^
^
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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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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L 006 128 871 8
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p^A 000 548 7bJ ^
.-ry