredity seems to be very fair but he is stated to 
 be the seventeenth child, twelve of the children being "dead 
 babies." h'ritz was born prematurely at seven months and is 
 said to have weighed but two pounds! lie was always deli- 
 cate and backward in growth and did not begin to talk until 
 he was two years of age. 
 
 He is more than four pounds above in weight and one and 
 three-tenths inches above in height. His head is nineteen 
 mms. too small in circumference, the deficiency being mainly 
 in breadth. His spirometer test is a little above the normal, 
 and in strength of grip he is not far from normal but is dis- 
 proportionately strong with the left hand. His vision and 
 hearing are normal. 
 
 Idle u]iper teeth are separate and notched, but in fair con- 
 dition. The uvula and soft palate are defective. The nails 
 are unusually short. The bodily attitudes taken suggest lord- 
 osis. Medical examination adds onl\' that his peripheral cir- 
 culation is not very good. 
 
 In school Fritz reads pretty well in the first reader, adds 
 and subtracts a little, and has reached his fifth table. His 
 teacher is well satisfied with the simple work that he attempts 
 in spelling, drawing", manual work and calisthenics. Fie is a
 
 ci-iNUwr. s'rrii]i:s <m- iiokdiok casks. 
 
 14.^ 
 
 j4i)(i(l (lancer, ■"allcnds" well, and is oiil}- lri)ul)K>omc by his 
 ])ctt\' lhic\-in,L;. which he "lies out nl" when ixissihle. I!i> 
 attendanl re])()rts thai he is ""kind u|' >neakin^ ' and that he 
 "steals a lot."" I le assists in the entertainnienl>, sin.uin;^' with 
 a rather sweet voice; and he ainust-s hy telling stories ot wliat 
 he sees in the institution's ])ictiu"e-show'^. Mis tales, how- 
 ever, do not hear \'erihcation vcr\- well. 
 Mentally h'ritz tests to the level of 
 seven and a half \ears with a retarda- 
 tion of three and a half years. Mis 
 s])cech is sli,ulul\- defective. I ie 
 worked tweh'e luinntes tr\in^" to i)ul 
 to.i^ether a^ain the two i>ieces ot a 
 rectanj^ular card that had l)ccn cut 
 diagonally and separated, and lie failed 
 in the end. Me fre<|tientl\- made in- 
 congruous and rather silh replies, an- 
 swering "twenty-four" when asked 
 how many hngers on Ijoth hands, an- 
 swering "Saturdax'"' when asked to 
 give the year, and sa\ing "twent\'- 
 two" for "four" when comiting hy 
 twos. "Take m_\- picture taken Satur- 
 day" was his suhstitute for "Take m\- 
 ])icture Saturday." ( )n another occa- 
 sion in telling of a strav dog he said 
 "I lis name's Charlie l^'rancis. wc call 
 him a dog." Dtiring the testing he 
 (lived into drawers and cases in s])ite 
 
 of commands to let things he, and teachers sa\' that he does 
 this in school and that he steals "right and left." Me did 
 not steal in this lal)oratory-rummaging, but seemed to rum- 
 mage as a sort of automatic necessity, mixed with some cu- 
 riosit}^ 
 
 l-l;!'!/ A.
 
 144 r.ACKWAKI) AXD FEEBLE-MINDED CIIII.DKKX. 
 
 His tendency to automatism appeared in his association 
 reactions, twenty-one in the one hundred trials being made 
 in exactly his mechan time of two seconds. Sixty-six times 
 he reacted with phrases or sentences, all but two being of 
 the nature of definitions. His associations are very simple, 
 rather ])uerile and naive throughdut, Init they are nearly all 
 naturally related to the stimulus, not senseless or bizarre. 
 
 b'ritz writes legibly, but utterly failed to use writing in the 
 tests that required it. When permitted to reproduce one of 
 the stories orally he told a pleasingly fluent story, short and 
 in the manner of a young child, and not very correct, but 
 with a simple harmony of ideas that hid the actual confusion 
 of memorv. 
 
 Jle merel}- copied the opposite and similar lists. When 
 asked to arrange the i)hotographs of our buildings as they 
 stand he placed them in two straight parallel lines along one 
 edge of the table. He steadily and rapidly increased his 
 speed of crossing A's and of placing the form board blocks, 
 from very weak beginnings. The tendency to automatism 
 here has a chance to exercise itself, without the necessity of 
 much real learning. 
 
 In general the tests and observations show us a child who 
 is clull and infantile, with few ideas and these confusing eas- 
 ily ; with rummaging and ])ilfering habits that are little re- 
 moved from the uu-mo^al ways of a \-ery young child in its 
 relations with pr()i)erty ; with a general feebleness and im- 
 maturity of mental ])erformance that seem of a piece with 
 the history of premature birth and weakness in infancy ; all 
 indicating a condition of congenital defect that will not be 
 outgrown. He can be made useful and happy under perma- 
 nent direction in souie well-chosen industrial occupation, and 
 in an environment 'where he need not be held to the adult 
 standards as to relations with projiert}- and facts.
 
 CI.INJCAL STUDIES OF JJUKDlvK CASKS. 
 
 145 
 
 riiicciit C, . i^T I'onrtccn Years. 
 
 CASE 33.— 
 
 Dull, 
 
 with Special 
 
 Diffi- 
 
 culty in the U 
 
 se of 
 
 Language. Physical 
 
 Stigmata. Th 
 
 eving 
 
 and Untruthful. 
 
 Nor- 
 
 mal Work in M 
 
 usic. 
 
 Vincent, another of our dnll l)(i\s. has Ix-cn liere since 
 KJ04. I li^ iiiolher was l)nt hftc-cn years old at his liirth. and 
 it is statccl ih.al she was epileptic. 'Idle home record ^ives 
 httle more c'.\ce])t that it seemed 
 impossihlc tHr tlic child to re- 
 member, and that he was nn- 
 trnthfnl and had "a tendency to 
 take anythins^" he sees whether 
 of value of not." He attended 
 school since becoming' of sch()ol 
 age. 
 
 Physically A'incent is slightly 
 above the average for his age in weight and height, and is 
 sixteen mms. above in cranial circumference. Mis lung ca- 
 pacity is approximately normal, but he is somewhat inferior 
 in strength of grip. The right eye has but two-thirds vision, 
 and there is strabismus. His hearing is normal. His head 
 shows some asymmetrical irregularity, the lower li]) has a 
 deep median vertical fissure, the upper incisors point toward 
 each other decidedly and are a little separate from the others, 
 and the lower middle incisors are n(^t well developed. He 
 has a diminutive uvula, short nails, and stuljby fingers thai 
 are over-tapered toward the ends. He has not had a medical 
 examination, 1)ut ai^pears to have good health. 
 
 In school \ incent has most tronble with reading, being in 
 the second reader class and poor at that. I le does soiue y:)rob- 
 lems in multi])lication and division and is reported "satisfac- 
 tory" in spelling, drawing, industrial work, calisthenics, and 
 especially in band work. He attends well in certain subjects 
 and badly in others, the personal relation with the teacher 
 seeming to have most to do with this. He plays solo horn 
 in the institution band, is an "excellent si"ht reader" with
 
 14') liACKVVAKD AND FEEBLE-MINDED CHILDKEN. 
 
 "normal musical ability," and from Thursday to Sunday will 
 learn a new selection to play as a solo for the chapel serv- 
 ice. On the other hand Vincent's attendant finds him to be 
 a great disappointment. He seemed to be one of the bright- 
 est boys when he came, but has "turned out to have little 
 sense," "not so much as he had." besides, he has a reputa- 
 tion for thieving'. 
 
 The mental examination gives Vincent an intelligence level 
 of ten and a half years, a retardation of three years. His 
 speech is defective for certain sounds. His reading is all 
 but impossible. He could not detect the nonsense in silly 
 statements, could not construct sentences which would use 
 three given words, etc. He tends to remain silent, giving 
 up the task if it is difficult. He shows no spontaneity, has to 
 be stirred to thinking and tends to lapse into a condition in 
 which he seems to be complacently void of ideas. 
 
 He said he passed through several "countries" on his way 
 here, but could not name any town that he passed. He 
 knew the name of his home town but had no idea where it 
 was. He talks in a very confused way of his pre-institution 
 experiences. He is apt to gaze at one fixedly without speak- 
 ing when one \V(^uld normally say something. His teachers 
 report that he has silly ways of laughing and talking, and 
 that he lies and uses profane and obscene language. 
 
 The written tests reveal mis-spellings and mis-writings 
 that amount to a form of agraphia. Much of the writing is 
 utterly illegible and the lines deviate from the horizontal by 
 as much as forty degrees. He writes mavmcs for marble, 
 shicks for checks, read for red. hitir and hire for her, bift 
 lire for icife liz'cd. sciirk and curk for struck, beiii!;ap for 
 bci^an. crow for ^totc. /;/;-// for fiini. luoom for wojiian, pech 
 for piece. These arc but a minor part of his mis-writings. 
 Yet so far as his writing can be read it indicates that his 
 thought has been proceeding naturally, if simply, but it has
 
 t'i.::\itAL S'LUDJKi OF UOKUEK CASKS. 14/ 
 
 been c)l)ScurL(l b\ his defective means of expression. There 
 seems to be a fnndaniental defect of language which may ac- 
 count for nuich of N'incent's trouble wiih and dislike for his 
 school work. It may ])ossibly accounl. as well, lor his con- 
 fusion of certain memories. 
 
 \\\' have here a boy who has some resources along with 
 some decided defects. Much n,a\- be done for him by util- 
 izing the former and minimizing the effects of the latter. The 
 defects, however, seem to be ])art of a fundamental lagging 
 in develo])mcnt which J am not sanguine of seeing removed 
 b\' an\' treatment.
 
 148 IIACKWARI) A.\]i FEEBLE- :\1 1 XDED CHILDREN. 
 
 David F., As'e Niiictd'n Years. 
 
 '.i' 
 
 CASE 34. — Dwarf- 
 ed and Apparently 
 Hydrocephalic. Dull, 
 but Well - Balanced. 
 Industrious and 
 Trustworthy. Lacks 
 Self - Direction and 
 Spontaneity. 
 
 David is one of the institution's steadiest and most reliable 
 boys, here since June, i<)02. His large head, short stature, 
 slow and even gait, make him a familiar tigure about the 
 
 institution. There is no record 
 as to his fan.iily, and we know 
 onlv that he had been in one of 
 Chicago's charitable institutions, 
 that he was in school three years, 
 and that he was considered to be 
 hydrocephalic. 
 
 Physically he is about forty 
 pounds below the normal in. 
 weight and 8.7 inches below in 
 height, and of stocky Iniild. 1 lis head measures thirty-three 
 mms. more than the normal circumference, and is asymmetri- 
 cal in total configuration while fairly regular in details. He 
 shows seventy-six cxi. in. less than the lung capacity usual 
 to his age. and his strength of grip is one-third less than the 
 normal. \'ision is but two-thirds in either eye, and his 
 hearini2f is sliHuh- dull on the left. 
 
 His lips are thick and his [)alate is square-angled, flat, 
 and broad. The palpebral fissures are not large, the skin 
 is dark, there is slight lordosis, and the general body bal- 
 ance is not ver\- well maintained. There has been no medical 
 examination, but he has been considered to be healthy. 
 
 Tn school David reads "very intelligently'' in the fifth 
 reader, works problems in fractions and even some in "In- 
 terest." is good at spelling and fair but not neat in drawing. 
 He is awkward in calisthenics and in dancing. In manual 
 work he is very satisfactory, "has ideas" and uses them in 
 arranging his work, chooses the right tools and goes ahead 
 using them with skill. He recognizes his mistakes, of him-
 
 CL.INICAr. STI'DIKS Oi" IU)RI)I-:K CASl'.S. 
 
 149 
 
 self, lie shows niucli interi'sl in lii^lDry, alleii(l> well, j^eis 
 on well with others, is irustwoiilix . eU'anlw and ■"newr ox'ts 
 excited." He plays solo )'> llat clarionet in the band and 
 orchestra, makes abonl normal ])nl!4re-^s here, and "will he 
 
 DAVID F. 
 
 a good sight reader and a good clarionetist," to quote his 
 instructor. 
 
 When questioned David readily told nie the capitals of 
 California, Texas, IlHnois, and the United States, the names 
 of the largest and the smallest ocean, the boundaries of his 
 own state, the name of the largest city in California, in Illi- 
 nois, and in the United States, etc. lie said the T\e\olnlion
 
 150 r.ACKWARD AXD FEEliLK-M IXDED CHILDREN. 
 
 occurred because England would not let the colonies send 
 men to Parliament to help make laws. His answers were 
 given in a uniformly intelligent manner. 
 
 Fairly informed and well-adapted as he seems to be in the 
 knowledge current in the school, the request to do a few 
 simple operations with numbers gave a significant kind of 
 failure : Asked to multiply 20 X 476 he was completely 
 confused and finally gave as the product 116^3. He divided 
 a five-place number bv 2Tf, correctly enough until he obtained 
 a remainder of 16, which he added to the quotient as .16. 
 This does not mean that David cannot think. He daily 
 proves that he can think in the shoe shop and manual train- 
 ing room. But it does show that with these abstractions 
 thinking was at least very difficult for him. 
 
 Examination with the Binet scale gave David a mental 
 age of eleven and a half \ears, a retardation of seven and a 
 half years. He was steady, without a trace of confusion 
 or emotion. Even the presence of a roomful of visitors did 
 not atTect his responses. ( )n being partially re-examined 
 later he gave about the same results and with the same 
 equanimitw He shows some distinct defects of articulation, 
 but otherwise his reading of an ordinary page was fluent 
 and was practically without errors, though with a reading- 
 class drawl. His reactions in these tests were sane and 
 sound as far as his mental resources permitted him to go. 
 but he was not very spontaneous or able in his thinking, 
 and was slow and easy-going. 
 
 In the written tests his handwriting is rather awkward and 
 scrawled, but is fairly legible. The capitals and marks are 
 usually correctly placed, and he rarely mis-spells. His com- 
 position shows logical and natural sequences thruout, but 
 with no originality anywhere, except that in making up a 
 story of the trip in a flying-machine he reviewed a few geo- 
 graphical points that one might cover in such a trip. The
 
 Cl.lXKAI. S'lL'DJl'.S Ol' I!0U1)1-:K CASES. 15I 
 
 results in all these tests show steady, effective work of mod- 
 erate quantity and quality, on the whole hardly slronijer than 
 his Rinet level would suggest. \'isual defect nia\ have had 
 to do with the fre(|uent omissions in tlu- A-test. I lis ahnor- 
 niallv slow rate in ta])])ing with either hand reminds u> of 
 his awkwardness and slowness oi movement in various kinds 
 of activity. 
 
 David's phlegmatic disposition and trn>tworihy moral 
 character give him a great advantage in making social adap- 
 tations. He has worked faithfullx at shoe-making until he 
 practicalK' knows the Inisiness in its simpler details, and he is 
 inclined to follow it as a trade. 
 
 We have here a l)o\' who is hut very little helow the l)order- 
 line of feehle-mindedness, and who is so happily balanced in 
 his reactions and conduct that his readiness to conduct his 
 own affairs is apt to be over-rated. lie proved the latter b\- 
 a test of his own contriving: Prompted j^robably l)y the ex- 
 ample of more restless spirits rather than by inherent discon- 
 tent, lie ran away and remained away for some little time. 
 r>ut he was unable to "make it go" or to know what to do, 
 though abundantly able to earn a living at sh(X'-repairing 
 or at other work. He was iinally returned, has seemed to be 
 more contented, and is doing well. 
 
 Such a child must be trained to a self-supporting occupa- 
 tion, must be furnished permanent, kindly, directive control, 
 and must in some way be jjrevented from rej^roducing his 
 kintl. At present, institution life is the solution. But chil- 
 dren of this grade can seldom be retained in institutions ; 
 and for still other reasons society should undertake the task 
 of adapting and caring for such children in their habitat. 
 Social agencies in the home city should be fitted and em- 
 powered to exercise the necessary control, and these agencies
 
 152 BACKWARD AND FEEBLE-MINDED CHILDREN. 
 
 together with special schools must solve the problem of 
 fitting such children to render useful service in their natural 
 environment. Under such a regime David would support 
 himself in society as a contented shoemaker, would help to 
 entertain the conmiunit\- with his music, and would be made 
 to live the life of a useful if humble citizen.
 
 CLINICAL S'JL'DILS OF BORDICR CASES. 1 53 
 
 Theresa II.. Colored. .C^e Sixteen and Oiie-halj Years. 
 
 'Ilie case of this culorrd '^\v\ is (if inUTcst because she has 
 sliown, ill ihe tests, a stronger meiUahls tliaii ha\e any of 
 the others, and has earned the rij^ht to he ^^rouped with cer- 
 tain chisses of normal children. 
 
 She came to Lincoln from one 
 
 of Chicayo's charilahle institn- 
 
 CASE 35.— Practi- 
 cally Normal Intelli- 
 gence. Musical, and 
 Skillful at Work. 
 Sulky in Manner, 
 with Outbreaks of 
 Stubbornness. A 
 Problem of Social 
 Adjustment Outside 
 of Institutions. 
 
 tions, anf! nothnii; eonld he learn- 
 ed of her faniih. She was horn 
 in Kansas, was inclined to he dis- 
 obedient and s]>unk\ and at times 
 refused to work. .She anuised 
 herself b\- reading and had been 
 in school two years. She tells 
 me herself that she was first in 
 a (hicae'O Home for the h'riend- 
 
 less, then in an Industrial School till she finished the fourth 
 grade work, then in a jirivate home till she finished liftii 
 grade school work, and was then ])laced in the charital)le 
 institution whence she came to Lincoln. Ilere she has 
 worked in the laundr\' forenoons and attends school after- 
 noons, taking onlv sewing, nuisic, and calisthenics. 
 
 Phvsicallv Theresa is ten ])Ounds hea\'ier and an incii 
 taller than most girls of her age. I ler head has tweiUy-two 
 mnis. UKjre than the normal circumference, the excess benig 
 in the unusual development of the forehead, which ])rojects 
 far beyond the eyes. The jaws also project well forward, 
 the base of the nose is low. the lips are thick, the thyroid 
 is slightly larger than normal. She has a slovenly, untonecl 
 carriage in walking and when seated, but shows no other 
 bodily defects. ^Medical examination revealed some impair- 
 ment of the right lung, but her health is generally good. 
 Ller lung capacity was twenty-nine ciL in. below the normal.
 
