cie> Cornell University Library RJ 499.C18 The subnormal child, a study of the chil 3 1924 003 469 339 THE SUBNORMAL CHILD A STUDY OF THE CHILDREN IN A BALTIMORE SCHOOL DISTRICT BY C. MACFIE CAMPBELL. M. D.. , Henry Phipps Psychiatric Clinic, Baltimofe, Md. SECOND PRINTING THE NATIONAL COMMITTEE FOR MENTAL HYGIENE. Inc. 50 Union Square New York City 1919 REPRINT No, 1 ^he Jj'ationai Committee for ilHmtal I, ." , FctpOTJEDlSOQ; . , , .IwdOBPcnikTEpl^lg, . ji,.' v , ' ' Dr. Waltbji 'B. James . ene Chables W.- EiiiOt Dk. /BbrNakd, SApHS DB.'WitLiAii H. Welch Dk. Db, Qtto T* Banjtapd , ■' .; - Mceciiiive C&mmitfm ;. ■ -,■'', Dr.. William L. RnssBLt, iiDhairiSan,\^ :GB0E&B' iStXTMEK' ■ ■ :,''; "; ■'!" J\ll-ATiHEW C./;Ft'EMlisf.G Dr. WajutIbr B. JamJbS', Stephen P. Duggan I ; '_ ', ,'De. 'Tf altb'S' E;' „|!bhjs:>.ld. , Walter B.-FEenald, Chairman ■' . Da V. v., ANBBK9op,|PsyCliiatristim-Gh8i.rge Dr. , ', " ', ^g/r Worle^ Committee ' De. De.' Owiir 06pp G-eobgS H. Kiebt' D^\ L.,,PiBH(JB', Ci'f*''^ . •ChABLBS= ,8. ElTTLB , ■ ' , De. Chables L. t)A^A', Chairman " ■■ ' MnaTiee'Copirriittee " De. Waltiee B. Jam:^?, Chairman ' Otto T; BASnaud ' i '.'■Riis'SBLL H. Chittenden ,, Db. Wir.LiAM B. Col'kt; ;;'' Stephen ;P.' DueGAJf ' William J. HoGflsoN Dk. Frankwo^P E; Williams, .VicetQliainlian Dr. Thomas W. Salmon, MediC£^^Pirecio^ ' / ; IlE. PBAN.EJTOOD; 'E. WlLLJ^AMS, ' i; Associate! Medibal Director CLIFPOBDWr JBiEBES, Secretary m^M^t ^ M^. Wu^ M. AcKKR. Honie^, N. Y: ^ ;' ; . ■ Si''*!'! A. ALDEKMAIf, OUarlpttesvUle, Va. Jjiiig. A... A. ' ANDEEaON, tJEfeenwIifeh, Conn.' Dr: PitiBoa ?'AiLEr, How, X9*H <• De. C^AiELES p. HanceoSt, .Goricord, N. If. . Otto t.' Bannard, N^w York j . i ' I)E.:LifW^i,i.YS P BakkEk, iBaMiaore- ^ • : Db IACjBeeT-'M;. iBiMteTT, Ann-Aibpr, iMloK. ' V ' Dr. Prank BitiMasA;C!lilaa«) .111' '1 '; ^ ! ', SOEO. Ge». BcPERTBLtTK) Washington , ,' : '';Pr.-,Geoegb^B^mbje,'N6w Bayen '^ '■•/DR./GrALDBRBripittER, Pr,OTidqnfe'e, ; Wiiiiw*« H.\an4ii?Aia,' WOrfjeste* . f.-' /» ,:<, "Dr. C..'MAoFiBf;OA'irpBELL,^altanorw •:''•' .( BusSell' H. CHITTENDHiNV-NeTCjHaTfetlt, .„ '' ,- Dr. L. Pierce Q^^lkk; Ne'w' "yprk'^ - ', ;;'■ ■ DR.:WjmA'MvB.'.C6iET, New SO&'k' i." ■' ' De. QWen Cdp^i Phlladolphl* ' " ' DrI Charlks L.. Dana, New york O.JB. Datenpoex, ColdiSprtng Parbor; N; Y. Stephen P. DcasAN, N«w; Yorfk i , ' .? ■ .OHArfasW.' Bliot, QainbrJdgfe','^ "■'jj ,■ m , ■ .' DK. CHAi£LE§ P. ,EMERa ;,',: /iBvtUfi PisheB N^W/HfliTen , ■ . •, . MA^TpEW 0. PtEm^iG, New York ' , ■ HoMEft POtKa; N«w 'York . ' i De. CafbLBSLH.. PEkziBB,; PUJadelptila PEANjCas -1). .(JaliLatin,, New Tdrk ' , ' ! ; JamSs OARDiNAL'GtRBoifs, B^Umo're Aethue T. Haddey,' New Ha^'en Dr. William Healy, Boston ,- Dr. AbthDe p., HbreiSo,' Baltimore JIenrY L.'Hi&ginson, BdetJon . vDb. AmttubT lloo^v Santa Barbara, OaL ' :WILLIA^^. 'HoGGsoN,, Greenwich, Conn. DB. 'Walter B. James, New York .JIrs; William James, Cambridge HarBy Pratt Jddson, Chicago Dr. OBArles G. . Kbrlet,. New YoVk Db. GBOBiGt^ fi. ?ieBy, N6w. Y-6rk FBAnklin B. KiBKBBiDE,,-'New York ' ■ ■ ', ' De. George m. guNB,'Bpaton , '• - , John 'KOESNii Bbston , '' i i^.,- ••" '■ JuLLA C. L^THEqp, Washlngtbij j , Ad6lph.LewJ86hn, N^.^.Y'Ol^f' Samuel McCtfNE Lindsay, 'N'es^ York ' /. Dr. Charles's. LiXTLE,'ThJeUaJ\N.;T;," , Oeoege. p.- MoLsA'I'ijSB'isbnry^ Conn^ ( ' ' " ' , '% BVBEpr-MApY,'.'S8ail3drOUgh('N,, 'Si.,.',-;.. I.- * MaeOus M.'TSfLABiSsi New' "tork , , ^' ' ■ ; sritnta B. MidKBi'New York \ ' ,, MRS. WiiJiJAM s. 'JttQHEpE, ^Ciil6ag<> >' , ' '■ . Dr. J. lyiciiiWooMEEY sroSHER, Aloanyj ' ' i I)B.'PBATni; pi No'iiBTOy,.J^cki9onyllle, 111. : ' CYEtrs NoB^HROPi minneapoUs ■■■'■.■'! ' iWjLLiAM CHteBciHyO^OHN, Ne^ York y ', 'HA»Ef7i,ps6bB^E,.N6Wal;li,'N. J. ■ , Dr., StewAbT; P^-tqw, Pxlflceton- , "Db,i Epiro»8si(idKiPETEESdiJ,.New York , ': HbnBy 'PHipi^'s, New York \ i .v, '; , GipffbsD PiNCHOT,.'WaaiilnB|0ii ■ , i'BBtiENCE .M. l^SEtT, 'New York ', , , .!>»;'■ Robert L. 'EiqaaSAjs, Talniagei CaL ',mBS.''0HAEi,E6 o. BttsEYj, ■^neatly HUle, N 'l>«.'2i^iLl.iAM L.-JSDasEtLi'''Wlilte''Pl83hfi N. ,Db. BiplNARD SaOhs, New, York " • ' r- JACOB' Gould SoHUBMA'i^/ithaca, ; Dr^ B'. 'DoOqlas SifJGER, Kah^ak6e, HI," ' DR. ElmeRi B.lSpoTBjAiw, Bostqity., ,' , ' Db. Mi ALLW 'StABB, N^W YoiJl!-.' ,'- DBj Bebby K. BTEiDMAk, BrookUne, Mass. ■ ASBoS PHEtpB StokeS, NeWHaven ' Dk.\Ghabl^b p. SiotBS, BrtareUff, N; Y. Db. ,'P4e4DIift»ci5 TiEKHy, NeV York ViOTOB MbBRis tYLEHj New Haven ,■ I V IlRS. WpiuATM K. -Vaspbe^t,' New York Henby JA" liYKE, Prlhcw>ii ,• ■ De. Henbt p. WALCoti, Cambridge :■ . LftLiAN ■ D: .Wald, ■ iTAw York' , ,- ',, - ," ', ' / Be. WitiaAM H. WBfLCH, BaltltaorB' i !-' ' BENjAfini, IDE Whbeleb, Berkeley, CaL ; , D4.. liSTBtiAM A: 'Wi(rrB,>.'WM.hlnjgton J ' D^. Heney Siirpi WiLUAMg, N6w,,YorK' , ■; ' BoBEBT A. Woods, Bpstdn . <■» ■ ':■,■.'■% BoBEBT M. YeeKes, Washlnston ■ , ' ,' CHIEF/ PTIKPOSES': To work for, the eonaemation bfmentqi Imnitth,' to promote tim s^dyof m^'itf.al disorOers :■ '''ancl mental d^eksiK all -thfir- forms finfl relaliem;' to obiain "and' die^emi^atiMlable-dUtaeonXerrUng them; to help ralfif the standards of car^ arsfl .treattmnt; 'toi lietpa>-or.dl«,ateescisif,n)g ageivcies, S'ederai Statem.dlocal,and1o,organizf:irievery,Mate'anafflliaied Society for MeritalBygiene. [Eeprinted from Mental Htgibne, Vol. I, No. 1, pp. 96-147, January, 1917.] THE SUBNORMAL CHILD— A SURVEY OF THE SCHOOL POPULATION IN THE LOCUST POINT DISTRICT OF BALTIMORE* C. MACFIE CAMPBELL, M.D. Associate Professor of Psychiatry, Johns Hopkins University A PSYCHIATRIC dispensary has few problems more im- portant than those presented by the children who are brought there for treatment. These children may be divided into two large groups: the first includes those who may roughly be called neurotic children, the second those children who present conditions of mental defect. The neurotic children show a great variety of symptoms, which call for the detailed study of the individual child and of the home environment; their treatment usually requires the regulation of the home hygiene. In order that this may be done, trained social workers are frequently essential; otherwise ignorance, indifference and the force of habit lead to the neglect of medical advice. The situation is similar to that in cases of tuberculosis, where unless the visiting nurse gives practical help in establishing better habits of hygiene the advice of the physician may lead to no practical steps. This extension of the range of help, due to the more adequate conception of medical responsibility, not only benefits the individual patient, but safeguards the community from the spread of the infection. The provision of the necessary workers is sound economy. The treatment of the neurotic children does not necessarily involve more than the study and readjustment of the individual patient and the home environment; it is true that an urgent pleaf has been made for the establishment of special educational provision for many of those children, for whom the usual school environment is held to be quite detrimental, while their demands are not met by grouping them with those who suffer from mental defect. The second group, that of the subnormal children, raises issues which go beyond the more individual problems of the neurotic child. *The survey was made possible through the generosity of Mr. Henry Phipps, who in 1913 made a special gift for the purpose. tZiEHEN, Th. Die Erkennung der psychopathischen Konstiiutionen {kranhhaften seelischen Veraidagungen) und die Sffentliche Fiirsorge fur psychopaikisck teranlagte Kinder. Berlin: Karger, 1912. 2 The Subnormal Child In the case of the subnormal child the personal hygiene and that of the home must be supplemented by a school training adapted to his special needs; without suitable school opportunities no adequate solution of the problem of the subnormal child is possible. While the neurotic child may be able to make use of the same curriculum as his more stable comrades, the subnormal child with his constitutional limitations is quite unable to do so. He suffers from the lack of a suitable school environment and upon his constitutional limitations there may be grafted un- desirable traits, which a wiser education might have prevented. Education should aim at the best training for the adult tasks, and the type of training which is best for the prospective self- supporting citizen is not necessarily suitable for those whose limitations will prevent them from ever being quite independent and from taking up the full responsibilities of citizenship. In relation to the subnormal child the physician may give advice as to the necessary conditions for his school training, but this advice is of little use if the requisite school opportunities do not exist. With the aid of the social service department he may be in a position to reorganize the hygiene of the home, but individ- ual workers cannot create a school organization. For the creation of the necessary school organization one must depend upon the co-operation of the community in general, upon its realization of the importance of the problem, upon its intelligence and earnestness in dealing with it. The actual number of subnormal children among the school population is much greater than is generally recognized; they seriously hamper the education of the normal children. These subnormal children later recruit the ranks of those dependent upon society, and are apt to be found among the vagrants, the paupers, the alcoholic, the prostitutes and the delinquent. It is not yet sufficiently realized that "mental defect forms the largest single cause of delinquency to be found by correlating tendency to offend with characteristics of the offender."* It is obviously in the best interest of the normal child, and of the normal adult that this problem of the subnormal child should be dealt with in a sound manner. *Healt, William. The Individual Delinquent; p. 447. Vide Goring, Charles. The English Convict, A Statistical Study, p. 260. "It is clear that the relationship between mental defectiveness and the committing of all types of crime, with the exception of some kinds of fraud, is an extremely intimate one it is evident that defective intelligence is one of the primal sources of crime in this country." The Subnormal Child 3 The community which would equip modern hospitals for the treatment of its typhoid patients, but neglect completely its water supply, would show little judgment; but it is no more intelligent nor economical to lay all the emphasis on the organiza- tion of reformatories, almshouses, foundling asylums, jails, etc., while neglecting the school training of the subnormal child. In the case of an unsanitary water supply and typhoid fever, a timely epidemic with its attendant expense and loss of life serves to awaken the community from its indifference; unfortunately no such dramatic episode can be relied on to awaken the com- munity to a sense of the insidious and far-reaching results of the failure to give the subnormal children in the community appro- priate training during the school period, and to make adequate provision for them. To deal adequately with the whole situation is an enormous task; few communities have even taken steps to get the necessary data for estimating its exact extent. The present survey is one step in the direction of getting the relevant data for the city of Baltimore. The aim of the survey was to make a careful census of the children of school age in some one district, to find out how many children were subnormal and to determine approximately the degree of the constitutional defect of these subnormal children. The District Covered by the Survey For the purpose of the survey, part of the Locust Point district was chosen; it furnished an area of manageable size, strictly delimited, and in whifch the hearty co-operation of the school authorities was guaranteed. Locust Point cannot claim to be a typical district of Baltimore, and the data collected from this district have to be considered in connection with the social and economic conditions of the district. On the other hand there are few of the larger American cities without districts which present similar conditions, and the figures collected from this district, although not to be used as a definite unit of measurement for the whole of any city, have an independent value of their own. Taken in conjunction with the later survey of other districts they should be of use for the approximate determination of the number of children with special requirements in the whole city. » In the report of the College Settlement Association for 1911 the following description is given of the Locust Point District : 4 The Subnormal, Child "The section of Baltimore known as Locust Point is a long, narrow tongue of land jutting out between two branches of the Patapsco River. Although the Point can be reached in twenty minutes by electric car from the center of the city its peculiar