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Full text of "Mentally defective children"

MENTALLY DEFECTIVE CHILDREN 



MENTALLY DEFECTIVE 
CHILDREN 



" 

ALFRED BINET AND TH. SIMON, M.D. 

AUTHORISED TRANSLATION 

BY 

W. B. DRUMMOND, M.B., C.M., F.R.C.P. (EDIN.) 



AUTHOR OF 
! AN INTRODUCTION TO CHILD STUDY," BTC. 



WITH AN APPENDIX CONTAINING THE BINET-SIMON TESTS 
OF INTELLIGENCE BY 

MARGARET DRUMMOND, M.A. 



AND AN INTRODUCTION BY 

PROFESSOR ALEXANDER DARROCH 



FOURTH IMPRESSION 



LONDON 
EDWARD ARNOLD 

[All rig -fits rtservea\ 



PRINTED IN GREAT BRITAIN BY 

BILLING AND SONS, LIMITED 

GUILDFORD AND ESHBK 



B5DS 



INTRODUCTION 

THE Binet-Simon tests of children's intelligence have been 
the subject of much discussion during the past few years, 
both in this country and in America. Much of this discus- 
sion seems to have been carried on, at times, without any 
knowledge of the original aim or purpose for which these 
tests were devised, and as if, so to speak, they were in- 
vented as a means for ascertaining the relative intellectual 
powers of all children, and so of affording to the teacher 
a ready and sure means of accurately classifying and 
grading the children under his charge. As a consequence, 
there is a tendency, in some quarters, to search for and to 
endeavour to establish some absolute standard or criterion 
of intelligence which shall be valid, irrespective of the 
nationality, or the class, or the particular environment of 
the child. 

It is hoped that the publication in translation of the 
work of Binet and Simon in which these tests first appeared, 
along with the complete series of tests as extended and 
revised during the lifetime of the former, will tend to 
remove this twofold misapprehension, and make the educa- 
tionalist, as well as the wider public interested in social 
questions, acquainted with the real purpose which under- 
lay the devisal or invention of the tests, and so enable all 
to perceive that their relative value, as measuring stages 
of intelligence, must be judged by the purpose for which 
they were devised. 

Now, the main purpose of the authors in the devisal of 



JW843387 



vi MENTALY DEFECTIVE CHILDREN 

these tests is to furnish to the teacher a first means by 
which he may single out mentally backward children, who, 
upon further examination, may also be found to have some 
mental defect or peculiarity which prevents them from 
fully profiting by the education of the ordinary school, 
and who probably would benefit more by being educated 
in a special school or in a special class. But the final 
selection, it is contended, of defective children for special 
education demands the experience of the doctor and of the 
psychologist, as well as the knowledge of the teacher, and 
the aid of all three is necessary in the devisal of courses 
of study for the mentally defective. Especially important 
is the division of mentally defectives into two main classes 
the feeble-minded and the ill-balanced. The latter, as a 
rule, are easily marked out from the normal child, and, if 
not specially looked after, may in later life become a 
menace to society. The feeble-minded, on the other hand, 
may easily escape the notice of the teacher, and may pass 
through the ordinary school unaffected and unimproved, 
enter into society, and propagate their kind. Both classes 
require the special care of the community, and their proper 
education and training are of the gravest importance for 
the welfare and stability of society. In this selection and 
education of mentally defective children, three positions 
of Binet and Simon are worthy of consideration. In the 
first place, it is contended that a physical examination 
alone can never allow us to dispense with a direct examina- 
tion of the intelligence, and that " anthropometry, stig- 
mata, and physical appearance must take a second place 
as means of discovering in school the feeble-minded and 
the ill-balanced." Again, " mental deficiency and want 
of balance are peculiar mental conditions which it is often 
impossible to connect with definite pathological changes/' 
Hence the examination of the medical man is not decisive. 