 154 
 
 UACKW AKD AND FEEBLE-MINDED CHILDREN. 
 
 but in strength of grip she exceeded the normal with the 
 right hand, and lier left was three kilograms stronger yet 
 than her right, though she is not left-handed. Her vision 
 and hearing are normal. 
 
 In school she gets on well with others and attends as weil 
 
 as normal girls usually do. 
 Tn the calisthenics class she 
 is called the best pupil. Her 
 violin teacher is very proud 
 of the progress that Theresa 
 makes. She likes her music 
 and "sticks to it," learns her 
 ])ieces aptly and well, and 
 for a good while has played 
 violin selections in the 
 school entertainments. In 
 the sewing-room she does 
 her work beautifully. She 
 works slowl}-, but the work 
 is of fine quality and she 
 readily catches new ideas 
 about it. She is very quiet, 
 talks iileasantly with the 
 girls but not with others, 
 nods her head or hardly re- 
 plies when spoken to by her 
 teachers, and regularly 
 maintains a sulky attitude 
 and manner. Sometimes 
 she has to be coaxed to go 
 to her class exercises, but she goes. The girls all seem to 
 like her in spite of her color and her sulky manner. 
 
 In the mental examination she passed all the Binet tests 
 through twelve years, passed the first paper-cutting test and 
 
 THERESA H.
 
 ci.i.NMc.M. sin)]i;s (w- 1!()KI)i:i< r.\si:.s. 155 
 
 the test for opposites, and canK'(l half criMlit in another of 
 the tests for fifteen AX'ars and ahii\-c. Slie wa^ q-iven only 
 iouv ui these /;;i^7/rr tests of the ^cak^ as this pari of it was 
 not yet formulated. 1 ler respon>es were intellii^ently j^iven 
 and showed alisolute steadiness and eontrol. 
 
 In the written tests her handwriting' i> le^ihle and nor- 
 mal. Every word is s])elled eorreeth', inehidinL; sneh words 
 as pedestal, beautiful, statue. Christmas. Court House, quar- 
 rel, and prettier. She uses few ea])itals and mark>. Iler 
 eoniposition is not infantile thou.i^h fairl\' sim])le. and shows 
 normal se(|nence.s generally, in one ])laee when tellini;" of 
 the bean's narrow escape from death she makes him sa\, "I 
 have just escaj^ed a narrow death." She is too >low to .give 
 a very large output in the stor\- re])rodueiion and invention, 
 hut what is given is of normal qualit}- th.ough showing hut 
 little imagination. She wrote ten opposites in the first min- 
 ute of the test, and wrote all of the op])osites and similars 
 correctly. She crossed 05 .V's in two minutes at the tirst 
 trial and all of the too at the second trial. She made no _ 
 errors liere, and gave no incorrect details in rei)roducing 
 stories. All this speaks well for the normality of her intel- 
 ligence. 
 
 The attendants find Theresa to be a most capable laun- 
 dry worke\ . who does nicely the finer as well as the heavier 
 ironing, and is able f(M' "the work of an attendant" and who 
 generally works pretty well. I'.ut by times she becomes sul- 
 len and stubborn, and may refuse to work. In these moods 
 she has even gone so far as to take a hot knife an<l brand 
 other girls, causing, however, only superficial burns and 
 probably not intending to injure them seriously. 
 
 It is the ca.se of a girl wdiose intellect is of a strength to 
 float her at work in society ; whose intellect is not only of suf- 
 ficient quality but, unlike that of Prudence S. and Viola H., 
 it is not frail, does not show tendencies to confusion. TTow-
 
 156 BACKWARD AND FEEBLE-MINDED CHILDREN. 
 
 ever, in the levels above twelve years of mental age, defects 
 when present are apt to manifest themselves on the side of 
 the feelings and the emotional control, in will and action and 
 in the social relationships. With Theresa there is some ab- 
 normalit}- in all of these. She works too slozi'ly for the pace 
 of life outside, does not get very much done in spite of her 
 good quality of performance, and rightly or wrongly is really 
 accounted to be lazy. She has a dogged, sullen attitude, with 
 difficulty in maintaining normal social relationships; and al- 
 lowance must constantlv he made for these peculiarities, al- 
 lowance, however, which is not so readily granted outside 
 of such institutions. While not explosively emotional, Ther- 
 esa has a "sneaking way of getting even" and of getting out 
 of things, and her abnormal sulkiness could easily be trans- 
 formed into viciousness. 
 
 Still, this girl has quite as good a mind as thousands of 
 colored' girls who are making their own way outside. She 
 is not "feeble-minded" in any technical sense, and T should 
 like to see her tried at work outside, if possible under proba- 
 tionary direction with at least the privilege of return if that 
 should seem best.
 
 chapti:r v. 
 
 TAIU'l-ATI' )XS Ol' DA'IW. Sr(^( ll-.STF.H CROrPS, 
 AND LI.\I':S ()!•■ TKAXSITK ).\ !• K( )M I'l'.i'.l'.LE- 
 MINDEDNESS TO NOK-l-'EKilLK-Al 1 XDEDX I'LSS. 
 
 S(ime of the iiu'asiircnK'iits and tests have l)een made on 
 praeticahx- all of the eases. The resnlts of most of these, as 
 far as the\- len.d themselves U) numerieal statement, are 
 broui^ht together in the tallies of iMgs. 31-35- ^^ '^^ ^" ''^' 
 remembered, however, that the i)nr])ose of these studies has 
 been elinieal and not statistieal ; and for the most part it is 
 ])etter, for the present, to refrain from making- o-eneraliza- 
 tions npon the averages stated. Man_\- of the tests have been 
 snfificienth- deseribed in the slndies themselves, or are al- 
 readv familiar from other sonrees. 1 shall here state l)rietl\- 
 the eonditions and norms observed in eertain oi the tests 
 and measurements, information as to the others being easily 
 accessible in the manuals of tests. 
 
 The l*>inet scale was used in the form i)ublishe<l b_\- Ibnel 
 in 1908. Dr. Cioddard is doubtless right in considering that 
 this scale measures the amoimt of retardati(tn about as cor- 
 rectlv as does an\- later revisiou. It includes tests for read- 
 ing, writing, memorx' for what is read, etc., which nw s()iue- 
 times referred to in these studies, and winch are not in the 
 revised scale. Their nature, however, is doubtless sutTi- 
 ciently clear from the references to them in the studies. 
 Reliance has not been placed on the old test^ for the fliir- 
 tCi'ii-ye'dV level, which were too dirticult. and which in anv 
 case were seldom reached 1)\- our children. The tests were 
 applied essentialh' as directed in m; s\llabus of them. ])ub- 
 lished in the Jountal uf Educational J'sycholo,^}' for Oc- 
 tober, 1910. 
 
 157
 
 158 
 
 IIACKWAKD AXD FliEULE-AlIXDED CHILDREN. 
 
 
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 1-K) 
 
 
 
 
 HN 
 
 
 HN 
 
 HN 
 
 
 r* 
 
 
 
 
 
 bo 
 
 CO 
 
 Ol 
 
 
 ■1 05 
 
 CO 
 
 I— ( 
 
 I— ( 
 
 CO 
 
 ■^ 
 
 liD 
 
 CD 
 
 CO 
 
 •* 
 
 o 
 
 CO 
 
 in 
 
 lO 
 
 lO 
 
 a a 
 
 
 1-1 
 
 T-H 
 
 T- 
 
 ■H 1-H 
 
 1—1 
 
 1—1 
 
 l-H 
 
 r-H 
 
 1— ( 
 
 r-< 
 
 CO 
 
 1—1 
 
 1—1 
 
 1—1 
 
 1—1 
 
 
 
 
 1 * 
 
 
 
 ffi 
 
 <j 
 
 7 
 
 5 ^ 
 
 2 
 
 ^ 
 
 < 
 
 ^ 
 
 K 
 
 ^ 
 
 fa 
 
 i-j 
 
 Oh" 
 
 1-5 
 
 d 
 
 
 wis 
 
 
 
 O 
 
 U 
 
 o 
 
 c 
 
 5 Q 
 
 fa 
 
 fa 
 
 fa 
 
 o 
 
 ►-5 
 
 \^ 
 
 § 
 
 ^ 
 
 D5 
 
 m 
 
 ><:q3<<oh<i3 

 
 TACULATIU.X 0\' DATA. 
 
 15>.' 
 
 
 2 
 
 lA 
 
 
 
 OS 
 
 Oi 
 
 - 
 
 - 
 
 
 c^ 
 
 
 
 
 r- 
 
 
 -< 
 
 us 
 
 
 e* 
 
 e<i 
 
 
 
 in 
 
 e* 
 
 Oi 
 
 o 
 
 i 
 
 
 ^« 
 
 o 
 
 
 OS 
 
 
 *1 
 
 Q< lA 
 
 •d . 
 
 z 
 
 Z 
 
 Z 
 
 2 
 
 2 
 
 z 
 
 o 
 
 Z 
 
 z 
 
 z 
 
 z 
 
 z 
 
 z 
 z 
 
 z 
 
 z 
 
 z 
 
 zs 
 
 
 z 
 
 a 
 
 Z 
 
 2 
 
 a 
 
 z 
 
 o 
 
 Z 
 
 a 
 
 z 
 
 z 
 
 z 
 
 z 
 
 z 
 
 z 
 
 z* 
 
 w 
 
 I 
 
 cc 
 w 
 
 fa Q 
 
 X 
 
 o 
 o 
 
 >« 
 
 Q 
 
 « . 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 »Ti 
 
 c~ 
 
 1— ( 
 
 -" 
 
 CO 
 
 z 
 
 
 t-H 
 
 » 
 
 -r 
 
 e<i 
 
 CD 
 
 OJ 
 
 CD 
 
 CO 
 
 r- 
 
 CO 
 
 »— 1 
 
 C0 
 
 r» 
 
 >.^ 
 
 
 lA 
 
 
 
 lA 
 
 nri 
 
 
 
 lA 
 
 (M 
 
 r^ 
 
 CD 
 
 CO 
 
 ce 
 
 l-H 
 
 »-H 
 
 w 
 
 
 Q 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 t; c 
 
 lO 
 
 C^ 
 
 t-l 
 
 00 
 
 T— 1 
 
 (M 
 
 OS 
 
 .. 
 
 00 
 
 lO 
 
 CD 
 
 e<i 
 
 eM 
 
 «5 
 
 OS 
 
 LC 
 
 lA 
 
 O 
 
 a . 
 
 CO 
 
 nn 
 
 lO 
 
 r^ 
 
 (M 
 
 fTl 
 
 r— 
 
 r^ 
 
 o 
 
 O 
 
 CO 
 
 « 
 
 (35 
 
 «^] 
 
 lA 
 
 CD 
 
 w 
 
 '^ 
 
 
 •—1 
 
 CO 
 
 ^ 
 
 OJ 
 
 
 ^ 
 
 e<i 
 
 
 (M 
 
 (M 
 
 T— ( 
 
 
 e<i 
 
 M 
 
 eo 
 
 
 « 
 
 
 
 
 ^;e 
 
 W.£ 
 
 
 bo 
 
 0) 
 
 z z z 
 
 ^ ;C ;& lA 
 
 iAe<icc-^'M<*e>i'-7e<i>T-!cr— ^ 
 
 _ - - 5_, _ 
 
 ae 
 lAcgiAiAe^ e^]eJ^7^Q^^■e<I oo O 
 
 z ^ z 
 
 iM CO CD M C^l OO 
 
 OJ lA ^ M t^ 
 
 -< t^ cDLO-^e^i cot— — < o 
 e^iLOl'COOoe^aOJrt ^^ 
 
 oe M LO t- ^ 
 
 oe OS <3- 
 
 Oi Tt » e^ M Oj *r 
 
 a 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 ce 
 
 w 
 
 ■* 
 
 lA 
 
 CO 
 
 
 Z 
 
 ao 
 
 CO 
 
 c- 
 
 ae 
 
 CD 
 
 CD 
 
 ec 
 
 00 
 
 ce 
 
 ce 
 
 •!P 
 
 CO 
 
 e>] 
 
 s 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 •9" 
 
 
 M 
 
 
 IM 
 
 ce 
 
 (M 
 
 ^»" 
 
 M 
 
 'H 
 
 lA 
 
 r- 
 
 00 
 
 CO 
 
 <>\ 
 
 ce 
 
 "»< 
 
 r- 
 
 TT 
 
 t^ 
 
 
 
 ^ 
 
 - 
 
 M 
 
 
 M 
 
 
 
 
 
 CO 
 
 
 OJ 
 
 -• 
 
 (M 
 
 
 e>] 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 «5> 
 
 0! 
 
 CO 
 
 
 
 CO 
 
 OS 
 
 (N 
 
 X 
 
 ev] 
 
 "f 
 
 liT' 
 
 «> 
 
 w 
 
 
 ce 
 
 M 
 
 X 
 
 OS 
 
 — 
 
 0- 
 
 
 iM 
 
 T— 1 
 
 
 ce 
 
 — 
 
 (M 
 
 
 CO 
 
 T-H 
 
 
 CO 
 
 1— 1 
 
 e<i 
 
 — 
 
 C<1 
 
 »j" 
 
 
 -*->' 
 
 (M 
 
 lO 
 
 CO 
 
 00 
 
 ^" 
 
 
 t— 
 
 ^, 
 
 ^p 
 
 ae 
 
 Oi 
 
 t^ 
 
 CO 
 
 r- 
 
 00 
 
 c- 
 
 ^^ 
 
 00 
 
 
 CD 
 
 CD 
 
 
 
 SM 
 
 CO 
 
 O^ 
 
 
 ^r 
 
 e<i 
 
 1 — 1 
 
 c- 
 
 o 
 
 T-H 
 
 o 
 
 CO 
 
 o 
 1—1 
 
 
 CO 
 
 - 
 
 HIM 
 
 
 rtW 
 
 rf(N 
 
 HIM 
 
 H^ 
 
 HIM 
 
 hCJ 
 
 HIM 
 
 HIM 
 
 
 HCl 
 
 HIM 
 
 H»N 
 
 HIM 
 
 
 
 «9" 
 
 s 
 
 OS 
 
 CJ 
 
 © 
 
 ^^ 
 
 OS 
 
 O 
 
 OS 
 
 ao 
 
 ^4 
 
 o 
 
 o 
 
 O' 
 
 e^ 
 
 IN 
 
 o 
 
 ^* 
 
 r- 
 
 • 
 
 -" 
 
 
 ^* 
 
 
 ^4 
 
 
 ^* 
 
 
 
 '"' 
 
 ^* 
 
 ^^ 
 
 T-H 
 
 ^' 
 
 ^ ' 
 
 ^* 
 
 *^ 
 
 
 o 
 
 r* 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 61! 
 
 
 T*A 
 
 
 
 HIM 
 
 HIM 
 
 
 H»M 
 
 
 hKJ 
 
 
 HIM 
 
 
 
 
 
 -«j 
 
 
 
 (M 
 
 1-H 
 
 
 T-H 
 
 CO 
 
 00 
 
 1-H 
 
 T-H 
 
 T-H 
 
 T-H 
 
 CD 
 
 T-H 
 
 CM 
 
 CO 
 
 1— ( 
 
 T 1 
 
 CD 
 
 f— 1 
 
 CO 
 
 o 
 
 T-H 
 
 T-H 
 
 T-H 
 
 T-H 
 
 T 
 
 a; 
 
 o 
 
 <5 
 
 z 
 
 S' 
 
 K 
 
 ffi 
 
 ^ 
 
 d 
 
 w 
 
 d 
 
 J 
 
 < 
 
 m 
 
 K 
 
 X 
 
 ^ 
 
 r ~\ 
 
 Q 
 
 
 cd 
 
 m 
 
 d 
 
 Q 
 
 ^ 
 
 ffi 
 
 K 
 
 ffi 
 
 'B 
 
 z 
 
 Cli 
 
 Q^ 
 
 H 
 
 > 
 
 ^ ^ 
 
 ^ 

 
 l6o JiACKWAKD AND FJililJLli-M 1 XUKU Cllll.DKliN. 
 
 The norms used in the tables of Figs. 31-32 are taken from 
 the Chicago Child Study Reports, with the exception of 
 those for cranial measurements, \\hich are from West and 
 MacDonald as given by Whi])ple. The cranial measure- 
 ments are those for greatest circumference, greatest length, 
 and greatest breadth, measured with steel tape and the 
 Smedley cephalometer. The s])irometer tests were made 
 with the ordinary wet spirometer, counting the best in three 
 trials. The Smedley dynamometer was used, counting the 
 best in three trials with each hand. The tapping was with 
 the Jastrow key and the counting register was used, check- 
 ing for errors by using the k\-mograph or by careful obser- 
 vation. Both the Snellen and the McCallie cards have been 
 used for testing vision. The AlcCallie audiometer was used 
 for some of the cases, but the results tabulated are those for 
 practical normality shown in hearing low conversation or 
 whispering, at distances established as norms. The results 
 for case P. S. are not counted in making up the averages for 
 any of the tables, as it was desired to know the averages 
 only for children who were found to be defective in intelli- 
 gence. 
 
 In b'ig. 33 Story I is of "The Marble Statue," given as 
 directed in \\'hipple's Manual. It contains 166 words and 
 sixty-seven "details." Story II is of "The Straw, the Coal, 
 and the Bean." and contains 568 words and 200 "details."* 
 It was read to the children as for Story I, and the results 
 were treated similarly, in each case allowing twenty to 
 twenty-five minutes for reproduction. In almost no case 
 was more time desired. 
 
 *This is taken from a supplementary rearler. "Si.xteen Stories," published 
 liy A. Flanagan ("o.. rhicago. It is a simply told tale of the escape of these 
 worthies from the pot and fire of an old woman ; of their recounting their 
 adventures and journeying together to a stream, where the straw and coal 
 met disaster while the bean laughed till she burst her skin. She was sewed 
 uii by a kindly tailor, but still bears the scar.
 
 TAIUJLATIOX UF UATA. 
 
 10 I 
 
 MENTAL TESTS OF BORDER CASES. 
 
 Name. 
 
 Asro. 
 
 Stni-y Kefd. 
 