geographical position creates many of the problems found in isolated communities, without freeing the district from the larger municipal problems that today confront the city of Baltimore. . . . Large tracts of waste land give a sense of wide, free spaces and elbow-room for everybody; but, as a matter of fact, the population of the Point ... is crowded into uniformly small houses, where the large families suffer all the bad results of congested living. . . . "Life at Locust Point is largely colored by industrial conditions. The industries, for the most part, employ cheap, unskilled labor, a fact that keeps the majority of families close to the poverty line, and too often below it. The B. & O. Railroad employs a large number of men in its warehouses and freight yards. Two fertilizer plants fill the air at intervals with the disagreeable odor of sulphuric acid. Pottery, enamel ware, paper bags, furniture, and glass bottles are other products of the Point. There is a large contingent of stevedores, whose work is ill paid and irregular, with long periods of idleness. Two canning factories give seasonal occupation to large groups of women, and also to children who are permitted to work in these factories at twelve years of age. Children much younger are frequently taken from school to serve as unpaid helpers to their mothers and older sisters. Many of the girls who live on the Point and come to the Settlement are employed farther uptown in a tobacco f&ctory, with disastrous results to their health. "The Roman Catholic and the German Lutheran churches have thei largest congregations, but the Congregational and the Episcopal churches are also represented. "The recreation facilities of the Point are very limited, es- pecially in the winter. During the summer Latrobe Park, almost opposite the Settlement, with its well-equipped play- ground, open-air gymnasium, athletic field and bath houses, is a great boon to the people, but during the cold weather the wind-swept Park is deserted. Two moving picture shows, one large German dance hall and two Hungarian dance halls, all connected with saloons, represent the organized commercial forms of amusement." The Subnoemal, Child 5 There are thirty saloons in the district. The pottery work re- ferred to in the above report has been shut down for over two years, and this is only one evidence of the industrial decline of the district during that period. As to the racial composition of the population, in 243 out of the 1,389 families in the district no adequate data were obtained; of the 1,146 families with regard to whom satisfactory data were available, in 523 both parents were of English-speaking races. Only 78 children of the school population had been born abroad. The population of the district is exclusively white. Method of Collecting Data* The aim of the survey was to make a census of the children of school age, and to estimate each child from the point of view of his adaptation to his environment and of his promise of adult eflSciency. As a large number of children had to be covered the estimation of each child had to be summary. The necessity of covering the whole ground in a limited time was also a condition of the work. Early in the summer a large number of children migrate with their parents to the strawberry fields, before the end of the school session; a large number return only after the opening of the winter session, being detained at the canneries. The distribution of the children in the schools is not stationary; a child, who in one school session is in the public school, may in the next session be found in the parochial school. Care has to be taken to avoid counting such children twice. The local situation is apt to change; thus before the survey had been completed the Paret Memorial Kindergarten was given up, and many of its children were distributed in the public and the parochial schools. The whole district was covered by the house-to-house visits of two field-workers. They were asked to get those data bearing on the condition of the children, which could be gathered easily and to form a crude estimate of the physical and mental hygiene of the home. Such a rapid survey obviously does not permit the worker to gather any data of statistical value bearing on the *The home data were collected by Miss S. L. Jean and Mrs. Margaret J. Ware; the school data were obtained by Miss M. W. Moore and Miss M. Pope. I am much in- debted to these workers for their painstaking and conscientious work in the collection of the data, and for much help in their tabulation. I am glad also to take this opportunity to acknowledge the courtesy and cordial co-operation of all those connected with the various schools in which the children were examined. The special district was to a large extent chosen because in it Miss Persis K. Miller, principal of Public School 76, was giving an admirable practical example of the extreme importance of the school as a community centre. 6 The Subnormal, Child heredity of the children, but this aspect was not neglected; the mental level of the mother, the industrial efficiency of the father could frequently be noted. The economic status of the home was noted, and those factors which were considered of special im- portance for the mental hygiene of the child. The home visit enabled one to have an estimate of the individual child from the parent's point of view. The results obtained were fuller than could have been expected in view of the limited time, because the field-workers were already very familiar with the social life of the district and found quick entry into the homes. The co-operation of the community was excellent; in remarkably few cases was there any suspicion or antagonism shown to the field-workers. The fact that the workers introduced themselves as coming in the interest of the children smoothed the way. Their cordial recep- tion in the homes is an example of the valuable opening into the home given by interest in the welfare of the children, a principle which should stimulate us to look on the school system as one of the most direct universal agents for bringing influence to bear on the home life of the community. The other two workers took up the efficiency of the individual children at school with the valuable aid of the data made available by the school authorities; they reviewed the school progress of the individual child, his grade, the physical condition as recorded by the school physician; they discussed in conference with the teachers the characteristics of the child; more than half of the children were tested by the Binet-Simon intelligence scale (Goddard's modification). For each child two cards were filled out, one with the record of the results of the school investigation, the other with that of the results of the home investigation. The estimate of the require- ments of the individual child was based on the collation of these data. It is well to emphasize this point, as otherwise there might be some misunderstanding. It is true that in all doubtful cases the Binet-Simon intelligence tests were applied, but in no case was the classification of the child based merely upon the result of this part of the total examination. The Application of the Binet-Simon Intelligence Tests This standard series of tests was applied at the schools by Miss M. W. Moore, who had worked for two years under Dr. Goddard at Vineland, and who had later spent several months applying The Subnormal Child 7 intelligence tests to immigrants at Ellis Island. Due regard was paid to the possible influence of difficulty with the language, and on this basis the results of the tests were put aside in fifty-two cases. For the benefit of those not familiar with these tests a brief description of the method may not be out of place. The Binet-Simon scale of intelligence tests consists of a series of tests arranged in groups of ascending difficulty so that each group of five tests can be successfully answered by the average child of a corresponding age; thus there is a group of tests which can be done successfully by the average seven-year-old child, who however is unable to succeed with the following group which is adapted to the more mature powers of the eight-year-old. A child, no matter what his actual (chronological) age, who in this examination is only able to reach the level of the average seven- year-old child, is said to have the "mental age" of seven. Fre- quently a child who is unable to do successfully any complete group of five questions beyond a certain group is able to do isolated questions in these higher groups. Credit is given for these questions according to the arbitrary rule that, for every five isolated questions answered successfully, an additional year is added to the age corresponding to that group of questions, all of which have been successfully answered. Thus the child who answers successfully all the questions corresponding to the age of seven and although not answering completely all the questions corresponding to the age of eight, still answers ten of the later questions, is awarded two additional years; his "mental age" accordingly is not seven, but nine years. In tabulating the data the age of each child has been given in years and months, while the figure for the "mental age" indicates the exact number of tests answered correctly; thus Robert A., 9:7, B. S. 8* indicates that the boy nine years and seven months old has been able to do the tests corresponding to the intelligence level of eight years, and four of the tests above this level. This scale was first worked out among the children of the working class in Paris, in a certain social and economic atmos- phere, where the children had a well-recognized school education. It must not, therefore, be taken as a scale which can at once be applied to a totally different environment, where social, economic and educational conditions are very different. It is, however, striking that this scale is so widely applicable as it is. Goddard, 8 The Stjbnoemal, Child after examining two thousand school pupils in New Jersey, is enthusiastic over the accuracy of the scale.* His own results, however, as pointed out by Thorndike, f hardly justify the complete satisfaction which he expresses, for the groups of tests, which are supposed to represent the average mentality of children of ten, eleven, and twelve years respectively, in reality correspond to ages slightly more advanced. The re- sults of the present survey show that the standards of the Binet- Simon scale are too severe for a population like that of the Locust Point district. This is shown by the fact that, in the one school where all available pupils were examined without selection, out of the pupils examined 196 showed some "mental retardation," while only six showed any advance ahead of their expected ' ' mental age." If the various groups of tests had corresponded to the real average ability of the various ages, then in view of the usual variation in normal children there would have been a large number slightly above as well as a large number slightly below the average. The children of the public school were not examined without selection, and so there are no figures available with regard to the total number of children there above and below the average level demanded by this scale. The results of the examination of the children of this district by this scale are, therefore, not to be taken without some interpretation, and in this survey the scale was used merely for the purpose of a preliminary sifting and for greater definition without anything more than a relative value being given to the figures. The fact that the mental age of a child lags behind its chrono- logical age to a definite extent does not necessarily enable us to forecast accurately the development of that child. Thus the child who at eight only attains the "mental level" of five years, i. e., who shows three years' "retardation," may at twelve show a much greater degree of retardation; on the other hand he might theoretically show less than three years' retardation. At present the necessary experience for formulating an accurate forecast is wanting; when a large group of children, such as those examined during the present survey, shall have been re-examined at intervals of five years, the desired data will be available. It may then be *GoDDAED, H. H. Two Thousand Normal Children Measured by the Binet Measuring Scale of Intelligence, Pedagogical Seminary, 1911, pp. 232-259. fTnoENDiKE, E. H. The Significance of the Binet Mental Ages, Psychological Clinic, December, 1914. The Subnormal Child 9 possible to forecast more accurately from a definite degree of mental retardation at each age the probable later limitation of the individual's mentality. The most important question to be answered is whether the child will develop mentally to an extent which will enable him to be self-supporting. The level of intelligence, of course, is no,t the only condition which determines the ability of an individual to support himself and to keep above the ranks of those dependent upon society; other factors are of great importance, such as the emotional responsiveness and stability of the individual, and his general output of energy. Below a certain level of intelligence, how- ever, the individual is bound to become dependent upon the family or the community; and in Baltimore it is probably a very conservative estimate to place this lower limit at the intelligence level corresponding to the "mental age" of nine. It is perhaps possible under exceptional circumstances for an individual with such a modest equipment of intelligence to support himself, if the other factors in his constitution are very favorable. The group of children whose intelligence may rise up to this level but never develop much further will repay special con- sideration, for their future career as helpful workers on the one hand or as dependents and delinquents on the other, may depend to a large extent upon the appropriate or inappropriate nature of their school training. The above statements are commonplaces to those who are brought into contact with the problems of the feeble-minded; both the practical as well as the theoretical aspects of the question are discussed in detail in Dr. Goddard's book in which he presents the material studied at Vineland and the conclusions which he has drawn from its study.