Mentally Defective Children Part 8

=Elimination of Hospital or Asylum Cases.=--Only defectives likely to improve are to be admitted to the special schools. That is only common sense. Everyone knows that the epithet "defective" does not belong to a single type. There are various categories which extend between two extremes: the purely _vegetative idiot_ who cannot speak, or walk, or even feed himself; and the slightly _feeble-minded_, who may easily be taken for normal. In spite of all our sympathy for these poor creatures whom Nature has treated so cruelly, we could not think of supplying them without distinction with all the benefits of education.

It is certain that the worst affected would not profit much thereby.

It is pure folly to devote six or eight years to teaching the letters to a child who will never be able to read, or who, if he should manage to read a little, will not understand what he reads. To such an unfortunate it is quite enough to give lessons in walking, feeding, dressing himself, and in simple occupations, such as dusting or sweeping. Such cases do not require schools so much as places where they can be taken care of. These will cost less to establish, especially in the country. Educational efforts should be concentrated on the defectives who are less profoundly affected. It is they alone whom one should try to instruct. This is the practice which is rightly followed abroad. For administrative purposes the defectives of different grades may be divided into two groups, medical cases and educational cases, or preferably, in order to obviate the use of the equivocal term "medical," we may speak simply of hospice cases and school cases to show the difference in their destination. The exact terms employed matter little so long as we understand what we mean by the words.

We have just pointed out the importance of reserving the schools for defectives for improvable cases. But it is necessary to correct this word "improvable," because all defectives can be improved more or less. Their a.s.serted _arrest_ of development is not complete, and the expression is equivocal. It would be better to replace the word "improvable" by the following more precise phrase: "Capable of being taught to gain, in part, their own living." Which of them are in this position? Unfortunately, we do not know. All such questions should have been solved long ago, since thousands of defectives have pa.s.sed into the hospices. It would have been enough to have followed them up, to have found out what became of them, and to have drawn conclusions.

But this has never been done methodically, and for the present we are reduced to conjecture. The nearest estimate we can form is that the social value of any individual case, not epileptic, is in inverse proportion to the degree of deficiency; the imbecile would seem to be more improvable than the idiot, and the feeble-minded than the imbecile. But this is simply hypothesis, and we accept it quite provisionally, until exact investigations have been made which will permit us to replace conjecture by demonstrated truth. Consequently we shall open wide the doors of the school to the feeble-minded and close them to the idiots, while as to the imbeciles, we shall have to find out whether the proper place for them is the school or the hospice. It will be necessary to find out in what measure, and at the price of what effort, an imbecile can be instructed to the point, say of being able to read. There are two other indications which may help us. Cases of _acquired_ mental deficiency--that is to say, cases who have become defective as the result of something which affected them after birth--are usually less improvable than _congenital_ cases, or cases where the deficiency is due to some cause acting before birth. And, secondly, cases affected by epilepsy, with fits or frequent attacks of vertigo, usually undergo a progressive mental deterioration.

What distinctions can we draw between the different degrees of mental deficiency? Such a question, we think, might be asked with regard to the ill-balanced as well as the defective. With respect to the former, we have no criterion at present to offer. It will be enough to pick out and send to the hospices _the most ill-balanced_, those whose presence among normal children would be a danger owing to the perversion of their instincts or the brutality of their impulses.

With regard to mental deficiency, we think it possible to formulate precise definitions which will enable all competent persons to agree as to the diagnosis of idiocy, imbecility, and feeble-mindedness. We are aware that in making this statement we are running counter to the general practice of medical alienists. When these, in an admission certificate, call a child "idiot," "feeble-minded," or "imbecile,"

they are rarely in agreement with the confrere who, a few days later, examines the same child, and makes a new diagnosis. We have made a methodical comparison between the admission certificates filled up for the same children with a few days' interval by the doctors of Sainte-Anne, Bicetre, the Salpetriere, and Vaucluse. We have compared several hundreds of these certificates, and we think we may say without exaggeration that they looked as if they had been drawn by chance out of a sack. This is a fact which many alienists have already suspected, and Dr. Blin[11] has expressed himself frankly on the subject.

What is the cause of such contradictions? They result, in great measure from the use of ill-defined terms. To the majority of alienists, the idiot is one who is _profoundly_ affected in his mental faculties, the imbecile is _a little less_, and the feeble-minded _less still_. What mean those words: "profoundly," "a little less,"

"less still"? No one defines them. They are taken to be indefinable.

It is no wonder they are understood so differently. All this trouble would disappear if the following definitions were adopted:

DEFINITION OF AN IDIOT.

_An idiot is any child who never learns to communicate with his kind by speech--that is to say, one who can neither express his thoughts verbally nor understand the verbally expressed thoughts of others, this inability being due solely to defective intelligence, and not to any disturbance of hearing, nor to any affection of the organs of phonation._ Since a normal child of two years of age can understand the speech of others, and can make itself understood by others, so far as its simple wants are concerned, it is evident that the distinction between an idiot and a normal child is easily made.