 F. A 12 
 
 F. J 12.5 
 
 C. H 13 
 
 E. N 14 
 
 V. C 14 
 
 J. H I 14.5 
 
 R. P j 15 
 
 G. J 1 16.5 
 
 K. M 17 
 
 D. F 19 
 
 M. E 36 
 
 Bovs' Av. 
 
 
 61 
 18 
 48 
 77 
 92 
 
 
 58 
 
 146 
 
 58 
 
 144 
 
 157 
 
 ^C2 C-il^ 
 
 story nefd. 
 
 
 feti 
 
 Story 
 Inven. 
 
 Orientation. 
 
 t.ts| rSO'i !?/5l b Ic .C5 
 
 w^: ^^1 ^ 
 
 13| 
 16 
 22 
 
 
 13 
 35 
 
 9 
 
 37 
 42 
 
 78 18 
 
 2 
 
 39 6 
 
 1 120 25 
 
 
 
 n 14 
 
 5 
 
 
 
 48 
 24 
 
 94 
 
 20 
 
 1 
 
 249 
 
 54 
 
 • 1 
 
 22 
 
 
 
 
 
 89 
 
 23 
 
 
 
 273 
 
 66 
 
 
 
 119 
 
 32 
 
 
 
 313 
 
 77 
 
 3 
 
 282 
 
 73 
 
 3 
 
 145 
 
 34 
 
 2 
 
 29 15 
 33 22 
 
 48' 
 
 82 
 
 
 53 
 66 931 21 14 1 
 
 13 
 
 0' 54 
 0j__- 
 
 17 
 76 
 
 «1 
 107 
 
 41 100 
 
 37 32 
 
 W D. 
 
 12.5 
 11 
 
 
 1 1 ! 
 
 __.'.._' 45 
 
 60 
 
 6 
 
 H. G 
 
 69 
 
 22 
 
 1: 106 
 
 26 
 
 
 
 33 ___ 
 
 
 P. S 
 
 11.5 100 
 
 19 
 
 8(i 
 
 47 
 
 
 
 11 41 
 
 
 
 H. E 
 
 12 
 
 
 
 
 
 (1 
 
 (1 
 
 (1 
 
 II ___ 
 
 
 
 
 B. A 
 
 13 
 
 20 
 
 6 
 
 1 6 
 
 •> 
 -> 
 
 
 
 15 9(1 
 
 64 
 
 7 
 
 N. I 
 
 13 
 
 38 
 
 8 
 
 85 
 
 24 
 
 
 
 23 -_- 
 
 
 
 
 
 P. A 
 
 13 
 
 100 
 
 20 
 
 2 134 
 
 29 
 
 3 
 
 14 ()5 87 
 
 77 
 
 7 
 
 W. C 
 
 13 
 
 155 
 
 39 
 
 7 238 
 
 46 
 
 (; 
 
 28 147 ___ 
 
 — 
 
 
 
 F. H 
 
 14 
 
 11 
 
 2 
 
 <l 98 
 
 24 
 
 2 
 
 42 — 
 
 
 
 
 
 B. N 
 
 15 
 
 142 
 
 31 
 
 JO 231 
 
 52 
 
 3 
 
 57 57 90 
 
 69 
 
 2 
 
 D. H 
 
 15.5 
 
 150 
 
 38 
 
 4 89 
 
 16 
 
 1 
 
 58 48 ___ 
 
 
 
 
 
 T. H 
 
 16.5 
 
 148 
 
 35 
 
 134 
 
 30 
 
 
 
 21 (;2 -__ 
 
 
 
 
 
 M. G 
 
 17 
 
 94 
 
 22 
 
 99 
 
 25 
 
 2 
 
 55 4 .__ 
 
 
 
 
 
 H. A 
 
 18.5 
 
 
 
 
 
 1 248 
 
 59 
 
 2 
 
 3() 18 68 
 
 54 
 
 4 
 
 W. J 
 
 20 
 
 17 
 
 6 
 
 7(; 
 
 22 
 
 
 
 23 
 
 
 
 D. M 
 
 22 
 
 23 
 
 9 
 
 41 
 
 8 
 
 6 
 
 41 9 24 
 
 (1 
 
 V. H. 
 
 23.5 170 
 
 49 
 
 1 451 
 
 132 
 
 3 
 
 59 131 
 
 
 
 
 (iirls* Av 
 
 __._81.2 
 
 20.5 
 
 1.3 136 
 
 33 
 
 2 
 
 33.7 36 — — 
 
 1 
 
 Total Av 
 
 79.8 19.5 
 
 1.2 140 
 
 33.5 
 
 2 
 
 35.2 34.3 51 
 
 1 1 1 
 
 44 
 
 ( 
 
 38 
 
 1 
 
 Fij. 
 
 33.
 
 l62 U^-n^rvAVARD AND FEEBLE-MINDED CHILDREN. 
 
 In the test foi 'story invention," the children were first 
 interested in a boy and his sister who Hved on a farm near 
 Springfield, 111., and who were given for a Christmas present 
 a flying-machine which was so simple that they could fly 
 with it. The day after Christmas they placed in it food and 
 coft'ee to last them two days, and with fifty dollars given 
 them by their grandfather they sailed away to see the world. 
 What would they see, and what would happen to them until 
 their return? Fifteen minutes were given in which to write 
 a story of the trip, making believe that the child tested was 
 one of the two lucky children. All began with apparent en- 
 thusiasm, but scarcely any wanted more time. The tendency 
 to automatic repetition shows in the children's written re- 
 hearsal of my preliminaries in spite of being cautioned to 
 write only of the trip. 
 
 The tests for directions known and for remembered rela- 
 tive locations, grouped as "orientation" tests, were newly 
 devised, and have been described in the studies. They are 
 quite worth trying out with normal pupils of successive ages, 
 to establish norms. The essentials are ( i ) to place in rela- 
 tive order the pictures of nine of the buildings or resorts 
 which are best known to the child; (2) to indicate the direc- 
 tions of four well-known places, two distant and two local ; 
 (3) to indicate the directions of the four cardinal points. 
 The time is not limited. 
 
 The test for similars was newly arranged, and proved to 
 be fully as valuable as that for opposites. The directions 
 were to "Write a word that means something like what this 
 word means, a word somewhat siiuilar to this word in mean- 
 ing." Sufiicient examples were given to illustrate thor- 
 oughly. The list follows : Night, love, tobacco, tent, sweep, 
 feel, board, lightning, bird, stone, foggy, dark, pretty, afraid, 
 daisy, winter, big, snow, coat, run. The first test for similars 
 was given as for opposites. giving ten to eleven minutes to
 
 TAIUJLATKJ.N ()!•■ DATA. . 1 1^) 3 
 
 write the "similars" on the printed shp. Test II, for similars, 
 j:jiven to tiie boys on the following- clay and using the same 
 list, was as follows : The children had blank slips with spaces 
 numbered from one to twenty. The words were pronounced 
 to them as distinctly as possible, with a pause of about forty- 
 five seconds after each in which to write its similar. The 
 directions and illustrations were repeated. 
 
 In the tests for opposites, Whipple's lists A and 11 were 
 used, and his directions were given. The children wrote 
 for sixtv seconds, and the results were recorded ; then ten 
 minutes more were given to complete the list. Test II was 
 given on the day following Test I, and with a different list. 
 
 Vov the A-cancellation tests, the Xorsw^orthy lists OV 
 and GA, the former given also by Whipple, were used, and 
 Whipple's directions were followed, using a constant time 
 of two minutes each for Tests II and III. In Test I. given 
 only to boys, an accident interfered with the time-taking, 
 and the time may have been a little less than two minutes. 
 The test is otherwise entirely admissible. The boys had an 
 advantage over the girls in having the preliminary practice 
 furnished by this test, the tests being given in secpience as 
 numbered. 
 
 Professor Binet considered that the A-test was a satis- 
 factory test of the attention, but only when the children were 
 left together to do the work in the absence of their teacher 
 or other care-taker. This test was tried, the children being 
 reminded that some people thought they would not stick to 
 work when their teacher was away. The result was that 
 more was done in the absence of all supervision, though with 
 many more errors by the girls. The appeal to the children's 
 pride seemed to meet a definite response, and had something 
 to do with increasing the output.
 
 164 r.ACKWAKl) AND FEEBLE-MINDED CIIILDKEN. 
 
 MENTAL TESTS OF BORDER CASES. 
 
 Test. 
 
 Similars. 
 
 liight. 
 
 I i II 
 
 Wrong. 
 
 I II 
 
 Opposites. 
 
 A— Cancellation. 
 
 I Min. 
 
 II 
 
 II Min. Crossed. 
 
 Omitted. 
 
 I II 
 
 II III I 
 
 II III 
 
 Name. Age. 
 
 r. A 12 
 
 F. J 12.5 
 
 C. H 13 
 
 F. N 14 
 
 V. C 11 
 
 J. H 14.5 
 
 R. P 15 
 
 G. J 16.5 
 
 K. M 17 
 
 D. F 19 
 
 M. E 36 
 
 Boys' Av. -- 
 
 
 
 
 
 19 
 
 
 
 
 
 
 
 
 
 
 
 17 
 
 44 
 
 62 
 
 
 
 1 
 
 2 
 
 9 
 
 3 
 
 4 
 
 2 
 
 3 
 
 4 
 
 4 
 
 38 
 
 67 
 
 80 
 
 62 
 
 31 
 
 
 
 13 
 
 
 
 2 
 
 2 
 
 4 
 
 2 
 
 7 
 
 37 
 
 52 
 
 66 
 
 8 
 
 2 
 
 5 
 
 10 
 
 5 
 
 4 
 
 3 
 
 3 
 
 6 
 
 11 
 
 58 
 
 71 
 
 89 
 
 2 
 
 1 
 
 3 
 
 12 
 
 8 
 
 7 
 
 
 
 4 
 
 7 
 
 9 
 
 44 
 
 81 
 
 96 
 
 
 
 
 
 
 
 1 
 
 
 
 8 
 
 
 
 
 
 
 
 
 
 41 
 
 73 
 
 79 
 
 5 
 
 4 
 
 5 
 
 9 
 
 2 
 
 10 
 
 3(?) 
 
 ___ 
 
 9 
 
 11 
 
 43 
 
 58 
 
 69 
 
 3 
 
 13 
 
 20 
 
 20 
 
 
 
 
 
 11 
 
 10 
 
 19 
 
 19 
 
 49 
 
 71 
 
 95 
 
 1 
 
 4 
 
 
 
 3 
 
 8 
 
 17 
 
 
 
 2 
 
 
 
 2 
 
 30 
 
 50 
 
 60 
 
 70 
 
 50 
 
 18 
 
 20 
 
 
 
 
 
 18 
 
 20 
 
 20 
 
 20 
 
 56 
 
 83 
 
 82 
 
 10 
 
 15 
 
 19 
 6.5 
 
 14 
 
 10 
 
 1 
 4 
 
 8 
 
 5 
 
 10 
 5.6 
 
 15 
 7.5 
 
 19 
 9.3 
 
 66 
 44 
 
 98 
 68 
 
 97 
 
 80 
 
 28 
 17 
 
 2 
 11 
 
 5.5 
 
 4 
 
 
 6 
 
 2 
 4 
 7 
 1 
 
 43 
 10 
 3 
 
 7.7 
 
 H. G 11 10 
 
 P. S 11.5 18 
 
 H. E 12 
 
 B. A 13 4 
 
 N. L 13 12 
 
 P. A 13 17 
 
 W. C 13 17 
 
 F. H 14 
 
 B. N 15 19 
 
 D. H 15.5 20 
 
 T. H 16.5 20 
 
 M. G 17 17 
 
 H. A 18.5 16. 
 
 W. J 20 71. 
 
 D. M 22 I 11'. 
 
 V. H 23.5 20. 
 
 Girls' Av. _-__ 12.7 
 Total Av. 10.1; 
 
 3. 
 
 2'. 
 
 20!. 
 
 3. 
 
 1. 
 
 ^i 
 
 tj . 
 
 21. 
 20j. 
 ll. 
 0. 
 0. 
 
 ij. 
 2L 
 
 7! 
 
 71. 
 oL 
 
 - ' 3'— 
 
 ____j 6L_. 
 
 ____ 3__. 
 
 5 __- 
 
 ___.i 0_- 
 
 i ?'__. 
 
 - I — 
 
 10... 
 
 10 — 
 
 _.-. 2L_. 
 
 i 4__. 
 
 ...J 0'__. 
 12 
 
 12 
 
 ___ 17 
 
 11 
 
 -_- 47 
 
 1 
 
 ___ 49 
 
 3 
 
 ___! 
 
 15 
 
 — 35 
 
 
 
 ___ 63 
 
 6 
 
 ___ 65 
 
 
 20 
 19 
 
 20 
 
 4;, 
 
 I 20__J 
 
 5r 
 
 63t 
 
 77' 
 38' 
 44' 
 87'' 
 92' 
 50i 91, 
 50l 67'. 
 87100, 
 95 100 , 
 81| 98, 
 801 92. 
 60; 89I, 
 84l 98'. 
 70 97'. 
 
 6 
 1 
 
 
 2 
 14 
 3 
 7 
 1 
 
 
 2 
 
 
 45 
 1 
 
 13 
 1 
 
 10 
 7 
 
 Oi 
 
 4.7 
 4.5 
 
 4.4! 
 
 5!. 
 
 9.4 
 9.4 
 
 59 81 
 63 81, 
 
 
 2 
 
 6 
 2 
 13 
 
 .3.4 6.6 
 
 .; 6.7 7.1 
 
 Fif
 
 TABUl-ATlOX OF DATA. 165 
 
 For llu' association tests tabulalal in Imj;'. 35- tlie list of 
 lOO words nsc'l 1)\- Kent and Rosanoff'' was nscd with all 
 but cases K. A., l*". |.. J. II.. and M. K. A li'^t adapted from 
 Wehrlint was used with the others, who were tested before 
 the Kent-Rosanotf ni()noL;ra])h reached me. The children 
 faced the experimenter, and the word was pronounced after 
 a preliminary "ReadN-." The time was recorded with a 
 stop-watch. In the table, "Common" is used as with Kent 
 and RosanoiT for the words that are to be found in their 
 "Frequency Table" of reactions made by normal ])ersons- 
 The "Normal, single word"' column includo any additional 
 sinele-word reactions whose relation to the stimulus was an 
 obviously natural one. "Motor Speech" names the \vords 
 given because of their habitual association in spoken utter- 
 ance with the stinudus word. The "Terrors" were failures 
 to react at all. Fgocentric is used to name reactions in which 
 the stimulus word is taken to make immediate reference to 
 the child himself. They can hardly be said to have occurred. 
 The other rubrics are used as described in the case studies, 
 or as defined by Kent and RosanolT. Such normals as are 
 given are for children under sixteen, and are taken from 
 Kent and Rosanoff, except that the median reaction time 
 is that given for uneducated adults 1)\- Jung.:!: 
 
 It will be noted that the children's ages stated in the later 
 tables vary slightly from those given in the earlier ones. The 
 tests reported in the former were made at a correspondingly 
 later period. 
 
 The disproportionate strength so frecjuently shown with 
 
 *Kent and Rosanoff : A Study of Association in Insanity, .\merican .Tonr- 
 nal of Insanity, Vol. LXVII. Nos. ] and 2, 1910. 
 
 fK. Welirlin : Ueber die Assoziatloncn von Iniliczillcn iind Idinlen. .Tunj;'s 
 Studies, I. 
 
 tJung's Diagnostische Assoziations— Studien, I, p. 198.
 
 1 66 
 
 BACKWARD AND FEEBLE-MINDED CHILDREN. 
 
 ASSOCS. TO 100 GIVEN WORDS. 
 
 Name 
 
 < 
 
 1— < 
 
 i-j 
 
 < 
 
 «!< 
 
 ffi 
 
 ^' 
 
 *4 
 
 < 
 
 S 
 
 w 
 
 
 tj — 
 
 
 &; 
 
 ^ 
 
 ti 
 
 CQ 
 
 oi 
 
 1-5 
 
 M 
 
 d 
 
 X 
 
 Q 
 
 g 
 
 < 
 
 T^B. 
 
 Age 
 
 12 12.5 
 
 12.5 
 57 
 
 13 
 67 
 
 13 
 24 
 
 14.5 
 
 15 16.5 18.5 
 
 22 
 
 36 
 
 — 
 
 
 
 Xormal. 1 Word- 
 
 21 
 
 42 
 
 16 
 
 92 
 
 89 
 
 22 
 
 83 
 
 12 
 
 48 
 
 97 
 
 Coin nion 
 
 
 39 
 1 
 1 
 
 2 
 
 66 
 1 
 
 
 24 
 
 5 
 
 
 
 88 
 
 5 
 
 84 
 2 
 3 
 
 17 
 
 
 
 75 
 1 
 1 
 
 
 
 56 
 
 96 
 
 Doubtful — 
 
 
 
 
 Non-spociflf. 1 W'd. 
 
 
 
 5 
 
 Phrase or Sent 
 
 60 
 
 
 
 
 
 1 
 
 68 
 
 50 
 
 1 
 
 1 
 
 1 
 
 
 
 86 
 
 — 
 
 — 
 
 Def. bv ditto 
 
 64 
 
 
 
 
 
 1 
 
 68 
 
 49 
 
 1 
 
 
 
 1 
 
 
 
 86 
 
 — 
 
 — 
 
 Tautology 
 
 2 
 
 
 
 
 
 
 
 15 
 
 13 
 
 
 
 
 
 
 
 
 
 2 
 
 — 
 
 
 Sound 
 
 2 
 
 1 
 
 7 
 
 1 
 
 
 
 4 
 
 2 
 
 
 
 42 
 
 
 
 
 
 — 
 
 
 
 Neologism 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 5 
 
 
 
 
 
 — 
 
 
 
 Senseless 
 
 
 
 
 
 
 
 2 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 — 
 
 
 
 Motor Speeeli 
 
 2 
 
 
 
 4 
 
 
 
 3 
 
 1 
 
 1 
 
 
 
 2 
 
 
 
 1 
 
 — 
 
 
 
 Stereotypy 
 
 
 
 
 
 
 
 2 
 
 
 
 
 
 1 
 
 
 
 o' 
 
 
 
 — 
 
 
 
 Perseveration 
 
 
 
 9 
 
 
 
 4 
 
 
 
 5 
 
 
 
 
 
 2 
 
 
 
 — 
 
 
 
 Repet. of Stini 
 
 1 
 
 
 
 1 
 
 
 
 
 
 1 
 
 
 
 
 
 3 
 
 13 
 
 — 
 
 
 
 Errors, Total 
 
 9 
 
 40 
 
 30 
 
 27 
 
 4 
 
 
 
 1 
 
 4 
 
 24 
 
 
 
 
 
 12.6 
 
 
 
 Errors from Ignor. 
 