* The actual extent of the problem in the Locust Point district of Baltimore can be seen from the following data. Census oj the Population of the District Surveyed Total population 6,089 Adults (above 16) 3,513 Children (under 16) 2,576 Children under 6 984 Children over 6 1,502 Age not determined 90 *GoDDAED, H. H. Feeble-Mindedness, Its Causes and Consequences. New York, 1914. 10 The SuBsroKMAL Child Children of school age 1,502 At school 1,281 At home (mostly over 14 years) 128 At work (many over 14 years) 93 Children at school (distribution in May, 1914) 1,281 Public School 76 764* School of Our Lady of Good Counsel 379 Holy Rosary School 35 St. Stanislaus School 6 Paret Memorial Kindergarten 7St Social Settlement Kindergarten 24 1 In addition to these 1,281 children distributed in the various schools, the home visits discovered the following group of chil- dren of school age who had not attended any school : B., eight years, was kept at home on account of hare-lip; the parents were not married. K. S., ten years, had never attended school; the mother, an immoral woman, wanted the child at home. E. C, eight years, had never entered school, ran around among the worst associates; mother immoral. W. N., ten years, and L. N., eight years, had not entered school; were accustomed to steal coal and sell it. F. M., ten years, deaf mute, had received no education. There were also discovered by the home visits six children with such marked mental defect that they had never been sent to school. These children belonged to the group of idiots or low- grade imbeciles, and the problems they presented were merely those of custodial care. Two children from this district were already in the Rosewood Training School. The total number of 1,281 school children can be divided into large groups according to their mental level, this term being used to include not merely the intelligence of the child as deter- mined by standard tests, but also those other mental factors which determine its ability to adjust itself to its environment. The children are accordingly distributed according to their pro- spective social efficiency. Group A: The first group of the total number of 1,281 school children consisted of 22 children with the most pronounced mental defect. The most that can be hoped for the future of such *Eight of these children were under six years of age. tThe number of the children in the kindergarten above six years of age. The Subnormal Child 11 individuals is that under especially favorable circumstances they may have some simple occupation, and may be safeguarded from the dangers to which they are peculiarly exposed. They cannot be expected to respond to standards which are binding on the normal adult; they will never be able to direct their affairs with ordinary prudence; for their support they will depend on the tolerance of their employers and the help of their friends. They will be specially liable to recruit the ranks of the vagrants, the alcoholics, the prostitutes and the delinquents. They will be unfit for parenthood. Their children, legitimate and illegitimate, will themselves in large proportion be mentally defective. Theo- retically it would be to the advantage of the rest of the commu- nity if such individuals were segregated in colonies, safeguarded from dangers and prevented from propagating; and the segrega- tion of such individuals would be most suitably carried out in childhood. In the present state of aflfairs, however, and for a long time to come, these children will be brought up at home and will go to school with their normal comrades. The school author- ities, therefore, cannot afford to ignore the problems presented by these children. The nature of these problems can best be realized by running over the extremely summary data presented in Table I (pages 118-120). In this district the children of this type constitute approxi- mately 2 per cent of the school population. The large majority of the group are in the ungraded class, having been found to be quite unsuited for the ordinary grades. But a glance down the last column will show that these children have frequently spent a considerable time in the ordinary grades before being relegated to the ungraded class. This is an extremely important point to note; not only does it mean that the defective child has been submitted to a kind of training not at all adapted to his special requirements, and therefore probably more detri- mental than beneficial, it means that the defective child has taken much of the time of the teacher which should have been devoted to the normal children. The presence of defective children in the ordinary grades means the serious dilution of the efficiency of the teaching of the normal children. Occasionally a teacher has reported an extremely slight improvement in the condition of one of these special children at the end of a session, but at the cost of the comparative neglect of the rest of the whole class. It must always be kept in mind that emphasis is laid on suitable ]2 The Subnoemal Child provision for the subnormal child largely in order that the normal child and the normal adult may have better training, better opportunities and fewer handicaps. Neglect of the subnormal means a handicap of the normal child. As one glances down the last column in the table the early beginnings of later delinquency are already only too evident. These children have not merely defective intelligence; that is from the social point of view the least important of their charac- teristics. Their general adaptability, . their responsiveness to moral standards is seriously at fault; they are difficult in their relations with their fellows, they tend to lie and steal, and sexual misdemeanors begin at an early age. The future of these individuals is already foreshadowed by the lives of other members of the same families. In several cases the mother is noted as living an immoral life, and in two cases the mother is said to be syphilitic; alcoholism, delinquency and sexual immorality stand out prominently in the family histories. The brother of one of these children, himself of very low mentality, married at fifteen; it is evidently possible in this community for a defective lad to get some official sanction for his marriage.* One girl of this group, a few months after the survey, took up work at a seine factory. She has entered the ranks of the wage- earners, but unfortunately without any safeguards whatever. Although the community through the school system was in a position to take cognizance of her marked limitations during many years, the girl becomes a wage-earning unit on the same footing as her normal fellows; the probable price that has to be paid for this neglect may be estimated by the fact that her mother and maternal aunt are immoral, and that her brother, alcoholic since childhood, has been several times in jail. With regard to this whole group the question may well be raised whether, in view of the present impossibility of retaining all such children in special institutions, some degree of super- vision might not be exercised over these individuals when they pass out of the school system. The nucleus of a possible depart- ment for this purpose already exists. In Maryland a child who is not yet sixteen and who is unable to pass the fifth grade is not allowed to work, except with a special permit from the Bureau of Statistics; this permit is not granted in any case unless the child *The boy had misrepresented to the minister his age and that of the girl he married, but evidtotly no further evidence than his own statement was demanded. The Subkormal Child 13 • is over fourteen. A great number of these children, therefore, come under the jurisdiction of the Bureau of Statistics, where they are liable to appear as soon as they are fourteen in order to be allowed to work; naturally this does not apply to the girls in any- thing like the same proportion as it does to the boys. The former are more likely to remain at home than to apply for a permit to go out to work. I This Bureau, therefore, if somewhat elaborated and working in close co-operation with the schools, is an organization, which the community has already at hand, by means of which the accurate enumeration and some supervision of these individuals could be accomplished. As it is, after the age of sixteen, they are officially lost to sight, and when their condition becomes such that the community has again to take cognizance of them, through one or other of the various conditions so frequently referred to already — illegitimate child birth, alcoholism, delinquency, pauperism — there is no provision of any kind available which takes into consideration their constitutional defect. The state of Maryland has made no provision for adult mental defectives, except for those who, before sixteen, have been admitted to an institution. They are, therefore, to be found in almshouses, jails and hospitals for the insane. Group B: The second group consists of 78 children with a mental equipment not so strikingly inferior as that of the children included in Group A. Even should the provision of institutions for subnormal children be very considerably aug- mented,- only a small proportion of this group of children would be unhesitatingly referred to them. Their prospects of modest social efficiency are slightly brighter than those of the children of Group A. The limitations of the latter children are so obvious that they are soon segregated in special classes; the limitations of the children in this group (Group B) are, however, not so glaring; the children are less promptly and less certainly separated from the normal children, and they are, therefore, to be found in much greater numbers distributed throughout the grades. As their defects are less glaring than those of the children in the first group, they are more likely to be misunderstood; they are more apt to be judged by the standards suitable for the normal child and to be punished for faults and deficiencies which are the almost inevitable result of their constitutional limitations. 