INTRODUCTION vii 

It must be accompanied and reinforced by that of the 
psychologist. In the second place, it is affirmed that in 
the devisal of schemes of training for mental defectives, 
we must take into account that the dominant features in 
their life are the " senses, the concrete perceptions, and 
motor ability," and that " in the education of defectives 
the workshop ought to become a more important place of 
instruction than the class-room/' In the third place, the 
position is strongly emphasised that " every class, every 
school for defectives, ought to aim at rendering the pupils 
socially useful. It is not a question of enriching their 
minds, but of giving them the means of working for their 
living/' 

Hence, the utility of special schools or special classes for 
such children depends ultimately upon their success in 
making their pupils, according to the measure of their 
intelligence, efficient workers. These two problems viz., 
(1) the method of selecting abnormal or defective children 
who are not sufficiently good for the ordinary school, nor 
yet sufficiently bad to be classed as idiots or imbeciles; 
and (2) the devisal of courses of education and training 
which may tend to make them hereafter useful workers 
and citizens are of first-rate importance to us at the 
present time. Under recent legislation, public local author- 
ities have been entrusted with the devisal of the means 
for the proper selection and the proper education of defec- 
tive children, and the utmost wisdom and care should be 
taken in the beginning of this new movement. The many 
errors that administrators may fall into are fully set forth 
in this little volume (c/. p. 78 et seq.), and the concluding 
chapter on the utility of special schools should be read by 
all who have to do with the administration of the new Act. 

The importance of the work of Binet and Simon to 
teachers and inspectors is without question, and were the 



viii MENTALLY DEFECTIVE CHILDREN 

duties of the teacher and inspector carried out as set forth 
in this volume (cf. p. 86) throughout the whole school, a 
much-needed improvement in our ordinary school educa- 
tion would soon result. 

Lastly, the volume is important as marking a new atti- 
tude towards educational problems, and as indicating the 
newer spirit in which we should undertake the training of 
all teachers. This new attitude and spirit are clearly set 
forth in the concluding words of the volume: " The essen- 
tial thing is for all the world to understand that empiricism 
has had its day, and that methods of scientific precision 
must be introduced into all educational work, to carrv 
everywhere good sense and light/' 

ALEXANDER DARROCH 

UNIVERSITY OP EDINBURGH, 
July, 1914 



CONTENTS 

CHAPTER I 
INTRODUCTORY 

PAGK 

INTEREST IN SOCIAL QUESTIONS .... 1 

SOME DEFINITIONS ...... 4 

SOME STATISTICS ...... 7 



CHAPTER II 

SOME FEATURES OF THE PSYCHOLOGY OF 
DEFECTIVES 

WHAT is A DEFECTIVE CHILD ? - - - - 11 
DISTRIBUTION OF DEFECTIVE CHILDREN IN THB PUBLIC 

SCHOOLS - ..... 15 

PSYCHOLOGICAL DESCRIPTION OF THE MENTALLY DEFECTIVE - 19 

PSYCHOLOGICAL DESCRIPTION OF THE ILL-BALANCED 21 

INTELLECTUAL APTITUDES OF THE DEFECTIVE - . 23 

b 



CONTENTS 



CHAPTEE III 

PEDAGOGICAL EXAMINATION OF DEFECTIVE 
SCHOOL CHILDREN 

PAGE 

THE BOARD OF EXAMINERS - - - . 37 

THE ROLE OP THE TEACHER: To PICK OUT THE CASES - 38 

THE R$LE or THE INSPECTOR: To ACT AS REFEREE - - 50 

TSSTS OF INSTRUCTION ...... 52 

READING* ...... 55 

ARITHMETIC .......58 

SPELLING - - .... 61 

PSYCHOLOGICAL EXAMINATION . . . - 67 

TESTS OF INTELLIGENCE . -67 



CHAPTEE IV 

THE MEDICAL EXAMINATION OF DEFECTIVES 
THE R6LB OF THE DOCTOR . 87 
THE DOCTOR NOT TO PICK OUT THE CASES 88 
THE PHYSICAL EXAMINATION - - - 91 
THE MEDICAL EXAMINATION - - 98 
MENTAL DEFICIENCY OR INTERCURRENT MENTAL AFFEC- 
TION? - ... 101 
MENTAL DEFICIENCY AMENABLE TO MEDICAL TREATMENT ? 102 
MENTAL DEFICIENCY COMPLICATED BY ILLNESS ? - - 107 
THE MEDICAL SCHEDULE * 115 