 2 
 
 1 
 
 1 
 
 3 
 
 3 
 
 
 
 1 
 
 
 
 
 
 
 
 — 
 
 
 
 Egocentric 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 Reminiscent 
 
 2 
 
 
 
 
 
 
 
 3 
 
 
 
 
 
 2 
 
 1 
 
 
 
 
 
 — 
 
 
 
 Unclassified 
 
 
 
 4 
 
 4 
 
 11 
 
 1 
 
 22 
 
 2 
 
 3' 
 
 5 
 
 14 
 
 
 
 
 
 1 
 
 Different Reacs 
 
 90 
 
 48 
 
 62 
 
 54 
 
 93 
 
 98 
 
 77 
 
 94 
 
 75 
 
 89 
 
 99 
 
 80 
 
 87 
 
 Med. Reac. Time__ 
 
 2.0 
 
 4.1 
 
 2.0 
 
 2.4 
 
 2.3 
 
 2.3 
 
 1.4 
 
 1.7 
 
 3.0 
 
 1.7 
 
 1.7 
 
 2.2 
 
 2.0 
 
 Fig. 35.
 
 TARUr.ATIOX OI- DATA. T^J 
 
 Ihe left hand niis^ht lead one to sn|)])()se that these ehildren 
 were left-handed. Ilowever, with the exception of X. L., 
 who is left-handed, and of C. A. and M . j., as to whom there 
 is at least no left-handedness recorded, the children all used 
 their riyiu hands ])referably and were considered to he 
 right-handed. 
 
 In spite of the fact that a niajorit)- of these children have 
 defective vision, onh- ]\ S. was wearing" glasses when the 
 tests were made, and only D. AT., 1 f. E., and G. J. have used 
 glasses while in the institution, as far as could be learned. 
 
 In closing this review it may be of interest to present the 
 results of a little test of these children's ideals concerning a 
 life-occupation. The children were asked, "If you could be 
 what ^'ou would most like to be when you are a man (Or 
 woman), what would you most like to be?" They were 
 given plenty of time for reflection, and in most cases i\.'rofc 
 their answers. I'nfortunately, some of the cases studierl 
 here were not included in this test, but such as were gave 
 the following re])lies: 
 
 Choice oi' Occupation. 
 
 Fred J Bandman. 
 
 Felix N r.lacksmith. 
 
 Polly A I like to be a true and noble lady. 
 
 Jerry If Engineer on train. 
 
 Bertha A School teacher. 
 
 Robert P Shoemaker. 
 
 Dora M Music Teacher. 
 
 George J Sailor or a good farmer. 
 
 Hester A Churchmember in the Baptist Church. 
 
 Minnie G Nurse. 
 
 Beulah N I would like to be a Catholick sister 
 
 and if not I would like to be a help to the church. 
 Marshall E.. .Officer of law (with a list of second choices).
 
 l68 BACKWARD AND FEERLE-MINDED CHILDREN. 
 
 Prudence S Like to be a teaclier when I get big. 
 
 Viola H. Actress. 
 
 Hilda E A show actreuss. 
 
 Wilda C Would 
 
 like to a true and noble ladv when I am big". 
 
 Fannie H 1 wish to be a music lady. 
 
 Nora L Music Teacher. 
 
 Delia Fl . . . . I would like to be a Christian when I grow up. 
 
 Wendy j Dressmaker. 
 
 Casper II Coiy boiy. 
 
 Kenneth M Carpten (carpenter) . 
 
 Fritz A Cow boy. 
 
 Vincent C Basketmaker. 
 
 David F.. .A good musician and work in some large factory. 
 Theresa H Dressmaker. 
 
 It is e>d4liint from the studies that the high-grade feeble- 
 minded fall naturally into certain groups ; and from these 
 groups I am convinced that one may pass by imperceptible 
 gradations into corresponding" classes of non-feeble-minded 
 persons, normal and abnormal. The largest number, more 
 than one-third of my special-study cases, are characteristic- 
 ally (/////. Many of these are practically normal in all the 
 affairs of a very simple life, and may be mistaken for nor- 
 mal children if one does not know their years and does not 
 press theiu with inconvenient tests of the functionings for 
 which they have not grown brains. They lack mental re- 
 sources and initiative, and tend everywhere to automatism. 
 They rarely learn to do long division, and it is rare indeed 
 that one advances further than this. There are doubtless all 
 shades of intermediary conditions from these cases to the 
 "dull" but normal pupils who made up ten per cent, of 
 Philadelphia's school classes according to Dr. Cornell's re-
 
 TAIUJLATIOX Ol' DATA. 1 6') 
 
 port,* th()iit;li some oi this latter (lullness was from remov- 
 able causes. 1 sn])])i»sf that iii\' (hiil cases c<M-res])on(l 
 rou.qhlv tn r.inet's arricrcs or hackicard children as distin- 
 !L:,iiishe(l from his iiiistiiblrs. In a .general wdv most of the 
 children ma\ he classed under one or other of these two 
 main nrou])in<;s, l!inet thidin^- that the l'"rench schools have 
 about two |)er cent of each in a total ot about five ])er cent 
 who are mentally defective. 1 hnd it convenient, however, 
 to apph' the term unstable especially to a j^roup, which has 
 at least four representatives in the cases studied, whose main 
 characteristic is their instability as shown in breaches of dis- 
 cipline, flighty attention, rovinq- tendencies and the like, 
 but uncolored l)y any s/^ccific forms of instal)ility that are a? 
 v.^ell-marked as epile])sy, hysteria, etc. 
 
 There is an intermediate group of four whom I have be- 
 come accustomed to call (///// itJistahlcs, children whose main 
 or usual characteristic is their dullness, but who intermit- 
 tentlv show more or less of instability. 
 
 x\ fourth group is of the Jieiirasfhcincally iiiisfdhlc. My 
 special cases include but two of these, but the institution has 
 many more. Chronic neurasthenia is generally founded 
 upon certain retardations in growth, and in these complain- 
 ing but comparatively intelligent feeble-minded persons we 
 seem to have the tail-end of the neurasthenia ]:)rocession. 
 
 A fifth group, including but one or two of my special 
 cases but with some little representation in the institution, 
 is of the hysfcricaHy iiiisfablc. There is little doubt but that 
 chronic hysteria, with its infantilism and its frequent develop- 
 mental defects, makes direct connection with this group of 
 the feeble-minded. 
 
 A sixth group includes the epileptic who are feeble- 
 minded. My original list of highest-grade cases included 
 three epileptics. Tw'o hundred and seven of the institution 
 
 *See Dr. ('ornpll's article iu The Psiiclinloiiicnl Clinic. May 1'>. IStis.
 
 I JO BACKWARD AND FEEBLE-MINDED CHILDREN. 
 
 children are considered to have epilepsy at present, and there 
 seems to he no doubt that the feeble-minded who have epilep- 
 tic convulsions are related by all degrees of transition to the 
 epileptics who are of approximately normal intelligence. 
 
 The seventh group is of the feeble-minded who show 
 characteristic tendencies to iiisaitity. Only one of my spe- 
 cial cases shows specific symptoms of insanity ; but I have 
 become accustomed to group with such children certain 
 others who show marked incoherence of response and action 
 with little appreciation of the seriousness of their errors. It 
 is well known that the feeble-minded have a special pre- 
 disposition to insanity. Tredgold finds this pre-disposition 
 to be twenty-six times that of the general population. Many 
 of the feeble-minded are actually insane for a part of the 
 time, and tlie insane group evidently makes continuous transi- 
 tions along several lines to the dementia praecox, manic- 
 depressive, and still otlier classes of the non-feeble-minded 
 insane. 
 
 An eighth group is of the moraily unstable. My special 
 cases have contained a small and variable number of these. 
 One case had as his most striking characteristic an ungov- 
 ernable and unreasonable tendency to steal. But many mem- 
 bers of the other groups have this tendency as well, and on 
 the other hand the "morally unstable" cases show more or 
 less of mental weakness. Still, remembering that our group- 
 ings are for purposes of convenience and are only marked 
 by the prominence of certain traits, the term morally unstable 
 applies to many cases not otherwise well characterized, but 
 which show distinctive defect in what men call the moral 
 nature. 
 
 A ninth group is of the children whose brains have suf- 
 fered from meningitis or from other sources of injury, toxic 
 or otherwise, such as has sufficed to produce a general de- 
 terioration. In still another group there is local or partial
 
 TMIULATION OF DATA. I/I 
 
 defect of certain mental nr jjliysical functions, sometimes of 
 the .senses, without much or any r^^eneral mental enfeeble- 
 nient. Such are our cases of a])hasia, and such was a com- 
 paratively intelligent deaf mute who was included in my 
 original list. 
 
 Last of the groupings needed for our own special cases, 
 there are what Dr. Cornell has called the relatively defective, 
 children whose minds would be comparatively good hut thai 
 they fail of their best development from poor health, poor 
 eyes, or improper home surroundings. Prudence S. and 
 \'iola II. would generally be said to belong to this class, 
 though its best representatives generally manage to kee]) 
 out of such institutions. 
 
 Of course the new admissions include, besides, small 
 groups of Alongolians, cretins, microcephalics, hydrocepha- 
 lics, and perhaps still others who show certain distinctive 
 mental traits. And even for the border cases the groups 
 above are not to be taken as either exhaustive or final. 
 Sometimes the same child may belong to more than one 
 group or may come to show the characteristics of a different 
 group as he grows older. Indeed many of these children 
 now studied in their early adolescence may be expected to 
 show some very ditt'erent traits within a vcr}- few years. 
 If we are ])rivileged to follow out the life-courses of these 
 cases, as T hope we may for some at least, they with others 
 to be studied will help to suggest the natural groupings that 
 we may finalh- make of defectives. The very difTefent char- 
 acters and life-conditions found for the various groups and 
 individuals here presented may help to show the futility of 
 many of the generalizations about defectives, and may sug- 
 gest the importance, for prognosis and treatment, of obtain- 
 ing a better knowledge of these groups, and of recognizing, 
 as well, the individuality that exists even among the feeble- 
 minded.
 
 1/2 BACKWARD AND FEEBLE-MINDED CHILDREN. 
 
 Certain lines of transition from feeble-mindedness to non- 
 feeble-mindedness are evidently suggested in these studies 
 and groupings. Connections are made with certain obvious 
 and important groups of oiu- "normal" population, on the 
 one hand, and of our abnormal hut non-feeble-minded popu- 
 lation on the other. The dull, the unstable, the relatively 
 defective, the partial defective, are all about us performing 
 functions in society, with such of the other classes as can 
 manage to make enough of sane adaptation. The problem 
 is the same for all. It is one of determining the mental level 
 of the life's capacity, actual and potential, and of adapting 
 his environment and activities to that level. For this work 
 of adaptation, joint study for the sociologist, psychologist, 
 and educator, the careful and contiiuied study of cases, nor- 
 mal and abnormal, will furnish the natural bases and mate- 
 rial.
 
 CHAPTER VI. 
 
 A S\"LI..\IU'S l-'OK 'nil'. CLIXICAL l-.XAM I X.X'PIOX 
 
 OF IIIILDREN. 
 
 Idcallw the examiner of a defeetive or e.xceptional child 
 should interview the parents and teacher, should have a note 
 from the famih- jihysician, and should have before him the 
 record of a recent medical and general physical examina- 
 tion. A carefull)- prepared history of the case which can be 
 placed in his hands when the child is presented will save 
 much time even when parent and teacher are present, and is 
 in any case very important for diag^nosis and prognosis. If 
 teachers, social workers, and others who send or brino" cases 
 to examiners are made to know the classes of facts which it 
 it most im])ortant to obtain in writing up a case, they may 
 often etfect a great economy of the examiner's time. They 
 should, as well, learn to systematize their own observation 
 of and thought about the cases : and in countless instances 
 all the examination that can be made must be prepared for 
 and given by themselves. 
 
 For economy of time and convenience of later reference 
 four blanks should be used ; one for the home record, one for 
 the teacher's report, one for the ])h}sical ( including the 
 medical) examination, and one for the mental examination. 
 These blanks may c(n'er all the points of the present syllabus 
 or only the most important of these. The points underlined 
 are those which should al-a'oys be en(|uirefl about if lime 
 permits. The liinet scale, given here as the most usable re- 
 
 173
 
 1/4 BACKWARD AND FEEBLE-MINDED CHILDREN. 
 
 source for making a brief but useful mental estimate, should 
 ordinarily be printed as it stands if used at all. Of course 
 the variant statements of the scale authorized by other psy- 
 chologists may be found preferable for certain purposes. 
 
 Each blank should contain considerable space for noting 
 supplementary data not asked for in the form proper, but 
 often very important. If blanks are not used, the liabit 
 should be formed of grouping the facts under such general 
 headings as heredity, development, medical history, environ- 
 mental and personal history: capacity, habits, and character; 
 school progress, physical "condition, mental condition. 
 It is of great importance that statements which seem to be of 
 doubtful validity should be so mentioned, and that notes be 
 made as to the apparent trustworthiness of the sources of 
 data obtained. 
 
 The forms here presented have been worked out in hand- 
 ling the cases at the Illinois state institution for the feeble- 
 minded. They will liave such modification as is needed in 
 adapting them to case study in the public schools and in 
 other institutions. They give such suggestions as our expe- 
 rience has furnished and are as incomplete and imperfect 
 as is the latter.
 
 TABULATION OF DATA. 1/5 
 
 Outline of Case /■..vcnniiiiitidii and Record. 
 
 A. HoMi-: Ri-:c()Ki). 
 
 I. llci-fdily. 
 
 II. 1 )tA(.'li)j)llH'llt. 
 
 III. jNIcdical history. 
 
 YV . I'Ju'ironiiK'iital and ])crs{)!ial liistorv. 
 V. Cai)acitics, hal)its., and character. 
 
 J!. T);ac]ii:k's or A rTi-:.\i).\\'i''.s ki'.coKD. 
 I. Ilal)its and cliaractcristics. 
 II. Capacities and inca])acities. 
 
 III. IntelHgence and jjerceptioii. 
 
 IV. Learning-, interests, imitation, and memory. 
 V. Morals. 
 
 VI. Social reactions. 
 
 C. Physical ILxamixaitox. ... 
 
 I. Anthr(jpometr_\- and description. 
 II. Defects and deformities. 
 III. Medical examination. 
 
 1). Mental Examination. 
 
 I. Tntellioence and retardation. The I'inet scale.
 
 lyG BACKWAIU) AND FEEBLli- MINDED CHILDREN. 
 
 A. HOME RECORD. 
 
 (Information to be obtained from parents, family physician, 
 and otliers who know the family well). 
 
 General. 
 
 Child's full iiaiiic and present address. 
 
 Aa}ite and address of parent or guardian. 
 
 Date of birth of ehihl. or, if iinkvuncn, apparent age. 
 
 Birthplace of ehild. of father, of motlier. 
 
 Oeenpation of father and mother. 
 
 Heredity. 
 
 
 1 
 
 2 
 
 3 
 
 4 
 
 5 
 
 6 
 
 7 
 
 8 
 
 9 
 
 10 
 
 11 
 
 12 
 
 13 
 
 
 bh 
 
 a 
 '> 
 
 a, 
 < 
 
 
 CO a 
 
 0) — 
 
 < 
 
 Cause of 
 Death. 
 
 
 "5 
 a 
 
 5 
 
 Ever receive 
 pul)lic 
 relief. 
 
 "33 
 o 
 
 J* 
 c 
 "S 
 Q 
 
 :s o 
 
 72 
 
 Insane, Epi- 
 leptic, or Fee- 
 ble-minded. 
 
 Standing in 
 Community. 
 
 ce S 
 
 0,1-1 
 
 02 
 
 Fatlicr . . . 
 
 
 
 
 
 
 
 
 
 
 
 
 
 Mather. . 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 Father's 
 father 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 Father's 
 
 mothur 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 r^lother's 
 father 
 
 
 
 
 
 .... 
 
 
 
 
 
 
 
 
 
 ^Mother's 
 mother. . 
 
 
 
 
 
 
 
 
 
 
 
 
 
 Brother 
 or sister. 
 
 
 
 
 ........ 
 
 ■i 
 
 
 
 
 
 
 
 
 
 it 
 
 
 
 
 
 
 
 .... 
 
 
 
 
 
 
 
 « 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 ' ' 
 
 
 

 
 A SVIJ.Al'.rS FOR CIJMCAI. i:X \ M I X ATIOX. 1/7 
 
 Vi'liaf other relatives of father or mother belou;^ under (^, 8, 
 or 1 1, i^h'tiii^ details:^ 
 
 Which of tlie above had any of the foHowiui^' coiulilions, 
 specifying" and giving;" details : Druii' habit, vaijrancy. 
 special i)eculiarities of mind or body, h_\ pochondria. sex- 
 perversion, defect of si^ht. hearing', or speech (stating;' 
 whether cons^enital or ac-(|nired), spasms or C(»nvnl>ii)ns, 
 chorea, hysteria, neurasthenia. ])aralysis, other nervous 
 diseases or conditions, apoplexy, heart disease, sudden 
 death, goiter, other severe disease or defect, serious opera- 
 tions, confinement in hospitals or institutions (what and 
 why?), miscarriages (number and cause?), cancer, 
 suicide ? 
 
 Development. 
 
 Order of birth. JJ'ei^ht at birth. Born at full term? 
 
 Deficiency or peculiarity at birth. What? 
 At zvJiat a^^e and lune :eere f'eenliarities first manifested? 
 At what age did the child recognize persons? Sit alone? 
 Stand alone? Walk alone? L'se spoon? Get first 
 
 teeth? 
 First words? First sliort sentenees? Aequire tidy 
 
 habits? 
 Know most of his letters? Get second teeth? Start 
 
 to school? 
 JJ'Jiat proi;;ress at school? Stopped at what age and 
 
 grade? Why? 
 Reads how? Writes how? Counts to? Adds? 
 INIultiplies ? Divides ? 
 Present weight and height ? 
 
 '&' 
 
 Medical History. 
 
 What 'ivas the condition of t/ie inot/ier's liealth or habits 
 during gestation?
 