34 The Subnoemal Child • It is well known that this lack of understanding of their limitations seriously increases the difficulties of these children, and favors the development of anti-social traits; it has much to do with the development of truancy with bad comrades, and of sexual and other forms of delinquency. The very fact that the intelligence of these children is more developed than that of the children in Group A increases the social danger of the development of delinquent trends. These children are less liable than those of the former group to become in adult life completely dependent upon society, and are more likely to be found in the general community drifting along at the lowest social level. Their general adaptability, their economic efficiency, their happiness will largely depend upon how far their early training has been adapted to their constitutional limitations and their special requirements. During the school period there is ample opportunity for the community to appre- ciate these constitutional limitations. The neglect of any special attention to their training has to be paid for later by the com- munity in the support of numerous dependents, who might other- wise, with a little care at an early state, have developed a certain measure of economic independence. In tabulating the data regarding these 78 children in this group a subdivision has been made into those who approximate closely to those in Group A (12 children), and those who, even with generous institutional provision, would probably remain to be dealt with by the school system (66 children). The prospects of social efficiency for the former group are extremely poor and the danger of later delinquency or sexual immorality is to a certain extent indicated by the brief notes on their personal traits and the family situation. This group of 12 children might quite appropriately be grouped along with those of Group A, which would then consist of 34 chil- dren; this group of defective children would then be estimated as forming approximately 3 per cent of the school population. It is obvious that the personal equation has to be considered in making use of statistics on subnormal children. It is worth noting that Dr. Goddard, in his survey of a school population of two thousand children, based merely upon the result of the Binet-Simon intelligence tests, concluded that of the children in the first six grades 3 per cent were feeble-minded, while 15 per cent were "merely backward." The Subnormal Child 15 In Table II (page 121) are tabulated the data with regard to the twelve children of Group B with the more pronounced mental defect. Of the 66 less seriously handicapped children of Group B there are many, doubtless, whose prospects seem extremely poor and who would probably have the best chance for a healthy, hap- py and modestly efficient life if they were at the present time placed in an institution for subnormal children; but in view of the actual situation, which makes no such provision for the more seriously involved children of this group (12 children) nor for the 22 children of Group A, it would be somewhat Utopian to suggest institutional provision for any considerable proportion of the less seriously handicapped children. Sentimental considerations rather than a sober appreciation of the actual facts and of the probable future course of events are apt to have much to do with the decision as to the individual case. In the case of a girl like G. 11, fourteen years of age, in the un- graded class, whose mother is living an immoral life, the very great probability that she will follow in her mother's footsteps might make admission to a special institution advisable. On the other hand such a proposal is apt to meet with considerable sen- timental opposition. In Table III (page 123) are tabulated the data with regard to these 66 children, the majority of whom will as adults be more or less able to drift along in the community and who belong to a type that will always form a considerable proportion of the school population. As adults these individuals are likely to lead rather shiftless lives; their wage-earning capacity is small; they are apt to indulge in alcoholic and sexual excesses; they tend to spread venereal disorders; at the best they are frequently dependent on charitable organizations for support, at the worst they are delinquent, alcoholic and disseminators of disease. During the early period of their lives, when much might have been done to develop the formation of good habits of adjustnient, they have been subjected to a school regime, which laid all the weight on a type of instruc- tion which they were constitutionally unable to absorb. To a large extent the instruction given to them was thrown away; and thus the time was wasted during which they might have been trained to find satisfaction in simple activities which were not without economic value. It is strange to think that in an intelligent community these children are drifting through the 16 The Subnoemal Child schools, without any serious organized attempt being made to deal with their problems. With regard to Tables II and III, it is to be noted that the data with regard to the children in the public school are fuller than those with regard to the other children. If it had been possible to have for all the children as full data as were available in the case of the children in the public school, the number of children in this group would no doubt have been still larger. To &,ppreciate the full meaning of the facts presented in the above tables it is necessary to form a picture of the adult life of these individuals, to see them as parents in squalid homes, living in irregular relationships with companions with cognate defects, a constant drain upon the facile and short-sighted charity of the community, drifting through life aimlessly and rather pitifully, reproducing without care and handing over to others their defective offspring, which the community will handle in the same haphazard maniitr as that in which it has dealt with the parents. The situation is well exemplified by the case of a mentally defective woman who came to the dispensary of the Phipps Psychiatric Clinic from another district. The patient, a woman of thirty-two, at the time of examination was pregnant for the seventh time. As a girl she had received little school education but had been brought up by her worthless parents to beg, lie and steal. The father was a professional beggar with a criminal record who exploited every charitable organization; the mother, probably feeble-minded, connived at the immorality of her daughters ; the family of this couple consisted of ten children. Of these ten individuals all except one became intemperate and immoral; all of the daughters, save one, married vagabonds and lived apart from their husbands. One daughter., an imbecile, was admitted to Bay View, but not before she had been seduced. Our dispensary patient had been seduced at sixteen; her seducer was married to another woman. She continued, however, to live off and on with this man for fourteen years, and already six children had been born from this depraved union. "She is still begging and stealing while the community cares for her children." The three generations of this family have cost the community thousands of dollars, which have been spent in no constructive work; the problems of the first couple have been merely mul- tiplied in the descendants. Before one turns away in economic The Subkokmal Child 17 indignation at suggestions for rather comprehensive provisions for the mentally defective, it is well to keep in mind the large amount of money which is being steadily expended on such families in palliative measures. The imbecile daughter, who was seduced before her admission to an institution, would have been admitted earlier had it iiot been for the persistent refusal of the parents to give their consent. It may be discussed how far, in such a situation, the community is not in duty bound to exert its authority, even though it should have to override the wishes of a professional beggar and his feeble-minded wife. The unfortunate woman of thirty-two with her seven illegitimate children might with suitable training have developed into a con- tented fairly efficient worker in some institution or in some other environment provided with certain saef guards. Her illegitimate children are the offspring of the neglect of the community and the mental defect of the mother; the money spent in caring for the seven illegitimate children might have been better em- ployed in the segregation of the woman. Cases like the above are familiar to most social workers. The extent of the ramifications of a bad stock in the community has been most strikingly exemplified by Dr. Goddard in his study of the Kallikak Family.* This information, however, acquired by special workers, and now available in print, has not as yet been assimilated by those upon whom the community depends for the initiation of practical steps of a constructive nature. Group C: In the two previous groups have been included those children whose special requirements are too obvious to be seriously disputed. The interests of the normal child and of the normal adult require that suitable provision be made for the training of these subnormal children. There is in addition to the two groups of children already discussed a third group, whose devia- tions from the normal are not so striking and whose special requirements may not be so generally admitted. A more thorough investigation would no doubt show that some of these children really belong to the groups already discussed. In any case the data available show that they are different from their comrades, while on the other hand they are receiving the same training as *GoDDAHD, H. H. The Kallikak Family, A Study in the Heredity of Feeble-Mindedness. New York, 1912. 18 The Subnoemal Child the latter. The very fact that their intelligence is not so strik- ingly defective as that of the children in the two previous groups suggests that here may be a much more grateful task to take up. The potential economic efficiency of these children is greater than that of the children in the previous groups, while as potential delinquents the somewhat higher level of their intelligence makes them only the more detrimental to society. There is, therefore, still more to be gained from consideration of the needs of the children in this group than from attention to the wants of the more defective. The alternatives of delinquency and dependency on the one hand and of fair economic efficiency on the other, in this group as in the others, will be considerably influenced by the training during the school period. This group consists of 66 children, the data concerning whom are tabulated in Table IV (page 129) . . The figures furnished in the preceding pages represent the number of individuals in the school population who have special requirements. It is of interest to know whether the proportion of families involved is the same as the proportion of individuals involved, or whether a few prolific families of bad stock create a somewhat exaggerated impression of general defect. The 168 children with special requirements represent 129 families; in 97 families only one of the children {i. e., of school age) belonged to the special groups, while in 32 families more than one special child was found, 71 special children being contributed by these 32 families. THE SCHOOL AND ITS COMPOSITION— DISTRIBUTION OF SUBNORMAL CHILDREN THROUGHOUT THE GRADES Reference has already been made to the fact that the fullness of the data available with regard to the children from the different schools varied considerably. The most satisfactory group from this point of view was that of the children of Public School 76. As a standard of comparison the analysis of the data with regard to this group of 764 children may yield figures more useful for some purposes than analysis of the total 1,281 school children of the district. In the case of these children there was as a rule available a fairly complete record of the whole school history of the child; it was quite complete from the date of its entrance into this school. In the case of each one of the children of this school, who showed any anomalous traits suggestive of mental The Subnormal Child 19 defect, the characteristics of the child were reviewed in a con- ference of the teachers and the special workers. Only those children were tested by the Binet-Simon intelligence scale whose poor school record or family history suggested the desirability of such a test. Of the 764 children those with special requirements were grouped in the three groups described above. Group A: The most defective children. In this group were 22 children. This number embraces the whole group of this type of children in the district. The explanation lies in the distribution of these children in the various schools. The pub- lic school has a special class, adapted to their needs, in which the training is almost altogether along the lines of manual occupa- tion. Almost all the children of this type in the district are as a rule, therefore, to be found in the public school; twelve of the children in this group at the public school had Roman Catholic parents. In October when the children of the parochial school were examined, two of these children were pupils there; they had been already examined in March, when they were pupils at the public school. It is obvious, therefore, that with regard to children of this type the proportion of 22 in 1,281 is to be taken as representing the local situation rather than the proportion 22 in 764, the latter proportion being due to the above accident of distribution. With regard to the other groups for whom no special provision is made in either school, except in so far as a few of them are to be found in the special class in the public school, there is not the same disturbing factor of distribution to be considered; the children in the public school, therefore, as far as these larger groups are concerned, more nearly correspond to a random sampling of the whole school population. Group B: Sixty-three children. Group C: Fifty-nine children. Group of apparently normal children: Six hundred and twenty children. These figures show that in this district 22 children out of 1,281 show a pronounced mental