DEFINITION OF AN IMBECILE.

_An imbecile is any child who fails to learn how to communicate with his kind by means of writing--that is to say, one who can neither express his thoughts in writing, nor read writing or print, or, more correctly, understand what he reads, this failure being due to defective intelligence, and not to any defect of vision or any paralysis of the arm which would explain his inability._ One will not count a child an imbecile until he has had much more than the normal time to learn to read and write. The normal time in schools is six months. A child who does not yet know his letters after being at school for two years is likely to be an imbecile.

Spontaneous writing or writing from dictation must not be confounded with mere transcription from a copy. The latter is a kind of drawing, and may be acquired by some who are incapable, from defective intelligence, of writing from dictation. Nor must real reading be confused with reading which consists in transforming graphic signs into sounds without meaning to the reader. The distinction can easily be made by giving the child in writing some simple order which he is to carry out, such as "Shut the door," "Knock three times on the table."

DEFINITION OF A FEEBLE-MINDED CHILD.

_A feeble-minded child is one who can communicate with his kind by speech or writing, but who shows a r.e.t.a.r.dation of two or three years (according to the rules already indicated) in his school studies, this r.e.t.a.r.dation not being due to insufficient or irregular attendance._

These distinctions are pedagogical. The inspector will make them easily. If he is ever in doubt, he has a doctor at hand who will advise him.

Obviously the idiot is a case for the asylum or hospice. Obviously also the feeble-minded is a case for the school. There remains the imbecile, about whom we may hesitate. From the moment the imbecile proves himself unable to learn to read or write, his place is in the workshop. We must find out to what extent he can profit by special education.

=True and False Defectives.=--We shall formulate a rule which will surely meet with no objection. It is that _none but defectives should be admitted to schools for defectives_.

The moment we begin to apply this rule in practice, however, we meet with difficulties. There are normal children who are very backward in their studies. They cannot profitably follow the proper cla.s.s for their age. Such children are numerous, and of great interest socially. As they are really intelligent they can certainly be helped to make up for lost time. Various terms have been applied to them, but it will be simplest to call them "backward" or "ignorant." In Belgium many such "ignorant" children were admitted to the first school for defectives. In fact, they formed the majority, and one can understand how easily the teachers collected them. These are the cases which give such grand results, and are sometimes exhibited as genuine defectives who have been improved by teaching. In France it has been agreed that the ignorant are not to be admitted to the cla.s.ses for defectives. The principle is sound. But let us not confuse the questions by approaching them both at once. Let us consider the defectives first, the ignorant or backward next. Even when we are agreed as to the principle, we find difficulties in practice. In the first place, there are the doubtful cases, children of whom we cannot say, even after prolonged examination, whether they are defective or backward. Demoor, in the return he published concerning the pupils of the first school for defectives at Brussels, noted a considerable number of these doubtful cases.[12] What should be done with such cases? The best thing to do is to admit them to the cla.s.ses for defectives, writing on their schedule a large mark of interrogation in order to guard against future deception. Again, it is not always easy to establish irregular or insufficient attendance when this is the cause of the backwardness.

The child may have been at several schools, and at some the teaching may have been faulty. There are some schools which practically produce mediocrity. In the next place, it is necessary to discover the causes of defective attendance. Sometimes these causes are completely extrinsic to the nature of the child--frequent removals, constant domestic disturbances, laxity of the parents, an infirm parent to be taken care of, etc. In such cases the interpretation presents no difficulty. But sometimes the case is more embarra.s.sing. It may be a thin child, who has been out of sorts for a long time. Without being, properly speaking, of defective intelligence, he is weakly, anaemic, and consequently incapable of sustained attention. Would it not be advisable to admit such a case, at least as a temporary measure, into the cla.s.s for defectives, until his system had recovered tone? Should we not also open the door to cases r.e.t.a.r.ded by adenoids? And if we enter upon this work of charity, shall we not also accept some of those physically abnormal children who, affected by Little's disease or Pott's disease, are so little at their ease among their more robust companions? And what, lastly, is to be done with children r.e.t.a.r.ded in their studies by an unrecognised myopia? It is evident that the question ceases to seem simple and easy when regarded closely. We may rigorously exclude from the cla.s.s of defectives the child who is simply ignorant, but there is a whole series of complex cases intermediate between the ignorant and the defective. The inspector, let us say in antic.i.p.ation, will consult his colleague the doctor with advantage about all these border-line cases. No breach of principle is involved here. It is necessary to be guided by circ.u.mstances. _The essential point is to mark distinctly upon the child's schedule the special reasons for his admission, in order to prevent ultimate deception in the shape of presenting the child as an average defective who has been improved by tuition in the special cla.s.s._

We now come to the normal, the really normal cases. There can evidently be no doubt as to what is to be done with them. They are provided for. They have only to remain in the ordinary school. We hope they will be kept there. We hope it; we even demand it with all our power. But we are not certain that it will be possible to save them from the special schools. How many vital interests are leagued against the keeping of that rule! And interests, when they are not looked after, are like the millions of ship-worms which slowly and silently corrode the most solid barriers.