 178 BACKWARD AND FEEBLE-MINDED CHILDREN. 
 
 Was she mentally troubled? How and why? 
 
 Was labor lojig and difficult ^^ Instruments used? 
 
 Anesthetics ? 
 
 Did child show deficient animation or vitality at birth? 
 
 Difficulty in breathing or nursing ? 
 
 Any indications of specific disease? What? 
 
 Malnutrition in infancy? Rickets? 
 
 Vv'hat troubles, if any, in teething? 
 
 Has child had the following, stating age and severit}^ : 
 Meningitis or "brain fever?" Diphtheria? Typhoid 
 fever ? 
 
 Scarlet fever? Whooping cough? Measles? 
 
 Chorea or St. Vitns dance? Tuberculosis? Scrofula? 
 
 Slee[^ zcalking? Night terrors? A^erz'ous attacks? 
 Describe. 
 
 Paralysis? Describe. AXHiat disease or trouble of 
 eyes? 
 
 Of ears ? Of nose and throat ? Of skin ? 
 
 Has child Jiad ef^ilepsy? fainting sf^ells or sl^asins? 
 
 State frequency of coni'ulsions, if any, and date of last. 
 
 What imperfections of speech? Of gait and movement? 
 
 J J' hat troubles, mental or physical, at puberty? 
 
 At the monthly periods? 
 
 Has the child been pronounced insane or feeble-minded? 
 
 When, and by whom ? 
 
 Name any other diseases or affections that child has had. 
 
 Has been in what hospitals or other institutions, and why ? 
 
 Has undergone what operations? IT hat severe acci- 
 dents? 
 
 When was the child last vaccinated? With what result? 
 
 Has the child recently been exposed to infection? State 
 disease.
 
 A SMJ-AUUS J-(.»K CI.IMCAI. KXAMIN ATU>.\ . JJ'j 
 
 Give name and address of physician wlio attended at birth 
 
 of child. 
 Ahiiiic and (tihlrcss of prrsriil fmiiily f^hysician . 
 
 l^WTROXMKXT AM) I 'I'-KSOXAF. ITlSTORV. 
 
 lias the ftunHy alicays ba'ii srlf-siif'portiiii^F Cleanly'^ 
 
 Hozi.' ret/.s- f/ic child treated hy and what 'icas the iiillnencc 
 
 of the fat her f ■ 
 Of the niothcrF Of stef-farent or otiiers c/hn'-iv/ leith 
 
 its care? 
 Was the ehi/d indiifi:^ed. maltreated, secluded/ 
 How many persons in the liome? Thnv nian\- rooms? 
 Was the home traiKjnil <ir (hstnrhed? Moral coiidifioii 
 
 of the home? 
 I! 'hat 'Was flie influence of child's associatesF 
 Of associates of the of^f^osite se.v/ 
 What Jiave been the child's i^rra/tw/ interestsF 
 In what ways has the child been useful ? 
 Iloa' does the child sfend its leisure tinief 
 Child's dei~»ortment and the im])ression made, at school? 
 
 At work ? 
 How loiij^ has child 7^'orked? .If what -work and ■woi^^es? 
 IIow does he care for n.ioney or valual)les ^iven or earned? 
 
 CaPACITTRS. HaIUTS. \XI) CiTAR ACTI'.K. 
 
 To what extent, if at all, has the child used alcoholic (lrink>!-' 
 
 Tobacco? Cocaine or other dru^s? 
 
 IVhat harmful personal haJnts does he have? 
 
 Does he run aioay from home? Ever hide or destrt^v 
 
 things ? 
 What is his attitude to animals? To playmates? To 
 
 parents ?
 
 l8o BACKWARD AND FEEBLE-MINDED CHILDREN. 
 
 Is child's memory good? What evidence of it? 
 What does he learn rapidly other than school work? 
 Does he pay attention well? Obey well? Feed him- 
 self? 
 Dress and undress? Tic a sitae lace? Have ii'orbld 
 
 fear 
 
 9 
 
 Queer ideas? Specify. Is child atteiitii'e to calls of 
 nature? 
 
 Docs he sleep ^^'cll? How many hours? 
 
 Underscore 7i'ords that describe child: Trustworthy, indus- 
 trious, untruthful, lazy, seclusive, moody, cheerful, sly, 
 selfish, slovenly, neat, ill-tempered, violent, excitable, 
 thieving, sissy or cry-baby, emotional, affectionate, . un- 
 feeling, fighter, fits of temper, obstinate, anxious, fearful, 
 complaining, gossipy, laugh or cry without cause, very 
 changeable, proud (of what), resentful. 
 
 What cause has been assigned for deficiency? 
 
 Of zahat delinquencies has child been guilty? Give details. 
 
 What other exceptional behavior has been noted? 
 
 What punishments have been inflicted? 
 
 What is child's attitude to7card correction? 
 
 What efforts hai'c been made to help child, zvhen, and by 
 ivhom?
 
 A SYLI.AHUS I'^OR CLINICAI. ICX A M I.\ "A'l ION . iSl 
 
 B. TEACIIRR'S OR ATTEXDAXT'S RECORD. 
 
 (Tile child should he under oI)Scrvati()n lor at least a month 
 before this blank is filled). 
 
 Observation data concerning- the habits, capacities, and men- 
 tality of Reported 1)\- I )ate 
 
 HaIUTS and ClIAKACTKRISriCS. 
 
 Is flic child T'Crv iicrvoits.' ll'Iicii, ami h(>:i' sIioik'ii.' 
 
 Is he noisy? Mischievous? How? 
 
 Docs he nut or stray axvayf Often?' (Jet lost? 
 When ? 
 
 Can he see well? Hear well? Does he read outside 
 of school work ? What ? 
 
 Docs he iccf (lay clotliiiii:;? Soil dax cloihiiii^.^ 
 
 ]Vhat iiiifortimalc habits, sexual or oIlicrTeiscF 
 
 Does he complain much ? Of what ? 
 
 In what leay is the cliild most tronhlesotnc or faultyf 
 
 In what does he most differ, if at all, from normal children?' 
 
 Describe his habitual position in study or recitation. 
 
 ( Underline below the zi'ords that correctly describe the 
 child.) 
 Cheerful. Alorose. Quarrelsome. Active. ( )bstinate. 
 Sensitive. Moody. Good-tempered. Excitable. Change- 
 able in mood or character. Sly. Resentful. Eazy. 
 Slovenly. Neat. Cleanly. Proud. Of what ? Silent. 
 Talkative. Obedient. Generally destructive. Heedless 
 of danger. Destroys clothing. Destroys furniture. Cry 
 without cause. Laugh without cause. Mouth usually 
 open. Emotional. Lacking in feeling. Anxious, Ln- 
 pulsive. Lack self-control. Easily managed. Supersti- 
 tious. Apprehensive or fearful. Fears what? Cranky, 
 Humorous. Very stupid. Selfish. Generous. Gossipv.
 
 l8>2 backward and feeble-minded children. 
 
 Capacities and Incapacities. 
 
 Does he help care for other children? 
 
 Need careful and close supervision? 
 
 Does he talk? Much? Distinctly? Can he do 
 
 errands ? 
 Does he know some letters? liow many objects can he 
 
 count ? 
 Can he add? Multiply? Divide? 
 Reads how, in ... . Reader ? Understands what he reads ? 
 
 well. well. 
 
 Writes fairly. Spells fairly. Copies dictation how ? 
 
 badly. badly, 
 
 well. well. 
 
 Draws fairly. PMays fairly, on what musical instrument? 
 
 badly. badly, 
 
 well. 
 Sings fairly. What kinds of songs or music? 
 
 badly. 
 What and how Ti.'cV/ can child do in manual or industrial 
 
 zvork? 
 In kindergarten? In gymnastics? In athletics gen- 
 erally ? 
 In entertainment work ? Details. 
 
 What other studies or work is he engaged in, and what prog- 
 ress in each ? 
 In ivhat docs he do his best work? His poorest? 
 What is he "good at" in any direction? 
 Are there times when he does much better or worse than 
 
 usual ? 
 How account for these variations? Wliat prevents his 
 
 doing better? 
 What noticeable defects has he?
 
 A SVLLAliUS FUK CI.IMCAI. i:X A M I X ATKJN. I (S3 
 
 L\ri:i.i.i(;KxcE and riiKCi-iniox. 
 
 Can he tie an ordinary knot? I'ndcrstand and obcv com- 
 
 niands ? 
 'i\dl time?' Take care of api)aratus and fnrnilnre? 
 llow complicatcci machines oi" tools can he use? 
 Mow weU ackipt himself to chan^e<l schedule or other new 
 
 conditions ? 
 
 Docs he fliiitk of i^'/iat to do in (-///c/xr/zc/W. or in pluy.^ 
 
 E.nu)iplcs. 
 What other c:'idc)iccs of iiitellij^ciicc or stupidity!' 
 Ever //,'/(/,-///(' llial lie secs tliiiii^s/ T/nit lie hears voices 
 
 or other sounds/ 
 
 M()\i:.Mi-:xTs .\x!) 1'i.an'. 
 
 Can he throw and catch a hall? Dance? llow well? 
 
 J low does he walk? Is he very awkward? \ery 
 
 active ? 
 
 Left-lianded? I'se hoth hands e(|uallv well?" Is he 
 
 quick or slow ? 
 
 What automatic movements or mannerisms has he. and 
 when ? 
 
 Mow does he i;o up and down stairs? 
 
 riay much, or at all? Mow? 1 low lon^- at one thin"-? 
 
 What, for example? Does he hnild blocks^ Collect 
 things ? 
 
 Excel or lead others in play? Play over past expe- 
 riences ? 
 
 "Make believe" much in play? Play alone or with others, 
 usually ?
 
 184 backward and feeble-minded children. 
 
 Learning, Interests, Imitation, and Memory. 
 
 Name the main interests noticed in this child, underlining 
 
 the strongest. 
 Does he learn new work easily ? Remember it well ? 
 Learn "pieces" easily? Remember them well? 
 Talk or seem to think nnich of old-time experiences? 
 Of recent experiences? Is he very forgetful? 
 What does he imitate ? How much and how well ? 
 Mechanically or with understanding"? 
 Hoiv inncJi progress or decline have you see in him, in hoiv 
 
 long? 
 Does he stick to tasks well? Willing and tries? 
 /,s- he easily confused? When and Iwzv? 
 Do you think he will improve, stand still, or go back? 
 
 Morals. 
 
 Is lie cruel? Profane? Obscene? Deceitful? 
 
 Thieving? 
 Untruthful? Lacking in shame or modesty? 
 Ever violent to others? Shozcr sense of duty? 
 Of right and zcrong, or remorse? 
 What evidences of interest in religion ? Is he trust- 
 
 Zi'orthy? 
 Of zi'hat immoral acts is the child frequently or sometimes 
 
 guilty? 
 
 Other Social Reactions. 
 
 Is the child easily led or persuaded? By ivhom? 
 Over-dependent on others? Like to have and show au- 
 thority ? 
 Is he confiding? Chummv? Timid?
 
 A SYLLABUS FOR CLINICAL LX AMIN ATION. 185 
 
 Bashful? Affectionate? Sociable? Sympathetic? 
 What is his attitude toward his parents? 
 Toward his l^rotliers or sisters?" Toward strangers? 
 Toward animals or pets? Docs he get on well ivith other 
 
 children? 
 Why not? Is he a sissy or cry-baby? 
 
 C. PHYSICAL EXAMINATION. 
 
 Anthropomi-:tkv and Di-:s( uiptiox. 
 
 IVeight. Height standing. Height sitfijig. 
 Chest girth at inspiration. At expiration. 
 Head circumference. Length. I'.readth. 
 Height above auditory meatus. Hair. Eyes. Com- 
 plexion. 
 Teeth. Scars. 
 
 Defi-xts and Deformities. 
 ( LTnderscore those found, in list below, and add any (~)thers. ) 
 
 Head: Micrijccphalic, macrocephalic, hydrocephalic, asyni- 
 
 metrical. 
 Vacc: Prognathous, iiiunobile. inferior maxillary small. 
 
 large, superior maxillary small, nasal Ix^ies 
 
 sunken, forehead retreating, uarroie: face ((syin- 
 
 metrical. 
 Nose : Much deflected ; septum abnormal, base of nose 
 
 broad, nostrils open foni'ard. 
 Lips: Hare-lip, lips very thick, very thin, fissured above, 
 
 below, very long, very short. 
 Teeth: Hutchinson's, persisting milk teeth, serrated, 
 
 pointed or notched, chalky, impacted, irregular 
 
 in shape or arrangement, decayed, rachitic.
 
 l<Sr) r.ACKWAKD AND FEEBLE-MINDED CHILDREN. 
 
 Soft Palate: 
 
 Hard Palate : Cleft, [ 'shaped, semi- V-shaped, saddle- 
 shaprd, high, iiarrozv. 
 
 Eyes: Pupil irregular or eccentric, congenital ptosis, epi- 
 canthus, oblique mongolian, palpebral fissure 
 small, cross-eye: asyniuieiry in size, in color. 
 
 Ears: i\v\ large, very small, Darwinian tubercle, abnor- 
 mal dcvelopnieut , asyinuictrical position or for- 
 mation. 
 
 Tongue : Very large, very small, thick, flat, jiointed, fis- 
 sured, enlarged pa pill (C. 
 
 Thyroid: Enlarged, atrophied, absent. 
 
 Thorax : P)reasts absent, atrophied, small, large, super- 
 numerary ; development of breasts in male ; 
 pigeon breast, funnel breast. 
 
 Upper Limbs: \'ery long, very short, asymmetrical; nial- 
 forniation of right, left hand: fingers united, 
 supernumerary, two-jointed, very long, very 
 short. Little fingers imperfect. Left-handed, 
 ambidextrous. 
 
 Lower Limbs: Club foot; toes united, supernumerary; 
 knock-knee, bow-legs, legs or feet very long, 
 very short, asymmetrical. 
 
 Genitals : Incomplete descent of one or both testicles. 
 Organs oi'er-dei'eloped. undeveloped, atrophied. 
 Ilermaphrodism. true or false. Phimosis. Ste- 
 nosis or reduplication of vaginal and uterine 
 '= . canals. Undeveloped uterus, ovaries, vagina. 
 
 Clitoris enlarged or hooded. 
 
 Skin : Pallid, sallow, leathery, prematurely wrinkled, birth- 
 marks. 
 
 Hair : Coarse ; scanty on face, eyebrows, chest, pubes. 
 Hairy moles or tufts on body. Bald spots. Eye- 
 brows meet. Abnormal distribution of hair.
 
 A SVLLAHUS FOR CLIMCAr. KXAM IXATION. 187 
 
 Nails : Thin and frial)le, pigmented, arched and thickened, 
 long, short, furrowed lengtliwise, crosswise. 
 
 Nutrition: Anccmia. Obesity. 
 
 Vasomotor: Flitsliiiii^, local heat or cold, excessive or 
 local sweating, factitious urticaria. 
 
 I'nclassified : ( iigantisni. dwarfism. Ccncral hahnicc re- 
 laxed. . Isyiiniielncal f^nslure or head ludance. 
 Scoliosis, lordosis. h'emiuiue as|)ect. Mincing 
 or shuffling gait. 
 
 ]\ri-:i)IC.M. EXAMINATTOX. 
 
 T. Neuro-muscular .System: 
 (a) Reflexes: Kjicc jerk, .lehilles. Pitf^iUary. Con- 
 junctival. Plantar, .\nkle clonus. Cremasteric. 
 Abdominal. Arm. jaw. Palatal. i 'har\iigeal. 
 Defecation. Micturition. 
 (Examine others where indicated. ) 
 (h) Electrical responses. 
 
 (c) Cranial nerves: IT. J'isual field. Optic discs. 
 Ill, 1\', W. Strabismus. ( )cular movements. 
 Nystai^^inus. I'tosis. Diplopia. \'. i motor, sen- 
 sory.) \M1. ( paralysis, tics.) IX, N, XKXll. 
 
 (d) J^ertcbral eoluiiin: { deviations, etc.) 
 
 (e) Sensation: J'isioii R. L. Heariiii^ R. L. Smell. 
 I'aste. Pressure. Temperature. Pain. Muscular. 
 Stereoagnosis. An;esthesias, h\i)er;esthesias, ])ar;es- 
 thesias, especiallv asymmetrical or local variations. 
 Headache. Vertigo. 
 
 (f) Motor: Tonicity. Strength. Co-ordination or 
 ataxia. 
 
 Tremors (coarse, fine, unilateral, intentional, spas- 
 tic, ataxic, intermittent, undulatory). Paralysis. 
 Contractures. Tics.
 
 iSS BACKWARD AND FEEBLE-MINDED CHILDREN. 
 
 Spasms (general, unilateral, local, tonic, clonic, 
 
 purposive), 
 (g) Other nerve signs, 
 (h) Speech: Stammering, stuttering, lisping, defective 
 
 articulation, semi-mutism, mutism, 
 (i) Writing: (j) Mimic and gesture: (k) Gait. 
 
 2. Eye, ear, nose, and throat : 
 
 3. Skin, mucous membrane, trophic disorders, 
 
 4. Circulation : Heart. Pulse. Temperature. Blood 
 
 pressure. Veins. Arteries. Blood. Vasomotor. 
 
 5. Respiration : Rate. Character. Chest inspection. 
 
 6. Alimentation : Stomach. Intestines and abdomen. 
 
 Breath. Tongue. Appetite. Digestion. 
 
 7. Liver, spleen, and pancreas. 
 
 8. Other glands {tonsils, adenoid vegetations, cervical. 
 
 sub-maxillary, axillary, inguinal, thyroid). 
 
 9. Cenito-uninary system : Reproductive activities and 
 
 misfunctionings. 
 
 10. Laboratory examination of sputum, blood, urine, etc. 
 
 11. Habits: (Sleep, drugs, beverages, tobacco, uncleanli- 
 
 ness). 
 
 12. Infections, vernu'n, vaccination.
 
 A SVLl.AItUS FOR CLINICAL L.\ AM I X ATK )X . l8g 
 
 D. MENTAL ICXAAl IXATION. 
 
 liilcUii^xiice aiul Rctardaiion. The lliiicl Scale as Revised 
 
 ])}■ Dr. Goddard.''' 
 