defect, 63 children out of 764 have a less marked degree of mental defect, making advisable some mod- ification of their school training; and 59 more children in this group of 764 would, under an eflScient educational organization, have attention paid to their special requirements. Should these figures appear extreme the data with regard to the children are available in the tables furnished above, and the grouping may be 20 The Subnormal Child modified according to individual educational standards. The exact requirements of the group of 59 children may be the subject of debate; but the special requirements of the 63 children in the previous group can hardly be called in question. It will probably be admitted by all who care to run over the data in the tables furnished above that in addition to the defective children of Group A at least 63 out of the 764 children, i. e., approximately 11 per cent of the children in this school, have special requirements in the way of school training. To say that in the case of 144 chil- dren out of 764, i. e., in 18 per cent the methods of school train- ing should be adapted to their constitutional limitations and to their prospective outlook for the future may appear extreme. The administrator of the traditional education may impatiently suggest that to go much further would mean that the education of the remaining 620 children should take into consideration their adult tasks and the conditions which regulate the formation of habits. And in this impatient suggestion we may perhaps learn the lesson taught by the study of the subnormal child. It may become recognized that not only for the subnormal child but for the normal child the task of education is that of forming the best habits of adjustment to the environment, which his consti- tutional endowment will allow. A discussion of the principles of education in general is beyond the scope of this survey; but the study of the subnormal child and of his training will furnish an important contribution to such a discussion. The extent of the influence of the subnormal children on the education of the normal school population may be better appre- ciated by the study of their distribution throughout the grades. This is shown in the following tables. In Table V (page 137) is shown the distribution throughout the grades of all those children who showed "mental retardation" by the Binet-Simon intelligence tests, i. e., who got a score by this scale which fell short of their real age by one, two or more years. In the public school only those children were examined by this method in whom other data indicated the possibility of some mental inferiority. If all the children had been examined, the number of those showing some "mental retardation" would have been undoubtedly larger; at the same time a certain number would have been found to show a " mental age " in advance of their real age. The number of children showing some "mental re- tardation" may seem unusually large to those unacquainted with The Subnormal Child 21 the terms employed. The limits of normal variation are such that "mental retardation" of one or two years, and perhaps even of three years does not necessarily mean that a child is subnor- mal; it is simply one fact which has to be weighed along with the school data and the other facts available concerning the child. The fact that in this survey a slight degree of "mental retarda- tion" has not been taken by itself as evidence that the child is subnormal and has special requirements, is made clear in the comparison between Table V and Table VI. In Table VI (page 137) is shown, the distribution throughout the grades of those "mentally retarded" children, who in view of all the other data available were considered as subnormal and with special requirements. The same data are presented in graphic form in Charts 1 and 2. Table VII (page 138) and Chart 3 represent the distribution in the grades of the subnormal children, arranged in the three groups described above (Groups A, B, C). The difference between Chart 4 and Chart 5 is much more striking than that between Chart 1 and Chart 2. The fact that such a small proportion of the "mentally retarded" children of Chart 4 appear as "subnormal children with special requirements" in Chart 5, is merely an indication of the inadequacy of the data obtained with regard to these children. In the absence of full data with regard to the school progress of the child, and without a detailed discussion with the teachers the result of the intelligence tests was in only a small proportion of cases considered suflSciently striking to place the child among the group of subnormal children. Out of 14 children in the parochial school who showed "mental retardation" of four years, only 6 were placed in the subnormal group; with regard to the other 8 the data available were extremely meagre. J. H., a girl twelve years seven months old, had the "mental age" of 8' and was in the fourth grade; she was born in Hungary and Hungarian was the language spoken at home; her father, a drunkard, committed suicide. This girl was not classed among the subnormal children, although many might consider the above data very suggestive. Similarly B. E., a girl twelve years seven months old, with the " mental level " of 8*, in the sixth grade (which does not correspond to the same grade in the public school) was not classified with the subnormal children. These examples show that the numbers given in this survey represent a sufficiently conservative estimate 22 The Substokmax, Child of the subnormal children. In the public school with the fuller data, out of the 31 children who presented four years' "mental retardation," 23 were definitely placed in the subnormal group; it is, therefore, reasonable to assume that a similar proportion would be found in the parochial school and this would give a much larger figure than 6 out of 14. Even in regard to the children in the public school the numbers given represent a mini- mum. Out of the 31 children in the public school with four years' retardation, 8 children were not classified as subnormal; of these 4 presented apart from the result of the intelligence tests no adequate data. The 4 other cases were the following : D. E., 14:4, B. S. 9', in sixth grade; has strabismus. Her sister although three years younger, 11:0, has practically the same level of intelligence, B. S. 9^. K. F., 12:6, B. S. 8^ in fourth grade. M. M., 13:6, B. S. 9^ in fifth grade; came to United States at nine years. N. L., 13:7, B. S. 9, in fifth grade; defective speech, and poor memory; had head injury at seven years. The Subnokmal Child 23 Table I — Group A: Twenty-two children with no prospect of becoming self-supporting adults Note; Instead of having their own initials in the following tables, the children are numbered and the sex indicated by the letter B(oy)orG(irl). (See explanation of Binet-Simon tests page 101.) Name Age Binet- Simon Grade Heredity Other Data B.l 11:0 7' Ungr. Brother, 13: 11, B. S. 10*, is working, inef- ficient. 3(?)yearsinlstGr, then 4 years in un- graded class, cannot do an errand, can't read, write nor count. B.2 12:1 74 Ungr. Mother immoral. Brother, 16, married at 15, of very lowmen- tality. Brother, 7, B. S. 3', is' delicate; be- gan to talk at 6. Difficult boy. G. 1 (Sister of B. 43 and B. 52) 12:9 72 Ungr. Mother of low men- tality, cannot speak English. Brother. 13:6, B. S. 9*. in 4th Gr.; thief. Brother, 11: 9, B. S. 81, in 2nd Gr. Restless, noisy, un- truthful; cannot read nor write nor do an errand. G. 2 11:7 6= Ungr. Mother of low men- tality. Father alco- holic. After If years in 1st Gr. has been 2 years in ungraded class; de- fective speech. B. 3 (Brother of G. 19 and G. 17) 14:3 '8' Ungr. Father slow, erratic. Pat. uncle insane. Pat. aunt immoral. Sister, 12, B. S. 92, in 3rd Gr., is difficult, steals, lies. Sister, 9:8, B.S. 73. in 2nd Gr. 4 years in 1st Gr.; after ^ year in 2d Gr. was placed in un- graded class: difficult, lies, smokes, steals. B. 4 12:6 63 Ungr. Father slow. Brother. 8:5, B. S. 5*, 2|years in 1st Gr. Doesn't know his let- ters, can't count, un- able to grasp instruc- tion; 3 years in 1st Gr. 2 years in 2nd Gr. B. 5 (Brother of G. 17) 14:4 74 Ungr. Mother alcoholic. Father of low mental- ity. Sister, 83, im- moral, guilty of infan- ticide (?). Brother {? age), immoral. Sister, 11:9, B. S. 9; speech defect; in 2nd Gr. Peculiar mood; lies, steals, smokes. G. 3 (Sister of B. 7) 14:1 6» Ungr. Mat. uncles and aunts (? number), defective. Brother, 16: 1, B. S. 7', after 1st Gr. has been 4 ' years in un- graded class. Unstable; 3 years in 1st Gr., 4 years in un- graded class; cannot do an errand, can't count nor read. M The Sxjbnoemal Child Table I — Group A — Continued Name Age Binet- Simon Grade Heredity Other Data G.4 (Sister of B. 6) 14:9 8 Ungr. Mother, immoral, syphilitic. Brother, 14:9, B. S. 62, in 3rd Gr.; is truant, lies. In ungraded class after being tried in 4th Gr.; truant; (?) sexual immorality. B. 6 (Brother of G.4) 14:9 62 3 Mother immoral, syphilitic. Sister, 14:9, B. S. 8, in un- graded class; truant; (?) sexual immorality. 2 years in 1st Gr., 2 years in 2nd Gr., truant, steals, lies; has recently disappeared. B. 7 (Brother of G. 3) 16:1 71 Ungr. Mat. uncle and aunts (? number), defective. Sister, 14: 1, B. S. a^, in ungraded class tor 4 years; was 3 years in 1st Gr. Puny; adenoids; un- stab e; 2 years in ISt Gr., then 4 years in ungraded class. G.5 10:0 6< 1 Mat. grandmother epileptic. Mother epileptic, of low men- tality. Sister, 11, highly neurotic. Childbirth very diffi- cult, development very slow; "highly neurotic" from in- fancy, wets clothing, 2J years in 1st Gr. B. 8 11:9 8 Ungr. Mother alcoholic. After 2 years in 1st Gr. has been 2 years in ungraded class; neurotic; chorea; in juvenile "court" tor stealing; considered detective by teacher and special worker. B. 9 (Brother ol B. 15, G. 53 and B. 87) . . 13:7 92 Ungr. Mother of low mental- ity. Brother, 10:7, B. S. 7«, in 3rd Gr., was 2i years in 2nd Gr. Sister, 9:8, B. S. 62, in 2nd Gr., was 2 years in 1st Gr. Brother, 7: 0, B. S. 5\ in Kg., is considered defective by teacher. After Ij years in 1st Gr. has been 2 years in ungraded class; poor character, very difficult. B. 10 11:1 6< % Mother has spells (? epileptic). Sickly, difficult. G. 6 13:4 83 Ungr. After IJ years in 2nd Gr. has been 2 years in ungraded class. G. 7 (Sister of G. 25) 9:2 52 Ungr. Mother of low men- tality, deserted by father. Sister, 12:4, B. S. 8', in 4th Gr. 2 years in 1st Gr., 2 years in ungraded class; can't read, write, nor count; poor at manual work: de- fective speech. The Stjbnobmal Child Table I — Group A — Concluded 25 Name Age Binet- Simon Grade Heredity Other Data B.ll (Brother of G.12) 14:6 8* Ungr. Mother is slow. Sister 12: 9, B. S. 73, in Sth Gr. After 14 years in 4th Gr. was placed in ungraded class. B. 12 12:3 7 Ungr. Mother, careless, is living in 2 rooms in a cellar. Absent-minded, dreamy, inattentive; after 1st Gr. was placed in ungraded class. G. 8 15:3 9' Ungr. Mother immoral. Brother, 21, of low type, has been in jail several times, alco- holic since childhood. Mat. aunt immoral; several cousins on mat. side defective. (Later; is working at a seine factory.) B. 13 (Brother of B. 14) 12(?) 6" (March 10, 1914) 72 (Oct. 13,1914) 2 Mother alcoholic. Brother, 13 (?), B. S. 8, in 2nd Gr. B. 14 (Brother oi B. 13) 13(?) 74 (March 10. 1914) . 8 JOct. 13, 1914) 2 Mother alcoholic. Brother, 12 (?), B. S. V, in 2nd Gr. 26 The Subnormal Child Table II — Group B: Seventy-eight children with less pronounced mental defect than those in Group A, but obviously with special requirements: (a) Twelve children, more seriously handicapped mentally than those in Table III. (See explanation of Binet-Simon tests on page 101) Name Age Binet- Simon Grade Heredity Other Date B. 15 (Brother of B. 9, G. S3, B. 87) 7:0 5' Kg. Mother of low men- tality. Brother, 13:7, B. S. 92, is in disci- plinary class, did not pass 1st Gr. Brother, 10:7,B.S.7«,after2i years in 2nd Gr. is in Srd Gr. Sister, 9:8, B. S. 6\ after 2 years in 1st Gr. is in 2nd Gr. Is considered mentally defective by teacher; is di£Scult to manage; speech defective. B. 16 (Brother of B. 19) 9:5 7> 1 Father, laborer, gave up work because it was too hard. Mother very deaf. Brother, 14:7, B. S. 10, after 3rd Gr. passed into ungraded class; steals. 