CONTENTS xi 

CHAPTEE V 

THE EDUCATIONAL AND SOCIAL RETURN OF 
SCHOOLS AND CLASSES FOR DEFECTIVES 

PAGI 

AN INQTJIBY IN THE HOSPITALS - - - 117 

THE EDUCATIONAL RETURN - . 136 

THE SOCIAL RETURN - . . . .140 

APPENDIX * 147 

DIAGRAMS -. 165 

INDEX ... 180 



MENTALLY DEFECTIVE 
CHILDREN 



CHAPTER I 

INTRODUCTORY 

The Present-Day Interest in Social Questions. Amongst 
questions of present-day interest, none are more discussed 
or attract a greater amount of attention than those which 
relate to social problems. The generous philanthropy of 
preceding generations seems to us to-day a little out of date, 
and we substitute for this virtue of the rich the otherwise 
fruitful idea that, by the very constitution of society itself, 
we are all in duty bound to occupy ourselves with the con- 
dition of our fellow-citizens, and especially of the less fortu- 
nate among them. This duty does not rest solely upon a 
sentiment of humanity. It is dictated equally by our own 
pressing personal interests; for unless, within a reasonable 
time, satisfaction is given to the just demands of the nine- 
tenths of society who are actually working for wages very 
little in harmony with their efforts and their needs, we 
already foresee that a violent revolution, from which the 
" haves " have very little to gain, will shake society to its 
very foundations. 

The consequence is that the very people who up to the 
present time have kept themselves most aloof from the 
social problem are being brought into contact with reality. 
It is a curious thing to see how scientific men, who for the 
past fifty years have never stirred a foot outside their 

1 



2 MENTALLY DEFECTIVE CHILDREN 

laboratories, are showing a tendency to mingle in affairs. 
In spite of the diversity of the forces at work, there is one 
general fact which is undeniable. Pure and disinterested 
science retains its votaries, but the number is increasing of 
those who are turning to science for useful and practical 
applications; albeit, they are thinking less of science than 
of society, for it is those social phenomena which are capable 
of amelioration which scientific men are now studying by 
the most exact methods for the benefit of men of action, 
who are usually empirics. 

Innumerable examples of this intervention of science in 
daily life might be cited. On the one hand, we see physiol- 
ogists Imbert, for example who are setting themselves 
to the study of the phenomena of the labour and the nutri- 
tion of different classes of workers, in order to find out 
whether the increase in wages and the diminution in the 
hours of work which the workers are for ever crying for can 
be justified by physiology. The day is not far off when 
such scientific observations, which are becoming more 
exact and more extensive, will play a part in the discussions 
between capital and labour. 

Another example may be given of a different nature, but 
of identical signification. Psychologists are studying the 
value of evidence, and are thinking out better methods of 
arriving at truth, in order to discover reforms which may 
be introduced into the organization of justice. An im- 
portant movement of this nature, started in France, is 
being continued in Germany with even greater energy 
(Binet, Stern and his pupils, Claparede, Larguier, etc.). 

As a last example we shall cite the most striking of all. 
This is the increasing interest which doctors are taking in 
the upbringing of the young, both in infancy and later. 
This is puericulture, and includes everything that is being 
done for the supervision, protection, and assistance of the 
mother and nurseling. It includes the medical inspection 
of school-children, which gives the doctor the opportunity 



INTRODUCTORY 3 

of caring for their ailments and preventing overpressure. 
It includes, lastly, all the reforms of but yesterday's date 
which make for a better hygiene, a better physical educa- 
tion. One might add also the work that is being done 
almost everywhere, in Germany, in America, in Italy, and 
in France (Laboratory of Psychology of the Sorbonne, 
and the Society for Child Study), with reference to the 
special aptitudes of children, and, as has been said a little 
ambitiously, the making of education an exact science. 