 Mental examiiialidii of lidrn 
 
 School L;rade Examined by Dale 
 
 Passed tests, of expected at 
 
 this age. Accordins^j- to these tests, child's intelligence is ap- 
 proxiniatel}' at the level of years, indicating a re- 
 tardation of years. Classified as 
 
 Conditions 
 
 Mentality of One inn! 7ico Vcars. 
 
 Eye follows light. 
 
 Block placed in hand is grasped and handled. 
 
 3. Suspended cxlinder is g'rasped when seen. 
 
 4. Candy is chosen instead of block. 
 
 5. Paper is removed from cantly before eating, cliikl hav- 
 
 ing seen the wrapping. 
 
 6. Child executes simple commands, and imitates simple 
 
 movements. 
 
 ♦While the tests are here arrdiujcd as in Dr. (Joddartrs revision, and 
 liis own statement is used for a few of tliem, 1 have usually used my ow)i 
 form of statement, made directly from Binet and Simon, and intended to 
 furnish a practically intelligible form of record for the essentials of each 
 test. The explanatory notes are adapted from my earlier syllabi for all 
 but the new tests. For the latter they make free quotation and paraphrase 
 from both (Joddard and Itinct. Acknowled.^^ment is horeI)y made for this 
 al)undant use of these authors' material, without holding them responsible 
 for my modifications in statement.
 
 ig6 BACKWARD AND FEEBLE-MINDED CHILDREN. 
 
 Mcniality of Three Years. 
 
 7. Touches nose, eyes, mouth, and pictures of these, as 
 
 directed. 
 
 8. Repeats easy sentences of six syllables, with no error. 
 
 9. Repeats two numerals. 
 
 10. Enumerates familiar objects in pictures. 
 
 11. Gives family name. 
 
 Mentality of Four Years. 
 
 12. Knows own sex. 
 
 13. Recognizes key, knife, penny. 
 
 14. Repeats three numerals in order, when heard once. 
 
 15. Tells which is longer of lines differing by a centimeter. 
 
 Mentality of Fiz'e Years. 
 
 16. Discriminates weiglits of 3 and 12 grams, 6 and 15 
 
 grams. 
 
 17. Draws, after copy, a square that can be recognized as 
 
 such. 
 
 18. Repeats "P^is name is John, lie is a very good boy," 
 
 and similar sentences. 
 
 19. Counts four pennies. 
 
 20. Rearranges a rectangular card that has been cut diag- 
 
 onallv into two triangles. 
 
 Mentality of Six Years. 
 
 21. Knows whether it is forenoon or afternoon. 
 
 22. Defines, in terms of use, the words fork, table, chair, 
 
 horse, mama, three satisfactorily. 
 
 23. Performs three commissions given simultaneously.
 
 A S\ l.l.Al'.US FOR CLIMCAI. KXA M I N ATIOX . I9I 
 
 24. Shows ri,G:ht hand, left ear. 
 
 25. Distin.^uislirs prclt}' frmii (hstincll)- u.^ly or (Iclonncd 
 
 faces, in ])ictures. 
 
 Mcntiilily of Sci-cii W'urs. 
 
 26. Counts 13 i)ennies. 
 
 27. Descrihes ])ictures sliown in Xo. lo. 
 
 28. Notes omission of eyes, nose, month, or arms, from as 
 
 many portraits, three of the four. 
 
 29. Draws (Hamond sha]K\ from copw so that it can l)e 
 
 recognized. 
 
 30. Names red, green, l)Uie, yelknv. 
 
 Mentality of lui^ht )'cuirs. 
 
 31. States difference l)etween pa])er and cloth, l)utterll)- and 
 
 fiv, wood and glass, in two minntes. two satisfac- 
 torily. 
 
 ^2. Counts from 20 to 1 in twent}- seconds, with not more 
 than one error. 
 
 j!,;^,. Names days of week in order, in ten seconds. 
 
 34. Comits values of six stamps, three ones and three twos, 
 
 in less than lifteen seconds. 
 
 35. Repeats five numerals in order, when prununnced once. 
 
 Mentality of Xliic ]'ears. 
 
 3f). (lives correct change from twent\- cents (two dimes) 
 
 paid for an article costing foiu' cents. 
 T,y. Defines in terms su])erior to statements of use. in \'o. 22. 
 
 38. Names the daw month, day of month, year, allowing 
 
 error of three da}s either way ou day of month. 
 
 39. Names the months in order, allowing one omission or 
 
 inversion, in fifteen seconds.
 
 192 DACKWAKD AND FEliULE-MINDED III ll.DRF.N. 
 
 40. Arranges, in order of weight, boxes of same size and 
 
 appearance weighing 6, 9, 12, 15, and 18 grams, in 
 three minutes. Two out of three trials. 
 
 Mentality of Ten Years. 
 
 41. Names a penny, nickel, dime, quarter, half, dollar, two, 
 
 five, and ten dollar bills, in forty seconds. 
 
 42. Copies design after ten seconds' exposure. 
 
 43. Repeats six numerals. 
 
 44. Tells what one should do in various emergencies, and 
 
 answers questions difficult of comprehension. 
 
 45. Uses three given words in two sentences. 
 
 Mentality of Eleven Years. 
 
 46. Detects nonsense in three out of five statements, in 
 
 about two minutes. 
 
 47. Uses three given words in one sentence. 
 
 48. Gives at least sixty words in three minutes. 
 
 49. Names three words that rhyme with obey, in one 
 
 minute. 
 
 50. Rearranges shufflefl words of 8-word sentences, two 
 
 out of three, with one minute for each. 
 
 Mentality of Twelve Years. 
 
 51 
 
 53 
 54 
 
 55 
 
 Repeats seven numerals in order, when heard once. 
 Defines charity, justice, goodness, two satisfactorily. 
 Repeats, with no error, sentence of 23-26 syllables. 
 Resists suggestion as to length of lines. 
 Infers correctly the fact indicated by circumstances 
 given, in each of two trials.
 
 A SVlJ,Ai;US K()K CI.IiMCAL E.\ A.M J N A I loX . 1 9.^ 
 
 Mciifalify of Fifteen W-ars. 
 
 56. liili'rfn'ts ])iclurc.s >li(i\\n in Xos. lo and 27. 
 
 57. Imagines clock-liand-^ inUTcliaii.i;c(l |i»r Imur (1.20 and 
 
 for hour 2.5''. U'IIihl;' the time. 
 5(S. Writes "C"aui;Iit a s])\'" in s_\niliol> after learnini;' code, 
 one error ])ennitted. 
 
 59. Writes correeth' the o])i)osiie of >eventeen out of 
 
 twent}' s^iven \\'or(ls. 
 
 Meiilality of .In Adult ("Over 15 Years"). 
 
 60. Imagines and draws result of cutting triangle from side 
 
 of twice folded ])ai)er. 
 6r. Imagines and draws new form ])roduce(l I)\- joining 
 transposed jjieces of diagonally divided rectangular 
 card. 
 
 62. Distinguishes lietween abstract terms of similar sound 
 
 or meaning. 
 
 63. Ciivcs three differences between the ])resi(lcnt of a re- 
 
 pul)lic and a king. 
 O4. Gives the central thought of a selection read to him. 
 
 No descriptive notes and directions can take the i)lace of 
 a careful reading of I'inet's articles in l\\niicc Psycholoi^iqiic 
 for 1908 and in the Bulletin de la Soeieie Ulve pour ffltv.de 
 Fsychologicjue de lliiifaut, for April, 191 1. The latter 
 article gives 15inet and Simon's revision of the original scale. 
 Dr. (loddard, after using the I>inet tests upon four hundred 
 feeble-minded children and two thousand normal children, 
 has made a further revision." With very minor modihca- 
 
 *Teachors, social Wdrkors, and others who aie thcni.sclvcs lo use the 
 Binet scale will find the pamphlet printed by Dr. Goddard in 1911, entitled 
 The Binct-^iinon Mcnsurhifi Scale for InteUUjcnvc, to be their best jAiiide 
 in English for the actiial giving of the tests. See the bibliogrnpliy to this 
 volume. See also my note concerning the need of some persoaal direction 
 in addition to such reading.
 
 194 BACKWARD AND FEEBLE-MINDED CHILDREN. 
 
 tions the latter is the scale here printed. Most of the tests 
 are the same as in the original scale, but some of them have 
 l^een distributed differently. The tests for thirteen years 
 have been ])laced higher, .\fter reading Binet's 1908 article 
 the following supplementary notes, bearing the numbers of 
 the tests to which thev refer, may give sufficient guidance 
 for making the tests which are not self-explanatory. The 
 first six tests, really part of an older scale described by 
 Binet in I'Aiuicc Psychologiquc for 1905, represent succes- 
 sively higher levels of mentality, as numbered, throughout 
 the first and second years. 
 
 No. 6. (a) Shake hands, (b) Be seated, (c) Pick up 
 the box. (d) Go to that chair, (e) Come back, (f) Clap 
 hands this way. ( g) Hands in air: (h) on shoulders; (i) 
 behind back; (j) one hand around the other, (k) Rise on 
 toes. 
 
 Nos. 8, 18. 53. Correct repetition of one sentence in three 
 suffices. 
 
 Nos. <;, 14. 35, 43, 51. Half-second intervals, uniform 
 emphasis, one success in three trials. 
 
 Nos. 10, 2/, 56. lUit one test is made, by presenting in 
 succession three pictures, asking for each, "What do you 
 see here," and noting replies. Binet's pictures are (a) an 
 old man and boy dragging up the street a cart laden with 
 their household goods; (b) a poor old man sitting by his 
 daughter, who is unwell, on a bench beside the street on a 
 dreary evening; (c) a man confined in a room bare except 
 for bed, chair, and tables, and looking out of his tiny window. 
 
 No. 12. "Are you a little boy or little girl?" 
 
 No. 16. Weights are of same size and appearance. 
 
 Nos. 19, 26. Child touches each penny as counted, tallying 
 correctlv. 
 
 No. 20. Place the pieces with the hypotenuses away from
 
 A SM.LAItUS FOR CLINICAL EXAMINATION. 
 
 195 
 
 each other. Child must discover for liim^elf that he has the 
 rija^ht form. See that he docs not turn over either ])iece. 
 
 Nos. 22, 37. One test for the two nunil)ers. Answers 
 which pass Xo. 37 arc sncli as "A li(jrse is an animal that 
 pulls a wagon," "A mamma is a lady who takes care of the 
 house, cares for the children," etc., — almost an\- response, 
 indeed, which is of hij^her order than the simj)ie "A chair 
 is to sit on," "A table is to eat on," etc., of Xo. 17 grade. 
 Three of the five must be satisfactory. 
 
 No. 23. "Put this key on the table, then close the doi>r. 
 then bring me that box," or a similar series of directions. 
 
 No. 36. Play store, give child some change, have him 
 sell a box and actually hand over the correct change. 
 
 Xo. 42. L'se this design. Expose ten seconds. Have 
 child draw his design on back of record sheet. 
 
 H 
 
 EJTS 
 
 No. 44. What ought one to do 
 
 1. When one has missed the train' 
 
 2. When one has been struck by a playmate who did not 
 do it purposely? 
 
 3. When one has broken something that does not belong 
 to one? 
 
 4. When he is detained so that he will be late for school? 
 
 5. What ought one to do before taking part in an impor- 
 tant affair? 
 
 6. Why does one excuse a wrong act committed in anger 
 more easily than a wrong act committed without anger? 
 
 7. What should one do when asked his opinion of some 
 one whom he knows onlv a little ?
 
 196 r.ACKWARD AND FEEBLE-MINDED CHILDREN. 
 
 8. Why ought one to jtidge. a person more by his acts 
 than by his words ? 
 
 Allow at least 20 seconds to each question. Five of the 
 eight must be answered correctly. 
 
 Nos. 45. 47. Words fairly equivalent to Binet's, for our 
 children, are "Chicago, fortune, and river," with preliminary 
 practice on the easier "Springfield, money, and boy." Must 
 be completed in about one minute. 
 
 No. 46. Announce that you will read some sentences, 
 each of which contains something foolish. Then read 
 slowly, in a convinced tone: (a) A poor bicyclist fell and 
 broke his neck, and died on the spot. He was taken to the 
 hospital, and they fear very much that he cannot get over it. 
 ( b) I have three brothers, John, Jim, and myself, (c) Yes- 
 terday the body of a poor }'oung girl was found, cut in 18 
 pieces. People think that she killed herself. ( d) There was 
 a railroad accident yesterday, but it was not serious. The 
 numl)er of dead is only 48. (e) We found a boy, with his 
 hands and feet tied behind him, locked in a room. We think 
 he locked himself in. 
 
 After each number ask what is foolish in it. The whole 
 test lasts about two minutes, and replies must be satisfac- 
 tory for three of the five numbers. 
 
 ,No. 48. Child is asked to say all the words he can think 
 of, such as table, beard, shirt, go, etc. 
 
 No. 49. First illustrate rhyming, by examples. 
 
 No. 50. ^lake sentences of these words : 
 
 (a) For — The — Started — An — W'e — Country — 
 b^arly — At — Hour. 
 
 (b) To — Asked — Exercise — My — Teacher — Cor- 
 rect — My — L 
 
 ( c) A — Defends — Dog — Good — His — Bravely — 
 Master. 
 
 No. 52. Ask "What is goodness," etc. Such answers as
 
 • A SVl.l..\i;US l-OK (I.IMCAI, ICXAMIXATION. 1<;7 
 
 "Goodness is to share with ()lhei->." "To return ijood for 
 evil:" "Charit\' is to i;ive nKmey to nld ])e(ii)le who cannoi 
 work," are satisfactory. 
 
 .\(). 5_:;. (a) I saw in the street a pretty httle (h>'j;. Me 
 had eurly hrnwn hair, short le.^s. and a Ions: tail (h) My 
 httle children, yon nmsl work very hard for a livin.t;. N'on 
 ninst .^'o everv niornini;" to yonr school, (c) johnny i^ otten 
 whipped for heing- naughty. I went to the store a.jid 
 hought a doll forniy sister. 
 
 No. 54. Prepare a hooklet of six pages. ( )n first page 
 draw two horizontal lines, in ink, the one to the lelt two 
 inches long, the one to the right two and a half inclu's. ( )n 
 second page, left line is two and a half inches, right three 
 in.ches. Third page, left line is three and right one is three and 
 a half inches. On the three remaining pages all lines are three 
 and a half inches long. The lines on each page are in same 
 straight line and separated hy a half inch. When the child 
 has found the right line longer three times in succession, 
 will he continue to make this judgment even wdien he comes 
 to those that are alike, or will he resist suggestion and i)ro- 
 nounce them alike? For the first two pages ask "Which is 
 the longer line?" For the others say merely "And there?" 
 
 No. 55. (a) "A man who was walking in the woods near 
 Chicago suddenly stopped, very much frightened, and then 
 ran to the nearest police statiori to tell them that he had ju->l 
 
 seen, fastened to the liml) of a tree, a '■'" ( h) 
 
 "My neighbor has just received some ])ecnliar visits. There 
 came, one after the other, a doctor, a lawyer, and a nlini^ter 
 (or ])riest). What is going on at my neighbor's?" 
 
 Such answers as (a) "A dead ])erson hanging," and lb) 
 "My neighbor is dying," are correct, and both numbers must 
 be answered satisfactorily. Doubtless this test can be im- 
 proved. 
 
 No. 56. In 10 and 2/ did child interpret the "feeling of
 
 198 
 
 BACKWARD AND FEEBLE-MINDED CHILDREN. 
 
 the picture," usu'ally "by some word of sympathy, fear, sor- 
 row, joy, or other feeUng?" 
 
 No. 57. Without seeing- a watch or clock, tell the time of 
 day indicated by the hands interchanged at these hours. 
 
 No. 58. While the following diagrams are being construct- 
 ed the child must give close attention, noting arrangement 
 of letters in alphabetical order, vertically in the first and sec- 
 ond and counter-clockwise in the third and fourth. The 
 second and fourth have a dot in each section. "Knowing the 
 scheme, the letters may be left out and a cipher dispatch writ- 
 ten by using for each letter the part of the diagram in which 
 the letter is placed in the key. For example, 'war' would be 
 written N/ J H 
 
 "Having made it perfectly clear, remove the key and have 
 child write on back of record sheet 'Caught a sp}',' in this 
 code." Allow one error, every wrong or incomplete symbol 
 countine: as an error. 
 
 A 
 
 D 
 
 G 
 
 B 
 C 
 
 E 
 
 F 
 
 H 
 I 
 
 J 
 
 • 
 
 K 
 
 • 
 ■ 
 
 L 
 
 M 
 
 • 
 
 N 
 
 • 
 • 
 
 
 
 P 
 
 Q 
 
 • 
 • 
 
 R 
 
 Note. This test, n'ccntl.v suggested by ]>r. Wm. Healy of Chicago, is said 
 to have been use 1 by the Southern army in the Civil War. 
 
 No. 59. Hand the child a slip of paper with the following 
 words printed in vertical column, with space to write the op- 
 posites at the right of each: (i) Good, (2) outside, (3) 
 quick. (4) tall, (5) big, (6) loud, (7) white, (8) light, (9) 
 happy, ( 10) false, (ii) like, (12) rich, (13) sick, (14) glad, 
 (15) thin, (16) empty, (17) war, (18) many, (19) above. 
 (20) friend. 
 
 Besides the obvious answers, the following receive whole 
 or half credit: (2) In or indoors (half credit); (3) lazy
 
 A S^•IJ. AIM'S FOR CI.IXICAI. I'.X A M 1 N ATIOX. 
 
 1 99 
 
 or slowly ( half) : (4) little or low ( half) ; ('5) short 1 half) ; 
 (6) soft or low (full credit). whis])er (half) : {<■)) sorry or 
 sorrow (half); ( lo) ri^iit or truth (half): (11) dislike. 
 unlike, or hate (full); (13) healihy (full): (14) nui'l 
 (full); ('15) l)road (half): (lO) tilled (full): (iS) none 
 ( full) ; ( k; ) under ( full ). The e<|ui\'alenl of seventeen cor- 
 rect answers must he i^iven. 
 
 No. ()0. ['"old a sc|uare paper in foiu". l)efore the child, and 
 cut from it a small equilateral triangle l>ased on the niidcUe 
 of the closed ed.^'e. Ask tti draw pai)er a> it will look w heii 
 unfolded. 
 
 No. 61. Present a rectangular card cut in two alon^ij," a b. 
 Suppose we should turn over the lower triaui^le so that c 
 
 shcnild lie at b and a c should lie 
 aloui^" a b. Remove the lower ])iece 
 and have child image and draw the 
 new total shape suggested, begin- 
 ning with the ti]iper piece. 
 