2 years in 1st Gr.; considered defective by teacher and special worker. B. 17 12:1 92 Ungr. Never beyond Srd Gr. ; considered defective by teacher and spe- cial worker. B. 18 12:9 91 Ungr. Mother alcoholic. After 2 years in Srd Gr. has been in un- graded class for 2 years; diflScult, lies, arrested for stealing. G. 9 13:4 92 Ungr. Mat. aunt epileptic. Brother, 11: l.B.S. 9. Epileptic; after Ij years in Srd Gr. has been Ij years in un- graded class. B. 19 (Brother of B. 16) 14:7 10 Ungr. Father, laborer, gave up work because it was too hard. Mother very deaf. Brother 9:5, B. S. 7\ 2 years in 1st Gr., considered defective by teacher and special worker. After 2 years in 1st Gr., 1 year in 2nd Gr., 2 years in 3rd Gr. has entered ungraded class; arrested for stealing money, smokes. G. 10 14:9 8' 4 Sister, 11:4, B.S. 9=. in 4th Gr., very slow Sister9:3, B. S. 73, in 2nd Gr., very slow. Very slow. G. 11 (Sister of B. 88) 14:4 9* Ungr. Mother after divorce lived with another man. Brother, 12:4, B.S.9,in4thGr.:had spasms in infancy. The Subnormal Child Table II — Group B — Concluded 27 Name Age Binet- Simon Grade Heredity Other Data G. 12 (Sister of B. 11) 12:9 73 5 Mother is slow. Brother, 14:3, B. S. 8*, after 1| years in 4th Gr. was placed in ungraded class. G. 13 14:3 9' Ungr. Mat. grandmother of low mentality. After 1 year in 3rd Gr. was placed in un- graded class; immoral. B. 20 11:4 7 1 , Mother immoral. Sis- ter, 12:4, B. S. 9', in 3rd Gr. B. 21 11:6 73 2 28 The Subnokmal Child Table III — Group B: Seventy-eight children with less pronounced mental defect than those in Group A, but obviously with special requirements; (b) sixty-six children with prospective sotial efficiency greater than that of the twelve children in Table II. (See explanation of Binet-Simon tests on page 1^1) Name Age Binet- Simon Grade Heredity Other Data G. 35 10:10 G. 36 B. 67 (Brother of B. 25) . . . . G. 37 10:9 7:10 91 Cousin defective, 13 4, B. S. 9*, is epileptic. 2 years in 3rd Gr. Defective speech. 72 91 G. 38 B. 68 B. 69 B. 70 G. 39 10:6 7:4 6:10 10:2 9:5 Mat. grandmother al- coholic, insane Mother stupid, almost illiterate. Parents have separated (American). Sister. 10:9, B. S. 1\ has been 2 years in 2nd Gr. 2 years in 1st Gr.; quarrelsome, easily loses control of tem- per. Father, tubercular was black sheep of family. Brother, 12: 7, B. S. 10, is in 4th Gr., with poor char- acter. Brother, 8: 9, B. S. 6^, poor charac- ter. 91 53 5> 8^ 8:0 6< Mat. grandfather al- coholic, illiterate. Mother started work at 10 years, married at 17, is neurotic. Brother, 10:5, B. S. 7*, in 3rd Gr., is very peculiar. Brother, 8: 9, B. S. 8, in 8rd Gr.,| is peculiar, unstable 2 years in 2nd Gr.; self -abuse; stubborn, quarrelsome, truant. The children have been taught to beg. Defective speech; 2 years in 1st Gr. Father insane. Pat, uncle peculiar, alco- holic. Mother (?) immoral. Father insane. Moth- er immoral. Mother died from apoplexy. Was 3 years in 1st Gr. Slow, morose, un- truthful. Seemed defective to special worker. 2 years in 1st Gr., 9 years in 2nd Gr. Sickly, "queer at times," deaf; drawl- ing speech. Consid- ered defective by teacher and special worker. Mongolian type; 2 years in 1st Gr. The Subnormal Child Table III — Group B — Continued 29 Name Age Binet- Simon Grade Heredity Other Data G. 40 10:3 8* 2 Mother of low men- tality. Sister, 8, had spinal meningitis at 11 m., has not talked or walked since, vio- lent, destructive. B. 71 (Brother of B.44) 9:0 73 1 Brother, 12, B. S. 91, was 2| years in 1st Gr., 2i years in 2nd Gr., is now in 3rd Gr. Sister died from spinal trouble. 2 years in 1st Gr. G. 41 6:2 4» Kg. Strabismus; appeared defective to teacher and special worker. G. 42 7:9 63 1 Mother immoral, al- coholic. Half-brother 12: 3, B. S. 8', is in 3rd Gr. 2 years in 1st Gr.; neurotic. G. 43 8:3 6^ 1 Mat. aunt and uncle (?) epileptic. Appeared defective to special worker. B. 72 (Brother of B. 58) 10:10 92 3 Mother, illiterate, says she has forgotten how to read and write (is American); married at 16, had 15 children, of whom 5 died in in- fancy with convul- sions. Brother, 14, B. S. 9, is in disciplin- ary class. 2 years in 3rd Gr. B. 73 8:5 73 3 la considered defects ive by teacher; gen- era! behavior poor; untruthful, dishonest. Adenoids, middle-ear disease. G.44 (Sister of G. 26) 8 & 1 Mother, in U. S. 5 years, cannot speak English. Sister, 11:1 B. S. 7, is difficult to manage. Ij years in 1st Gr.; unstable, difficult to control, considered defective by teacher. B. 74 10:8 9 3 2| years in 2nd Gr., diEcidt character; untruthful, truant. B. 75 8:9 72 1 Brother, 13:9, B. S. 9^ smokes constantly. Several cousins de- fective. 2 years in 1st Gr. 30 The Subnormal Child Table III — Group B — Continued Name Age Binet- Simon Grade Heredity Other Data B. 76 9:4 R 3 Sister, 11:4, B. S. 9=, is difficult child. Considered defective by teacher. B. 77 (Brother of B. 49 and B. 86) 7:8 0' 1 Father alcoholic. Brother, 12:6, B. S. 9', has chorea; after Ij years in 2nd Gr. has spent 2 years in ungraded class. U years in 1st Gr.; difficult boy; self- abuse; smokes, plays truant, steals. Born with 6 fingers on each hand; is. considered defective by teacher and special worker. B. 78 6 42 Kg. Drools; considered defective by special worker. B. 79 5 3' Kg. Neurotic; self-abuse; choreiform movements considered defective by special workers. G. 45 10:11 82 2 1| years in 1st Gr., 2 years in 2nd Gr.; in- dustrious, stupid. B. 80 (Brother of 59) 10:3 73 3 Mother, very igno- rant. Father has de- serted family. Broth- er 14, B. S. 91, is diffi- cult. Brother, 15, very slow, is at work. G. 46 (Sister of G. 52) 10:11 & 2 Sister, 12: 0, B. S. 8«, in 3rd Gr. 2 years in 2nd Gr. G. 47 (Sister of B. 26) 11:10 9 3 Brother, 10:5, B. S. 81, in 2nd Gr. Blind in one eye from memngitisatl2weeks. G. 48 (Sister of B. 3, and G. 19) 9:8 73 2 Father slow, erratic. Pat. uncle insane. Pat. aunt immoral. Sister, 12, B. S. 92, in 3rd Gr., is difficult, steals, lies. Brother, 14:3, B. S. 8=, after 2nd Gr. entered un- graded class, is diffi- cult, lies, smokes. 2 years in 2nd Gr., tubercular, bed-wet- ter; defective speech. G. 49 10:4 8 i Brother, 13: 10, B. S. 10, 2 years in disci- plinary class. Sister, 8:3, B. S. 6^ 2 years in 1st Gr. The Subnormal Child Table III-^Group B — Continued 31 Name Age Binet- Stmon Grade Heredity Other Data G. 50 (Sister of B. 88 and B. 50) 8:4 6' 1 Mother alcoholic, ner- vous, with strabismus. Brother, 11:2, B. S. 7, is in ungraded class after 2 years in 2nd Gr. Brother, 9:4, B. S. 71, is in 2nd Gr., difficult; considered defective by teacher and special worker.' 2 years in 1st Gr. B. 81 10:10 8» 2 Sister, 13:7, B. S. 10, in 5th Gr. Brother, age (?), can't read nor write, truant. First went to school in the coimtry. 2 years in 1st Gr. B.82 (Brother of B.30) 9:7 71 3 Brother, 7: 10, B. S. 5S 2 years in 1st Gr., wets clothing, difEcult boy; considered de- fective by teacher and special worker. Considered defective by teacher and spe- cial worker. B. 83 11:11 9 3 2 years in 1st Gr., 2 years in 2nd Gr. B. 84 11:10 9' 3 Parents alcoholic. Father deserted fam- ily. 2 years in 2nd Gr. B. 85 12:0 9" 5 Not doing even 4th Gr. work; defective speech. B.86 (Brother of B. 49 and B. 77) 11:1 9 3 Father alcoholic, not s el f-s u p p r t i n g. Brother, 12: 6. B. S. 9', in ungraded class; chorea. Brother, 7: 8 B. S. 6', born with six fingers, difficult. In 1st Gr. from 6 to 9; deaf; smokes. G. 51 (Sister of B. 23) 13:6 101 5 Mother, 9 years in U. S., does not speak English. Brother, 11, B. S. 9'. in ungraded class, very inefficient. Considered defective by teacher and spe- cial worker. G. 52 (Sister of G. m 12:0 8* 3 Sister, 11: 11, B.S. 82, 2 years in 2nd Gr. Defective speech, the family, German, have had no settled resi- dence in this country. G. 53 (Sister of B 9, B. 15 and B.87) 9:8 6" 2 Mother of low men- tality. Brother, 13: 7, B. S. 92, did not pass 1st Gr., is in dis- ciplinary class. Brother, 10:7, B. S. 7*, in 3rd Gr. Brother, 7:0,B.S. 6', inKg. is considered defective by teacher. Was 2 years in 1st Gr. 32 The Subnormal, Child Table III — Group B — Continued Name Age Binet- Simon Grade Heredity Other Data B. 87 (Brother of G. 53, B. 9 and B. 15)... 10:7 74 3 Brother of above. Was 2| years in 2nd Gr.; highly neurotic. B. 88 (Brother of G. 11) 12:4 9 4 Mother, after divorce, lived with another man. Sister, 14 : 4, B. S. 9*, in ungraded class. Spasms in infancy. B. 89 (Brother of B. 27) 11:9 8^ 3 Brother, 13, after 2i years in 3rd Gr. was put in ungraded class; now has permit to work. Brother, 9:6, B. S. 72, 2 years in 1st Gr. ' G. 64 13:4 9' 4 Father was divorced by mother on account of infidelity, tuber- cular. Stammers. Lives with father and step- mother, cleans the bar of the saloon; 2 years in 1st Gr.; 1| years in 3rd Gr.; very slow. B. 90 10: 11 8 2 Previously irregular attendance at country school; convulsions at 4 years; neurotic, easily excited. B. 91 11:7 81 3 Brother, 14, as infant had marasmus, was 3 years in arms. Difficult boy; 2 years in 2nd Gr., 1 year in ungraded class. G. 55 12:4 8« 4 Mother alcoholic, im- moral. Difficult childbirth; convulsions ; is kept at home to do house- work. B. 92 13:3 9' 4 Mother highly neu- rotic. Truant, smokes, lies; 2 years in 4th Gr. Poor home atmos- phere. B. 93 11:8 8» 3 Sister, 13: 9, B. S. 8', in 6th Gr.; born in Germany. Has been kept at home to look after baby. G. 56 12:8 9 3 1^ years in 2nd Gr., 8 years in 3rd Gr. G. 57 13:1 10 6 Father alcoholic. Mother (?), epileptic. Truant, immoral, lies; (?) epileptic. The Subnormal Child 33 Table in — Group B—Concluded Name Age Binet- Simon Grade Heredity Other Data B 94 13:11 Kfi G Brother, 11: 0, B. S. 7', never got beyond 1st Gr.; imbecile. Is working (later re- port); employer re- ports that he is very inefficient. G. 58 13:3 9* 4 fi 95 12:4 8= 4 Father (American) cannot read nor write; is alcoholic. 2 years in 3rd Gr.; has choreiform move- ments. G. 69 13:4 10' 5 Neurotic; considered defective by teacher and special worker. G. 60 13:11 9' 5 Mother has "spells." Sister highly neurotic. Highly neurotic; not interested in school, does other worjc effi- ciently. Has evidence of organic brain dis- ease. B. 96 13:8 9' 4 G. 61 13:4 9^ 4 Troublesome; likes the boys. G. 62 12:4 8* 4 Mother stammers, is Hungarian, 10 years in U. S., speaks very little English. Came to U. S. at 2 years; described as very slow, is over- worked at home. B. 97 14:2 S* 4 Hungarian, 3 years in U. S., lies, cheats, drinks, makes good progress. G. 63 11:1 8" 2 G. 64 10:2 73 2 Mother has strabis- mus. G. 66 10:1 8 2 Mother is slow. Sis- ter, 12: 9, B. S. 7s, in 5th Gr. Brother, 14: 5, B. S. 8*, in un- graded class. B. 98 9:10 6 1 Father alcoholic. Language spoken at home is Polish. B. 99 9:8 6 1 Born in Poland; ex- tremely poor home conditions. B. 100 14:8 10 5 Brother, 13:6, B. S. 11, in 5th Gr. Neurotic. B. 101 14:3 92 8 34 The SuBNOEMAi Child Table IV — Group C: Sixty-six children with sufficient indication of mental anomalies during the school-period to make modification of the usual school training desirable Name Age Binet- Simon Grade Heredity Other Data B. 22 9:7 8* 3 Considered defective by teacher and special worker; neurotic, stubborn, queer, dif- ficult to manage. B.23 (Brother of G. 51) 11 9' Discipl. Mother, 9 years in U. S., does not speak English. Sister, 13: 6, B. S. 10'. After 2 years in 2nd Gr. has spent 2 years in an ungraded class; considered defective by teacher; at home he is forgetful, cannot go on an errand with- out a note; docile, cheerful. B.24 (Brother of B. 38 and G. 23) 10:1 7« 2 Mother, 20 years in U. S., does not speak English. Brother, 12: 2, B. S. 91, is in 3rd Gr. after 5 years at school; teacher con- siders him insane. Sis- ter, 13:5, B.S.9» has been 2 years in 4th Gr. Is very difficult; has middle-ear disease; education is inter- fered with by berry- picking and tomato- canning; considered defective by teacher and special worker. 1| years in 1st Gr., 2 years in 2nd Gr. B. 25 (Brother of B.67) 8:9 6« 1 Father, tubercular, the black sheep of his family. Brother, 10: 9, B. S. 9', is in 3rd Gr., difficult. 2 years in 1st Gr., truant, smokes, lies; considered defective by teacher and spe- cial worker. Children are taught to beg. B. 26 (Brother of G.47) 10:5 81 2 Sister, 11:10, B.S. 9, in 3rd Gr. 2i years in 1st Gr.; truant, difficult. B. 27 (Brother of B. 89) 9:6 72 1 Brother, 13, after 2 years in 3rd Gr. was put in ungraded class ; now has permit to work. Brother, 11 ■ 9, B. S. 8*, after 2 years in 2nd Gr. is in 3rd Gr. 2 years in 1st Gr. B. 28 (Brother of B. 50 and G. 60) 9:4 V 2 Mother alcoholic, ner- vous, with strabismus. Brother, 11:2, B. S. 7, is in ungraded class after 2 years in 2nd Gr. Brother, 13: 2, B. S. 10', 5 Gr., 2 years in 5th Gr. 2 years in 1st Gr. Difficult boy; con- sidered defective by teacher and special worker. The StTBNORMAX, Child Table IV— Group C — Continued 35 Name Age Binet- Simon Grade Heredity Other Data B. 29 10 71 1 Mat. aunt and pat. aunt had epilepsy. Difficult boy; bed- wetter. G. 14 10:9 82 2 Chorea; 2 years in 1st Gr. B.30 (Brother of B. 82) 7:10 5* 1 Brother, 9: 7, B.S. 71. 2 years in 1st Gr.; wets clothing; diffi- cult boy, considered defective by teacher and special worker. B.31 10:7 81 Ungr. Auntand uncle feeble- minded. 2J years in 1st Gr., speech defective; con- sidered defective by teacher and special worker. B.32 11:7 91 3 Father very excitable. Extreme restlessness from infancy; very difficult, upsets the class; considered de- fective by teacher and special worker. G. 15 10:3 8 2 Father, educated, er- ratic, unable to make a living. Brother, imbecile, in institu- tion; 2 grown-up brothers (24, 22) usu- ally idle. Chorea. 