In the first place, there is the interest of the parents. When it is a question of secondary education, of rich or middle-cla.s.s parents, there is nothing to fear. The bourgeois do not love their defectives; they are ashamed of them. They send them to a distance, to some private inst.i.tution. They never speak of them to anyone; they do not visit them; they abandon them. But the common people have more heart or less prejudice. They will not be afraid of the special school for defectives any more than they are of the hospice. When they have a really defective child in the hospice, they never cease to visit him.

We can imagine the results which such a state of mind will bring about. If these fathers and mothers of the working cla.s.s were to hear of the existence of a boarding-school where children receive board, lodging, and clothing, they would flock to obtain admission even for their normal children, although it were well known that the school admitted only the feeble-minded, defectives, and fools. If necessary, they would get munic.i.p.al councillors to back up their demands. This abuse was practised recently in the case of a reformatory, which was rapidly filled with ordinary children, whose sole characteristic was this--that their parents had political backing.

This fraud--for it is one--will not be perpetrated in the case of the special schools and cla.s.ses where no greater material advantages are given to the pupils than is the case in the public schools, but it is to be feared that it will recur in the case of special boarding-schools for defectives. Such schools, if they are not carefully looked after, will turn out plenty of normal young people!

And this is not all. It is not only the parents who will try to deceive. Think also of the heads of the schools for defectives. What is their interest? Take note of it, for it is important. One should always try to foresee the results of human frailty. In every new school which is started one should watch that part of the organisation which gives most scope for charlatanism.

The head-masters and the teachers of the defectives will certainly have a tendency to show off before visitors children who have never been mentally defective, or who have been so to a very slight degree.

They will take good care to say nothing about the condition of the child on admission. Or, if necessary, they will tell lies--pious lies, told in a good cause, and for the honour of the school! These children will be shown off as advertis.e.m.e.nts, which will be just as illegitimate as if the schools for deaf-mutes were to present to visitors the semi-deaf-mutes, or the deaf who had formerly been able to hear, and to claim the entire credit for the facility with which these pupils could read the lips or p.r.o.nounce words.

All such impositions will continue to be practised as long as those who visit such inst.i.tutions are content to look about and docilely question the children presented to them by the teachers, instead of personally selecting the pupils to interrogate.

There is another reason why the heads of schools for defectives will keep their doors wide open to normal cases. This is, that in some cases a dearth of pupils may arise. A school is opened; it begins its work; the staff signs on. There is not much to do; there is no gossip about the matter; everyone is happy. But the number of admissions slowly decreases. It begins to be feared that the inspector will in his report notice the decrease, and that the school will be closed as of no public utility. Pupils, therefore, must be found, and if they must be found, found they will be. Recollect those evening cla.s.ses held in the elementary schools, where the teacher, fearing he will have to speak to empty benches, begs the head-master to send him some school children as an audience. Think of those libraries, where the staff, uneasy at the desertion of the public, pays a gratuity to an industrious reader for show!

We strongly insist that the inspectors should be alive to this danger.

They will be seated by the side of the manager of the special school.

Let them take note that this manager has a direct vital interest to admit normal children. It is upon the inspectors that we rely to see that everything is done honestly and correctly.

=Schedules of Particulars.=--Full and detailed particulars regarding every child admitted to a cla.s.s for defectives should be furnished by the head-master and teachers of the school from which he came. They will do this easily, for when a child is a little peculiar he attracts attention. Abnormal children never escape unnoticed. It is of the greatest importance that the future teacher of the child in the special cla.s.s should be correctly informed, and that what has already been observed should not be lost. Let it be remembered that the education of defectives should be individual, _made to measure_, as has been said with picturesque exaggeration. Now, if the child is to be individualised, he must be well known, well studied.

The necessity of some definite method of collecting particulars has been experienced abroad. A scheme of questions has been prepared, to be answered by the teacher who sends the child. The plan is a good one. It avoids the worry of lapses of memory. We suggest the following questionnaire:

PARTICULARS.

SUPPLIED BY THE ORIGINAL SCHOOL.

_Concerning_ .......... _Admitted_ ..........

_to the special cla.s.s at .......... school._

GENERAL PARTICULARS.

Original school: Full name of child: Date of birth: Standard to which he belongs: Is the child considered mentally defective?

Is the child considered ill-balanced?

FAMILY HISTORY.

Names of father and mother: Address of parents: Occupation of parents: Particulars of family which it would be useful to know:

SCHOOL ATTENDANCE.

How long has the child attended school?

What standards has he pa.s.sed through, and how long was he in each?

Regularity of school attendance: How many days was he absent each year?

What were the most frequent reasons for absence, if any?

What other schools has he attended, and at what periods?

INSTRUCTION.

What amount of intelligence has he (count from 0 to 20)?