 No. 62. What are the dift'erences between — 
 
 (a) Pleasure and welfare? 
 
 (b) Evolution and revolution? 
 ( c ) Elvent and ])re\'ent 'f 
 
 (d) Poverty and misery? 
 
 (e) Pride and pretension? 
 
 No. 63. "There are three differences between the presi- 
 dent of a republic and a king. What are thev?" The an- 
 swer should contain the three ideas that ( i ) royalty is heredi- 
 tary, while the ])resi(lent is elected: (2) a king reigns for 
 life, a president for a limited ])eriod ; ( 3 ) a monarch has ex- 
 tensive powers, while a president's powers are ustially less 
 extensive. 
 
 No. 64. Explain that }'Ou will read a selection to which 
 subject is to give close attention, and that he is to tell the
 
 200 BACKWARD AND !• I:KI5LE-MI NDED CH H.DRICX. 
 
 substance of it afterward. Read slowly, in a clear voice and 
 with expression, the folloxvinj;- : "One hears verv different 
 judgments on the value of life. Some say it is good, others 
 say it is had. It wonld he more correct to say that it is 
 ordinary or of middling worth ; because on the one hand it 
 brings us less happiness than we want, while on the other 
 hand the misfortunes it l^rings are less than others wish us. 
 It is this ordinary (jr medium cjuality of life that makes 
 it endurable : or, still more, that keeps it from being posi- 
 tively unjust." 
 
 The suljject nuist give the central thought in his own 
 words; c. i,'., "Life is neither good nor bad, but medium, be- 
 cause it is inferior to what we wish and not as bad as others 
 wish for us." 
 
 Tn making the records of the tests we itse a plus sign for 
 passed, a minus for failed, an exclamation point for absurd 
 response, A for failure through inattention, T for failure 
 through timidit}', R for failure through resistance, I for 
 failure through ignorance. In rare cases partial credit is 
 given, expressed in a fraction. The testing should begin 
 below the child's apparent level. Indeed, I usually try all 
 the tests that I am not certain of the child's passing, and the 
 testing should continue mitil there is no possibility of his 
 going further. He should be encouraged and praised when- 
 ever possible, and failures should never be dwelt upon. In 
 making the count the child is credited with the age level at 
 which he i)asses all the tests, i:)lus one year for each five tests 
 passed at higher levels. We record also the total number of 
 tests that are passed, with the number that should be passed 
 at the child's age. We have found it convenient to use half 
 years: that is, the child's age may be lo^ and his mental 
 level 8>4. 
 
 Usuall}- it is far better to be alone with the child, and in 
 anv case the test must not be discussed or in any wav in-
 
 A s^•l.l..M;^s for ci.ixical kxa.mixaiion. 201 
 
 UTt'crcd with. Man)' of the chihl's responses should be 
 co])ie(l verl)atini, and noles should he made of hi^ conduct 
 shown in tlu' \-arious circumstances of the testing'. 
 
 I''inall\ , I w'oidd ur^e ai^ain. a> earlier/'' that ■"ihe^e I'.inel 
 tests must he u>ci\ with iud.i;ment and trained intellifj^ence. 
 or they will certainK- hrini;- tIlemsel\■e^ and their authors into 
 undeserved disrei)ute. Such a syllabus as is here ])resented 
 by no means prepares mothers and teachers to make any 
 \-alid test either of their children or of the scale. .\ child 
 will often be shown to have the knowled.^e needed in a test 
 in w hich he failed, and the test will then l)e called inadequate. 
 I'.ut the test is not of k-now ledge merely, but of the abilit_\- 
 to use knowledge in meeting a situation created b}' the stand- 
 ardized conditions of the test. Results can be considercl 
 validf onl\ when the tests are made b\- an ex])erience(l psy- 
 chologist who has familiarized himself with Itinet's direc- 
 tions, or by other competent persons who api)ly the tests 
 imder the direction and su])ervision of such a psychologist. 
 
 Jf the tests are to be used in determining who are to be 
 placed in special classes, the little book Lcs Eiifaiifs An- 
 onuaux, h\ llinet and Simon, will be found extremely valu- 
 able. According to this l-'rencli ])lan, a pedagogical exami- 
 
 *.lo\irnal of Va\. l'sycIlol()i;y. Oclolin-. llllO. 
 
 vThat is. it is only wlien tlie tests are made under such conditions tliat 
 I lie results can be expected to lie reasonably free from errors, and entitle;! 
 to publication or record as liaving sucli scientific validity as can be claimed 
 for the scale. I'.ut on the other hand I finite auree with Dr. Goddard that 
 Uiis and similar scales will have a vei-y lar^e use and usefulness in the 
 hands of intellijient teachers and social workers everywhere, in maUinj;' 
 (ililirii.riiii<itr estimates of children's mental status, for immi'diate local use. 
 'I'he directions yiven here, supplPmeuted by those in ]>r. Ooddard's pampblel. 
 will quite sulhce for this. i)rovided that there can be further direction on 
 points as they conn- uii, and occasional supervision of the testing itself, by 
 some one who has at least been adecpiately trained in the actual siving 
 of the tests. Only the exceptionally intelligent can safely dispense with 
 such prrsoiKil direction and correction, in the beginning. Indeed the excep- 
 tionally intelligent are tisually themselves among the tirst to feel the initial 
 need of it.
 
 202 BACKWARD AND FEEBLE-MINDED CHILDREN. 
 
 nation must first show a pedagogical retardation of three 
 years, or of two years if the child is under nine. Then the 
 mental tests are used, and only the backward children who 
 show an equal amount of uicnfal retardation are sent to the 
 special classes. It is to be noted, however, that beside the 
 ch.ildren whose main characteristic is their mental 'back- 
 wardness' P.inet woidd send to special classes the "un- 
 stables." who are apt to show a mental retardation of only 
 one or two years.
 
 CHAPTER VII. 
 
 COiXCLl'SION. Tlll<: AlEXTAL FUNCTJOXS TO WIL 
 TESTED AND ()1 '.SERVED. 
 
 To obtain a(le(|uale account of an}' mind there is. of course, 
 much to be done beside testing' the intelHgence. Much fur- 
 ther knowledge of the intelHgence itself may lie gained l)y 
 using a variety of tests not contained in the scale of liinet 
 and Simon. Many of these further tests have been well de- 
 scribed in recent manuals and articles, and some of the most 
 usable or important of the latter are listed together in the 
 brief bibliography at the close of this volume. As the syl- 
 labus of the preceding chapter has special reference to routine 
 work with cases, it has not seemed best to complicate matters 
 by attempting here a formulation of research tests. A tenta- 
 tive scheme of the latter was worked out at Lincoln, includ- 
 ing, beside many standard tests, a number that were being 
 newlv devised and tried. However, all that have reallv con- 
 tributed much to an understanding of the cases studied have 
 already been referred to. and a statement of others may be 
 made when there is time to perfect them. 
 
 It is for the mental levels above the twelve-year limit that a 
 further formulation of tests and of lines of observation is 
 most urgently needed. Intelligence itself normally continues 
 to make some gain in efficiency and some transformation in 
 character year by year to maturity, and even on thru middL- 
 life. But the intellectual advance is progressively more spe- 
 cialized and variant with the individual, making more diffi- 
 
 203
 
 204 r.ACKWARn AND FEEF.LE-MI XDED CHILDREN. 
 
 cult its measurement l)y any standardized schema or scale 
 of tests. At any rate, in these higher levels the further men- 
 tal growth and the retardations that concern us most are not 
 so much in the intelligence as in the feelings, the emotions, 
 the instincts, and in the control and direction of these and of 
 the functions generally ; in the new consciousness of a \ie\\ 
 self, and in the widening of social consciousness and social 
 relationships, with the master function of sex always prom- 
 inent. 
 
 At these levels the structures necessary for all mental func- 
 tionings may be supposed to have been grown, though per- 
 haps badly grown and of strength insufficient for their work. 
 Arrest at these levels leaves the youth in the zone of the 
 psycho-neuroses, characterized in part, as Dubois of Berne 
 has said, by "the intervention of mind, of mental representa- 
 tions, in all their symptoms." The functions do not grow 
 to the possibility of making the higher adaptations, or make 
 them so feebly that they are easily shattered in emotional 
 shock and in the varied vicissitudes of mature life. "The neu- 
 roses appear almost always at the ages in which the organic 
 and mental transformation is the most accentuated, says 
 Janet, "at puberty, marriage, the death of intimate relatives 
 or friends, the changes of career or of position." 
 
 Into the classification of the neuroses it is not my pro- 
 vince to enter here, but merely to point out that they form the 
 next higher rungs in the ladder of retardation, continuously 
 transitional, in my judgment, from certain classes of the 
 feeble-minded. h\)r clinical pictures of these higher defec- 
 tives we have especially the extensive and excellent studies 
 of Janet, on neurasthenia, psychasthenia. hysteria, and cer- 
 tain forms and equivalents of epilepsy. For certain forms 
 of hysteria at least, many would consider Freud to be still 
 more enlightening. Then in Adolf Meyer's interpretation 
 of dementia prascox we have an equally important account of
 
 MKXTAi. iTXCTioxs TO r.K 'n:s'ri:i) vxn <)r.si:K\iii). 205 
 
 other forms of late iiK-ntal arrest and deterioralion. A^ain. 
 011 lines leading;" toward inanic-(le])ressive and other forms 
 of insanity, Knepelin's studies arc well kimwn and are of 
 eourse illuminating. In these and nther clinical studii's there 
 l^egin to l)e sug'j^'ested the tunctinns which h^uri' nn i^t in the 
 higher forms of arrest; the functions which are hasal and 
 primary, whose imperfect development and insufficient or 
 perverted exercise entail serious consequences. The selection 
 of these finictions and of tests for their condition of effi- 
 ciency or inefficiency is work for a clinical psycholoj^y that 
 still awaits formulation. As to what these functions are I 
 shall here onl\' refer to some very tentative notes which 1 
 have alread}' ])rinted elsewhere and for whose revision there 
 is now but little time, ddiey at least contain suggestions that 
 have a certain value if happily the brevity of statement may 
 not lead to too much of misconstruction: I'irst of all. 
 the function of completed action in rapport with the widen- 
 ing demands of maturing life, really the intelligence or rather 
 mental efficiency taken in the very broadest sense, is the 
 most difficult and highest function, as Janet so often urges. 
 Then of less general functions we know that in ore in cut and 
 the control of movement are essential, and we are indeed al- 
 ready provided with some good tests of this function, though 
 standard norms are yet to be establishe<l. We know that 
 attention is somehow fundamental, that normal grij) that a 
 mind takes upon itself in holding down to an adaptation 
 called for ; and we know that attention is oi the essence of 
 71'///. The function of synthesis, of mentally spaniiniL:; nu- 
 merous or complex elements, is in part identical with the 
 power of attention, InU onh- in part. Can the patient keep 
 track of the score at a ball game, make plays that he knows 
 how to make in a game of cards, hold a row of numbers or 
 objects in order till he can give an account of them? It is 
 not merely to have attention power to ignore extra or dis-
 
 206 BACKWARD AND FEEBLE-MINDED CHILDREN. 
 
 tracting factors, but synthesizing power to face and use 
 them all in getting a result. Emotivity, in Janet's fruitful 
 use of the term for the general tendency to interrupt adapta- 
 tions by mal-adapted phenomena of confusion, emotion, and 
 derivation, is the opposite of the power of synthesis. It is 
 one of the most fundamental conditions in neurasthenia and 
 hysteria. 
 
 The function of feeling, with its phases of susceptibility to 
 pleasure and pain through the various interests, notably the 
 /i/ay and art interests, this we are finding to be quite different 
 from emotion and emotivity. New means of testing this 
 side of life are recently being developed and it is not so im- 
 possible a field as it once seemed. The condition of the 
 instinctive activities is of course to be noted as well. Incom- 
 ing, memory, and the ability to make report, together form a 
 practical function of the greatest importance. Reasoning, 
 just the intelligence made articulate by the use of general 
 rules and abstract conceptions, is to be examined as a devel- 
 opment of the intelligence. 
 
 Then we have the function of forming ideals and of esti- 
 mating lvalues and relative worths, for the guidance of judg- 
 ment and action. There are the self-estimations and self-re- 
 lationships which make up the social phases of mind and 
 which include the bases of morals and religion. And there 
 is the function of self-direction and the opposite tendency to 
 a mental attitude and condition of dependence. There is 
 further the difficult but not so hopeless problem of tempera- 
 ment and personal attitude. 
 
 In certain cases, certainly, the characteristics of association 
 and of the train of thought become of extreme importance, 
 and the orioitation in space and time. The rate and degree 
 of intensity at which mental work goes on, the behavior in 
 the face of difficulty, the facility of fatigue and of recupera- 
 tion, are also to be estimated. Most fundamental of all, for
 
 MENTAL FUNCTIONS TO BE TESTED AND OF.Sl-.RX I.D. 20/ 
 
 inlerpretin£i' a s;reat variety of cases, is the ability to main- 
 tain a sufficient and normal level of mental functionini;- or or 
 ])sychic tension. Janet, for instance, believes that the essen- 
 tial fact of the functional neuroses is the inabilit}' to reach 
 or to safeh' maintain normal levels of functioning'. 
 
 Whatever the fundamental fimctions ma\- be it is a next 
 step to determine at least more of them thaii have usuall)' 
 been clearly in mind when tests were ])lanned. Not that for- 
 mal tests can or m^vd be applied to all functions, thousj^h they 
 can help in the study of most. \or that a mind can be 
 picked apart and the pieces measured ])iecemeal. hi testing' 
 any function the mind is. of course, exercised in many other 
 functionings. Ihit a pro])er test calls the selected function 
 into dominant action, the conditions are standardized v.ith 
 reference to it. and the observation and record are devoted 
 to it. Jn making field observations and especiall}' in working 
 up field data the emphasis will come to be placed on what is 
 found to happen when these fundamental functions are in- 
 volved. Perhaps at present we need most of all a better for- 
 mulation of methods of field study; and ]:)ossibly if much 
 more attention were paid to the life-eoitrse of the ixitient 
 rather than to the multiplication of tests there would be 
 quicker progress to a decision as to which tests are worth 
 while. 
 
 Professor P)inet has rendered a great service by determin- 
 ing the normal behavior, at each age to twelve, of a group 
 of related functions, mainly of the intellect and loosely 
 classed together as the "intelligence"; a tenu, by the way. 
 that has come to have a very elastic content. The phases 
 of mind that are measured in his scale are fairly typical of 
 mental growth to the dawn of adolescence. \\'hich of our 
 investigators, coiupetent to the task, will make sure of some 
 great function or group of functions that rises into domi- 
 nance in this adolescence period, and will work out for each
 
 208 IJACKWARD AND FKEDLE-MI NUliD Cli ll.DKlCX. 
 
 advance in years its normal Ijchavior and transformation? 
 Wlien there has been such wise selection of the trunk lines 
 along which mental devel<)|)ment goes forward in these later 
 years, and of the ty])ical modes of deviation and arrest, and 
 when we know the normal progress to be expected along each 
 line with each added year, we shall then have constituted a 
 lialanced scale of norms for the later development of the es- 
 sential mentality. Such a scale will l)y no means be limited 
 to a formulation of tests, though it will include such tests as 
 can be utilized. But it will give noriual standards for judg- 
 ing the life as observed in its natural and normal activities. 
 
 All this is work for none but the most mature and com- 
 petent men who have abundant freedom and facility. For the 
 workers in the field I believe that a faithful following of the 
 fortunes of individual cases, using any tests and methods of 
 observation and study which will help to throw light on 
 essential conditions, is the kind of work most needed at 
 present. For statistical study, reliance cannot be placed on 
 the ])resent means for gathering data in most institutions ; 
 and it seems to me that in the present "frontier" stage of 
 this work the man who keeps face to face with his cases and 
 who works up the case-background in the light of which his 
 observations are to be interpreted, is the man who is likely 
 to help most to a real understanding of defectives. 
 
 In this belief, perhaps the very imperfections of these case- 
 studies and of these tentative syllabi and concluding for- 
 nudations may encourage others to frankly begin in their 
 own best way. with the cases and resources that are now 
 accessible to them. They will find the work of the clinician 
 to be as full of fascination as it is of opportunity for far- 
 reaching service.
 
 Fiir.LIOCiRAlMIV. 
 
 The followiiij;' list of books and journals includes llie most 
 indispensable, with some others that will assist in preparin,^ 
 for actual work with cases. lUblio^raphies in the works 
 here cited. es])ecially those by Goddard and .Macl )iinal<!, will 
 t^ive abundant further references. Dr. (Joddard has in prej)- 
 aration a much more extensive bibliography. ?\Ian\- ver\- 
 valuable short articles not listed here are included in earlier 
 volumes of the journals listed. Sets of these journals should 
 be at hand at least to the extent sug^ijested below. Any jour- 
 nal or book listed, and especially the foreis^n journals, may 
 be conveniently obtained throus^h (i. E. Stechert & Co., New 
 York, or A. C. McClurg & Co., Chicago. 
 
 JOURNALS. 
 
 Psychological Clinic. The Psych. Clinic Press, Philadel- 
 phia. Complete set should be owned, and is inexpensive. 
 
 The Training School. Published by X. J. Training School, 
 Vineland, N. J. Last four or five volumes should lie owned, 
 and are quite inexpensive. 
 
 .lournal of Psycho-Asthcnics. Published by Minn. ."-^cIiodI 
 for the b'eeble-minded, Faribault. Minn. \ ols. .\I\' and XV 
 should be obtained. 
 
 The Siin'ey. Xew York. 
 
 Anieyican Breeders' lVIaga::;ine. Washington, 1). C. 
 
 Tugcnics Rcfie^i'. Published by the F.ugenics Ivlucatiinial 
 .Siiciety. London. 
 
 209
 
 2IO BACKWARD AND FliEULE-M I NDED CHILDREN. 
 
 I'olta Rcz'icw. \'olta Bureau, Washington, D. C. 
 
 Jonrmil of Educational Psychology. Warwick & York. 
 Inc., Baltimore, Md. Obtain \'ols. I-II to date. 
 
 School Hygioic. Dr. Geo. S. Badger, 48 Hereford St., 
 Boston, Mass. 
 