2 years in 1st Gr., 2 years in 2nd Gr. B.33 12:3 101 Ungr. • After 1 year in 2nd Gr. has been 2 years in ungraded class; lies, steals, smokes. B.34 10:7 81 2 In 1st Gr. for several years. B. 35 (Brother of B. 48) 8:10 6S 1 Mother slow mentally, easily confused, alco- holic. Brother, 13:3, B. S. 101, jn ungraded class after 1| years in 5th Gr.; poor char- acter; very slow men- tally. 3 years in 1st Gr.; considered defective by teacher and special worker. B. 36 (Brother of B.54) 11:0 81 2 Sister, 15:9, weighs 248 lbs., is of low men- taUty. Brother, 13: 11, B. S. 10, after 3rd Gr. has been 2 years in ungraded class; dif- ficult, lies, smokes. 2 years in 1st Gr. 36 The Subnormal Child Table IV — Group C — Continued Name Age Binet- Simon Grade Heredity Other Data G. 16 11:12 8' 1 Sister,13:2,B.S.10«, in 5th Gr. 1| years in 1st Gr. G. 17 (Sister of B. 5) . . 11:9 9< 2 Mother alcoholic. Father of low mental- ity. Sister, 23, is said to have caused death of her illegitimate child. Brother, (age ?) immoral. Brother, 14:4, B.S.7S after 1 year in 1st Gr. was 2 years in ungraded class; lies, smokes, steals. Speech defect. B. 37 8:2 6' 1 3 years in 1st Gr.; considered defective by teacher and special worker; thief, born in Hungary. B. 38 (Brother of G. 23 and G. 24) 12:2 91 3 Mother, 20 years in U. S., cannot speak English. Sister, 13:5 B. S. 91, has been 2 years in 4th Gr. Brother, 10: 1, B. S. 7<,in 2nd Gr . atschool, is considered defect- ive. Difficult to controU considered insane by teacher. G. 18 10:9 72 3 Mat. grandmother al- coholic, insane. Mother stupid, al- most illiterate (Amer- ican). Parents have separated. Sister, 8: 8, B. S. 7", in 1st Gr. for 2 years. Cannot learn; is nerv- ous, cannot remem- ber if sent on errand; in 2nd Gr. for 2 years. G. 19 (Sister of B. 3 and G. 48). 12:0 92 3 Father slow, erratic. Pat. uncle insane. Pat. aunt immoral. Brother, 14: 3, B. S. 8', after 2nd Gr. en- tered ungraded class; is difficult, lies, smokes. Sister, 9: 8, B.S. 73, 2 years in 2nd Gr.; defective speech; wets bed. Is difficult, steals, lies; after i year in 4th Gr. was put back into 3rd Gr. B. 39 12:2 9' 3 Physical stigmata; neurotic; difficult. 2 years in 1st Gr., 2 years in 3rd Gr. The Subnormal Child Table IV — Group C — Continued 37 Name Age Binet- Simon Grade Heredity Other Data B.40 13:8 10' Ungr. Sister, 16, of very low mentality. Pneumonia at 6, fol- lowed by spasms; strabismus; difiScult, deceptive, smokes. B.41 13:10 10 Ungr. Sister, 10:4, B. S. 8, in2ndGr. Sister, 8:3 B. S. 6*. 2 years in 1st Gr. After 3rd Gr. passed into ungraded c ass. B.42 12:3 83 3 Mother immoral, al- coholic, erratic. B.43 (Brother of B.4) 8:5 5« 1 Father slow. Brother, 12: 6, B.S. 63, 3 years in 1st Gr. 2 years in 2nd Gr., 2 years in un- graded class; doesn't know letters, can't count, is diflncult. Defective speech. 2| years in 1st Gr. G. 20 13:2 92 Ungr. Brother, 12:2, B. S. 9S in 7th Grade. \ G. 21 12:0 S^ 4 Mother deformed. Sister has illegitimate child. B.44 (Brother oi B.71) 12:0 91 4 Mother slow. Sister died from spinal men- ingitis (?). Brother, 8:ll,B.S.7Msinlst Gr. for 2nd year. 2J years in 1st Gr., 2 years in 2nd Gr.; truant. B. 45 (Brother of G. 1 and B 62) 11:9 81 2 Mother, of low men- tality, cannot speak English. Sister 12:9, B. S. 7^, in ungraded class for 4 years after 1st Gr.; cannot do an errand; dishonest. Brother, 13:0, B. S. 9*, in 4th Gr.; thief. Born in Germany, language spoken at home is German. 1 year in Kg., 2 years in 1st Gr., 3 months in ungraded class, ^ year in 1st Gr., 1 year in 2nd Gr. B.46 8:11 5* 1 B.47 13: 7 101 Ungr. Father alcoholic. Brother is slow. (Par- ents American.) After IJ years in 3rd Gr. has spent 2 years in ungraded class; spasms in infancy; speech detect. B. 48 (Brother of B. 35) 13:3 101 Ungr. Mother, slow men- tally, easily confused, alcoholic. Brother, 8: 10,B.S.63,inlstGr. for 3 years; is consid- ered defective by teacher. After 1| years in 5th Gr. was put in un- graded class; defect- ive speech ; masturba^ tion; difficult boy, lies, smokes. 38 The Subnormal, Child Table IV — Group C — Continued Name Age Binet- Simon Grade Heredity Other Data B.49 (Brother of B. 77 and B. 86) 12:6 9' Ungr. Father alcoholic, not self-supporting. Brother, 11:1, B. S. 9, in 3rd Gr. Brother, 7:8, B. S. 61, born with 6 fingers; diiE- cult boy. After \\ years in 2nd Gr. has been 2 years in ungraded class; chorea; a teacher who knows him well be- lieves he can make a living. G. 22 12:5 9« Ungr. After 1 year in' 3rd Gr. has been 2 years in ungraded class; diflScult, sexual delin- quency. G. 23 (Sister of B. 38 and B. 24) 13:5 9 4 Mother, 20 years in U. S., cannot speak English. Brother, 12: 2, B. S. 91, in 3rd Gr. after 5 years a t school, considered insane by teacher. Brother, 10: 1, B.S.7Mn2ndGr.; is considered defect- i ve by teacher. 2 years in 4th Gr. G.24 13:10 9= Ungr. Brother, 12:2, B. S. 9, in 4th Gr. Sister, 10:0, B. S. 8, in 2nd Gr. B. 60 (Brother of B. 28 and G. 50) 11:2 7 Ungr. Mother nervous, alco- holic; strabismus. Brother, 13:2, B. S. 103, in 5th Gr. Broth- er, 9: 4, B. S. 71, in 2nd Gr.; difficult. Sis- ter, 8:4, B. S. 6S; 2 years in 1st Gr. After 2 years in 2nd Gr. is now in un- graded class. B. 61 13:0 91 4 B.62 (Brother of B. 45 and G. 1) 13:0 9* 4 Mother of low men- tality, cannot speak English. Sister, 12:9, B. S. 7^ never got be- yond 1st Gr., in un- graded class for 4 years; cannot do an errand; steals. Broth- er, 11:9, B. S. 81, in 2nd Gr. Steals; is considered silly by neighbors. G. 25 (Sister of G. 7) 12:4 81 4 Mother, of low men- tality, deserted by father. Sister, 9:2, B. S. 5^ in ungraded class, 2 years in 1st Gr., 2 years in un- graded class; can't read, write, nor count, poor at manual work; defective speech. Deaf; neurotic; ex- citable. The Subnoemal Child Table IV— Group C — Continued 39 Name Age Binet- Simon Grade Heredity Other Data B. 53 13:9 9 Ungr. Mother neurotic. Father alcoholic. 2 years in 1st Gr., I5 years in 2nd Gr., 1 year in ungraded class; in juvenile court for stealing coal. B.54 (Brother of B. 36) 13:11 10 Ungr. Sister, 15:9, weighs 248 lbs., is of low mentality. Brother, ll:0,B.S.8i,2years in 1st .Gr. After 3rd Gr. has been 2 years in ungraded class; lies, smokes. G. 26 (Sister of G. 44) 11:1 7 Ungr. Mother, in U. S. 6 years, does not speak English. Sister, 8, B. S. 6\ li years in 1st Gr. ; is a di£Scult child, considered defective by teacher. After 1 year in 1st Gr. has been 2 years in ungraded class. B. 55 13:8 92 Ungr. After 4th Gr. passed into ungraded class. B.56 13:9 92 5 2 years in 5th Gr.; smokes constantly. B. 57 (Brother of B. 80) 14:0 91 6 Mother very ignorant. Father has deserted family. Brother, 10: 3, B. S. 7', in 3rd Gr. Brother, 15, very slow, is at work. G. 27 (Sister of B. 98) 13:9 8' 5 Brother, 11:8, B. S. 8', in 3rd Gr. Has been kept at home to. look after baby. G. 28 13:1 8' 4 2 years in 2nd Gr., 1 year in 3rd Gr. B.58 (Brother of B.72) 13:11 9 Ungr. Mother (American) can neither read nor write, married at 16, had 15 children, 5 of whom died from con- vulsions in infancy. Brother, 10:10, B.S. 92, 2 years in 3rd Gr. Brother. 8:5, B.S. 7. Active, quarrelsome, lies, smokes; was ^ year in 5th Gr. G.29 7:7 5' 1 Father alcoholic. Defective teeth; de- fective speech; un- truthful ; 3 years in 1st Gr., has run away repeatedly; consid- ered defective by teacher and special worker. 40 The Subnormal Child Table IV — Group C — Concluded Name Age Binet- Simon Grade Heredity Other Data B. 69 14:3 9' 5 Brother, 11:7, B. S. 92 ; defective speech, neurotic. Defective speech. B.60 14:8 9« 7 Mother alcoholic. B. e"! 13:11 8' 7 B. 62 14:4 91 5 Father alcoholic. G. 30 12:6 7 4 B. 63 14:0 92 5 Brother, 11:8, B. S. 9S in 5th Gr. G.31 12:7 8* 3 Polish is spoken at home. B.64 7:9 4' 1 G. 32 (Sister of B. 20) 12:5 93 3 Mother immoral. Brother, 11:4, B. S. 7, in 1st Gr. G. 33 12:3 91 3 Neurotic. G. 34 10:4 7' 2 Sister, 11:7, B. S. 9'. B. 65 10:4 7 2 B. 66 11:8 74 2 Brother, 13:7, B. S. 10', 6th Gr. The Subnormal Child 41 What is immediately evident from the above tables is that throughout the first five grades there is a large number of sub- normal children who tend to waterlog the classes. The fact that some of these children progress so far in the grades is explained by the general school rule that after two years in one grade a child, even although unable to pass that grade, is promoted to the next grade. This somewhat perplexing rule to try the child on the more difficult, if he fail on the easier tasks, may have some justification in the hope that the personality of another teacher and the stimulus of a new grade may arouse dormant powers. The abrupt drop in the numbers of the sixth grade from those of the fifth is explained by the economic conditions of the district. A boy of fourteen who has passed the fifth grade is entitled to a permit to work, and therefore a large proportion of the children do not go beyond the fifth grade. As to the classes composed entirely of subnormal children one class is specially organized to meet the needs of these children, and is referred to as the "special " class; the other class is termed the ungraded class. In the tabulation of the individual cases, no distinction has been made between these two classes (Tables I to IV). In each public school there is an ungraded class, a collection of heterogeneous nuisances, who are placed there in order to relieve the ordinary grades of their presence and without any systematic attempt being made to estimate the factors involved in each individual case. The needs of these children are not specially considered, no attempt as a rule is made to equip the classes in relation to their needs, and the teachers are not trained to deal with the special problems of such a class; it is true that several of the teachers of their own initiative have taken advantage of the meagre opportunities which Baltimore oflFers for the systematic study of the subnormal child and his training. In the parochial school all the pupils were examined by the Binet-Simon scale. Chart 4 shows the distribution of the children according to grades and "intelligence" level; Chart 5 shows the distribution throughout the grades of those "mentally retarded" children, who in view of other data available were considered to be subnormal and to have special requirements. 42 The Subnoemal Child Table V — Distribution throughout the grades of the children with "mental retardation," Public school 76, Baltimore, Md., May, 1914 NOMBEK OF ChILDEEN RETARDED Years retarded Total Kinder- garten Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7 Grade 8 Special class Ungraded 1 113 107 66 31 15 i 2 1 1 4 1 31 21 6 2 16 23 5 1 31 17 13 1 18 23 13 8 3 10 14 16 7 3 2 4 3 1 1 1 1 1 ■ 1 6 3 2 1 1 1 2 2 3 8 4 7 5 4 6 2 7 ... 1 8 9 Total found re- tarded 340 5 60 45 62 65 50 10 3 15 •25 Total in school.. . 764 45 150 126 121 109 98 39 28 11 16 •21 •Five of the twenty-six children examined had left the school before May, at which date the school census was 764. These results are shown graphically in Chart 1. Table VI — Distribution throughout the grades of those children with "mental retardation" who were considered subnormal and with special requirements, Public school 76, Baltimore, Md., May, 1914 Number of Children Considered Stibnormal and with Special REQrrmEMENTS Years retarded Total Kinder- garten Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7 Grade 8 Special class Ungraded 1 26 34 38 23 15 4 2 1 1 4 10 10 3 2 13 i 1 2 9 7 11 1 7 7 3 1 3 2 3 1 1 1 a 3 2 1 1 1 2 2 3 8 4 7 5 4 6 2 7 1 8 9 Total subnormal. 144 4 23 22 28 17 9 1 15 *25 Total in school. . . 764 45 150 126 121 109 98 39 28 11 16 *21 •See footnote, Table V. These results are shown graphically in Chart 2. The Subnokmal Child 43 Table VII — ^Distribution in the school grades of the different groups of subnormal children, Public school 76, Baltimore, Md., May, 1914 Ndmbee OP Sdbsorm.1i, Children Subnonnal group Total Kinder- garten Grade 1 Grade 2 Grade 3 Grade 4 Grade Grade 6 Grade 7 Grade 8 Special class Ungraded A 22 63 59 1 1 11 11 3 10 9 1 20 7 10 i 5 1 11 4 Q B !9 C Total 144 4 23 23 28 17 9 1 15 23' Total Id school . . 764 45 150 126 121 109 93 39 28 11 16 21' •Five of the twenty-five children examined had left the school before May, at which date the school cenaua was 764; with regard to one additional child in the ungraded class, certainly subnormal, the data were inadeq^iate for further •olasfflBcatiou. These results ^re shown graphically in Chart 3. Table VIII — ^Distribution throughout the grades of the children with "mental retardation," Parochial school, Baltimore, Md., Oct., 1914 Number OP CniLDKEN IVITn "Mest AL Retardation" Years retarded Total Kinder, garten Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7 Grade 8 1 2 100 52 26 10 8 7 2 26 6 4 1 17 7 3 1 2 14 2 3 1 12 7 1 1 6 11 5 2 2 9 3 4 1 8 12 2 1 2 1 2 3 4 5 2 5 1 Total retarded.... 