Education of Defectives. The movement referred to, of 
which we see only the beginning, but which will result, let 
us hope, in an amelioration of the lot of the great majority, 
is now being directed to the education of the mentally 
defective. Their problem has been discussed theoretically 
for a long time, but nothing has come of it. Now the 
problem is entering upon a new phase, and something prac- 
tical will result. 

Without attempting to write the whole history, which 
would be nothing more than the study of what has been 
done in other countries, let us state where we are ourselves. 

It was in France that alienists first began to occupy them- 
selves with the children known under the various names 
of " abnormal/' " backward," " idiot/' " mentally defec- 
tive," " unstable," etc. Esquirol made the important dis- 
tinction between the idiot and the dement; and after him 
many other alienists notably Itard, Falret, Voisin de- 
scribed the principal symptoms of idiocy, or attempted to 
show that it is capable of amelioration. Seguin, a teacher 
of defectives, who has left an honoured name, showed ex- 
perimentally how one may, by dint of much ingenuity and 
patience, increase the intelligence and improve the charac- 
ter of some of these unfortunate children. 1 Lastly, in 

1 It is common to cite with respect the names of one's predecessors, 
and Seguin's portrait may justly hang in such a gallery of one's an- 
cestors. But Seguin's work must not be examined too closely; those 
who praise it have certainly not read it. Seguin impresses us as an 



4 MENTALLY DEFECTIVE CHILDREN 

our own day, Bourneville, the well-known physician of 
Bicetre, after having organised the most important clinique 
for idiots which exists in France, agitated with untiring 
energy for the formation in the public schools of special 
classes for the instruction of abnormal children. This 
scheme has been supported by a great many doctors and 
philanthropists, and laid before municipal councils, general 
councils, scientific societies, and all the numerous educa- 
tional congresses which have been held in France and 
abroad during the last twenty years. 

This effort has had no result; and whilst in the great 
majority of foreign countries there have been for a long 
time schools and classes for defectives the first German 
school, that of Dresden, dates from 1867 with us the only 
children of this kind who receive the care and education 
appropriate to their condition are the children of the rich. 
Poor children continue to attend the ordinary schools. 

It was not till 1904 that the powers that be awakened 
from their indifference. The Minister of Public Instruction, 
M. Chaumie, appointed a Commission to study the ab- 
normal physical, mental, and moral from the scholastic 
point of view. This Commission, over which M. Leon 
Bourgeois presided most ably, met a great number of times 
in 1904 and 1905, and drew up a complete scheme for the 
care and education of defective children, which has been 
embodied in a Bill by the Minister of Public Instruction. 

Some Definitions. Now, who are these abnormal chil- 
dren, and why should the authorities interest themselves 

empiric, endowed with great personal talent, which he has not suc- 
ceeded in embodying clearly in his works. These contain some pages 
of good sense, with many obscurities, and many absurdities. We 
refer the curious reader to his chief work, Traitement Moral, Hygiene, 
et Education des Idiots et des autres Enfants Arrieres, published in 
1846. One might make many criticisms on the writings of alienists; 
but to what end ? We prefer to say of such predecessors what 
Ingres said to his pupils in the Rubens gallery at the Louvre, " Salute 
them, but pay no attention to them !" 



INTRODUCTORY 5 

in their education ? For the sake of clearness, we must give 
some definitions. 

In medical terminology the term abnormal is applied to 
every subject who diverges so clearly from the average as 
to constitute a pathological anomaly. As a matter of fact, 
the abnormal constitute quite a heterogeneous group. Their 
common characteristic, which is a negative one, is that by 
their physical and mental organisation these children are 
rendered incapable of profiting by the ordinary methods of 
instruction in use in the public schools. The most definite 
types are the deaf and dumb, the blind, the epileptic, 
idiots, imbeciles, cripples, etc. There are in this list some 
classes which are of less interest to us than others, because 
the State has already to a certain extent provided for their 
needs. This applies especially to the blind, and to the 
deaf and dumb. It has always been perceived that such 
children were not like others, and could not be taught by 
ordinary methods. The blind can learn to read only in a 
book whose characters are printed in relief, and the deaf- 
mute cannot follow an oral lesson. The necessity of a 
special education for these two groups was therefore ob- 
vious, and at the present time about five thousand are re- 
ceiving care and a professional education in the State 
institutions and in private schools, the majority of which 
are religious. We shall not concern ourselves with them 
here, in spite of the interest which they awaken. Nor shall 
we discuss whether the methods which are used for their 
education might not be improved, though the question is 
attractive. But we must simplify the subject if we wish 
to get on. 