 Pedagogical Sciiiinary. Clark University, Worcester, 
 Mass. 
 
 Journal of the American Institute of Criminal Law and 
 Criminology. Chicago, Bl. 
 
 Eos. Published by A. Pichler's Witwe und Sohn, Wien. 
 
 Die Hilfschule. Carl Marhold, Halle, a. S. 
 
 I'Annee Psychologiqne. ]\Iasson et Cie, Faris. (Jbtain 
 the volumes at least as far back as 1908 or 1905. 
 
 Zeitschrift filr die Erforschung and Behaiidluiig des 
 Jugendlichen Sclncachsinns. Gustav Fischer, Jena. 
 
 Zeitschrift filr Kinderforschung. Beyer und Sohne, Lan- 
 gensalza. 
 
 Bulletin dc la Societe librc pour I'Etude psychologiqne de 
 I'enfant. Faris, 191 1. Biexpensive. Ciet the back numl>ers. 
 
 TESTS AND SYLLAni. 
 
 Whipple: Manual of Mental and Physical Tests. War- 
 wick and York, Bic. Baltimore, Md.. 1910. 
 
 Goddard. The Binet-Simon ?\leasuring Scale for intelli- 
 gence. Revised Ed., 191 1. Published by the Training 
 School, \'ineland, X. J. 
 
 Binet et Simon : Articles on measurement of the intelli- 
 gence, in I'Aunee Psychologiqne, 1905, 1908, and elsewhere, 
 and in Bulletin de la Societe librc, etc., for April, 191 1, espe- 
 cially. See Kuhlman in Journal of Psycho-Asthenics, \"ol. 
 X\', and Goddard reference aT)ove, for partial translations 
 of Binet-Simon articles on tests.
 
 MKNTAL I'UNCTIONS 'lO !!!•: 'IICSTl':!) AND 01'.S1:K\ i;i ). J I 1 
 
 KiK'N' : Tlu' lliiu't .Measuring' Scale, j. of I'.il. Ps\ch<)l- 
 o^y, Oct., Kjio. 
 
 1 luc\' : A S\llal)U.s iov the C liiiical I'.xamiiiation ol C liil- 
 dreii. Warwick & N'ork, Ualtiinore. Md., I'^ii. Warwick 
 aiul \'ork also suj^ply record 1)lank> for liinet tests, in (|uau- 
 tities of a dozen or more. 
 
 Healy and I'ernald : Tests for Practical Mental Classifi- 
 cation. The Psychological Review Co.. lialtiniore, Md.. 
 1911. 
 
 White, Wm. .\. : Outlines of Psychiatry. .\ew ^'ork. nji i. 
 Contains much on methods of examination and tests. 
 
 Galton, v.: Report of the .\nthro])ometric C'onimittee of 
 British Association, London, 1893. 
 
 Macdonald, Arthur: See especially his Juvenile Crime 
 and Reformation, under "Pooks and Articles." 
 
 Norsworthy : Psychology of Mentall}- Deficient Children. 
 N. Y., 1906. 
 
 Chicago Child Study Reports, of Smcdley, ^lacmillan, 
 Eruner. Published by P)Oard of Education, Chicago, 111. 
 
 Kent and Rosanofif : A Study of Association in Insanity. 
 American Journal (^f Insanity, \ ol. LX\'I1, Nos. t and 2, 
 1910. 
 
 Jung: Diagnostische Assoziations- — Siudien. \'ols. T and 
 IT. Leipzig", t()o6 and 1910. 
 
 Toulouse: Emile Zola. Paris, 1896. 
 
 Report of Committee on Tests. American Psychological 
 Association, 1910. Psych. Review Pub. Co.. Paltimore. Md. 
 
 One should also own or have access to some standard 
 manuals of laboratory experimentation, such as Titchener's 
 Expcnnicntal Psychology. Toulouse et Pieron's Technique 
 de Psychologic Expcrinicntalc, etc.
 
 212 BACKWARD AND FEEBLE-MINDED CHILDREN. 
 
 BOOKS AND ARTICLES. 
 
 Tredgold : Alental Deficiency. N. Y., 1908. One of the 
 very best general treatises. 
 
 Barr, Martin, W. : Mental Defectives. Philadelphia, 
 1904. 
 
 Shuttlew^orth : Mentally Deficient Children. London. Get 
 recently revised edition. 
 
 Ireland, W. W. : The Mental Affections of Children. 
 London, 1898. 
 
 Seguin : Idiocy, and Its Treatment by the Psychological 
 Method. Brandon Printing Co., Albany, N. Y., 1907. 
 
 Dannemann : Enzyklopadisches Handbuch der Heilpada- 
 gogik. Carl Marhold, Halle, a. S. 
 
 Goddard : Bibliography of Mental Deficiency. N. J. 
 Training School, Vineland, N. J. 
 
 Goddard : Heredity of Feeble-Mindedness. American 
 Breeders' Magazine, Vol. I, No. 3, Washington, D. C. 
 
 Goddard : Two Thousand Normal Children Measured by 
 the Binet Measuring Scale of Intelligence. Pedagogical 
 Seminary, June, 191 1. 
 
 Huey : Retardation and the Mental Examination of Re- 
 tarded Children. Journal of Psycho-Asthenics, Vol. XV. 
 
 Meyer, Adolf: Preventive Mental Hygiene. Psycholog- 
 ical Clinic, June 15, 1908. 
 
 Meyer, Adolf: Dementia Pr?ecox. R. G. Badger, Boston, 
 1911. 
 
 Henderson, Chas. R. : Introduction to the Study of the 
 Dependent, Defective, and Delinquent Classes, and of their 
 Social Treatment. 2nd ed., Boston, 1901. 
 
 Binet : Les Enfants Anormaux. Paris, 1907. 
 
 Janet, Pierre : Les Nevroses. Paris, 1909. 
 
 Macdonald, Arthur: Juvenile Crime and Reformation. 
 Govt. Printing- Office, Washington, D. C, 1908.
 
 MENTAL FUNCTIONS TO BE TESTED AND OBSERVED. 21 3 
 
 Macdoiiald. Arthur: .Man and Al)nornial Alan. Govt. 
 Printing- Ofifice, 1905. 
 
 W'allin : The New Chnical I'sycholo^y and the Psycho- 
 CHnicist. journal of Ed. Psych., March, and April. 1911. 
 
 Ayres, L. ]'.: Laggards in otir Schools. Charities i'ul). 
 Com., N. Y., 1909. 
 
 Reeder, R. R. : How 200 Children T.ivc and Pearn. Char- 
 ities Pub. Com., X. Y. 
 
 Parmelee : Anthropology and Sociology in Relation tn 
 Criminal Procedure. The Macmillan Co., .\. ^^. 1908. 
 
 M?ennel : The Auxiliary Schools of (ierniany. Covt. 
 Printing Office. Washington, D. C, 1907. 
 
 Cornell, W. S. : Mentally Defective Children in the Pub- 
 lic Schools. Psych. Clinic, 'Slay 15. 1908. 
 
 !MacMurchy, Dr. Helen: Feeble-minded in Ontario. 
 Govt. Report for 1910. L. K. Cameron, l^ircmto, i<jii. 
 
 Holt, L. E. : Diseases of Infancy and Childhood. I'lftli 
 ed.. i<HO.
 
 INDICES
 
 INDEX OF CASES 
 
 I'.iTllia A 51 
 
 I'.ciiln li \ Tf, 
 
 Casijcr 11 i:!4 
 
 Clarence A ]()."> 
 
 Corliin (' 87 
 
 David K I-IN 
 
 Delia II li'S 
 
 Dora M 58 
 
 Fanny H IIH 
 
 Felix N 31 
 
 Fred J 2-1 
 
 Fritz A 14:^ 
 
 George J tL' 
 
 Harold U ill 
 
 Harriet (J li'5 
 
 I tester A tiT 
 
 Hilda K 113 
 
 Jerry II -lii 
 
 Kenneth M 139 
 
 Marshall E si 
 
 Milton J 110 
 
 Minnie G 7. 
 
 Morton W !»."> 
 
 Nora D lUii 
 
 Folly A 3fi 
 
 I'nidenee S 99 
 
 IJoliert I' 5 1 
 
 Samuel J 137 
 
 Stanley D 107 
 
 'I'h.-resa H 153 
 
 Vineent (" 145 
 
 Viola H liiJ 
 
 Wendy J 131 
 
 Wilda ( ' nn 
 
 Winnie D 42
 
 INDEX OF SUBJECTS AND NAMES 
 
 A— Caiu't'Ilation. ItllM, and see case 
 studios. 
 
 Age of new admissions, 15-17. 
 
 American Association for SliKly of 
 Feel>lo-minded, (>. 
 
 I'Annee I'sycliologitiue. 193-4. 
 
 Aphasia. S9. 91 IT., 95 ft"., 171. 
 
 Apra.xia, S9. 
 
 Association tests, 26, 39, 44, 49, 52. 60, 
 64, 68, 84, 144. 163-5. 
 
 Attendant's record, lSl-5. 
 
 Attention defects, 23 ff., 56. 85. 
 
 Automatism, 38, 44. 49, 82 ff.. 142, 144, 
 52, 60, 79. 
 
 Backward, use of term, 7-8, 169. 
 
 Binet, Professor, 6. 1G3. 169, 202, 207. 
 
 Binet and Simon tests, 9-10. 157. 173. 
 189 ff. 
 
 Blanlis, 173 ff. 
 
 Burt's alphabet test, 48-9. 
 
 Capacities. 179, 180, 182. 
 
 Chicago Child Study Jteports, 160. 
 
 Chorea, 128. 
 
 Classification and terminology, 5 ff. 
 
 Classification of defectives 168 ff. 
 
 Clinician-educators, viii. 
 
 Colored children, 113, 153. 
 
 Control defective, 27. 28, 34, 38, W), 65, 
 75 ff., 78, 81, 88, 97, 10<i-l. 104, 108 ff., 
 Ill, 114, 123-4. 
 
 Convulsions, 13. 31. 36. 54. 69. 75 ff, 78, 
 87, 95, 99, 178. 
 
 Cornell, Dr., 168. 171. 
 
 Criminals, feeble-minded are poten- 
 tial, 20. 
 
 Dancing, 51. 
 
 Defects and deformities. 185 ff. 
 
 Dementia praecox, 86. 204. 
 
 Development, data as to, 177. 
 
 Difficulty, tests of behavior in meet- 
 ing, 96. 
 
 Dull children, 42, 46, 51, 54, 58, 119, 
 122, 128, 1^1, 134, 137, 139, 142, 145, 
 148, 188. 
 
 Dwarf, 139, 148. 
 
 l-:uiot ivily, 206; see Control. 
 
 10iivir(Uiiiient and personal liistory, 
 J79. 
 
 IOl)ili'i)sy, 13. 70. 75. 169; see Convul- 
 sions. 
 
 lOxaiuination of cbildii^ii. 173 ff : out- 
 line of. 175. 
 
 Feeble-minded, numbers of. ] ; de- 
 fined, 6-9 ; diagnosis of, 8, 19 ; of 
 fair Intelligence, 17-18 ; individual- 
 ity of. 171 : transitions from, lo 
 non-feeble-minded. 157 ff. 
 
 Dr. Fernald. 1. 20. 
 
 Field study, need for melliods of. 
 207. 
 
 I'reud. I'rofessor, 204. 
 
 Functions to be tested, 203 ff. 
 
 Gestures, over-use of, 84 ff . 
 
 (ilasses, not often worn by institu- 
 tion children 167. 
 
 (;odd:ird. Dr.. x, 3. 157, 189. 19M. 201. 
 
 (Jossip, tendency to, 77. 
 
 <iroup work, 29. 
 
 Habits, 179. 181. 
 
 Habits aid attention, 29-30. 
 
 Ilealy. Dr. Wm., x, 198. 
 
 Hearing. 12, 14, 158-9. and see case 
 studies. 
 
 Directions, tests for knowledge of, 
 161. 162. 
 
 llardt. Supt. H. C. ix. 
 
 Heredity data, 176-7. 
 
 Higlu'r-grade defectives, 16-21, 151, 
 168. viii. 
 
 History of case, facts needed, 173 ff. 
 
 Home record of children studied. 21 ; 
 outline for. 176. 
 
 Hydrocephaly, apparent, 148. 
 
 Hysteria. 67, 72, 78, 169. 
 
 Idiot, 5-9. 
 
 Imbecile. 5-9. 
 
 Insane, numbers of. 1. 
 
 Insane children, 81 ff.
 
 220 
 
 BACKWARD AND FEEBLE-MINDED CHILDREN. 
 
 Insanity, children wlio show ten- 
 dencies to, 81, 170. 
 insanity, prevention by clinical over- 
 sight in schools, viii. 
 institutions will not care for liij^her- 
 
 grade defectives, viii. 
 Intelligence. 8, 91 flf., 183, 203, 207. 
 Intelligent children in institutions, 
 
 22, 62, 75, 91, 95, 99, 102, 148, 1.53. 
 Janet. Professor. 204-7. 
 Jolting, 97, 137. 
 ■Journal of Educational Psychology, 
 
 201. 
 .Jung's Studien, 165. 
 Kent and Rosanoff, 165. 
 Keratitis. 113, 116, 125. 
 Kraepelin, Professor, ix, 205. 
 Language disturbances. 14, 25, 33-4, 
 38, 39, 47, 48, 52, 56, 58, 59, 64, 73-4, 
 85, 89, 100, 114, 120, 126, 132. 135, 138, 
 141. 146, 150 ; see Spelling, Writing, 
 etc. 
 Lathrop. Miss Julia A., x. 
 Learning, capacity for, 184 : auto- 
 matic functioning mistaken for, 
 see under Automatism. 
 Left-hand disproportionately strong, 
 
 42, 102, 15S-9, 167, et al. 
 Level, adjustments of, 172. 
 Level, of psychic tension, 207. 
 Lincoln State School and Colony, 3, 
 
 4, 10, 174. 
 Local or partial defect, 170. 
 Lying, 66, 108, 115, 143, 145. 
 Manual work, viii, 29, 57, 133, 151, 154. 
 McCallie audiometer and vision 
 
 cards, 160. 
 Medical examination, 1S7 ff. 
 Medical history, 177-8. 
 .Medicine and psychologj', ix. 
 Memory defect. 48, 77, et al. 
 Meningitis, 13, 87, 95, 170. 
 Mental age of new admissions, 15-17. 
 Mental description, 5, 203 ff. 
 Mental examination, syllabus of, 
 
 189 ff. 
 Meyer, Dr. Adolf, ix, 204, 212. 
 Mimic defective, 32 ff., 90, 93, 95 ff., 
 
 109, 112. 
 Mongolians, 12, 13. 
 Moral imbecile, 105. 
 Morally unstable, 105, 170. 
 
 Morals, observation and record of, 
 
 184. 
 Moron, 7. 
 Movement and control of movement, 
 
 as function to be tested, 183. 
 Music, effect of. 24, 29, 32 ff. 
 New .Jersey Training School, 3. 
 N<"urasthenia. 62 ff.. 72, 169. 
 Normality of intelligence, 9, 18-19. 
 Occupation, choice of, 167. 
 Opposites, test for, 163-4, 198-9. and 
 
 throughout case studies. 
 Orientation tests, 161-2; also see 
 
 case studies. 
 I'edagogy, experimental, in institu- 
 tions, 3. 
 Personal interest as factor in train- 
 ing. 29. 
 I'hiladelphia, dull children in 
 
 schools of, 168. 
 I'hysical examination, 185 ff. 
 I'lay, observations of, 91 ff.. 96 ff.. 
 
 183. 
 I'remature birth. 54, 144. 
 I'sycho-neuroses, 204. 
 Relatively defective, 171. 
 Religion, tendency to talk, 77, 84. 
 Retarded, use of term, 8. 
 Research tests, 203. 
 Rosanoff. Dr., 165. 
 Royal Commission, 6. 
 Schools, feeble-minded In, 1, 14 ; ex- 
 ceptional children in, vii. 
 Senescence, premature, 82, 139. 
 Sensory acuity, 12, 14, 158-9. 
 Sex, male most liable to mental de- 
 fect, 14. 
 Sex tendencies, 61, 66, 77, 104, 117. 
 
 lis. 
 Similars, test for, 162, 164, and see 
 
 case studies. 
 Simon, Dr.. 201, et al., .joint author 
 
 of "Binef tests. 
 Smedley cephalometer and dyna- 
 mometer, 160. 
 Social reactions, 184, and see case 
 
 studies. 
 Sound associations, 60, 69, 106. 
 Special classes, vii, 7. 
 Spelling of defectives, 33, 34, 39, 48, 
 52, 56, 64, 68, 74, 79, 83, 100, 103, 117, 
 120, 123, 133, 135, 141, 146, 155.
 
 iM)i-:x oi-' sri'.jKc TS and .\.\mi:s. 221 
 
 State Board <if Adiiiiiiist ration, of rn'(l;;ol(l. lir.. 1:». 170. 
 
 Illinois, ix. 'rniancy. 110 et ai. 
 
 Statistical study. 208. Unstalilo cliildron, 19, 21', .31, :i«, ,50, 
 
 Story invention. IHl. 162. and .see 7,:'j. 'A. .'.S. f;2. 67. 72. 75, SI, ,S7, 99, 
 
 ease studies. 10r>. 107. IHi. ^V.',. 116. i:;i. 133-4, 1.".3 
 
 Story reprodueiioii. li;(i I. and see ff., 169. 
 
 case studi(>s. Urticaria. 73. 
 
 Syntliesis. function of, 205. Vagraney. lio. 
 
 Teacliers. clinical counsel to. vii. \ision. 12. It. l.'iSti. and see case 
 
 Teacher's record, lSl-5. studies. 
 
 Tests, description and results of. \'oices of defectives, .37. 3.S. 
 
 157 ft'., and see case studies. Welniin. K.. 165. 
 
 Thieving. .50, 66. 106. l(is. 112. 113, 113. Whipple. Professor. 160. 163. 2lu. 
 
 145. Writing of defectives, 25. 26. 33. 39. 
 
 Thought processes of feeble -minded. IS. .52, 59, 64. 6S. 79, KM). 114. 117, 
 
 See Language disturbances. Auto- 120, 12.3, 126, 129, 1.32, 1.35, 144, 150, 
 
 niatism. Association, etc. 155. 
 Thyroid, affection of. 12, 67. 131, 1.37, 
 
 153.
 
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