196 9 37 30 20 21 26 17 25 11 Totalin school. ... 463 68 110 65 55 40 40 38 31 16 These results are shown graphically in Chart 4*. 44 The Subnormal Child Table IX— Distribution throughout the grades of those children with "mental retardation" who were considered subnormal and with special requirements, Parochial school, Baltimore, Md., Oct., 1914 NOMBEE OF ChILDEEN CoHSroERED SxiBNOEHAI, AND WITH SPECIAL EEQniEEMBNTa Years retarded Total Kinder- garten Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7 Grade 8 1 1 3 8 6 8 1 3 1 3 3 1 , 2 ■ 2 1 1 2 3 2 2 3 4 1 5 Total subnormal.. . 26 S 9 3 1 S 2 1 Total in school. . . . 463 68 110 65 65 40 40 38 31 16 These results are shown graphically in Chart 5. Table X — Distribution in the school grades of the different groups of subnormal children, Parochial school, Baltimore, Md., Oct., 1914 NCMBEE OF SOE.N ORMAL Children Subnormal group Total Kinder- garten Grade 1 Grade 2 Grade 3 Grade 4 Grade 6 Grade 6 Grade 7 Grade 8 A 8 2 3 2 4 3 3 1 4 1 2 B C 1 Total subnormal . ■ 28 5 9 3 1 5 2 1 Total in school 463 68 110 65 65 40 40 38 31 16 These results are shown graphically in Chart 6. The Subnormal Child 45 SUMMARY The treatment of the subnormal child consists above all in giving him a training suited to his constitutional limitations. In Baltimore such training is at present available for only a handful of the subnormal children; the others rub along at school in the ordinary grades, where they interfere seriously with the teaching of the normal children, or they are found in ungraded classes where the "school nuisances" accumulate. The neglect of the training of the subnormal child has serious social and economic results; subnormal children are potential dependents on society and recruit the ranks of the paupers, the vagrants, the drunkards, the prostitutes and the delinquents. Such end-products, the result of the difficulty of adjustment of these individuals to their environment, are partly due to the absence of suitable training during the school-period. Assuming that the present type of school training is satisfactory for the normal child, how many children are there who through constitutional inferiority are unable to benefit by it, and require a special form of training? The present survey was undertaken to get some data which would help to furnish an answer to this question; in one district the school population was reviewed and the number of children with special requirements enumerated. This district is not to be considered as typical; it is of a very low social and economic level, and has a very large foreign population. Out of a school population of 1,281 children, 166 children were found to have special requirements on account of their mental constitution. The data with regard to these children are briefly tabulated, and they can be grouped according to the special point of view of the individual worker. The following classification was adopted as being the most useful in relation to the present situation in Baltimore. Group A: Twenty -two children showed a pronounced mental defect, which eliminated any prospects of their becoming self-sup- porting. In the absence of exceptionally favorable home condi- tions, training in a suitable institution would be best for these chil- dren; in view of the limited accommodations of existing institu- tions, these children remain a problem for the school system. Their training should be of a simple and concrete nature; good conduct and simple manual ability are the main objects to be aimed at. 46 The Subnormal Child Twelve children of Group B might well be included along with these 22 children, but the grouping has been made as conserva- tive as possible. Group B: Seventy-eight children showed a degree of mental defect less pronounced than that of the children in Group A, but so definite that their special requirements can hardly be debated. The nature of the training received by these children during the school period will have much to do with their social adaptability as adults; neglect by the community of their problems will in- crease the number of adult dependents. Group C: Sixty-six children were sufficiently handicapped men- tally for some modification of the usual curriculum to be dis- tinctly indicated. These children, too, are liable to recruit the ranks of the dependents and this chance is increased considerably by the lack of suitable training during the school period. Group D: One thousand one hundred and fifteen children seemed sufficiently well equipped mentally to digest the ordinary school curriculum. Instead of using as a unit of comparison the 1,281 school chil- dren of the district, with their heterogeneous data, it may be more ■ satisfactory, at least with regard to Groups B, C, D, to use the 764 children of the Public School, with regard to whom the data were more uniform. These children were distributed as follows : Group A: Twenty-two children. This large number is due to the distribution of this type of children in the different schools; with regard to Group A, 22 children out of a total school popula- tion of 1,281 gives the real proportion in the district. Group B: Sixty -three children; Group C: Fifty-nine children; Group D: Six hundred and twenty children. The accompanying tables show the distribution of these children throughout the grades. In order to train satisfactorily the children of the community the school authorities would require (1) to have an approximate idea of the composition of the school population, with some realization of the prospective adult level of the various groups; (2) to adapt the methods of training to the special requirements of the various groups; (3) to equip the schools and to train teachers so that the appropriate methods can be carried out. The details of organization, the comparative merits of special classes and special schools and the kind of training best adapted to the needs of special groups have to be determined after accept- ance of the above general- principles; The Subnormal Child 47 CMART I PER CENT DISTRIBUTION THROUGHOUT THE GRADES OF THE CHILDREN WITH "mental RETARDATION" PUBLIC SCHOOL. BALTIMORE, MD. (see table V) Kinder- garten PER CENT *0 60 2? 8.9 88.9 Grade 5 Grade 6 Grade 7 Grade 8 Specfal Class Ungraded Crass 2? 7' IC.^ B. 3? 3P 3? S9.2 100 1 00 6.' 6.' 53.9 "'■i*^^^^^^^ ' 30.8 AYEARSm°o"». »«« -J YEARS 'retarded M^iMmM *J retarde ^1 m 7 YEARS ^ Lm RETARDED YEAR RETARDED NOL 48 The Subnobmal Child CHART 2 PER CENT DISTRIBUTION THROUGHOUT THE GRADES OF THOSE CHILDREN WITH "mental retardation' who were considered SUBNORMAL AND WITH SPECIAL REQUIREMENTS PUBLIC SCHOOL, BALTIMORE. MD. (seE TABLE 121) O 20 Kinder. ^^" PER CENT 40 eo 8.9 garten ^^ Grade | Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7 Grade 3 M ^^ 2 6.' 6.' I* S 10.3 P M .B 9.^ 5.8 7= 9.2 6S 5.' 3.' I Special Class Ungraded Class 53.9 91.' 84.6 82.= 76.' 84.3 90.8 97* 100 100 30.8 7' 38 as /YEARS mSSc ^»||3 1 YEARS ^mm O YEARS ^^RETAROEO IHtMBSlSl >J RETARDED K^SJUjiiii L, RETARDED ilU I RETARDED I YEAR RETARDED The Subnormal Child 49 CHART 3 PER CENT DISTRIBUTION IN THE SCHOOL GRADES OF THE DIFFERENT GROUPS * OF SUBNORMAL CHILDREN PUBLIC SCHOOL BALTrMORE.MD. (see table "Sni) O 20 Kinder- ^^ garten '^M PER CENT 40 60 Grade | aJ P 7.3 Special C\ass Ungraded Class 84.3 9Q« 100 100 73.3 <»j^»a:;a»» -^^^as V- ~j^^..../,<. 3.8 A Oi^ii.DR£N Wirt4 NO fifiOSPSCT OP aecoMiNQ seL^'Suooa/tTiNO adults B CMIt-aRCN WITH OBVIOUS SPeciAL. pequitiEMENrs PflOBABt.e ABUU OEPBN08HT9 CHILDREN WfTM LESS MENTAL HANOIOAP- POTENTIAL. ADULT DEPENOEHTS or INEFF-tGIEMTS CZ] NORMAL 50 The Subnormal Child PER CENT DISTRIBUTION THROUGHOUT THE GRADES OF THE CHILDREN WITH "mental RETARDATION" PAROCHIAL SCHOOL. BALTIMORE. MD. ( SEE TABUE VnT ) o PER CENT 20 +0 60 60 100 Kinder- ^^ garter. ^^ l" IQ3 86.8 i 12.5 6.3 31.2 IYEARSm^o'-J Fretarded II m YEARS ETARDED ►YEARS .RETARDED I YEAR I RETARDED NOT. RETARDED The StrBNOKMAL Child 51 CHART 5 PER CENT DISTRIBUTION THROUGHOUT THE GRADES OF THOSE CHILDREN WITH "MENTAL RETARDATION" WHO WERE CONSIDERED SUBNORMAL AND WITH SPECIAL REQUIREMENTS PAROCHIAL SCHOOL, BALTIMORE. MD. (see table IXy PER CENT O 20 40 60 SO 100 Kinder- garten 100 Grade | | 6T!B 95.5 Grade £ KM 1 4.S 4« t' 8G.2 Grade 3 1 &3f 94,6 Grade 4 1 2.S 975 Grade S IH 12.3 87.' Grade 6 100 Grade 7 ■ 6 = 93.5 Grade 8 ■ I YEARSi , f'RETARDED I lOYEARS I ^i/RETARDED ►YEARS ■ RETARDED YEAR RETARDED INOL 52 The Stjbnokmal Child CHART 6 PER CENT DISTRIBUTION IN THE SCHOOL GRADES OF THE DIFFERENT GROUPS OF SUBNORMAL CHILDREN PAROCHIAL SCHOOL, BALTIMORE. MD. (see table X) Kinder- garten Grade | Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7 Grade 3 l«2.. a' 6J 4.» 10 2? PER CENT 40 60 100 93.6 9a» CHILDRCN WITH NO PRtSKCT OFBECOMINO SELF SUPPOKTme ADULTS CHILDKEN WITH Less HEKTAL HANDIOAP- POTENTIAL ADULT OEPeHBCNTS OP INEPFIOItNTS B CHILDREN WITH OBVIOUS SPECIAL REQUIREMENTS PROBABLE ADtILT OEPENOEffTS NORMAL THE NAtrONAl GOWMITTE^ IFOR MENTAL HVGIENE, IIVC. Sd'lJNIp;S[ SQUARE, N^WYORK^e^^ ; 10 DEPO'IV*sfRE;ET, CONCOfeD, JT. S. ',"'■' ^-r' ',■•>'■■- ''''■;'-, 'EDIJORIAL BOARD '- '0'\ ,;,:>;.'/,■;,; ;. ■':■■■■ Gs(m<3^^ShpKER,iii.'D.,J}eanoft/ieTaleMaifical,§c/U)ol ' „ , '' > ■''' , Walibb B. Fibhald, Mlp„ jS(«i)erimi^»(i«^^ Jfos«acAt««M« ^Mo^iiiFedilemindtd ,' , ; ' " . ^tssaiTUooB,%Ji.rF(yi'meTBiriiaw,Pi!i(Mi,atricI^ 'l -,,' > '' Stbpbbn p. DrGaAK,,PH.D,viV^««dr5f'^«cWto»VC!(i«eg^i0l^^A^,C4l!y 0^ • , ^■t^J^'i'B^'sois^'S^TS.-.lact^r^inJSfmro-bMogy.PHncetM ,, Vol: Hli. No 1. ■>:""'-"'( .. ; ' " ^;INI)Ei': ' ' ,^. ^ ';'.!' J/^' 'V::jAisrt!toi' 1819,, Editoiial. •'• ^•• i. ..... .'., ...,- ....... ....... ,v...'.. '• ■ >,• •••?•••• • ■ •• ■,• ■ • 1 Meiital*Hyg1ene,and the PB-blic S(ihOol . .......... ...... .', . . .-,.' . . . .-'.■•i, -i- . ,'Amolil Qesell 4 . Pacts of Miental Hygieme vfor te^aofiers,;^ ,- . . , : ....'.. ...... . . . :,M<*IW ^- pec^fiborn 11 Nervous Children and theij TramiJig/.^ ; . ,r., .■ •>. ■, 0,:Maelie, Campbell )6 Th6 Need,'loi'Instructi9h.:iii Ifeatal Hy^iep^; in Medical, laM. and :3^h«olqgi"'■''-';'>■■- .,,; <''''':;;'iH^..X) .;. .A^M Meyer .48 ; . Tie Siiiith (Jcfllege 'BX'Beiiment inTraiW&fe for;I?sfQhl^liiie'0ocSal Wprlj. .i,W.AL.Mei'i£0'n,i^^.<_ ' The Social Sfervlce Bureau, at Sing ping Prispn;;. . .?. .',;.. . . ..'. . . .... . , j. tPoM, Wander 65 ' ■ Annual Cen^uaof the liisaiieiPeeMe-Mindeai Epileptics and Inebriates I Horatio M, Pollock •'; ill lirtefitutions in the United States, January 1, l«i8. ..,.,,,.. .'. ) f^dith SL. ^urt^sh, , 78 l^oiefefanS Oomments'. . ... ..j,:' — ,; .':.■. V.. .'. .-.i;.;.'. ... . ;. . . . .;. ..,a., ,. — :.'.'. . . ...■.'. i.i-:' IPS . Abstracts .^ ''■ ^'--i. ^ ■•' ''"''^- , ■'.'■-■, '^^*^' , ; 1 '. . jiie'Scope and Aiifl.tijfVMentalfrygiene. ■, By.,"Wiliiam H; Bu^nhain.': • - - . . - ■>.;•'',. . 133 ; PSyctii^itric jUatejial in thd'Na;^! PriSoHat iRortsraouth, N. H. By A. L. Jacolsy . . . . . . 1^1 AStatisilc^l Stifldy of 164 PSitienfe, with Drug P^choseS. By Hofatio M:'Pollook. . . . , 141 Mental Defectives and&e liaw. ' ,Bj!;Prancis|rii. Gallatin ...:..!,. ■., 144 ,In Defeiise ot Worry, ;|;ditoii;^' in-'37ie (hitlbok. ." 147 Boo^t" Reviews ■ / 7''' J" -:■ '/'', , ■' ■■• ■■.-''; ,' '•'•:, ' '; .. Meiiiical and Surgical Therapy: ; Vbltiilae 2: .Neuroses; Edited by Sjr Alfred Keofehy. ' • I ,' ' , ' G J Ma^e, Campbell 150 TheThiloBbphy.bf Conduct; An OutlKsepf Ethical Principles. By '8. A. Mattiii'i i , -,, , ■./,;)',.■. '--.-■" ■■••'"'■";'";,,>■', '77 ',•■•,..' .V5,,v/' ■ ',,, , ", 'E. Er;0(mtfiardy.A5\ . PracHcai Medicine Series i Voruine 10: iCT'er^pus and ^Mental Diseaste. / '. ;' i 'TEc^tfed, by Hugh T. .Patrick altid Lewis J.; Pollock. ...... . . : .. . . . . Clflrence 't>f. ; C%eney, 153 The Third ^lidEourthGeneratipn; AW Introduction tP Heredity. 7! • /, .,,' ' ; ; ByEllfpt Rowland Dpwaihg^.' .1^7. ,7. ., ;...... :;. Charles B. Atveniport 153 , 'The Unmarrjed Mother. ' By Pef cy G. Ka'nunerer. . . . .. : . ; ........ .,'. Ernest \ik. Qt^es 154 . 'The ipental StirTey.< By Imdplf Pintner. ..,.,.... . .,,.«... . -. HHwrnas H- Haines 155 Die>psyehppaftiis'-■■"'-■■- .■ ;.•■■''• -^ ^ , 7}^&;Natioiial ©bmiait^ ^pr Mental Hygiene dpefe ilpfc, fiecessarily pndorse pr assume' respojl-' 7siWjiW/;f or' Qpiniofls ex:^f essed; oj ,8iij^^^^ made. Articles presented are printed tfpqii the vautijpfttyiof lietr writfers, 7The^r^iewing of 'a, book .does not ^m|)ly its re6ominendati6n )}j Jhe Natipnal'OoaalmTttee^fpr M^jital Hy^i^iie,' ; Though aU'articleB m/tbis magazine arp copyrigiited^ ' others-BMy quotes-frona ffleto freeljr l^'rptlied appropriate credit be given to Mental Htgien^'. ' ; SubgCaptipa: TwprapJlar£a'7yw;''''flf%;C^^^ Gpyres'ppil^pnce should be caddrfefise^ and checks made Myable tp '"Mental Hy^erte," or to The , Sfatioial Cpmmittee for Mejital^|[y^nfe,-l,iC4 50^«l0nSqtoa,re,'%Ne#,t'pM ■'-',.■ ' .vopyyg%l|18,'ljyTh^NatioJttal'0pmmj)ttee'f6;r^ ;,: