Popular Science Monthly/Volume 53/August 1898/Training of Mentally Deficient Children

THE TRAINING OF MENTALLY DEFICIENT CHILDREN.
By MARTIN W. BARR, M. D.,

CHIEF PHYSICIAN, PENNSYLVANIA TRAINING SCHOOL FOB FEEBLE-MINDED CHILDREN, ELWYN, PA.

A CORRECT classification is of paramount importance in the work of training the feeble-minded.

We must have some clear, positive standard by which we are to discern and separate the unimprovable from the trainable, lest we deceive the public by false hopes and accept those for whom we can do nothing. Again, the necessity for much individual work—the varied capacity of those to be trained, and the impossibility of bringing all up to one common plane—necessitate the arrangement of grades in which very different means of development may be employed to attain very different ends.

Guided by these needs, therefore, we have adopted a nomenclature dictated by experience as essential to the practical work of training, and which is also in accord with the anatomico-physiological demonstrations of scientific investigation.

This gives, broadly, two classes—the imbecile, trainable, and the idiot, unimprovable—which, modified, stand thus:

1. The imbecile—trainable in three grades: low, middle, and high.
2. The moral imbecile—found in all these grades; trainable only under rigid custodial care.
3. The idio-imbecile—improvable as regards cleanly living, and trainable in a very limited degree.
4. The idiot—except in rare cases and by expensive methods, absolutely unimprovable.

The imbecile, the only trainable class, divides into low, middle, and high grade. The first of these may be brought to give, always under direction, fairly good service for farm or house, if training be begun early, before apathy or indolence becomes a settled habit. He rarely if ever learns to read, and very soon reaches his mental limit. The imbecile of middle grade is capable of making great progress in primary-school work. I might say in about four years, especially if he has had previous training in the kindergarten, he will attain some proficiency in reading, writing, and number work, together with such a knowledge of form, color, and practice in freehand drawing as shall materially aid him in learning a trade; indeed, mental development for him is best attained through simple handicrafts having their initiative in the kindergarten.

The high grade shows children but slightly mentally deficient, who progress slowly as far as the ordinary grammar-school grade, frequently developing an aptitude for music, drawing, and the various industries. These are the backward children that the schools complain of—the "feebly-gifted" ones of England, the "tardivi" of Italy, "les enfants arrièrés" of France.

These are they so often not recognized in seminary or college life until under excessive pressure or the excitement of competition comes complete breakdown—idiocy, insanity, or early death.

So nearly normal are many of these that their defect would perhaps be noticed only by the initiated, and the question is often asked, "Why are these who do so well accounted feeble-minded?" the public little knowing that the time and labor have been double those expended for like results with a normal child.

The moral imbecile, generally of high or middle grade, quick of apprehension, crafty, and cunning; or, if of low grade, sullen and cruel often to brutishness, absolutely destitute of the moral sense—what might be termed ammoral or unmoral—is too dangerous an element to be permitted in the schools. This, the saddest victim of a fatal inheritance, is he who claims most at the hands of society and who gets least, because, precocious and often abnormally bright, he is, as a certain jurist once delighted in saying, "the kind we hang." As intellectual training does but add to his armament of ill, for him should be provided, within strongly guarded asylum walls, all the benefits of a manual training school and its outcome in the various trades, which shall at once give vent for his superflous energy and render him self-supporting; but this should be coupled with all the ameliorations of cheerful living that humanitarianism owes to this scapegoat for the sins of others.

Hard labor and lifelong sequestration are the only medicine for his ill—a disease too often due to the sins of a normal ancestry.

The idio-imbecile, who, as the name implies, partakes of the nature of both the idiot and the imbecile, is generally undersized, with very defective speech, and a limited vocabulary confined to a few scattered words, never a full sentence. His improvement is but limited. The most we can hope to do is to keep his nervous, restless fingers employed. He can sometimes learn to knit, to weave mats, or do simple housework, but never to read or write. For him, as for the idiot, but little can be done beyond giving the custodial care best adapted to his peculiar needs, the genuine benefit being found in the family relieved of such a burden, as it has been computed that for every case sequestrated, two if not four normal persons are released to society.

The idiot is usually but poorly developed, in most cases unable to stand or even to sit alone. Hardly conscious of his physical needs, he has no language but a cry, He rarely learns to talk; indeed, in all my experience of idiocy do I recall but two: of these one, after much effort, was able only to speak his brother's name, and the other acquired three words in three years.