We shall also exclude here the lowest grade of idiots, 
who require continuous medical supervision, and who are 
very seldom educable. These subjects are received into 
hospitals and asylums. When we have excluded these 
classes of children the deaf-mutes, the blind, and the in- 
educable idiots what remains ? 



6 MENTALLY DEFECTIVE CHILDREN 

Why, there remain just the very children with whom the 
new law will be concerned. In the meantime these are 
not in any special school; they are attending the primary 
schools, which cannot shut the door in their faces when they 
have arrived at school age. But they do not profit much 
by the instruction given in school, and this fact gives rise 
to vigorous complaints on the part of the teachers. These 
children, say they, are not in the least like the great majority 
of other pupils. A great many of them are mentally defec- 
tive. Without being completely lacking in intelligence, 
they are not sufficiently endowed therewith to work along- 
side normal children; they do not understand, they cannot 
follow; they profit so little by attending the school that 
some of them are never able to assimilate the instruction 
even of the elementary course. Very often they pay no 
attention whatever to the work of the class; and this is 
quite a good thing, for then the teacher forgets them in 
their corner, and goes on as if they were not there. But 
many of these children are ill-balanced ; they are excitable, 
and their bodies are never at rest; they are not amenable 
to ordinary discipline. They are a constant source of 
trouble and annoyance to their master and to their com- 
rades. The supervision of a single ill-balanced child is more 
trouble, the teachers sometimes declare, than the direction 
of twenty normal ones. Either one or the other must bo 
neglected, and the alternatives are equally objectionable. 

What, then, must be done with those children who are 
not amenable to the ordinary school discipline ? At first 
sight this seems a simple question. Let them be sent to 
an institution. We actually possess in the hospitals of 
Bicetre and of the Salpetriere, in the colony of Vaucluse 
to say nothing of provincial institutions establishments 
which make provision, both medical and educational, for 
children who are idiotic, imbecile, vicious, and epileptic. 
Is it not possible to send to these institutions all the ab- 
normal children who encumber the primary schools ? 



INTRODUCTORY 7 

No; it is neither possible nor desirable to pack them off 
to an asylum. These abnormal children are not in all cases 
so severely affected as to require segregation. We admit 
that such a measure is necessary for idiots of low grade 
who cannot even feed themselves. We have also no objec- 
tion to leaving to the asylums cases of very severe nervous 
disturbance such as epilepsy, for only there can they receive 
the medical supervision appropriate to their condition. 
They have more need of the doctor than of the teacher. 
As for the other abnormal children who constitute the great 
majority, it seems clear that the proper place for them is 
not the asylum, but the special school. They have suffi- 
cient intelligence to attend a school. What they probably 
require is instruction specially adapted to their mental 
state, and such instruction can be profitably given only in 
classes small enough to permit of individual attention. 

From all this we reach a very clear definition of what we 
mean by abnormal children, and a very simple indication 
of what should be done with them. Abnormal and defec- 
tive children are those who are suitable for neither the 
ordinary school nor the asylum ; for the school they are not 
sufficiently good, for the asylum not sufficiently bad. We 
must try what special schools and classes can do for them. 

Statistics. It is important to notice that the children so 
defined are not a negligible quantity. Their name is legion. 
And since number is the factor that gives importance to 
every social problem, we may say that the regulation of the 
lot of these children is a social question of the greatest 
gravity. 

The statistics which have up till now been published 
abroad do not give such precise information as one could 
wish regarding the number of the defectives. Some give 
the bare figures; others, using a better method, state the 
proportion of mentally defective children to the total popu- 
lation. There is also much doubt as to the way in which 
the statisticians have used the term " abnormal " or " de- 



8 MENTALLY DEFECTIVE CHILDREN 

fective." One inquiry relates only to children slightly 
affected; another bears upon all abnormal children, in- 
cluding the lowest grades of idiocy, and is therefore much 
more comprehensive. In other cases we are not told how 
the selection was made. 