A teacher endowed with originality in devising means, versatility in presenting so as to avoid monotony, gentleness and unwearied patience in constant repetitions, possessed of that fine perceptiveness and devotedness to her vocation that shall enable her to note improvement imperceptible to a layman—all these valuable qualities combined with good physical condition (which alone can insure that tenderness and firmness giving power of control over herself and the child)—may, in years, raise an idiot to the plane of an idio-imbecile, enabling him to do perhaps the work of an idioi-mbecile—an aid in the care of his associates. But is it worth it—more especially when, while we are raising the idiot to this, we are shutting our doors upon hundreds of idio-imbeciles who are lapsing into idiocy for lack of these very occupations which alone can keep them from retrograding? Will not history stamp such an act as in itself most idiotic, second only to that other of carefully guarding the comparatively harmless idiot and turning loose the moral imbecile, a firebrand upon society to desolate homes or to transmit his moral leprosy to generations?

The absurdity, therefore, of placing unimprovable idiots in a training school is self-evident. Yet willful misrepresentation on the part of a sensational press, coupled with every influence that mere sentimentality can bring to bear, is daily burdening our work with an element fit only for asylums, and crowding out the improvable imbecile who can in time be so trained as to enable him, under constant care and supervision, and with proper facilities for control, to become almost self-supporting—this, too, in a life freed from anxious care, and, what is of the first importance to society at large, a life freed from temptations, from opportunities for crime, and from the power of transmitting ill. Always under guidance, always under control, this "child"—who never attains the full measure of maturity—must ever be, lest his unconquerable indolence or his lack of will power make him the slave of vice, the victim of poverty and wretchedness, or the tool of the designing and the wicked.

So much for aims and means. A word further as to methods.

These, based upon the theories of physiological education dictated by Pestalozzi, Froebel, and Rousseau, first successfully practiced with mental defectives by Itard and by Seguin, include all the means that modern thought and experience have gathered.

Kindergarten, Nature studies, object lessons, sloyd, and the many occupations included under the name of manual training, all lend a successive and continuous stimulus—the one underlying principle and aim of the schools being to induce observation and comparison as a basis of thinking and doing.

Calisthenics and military drill induce physical development and muscular co-ordination, quick observation, and prompt subordination. These vital principles of physiological education have practical and intellectual application in the exercises in freehand drawing, modeling in clay and wood, in sloyd, in basket and straw braiding, and in the phonetic and articulaton drills and musical exercises of the classroom, each being the initial of a lifelong occupation. Believing as we do that "the working hand makes strong the working brain," there is always something for the child to do, some object to be made; not an abstract thing to be put out of sight when finished, but something of use to himself, or to one for whom he cares. Work constantly stimulated through the emotions is his, all along the line from kindergarten, classroom, and sloyd, to shoe shop, printing office, and other useful trades. Should his limit of application be soon reached, and the avenue of happiness and safe living be for him reduced to one single groove, the more active pursuits of the farm, the garden, laundry, or household service will interest and provide vent for superfluous energy or by constant stimulus keep him from retrograding or lapsing into apathy. For these varied occupations he is all the better fitted by the previous training of the senses received early in the schools, and if happily he should have there learned to read or draw, to color, to carve, or has acquired any skill in music, he will have many avenues of recreation closed to his less fortunate brother, to whose comfort and pleasure he himself will be the better able to minister.

All this we can do and are doing in our training schools, both here and abroad, in spite of being handicapped by the burden of the idiot, the care of the moral imbecile, without adequate accommodation, and by frequent loss, from one cause or another, of trained workers just as they become useful members of the community.

The possibilities for the trained imbecile have not, therefore, yet been made clear on account of this diffusion of energy, nor his true sphere recognized, mainly because of the false idea of cure which is continually being presented to the mind of the public.

Worse than foolish is the idea that training can prepare even those of high grade to battle with the world or fit them for any life outside of institution walls.

Animal propensities, weak wills, sluggish or excitable temperaments, characters utterly abnormal, will inevitably drift in large numbers to swell the insane or the criminal ranks; and it may not be out of place for me to say that from the standpoint of the alienist, criminal procedure against such irresponsibles, especially those in that period of adolescence when most susceptible to suggestion or to nervous excitations, is not less reprehensible than was the delusion regarding witchcraft in a less enlightened period of our history.