As to France, precise information has not been available 
until last year, when two inquiries were held one at the in- 
stance of the Ministerial Commission, the other organised by 
the Minister of the Interior. According to the former in- 
quiry, we find that the proportion of defectives amounts to 
scarcely 1 per cent, for the boys, and 0'9 per cent, for the 
girls. These percentages are evidently far too small, and 
we ourselves have discovered, by a small private inquiry, 
that many schools returned " none " in the questionnaires 
distributed, although the headmasters have admitted to us 
that they possessed several genuine defectives. In Paris, 
M. Vaney, a headmaster, made some investigations by the 
arithmetical test, which we shall explain presently, and 
reached the conclusion that 2 per cent, of the school popu- 
lation of two districts were backward. If we were to in- 
clude the ill-balanced, whose number is probably equal to 
that of the backward, the proportion would be about 4 per 
cent. Lastly, and quite recently, a special and most 
careful inquiry was made at Bordeaux, under the direction 
of M. Thamin, by alienists and the school medical inspectors, 
and it was found that the percentage of abnormality 
amongst the boys was 5*17. Probably the true percentage 
is somewhere in the neighbourhood of 5. All these in- 
quiries are comparable because they all deal with the school 
population. The great variation in the figures is due to 
several causes, the chief of which are the following: (1) The 
proportion of the abnormal varies to a surprising extent 
in different schools even in the same neighbourhood. Dr. 
Abadie, for example, has expressly noted that in some 
schools the proportion may be four times as great as in 
others. (2) The definition of a child of backward intelli- 



INTRODUCTORY 9 

gence has usually and quite gratuitously been left vague 
by the investigators; each interprets the term in his own 
way, whence arise great differences in the figures. (3) It 
is particularly difficult to define the cases that are to be 
reckoned as ill-balanced or unstable, and some teachers, if 
they are allowed, will place in this category all the pupils 
that they dislike. 

We have been led to interest ourselves in abnormal 
children in the following way: One of us, Binet, President 
of the Societe Libre pour I' Etude de I' Enfant, has for many 
years been in daily contact with the staff of the primary 
schools. In obedience to the wish of a great many teachers, 
he has formed, in connection with the Society, a committee 
for the care of abnormal children, upon which are many 
distinguished people, such as M. Rollet, M. Albanel, Dr. 
Voisin, Mme. Meusy, and, above all, M. Baguer, who is 
deeply interested in the education of defectives. This 
committee initiated various investigations relating to back- 
ward children. Some time afterwards M. Binet, having 
been nominated a member of the Ministerial Commission 
on Abnormal Children, became the director of the work of 
the Commission relating to the backward and the unstable- 
He then, in conjunction with Dr. Simon, undertook in 
certain districts various inquiries into the condition of such 
cases. In regard to several questions we enjoyed the in- 
telligent and devoted co-operation of M. Vaney, Head of 
the Primary School of the Rue Grange-aux-Belles, where 
one of us has founded a laboratory of pedagogy. We have 
thus been interested in abnormal children for a long time, 
either from the point of view of school organisation, or 
from that of their differentiation from the normal. Let 
us add that lately M. Bedorez, the distinguished Director 
of Primary Education in the Seine District, has kindly per- 
mitted one of us (Binet) to co-operate in the organisa- 
tion of some classes for defective children, which have 



10 MENTALLY DEFECTIVE CHILDREN 

been started experimentally in the primary schools of 
Paris. 

Let us now state quite clearly our aim in writing this 
book. Ever since public interest has been aroused in the 
question of schools for defective children, selfish ambition 
has seen its opportunity. The most frankly selfish interests 
conceal themselves behind the mask of philanthropy, and 
whoever dreams of finding a fine situation for himself in 
the new schools never speaks of the children without tears 
in his eyes. This is the everlasting human comedy. There 
is no reason for indignation. Everyone has the right to 
look after his own interest, so long as he does not compro- 
mise interests superior to his own namely, those of society. 
It is this social interest with which we are concerned. 
Having found out by our own personal experience how a 
class for defectives may be established and conducted, we 
have noted the faults which could not but be committed, and 
the mistakes which will certainly occur unless one is fore- 
warned and makes every possible effort to prevent them. 
May our book, then, be regarded as a means of prophylaxis, 
a means of escaping conscious or unconscious error. May 
it also prove a guide imperfect, no doubt, but still useful 
for the organisation of some of those social inquiries con- 
ducted in a strictly scientific spirit, which are becoming 
more and more necessary for the proper management of 
public affairs. 



CHAPTER II 
SOME FEATURES OF THE PSYCHOLOGY OF DEFECTIVES 

ALTHOUGH this book is specially intended as a guide to 
the admission of mentally defective children to special 
schools or classes, we cannot commence by an exposition 
of the methods of recruiting such children. We must first 
describe the children and indicate their principal character- 
istics, mental and moral. We must also discuss the ques- 
tion what a mentally defective child really is a very 
important question, upon which depends everything else, 
the organisation of the schools and the special methods of 
education. Every educational method depends upon a 
theory, formulated or implicit, which is at once its point 
of departure and its justification. One would run the risk 
of falling into a blind empiricism if one were content to 
apply an educational method independently of the theory 
which is its soul. 

There are two conceptions of a totally different nature, 
either of which may inspire the training of defective chil- 
dren. Let us examine each of these in turn, and find out 
which is the more reasonable. 

According to the first, the defective child is practically 
the same as a normal child several years younger; or, in 
other words, he is a child who has been retarded in his 
development. A backward child of twelve years of age, who 
has not yet been able to learn to read, would thus be com- 
parable to an ordinary child of six, who is just beginning to 
spell. It is evident that such a comparison must not be 
pushed too far. Many reservations must be made. On 

11 



12 MENTALLY DEFECTIVE CHILDREN 

the one hand, the defective has not so much time in 
front of him for development as a normal and younger 
child. He is then not strictly comparable to the latter. 
On the other hand, the very fact of his age has given to 
the defective of twelve a bodily and even a mental de- 
velopment never attained at six. For example, he is 
nearer puberty; his vocabulary is more extensive; and he 
possesses greater general knowledge. But these reserva- 
tions once made, the theory that the defective is the victim 
of a retardation of development has seemed reasonable to 
many competent people. As a rule one just accepts it 
without taking the trouble to formulate it in precise terms. 
Perhaps it is for this very reason that one accepts it so easily ; 
it is the classic theory. To the cursory reader it may seem 
that we adopt this theory ourselves, for we shall frequently 
use such phrases as " defective of eleven who is at the level 
of a child of nine/' But the sense in which we use such 
an expression must not be misunderstood, because it is 
only intended to imply that a certain standard has been 
attained. It has no bearing on the cause of the retarda- 
tion, nor upon its particular nature, nor upon the means of 
rectifying it. 

Now for the educational consequences of the preceding 
theory. If the backwardness is only a slowness of develop- 
ment, it will suffice to apply to the backward the same 
methods as to the normal. One will make them follow the 
same course of study and go just as far as possible. Every 
defective must work towards the primary school certifi- 
cate. To attain that end, he ought to pass through seven 
regular stages, one each year. The teacher of defectives 
cannot hope that he will bring his pupils to the last stage. 
He will stop half-way. One day, at the agricultural colony 
of Vaucluse, when some foreign doctors were visiting the 
establishment, the teacher showing his class to the visitors 
remarked with nai've pride: " Our pupils follow step by 
step the curriculum of the primary school/' 



FEATURES OF THEIR PSYCHOLOGY 13 

A second and totally different theory is tenable, and this 
one appears to us to be much nearer the truth. It is that 
a defective child does not resemble in any way a normal 
one whose development has been retarded or arrested. He 
is inferior, not in degree, but in kind. The retardation of 
his development has not been uniform. Obstructed in one 
direction, his development has progressed in others. To 
some extent he has cultivated substitutes for what is 
lacking. Consequently such a child is not strictly com- 
parable to a normal child younger than himself. So far 
as certain faculties are concerned, he remains at the level 
of a younger child ; but in respect to others, he is on a level 
with normal children of his own age. An unequal and 
imperfect development is consequently his specific charac- 
teristic. These inequalities of development may vary to 
any degree in different subjects. They always produce a 
want of equilibrium, and this want is the differentiating 
attribute of the defective child. But to draw a faithful 
picture we must add yet other traits. According to general 
opinion, mental deficiency is a disease, and although the 
idea of disease is very vague, we are inclined to fall in with 
this general opinion. In the first place, we frequently find 
in such children defects of speech. Besides, in studying 
their mental condition more closely, one finds in some 
cases peculiarities of understanding, reasoning, imagining, 
difficult to define, but which do not appear to have their 
equivalent in younger normal children, and which there- 
fore do not result from simple retardation of development. 
Here is a boy, twelve years of age, who tries to answer our 
questions, and succeeds pretty well; but hardly has he 
finished his answer when he deserts the subject altogether 
and begins to talk a lot of nonsense. This want of co- 
ordination in thought constitutes a special defect, and not 
a retardation of development. Possibly one would not find 
analogous features in other backward children, who tend 
rather to be laconic; but it is also possible that a careful 



14 MENTALLY DEFECTIVE CHILDREN 

analysis of their mental state might reveal in them other 
mental symptoms, and, indeed, such are very obvious in 
the variety called " unstable "or " ill-balanced." 

To sum up, we are of opinion that the defective child 
usually exhibits the following characters: (1) A retardation 
of development; (2) a defect of equilibrium i.e., the 
retardation is more marked in some faculties than in 
others; (3) individual peculiarities of a pathological kind 
in the mental powers. 

If this second theory is correct, there follows a very im- 
portant practical consequence namely, that the curricu- 
lum drawn up for normal children is very imperfectly 
suited to the defective. We cannot force the latter to fit 
the ordinary course. To attempt this would be quite as 
unreasonable as to make our teaching appeal to the ears 
of the deaf or the eyes of the blind. 

The first duty of the teacher is to take account of the 
faculties already developed, the aptitudes which are 
already apparent. His work is thankless and difficult; he 
would be foolish not to take advantage of the indications 
of nature. If a pupil show a special taste for any subject, 
it is evidently towards such a line of study that he should 
be directed. Consequently, in conformity with these ideas, 
we would reject on principle any programme of special 
instruction which would rigorously include all the children 
in a common plan. On the contrary, we would prefer for 
the defective a scheme which would take the most account 
of their natural aptitudes. 

Such considerations lead us to put the following ques- 
tion What are the most common aptitudes in children of 
this class ? We say " the most common," because we have 
not to do with a single well-defined type, for there are as 
many varieties as there are individuals ; but in spite of the 
number of those varieties, which shows the need for indi- 
vidual teaching, it will always be possible to establish cate- 
gories in which those most nearly alike may be grouped 



FEATURES OF THEIR PSYCHOLOGY 15 

It is also possible that the aptitudes most frequently lacking 
are always, or almost always, of the same nature. 

To solve the question which we have just raised, we shall 
employ two methods 

The questionnaire. 
Direct observation. 

A printed questionnaire containing thirty-eight questions 
has been distributed through the agency of M. Belot, 
school inspector, to the heads of all the elementary schools 
in two districts of Paris one central, the other suburban. 
Nothing would be gained by reproducing here the ques- 
tionnaire, which has served its purpose. We shall simply 
lay down the conclusions we have reached, after studying 
the replies with the greatest care. 

The replies confirm the division, which we have ourselves 
suggested, of all the abnormal into three groups: (1) The 
mentally defective; (2) the ill-balanced; (3) a mixed type 
which includes those who are both mentally defective and 
ill-balanced. The simply defective do not present any 
well-defined anomaly of character, but they do not profit, 
or profit very little, from the ordinary school teaching. 
The ill-balanced, who might also be called the "undis- 
ciplined/' are abnormal chiefly in character. They are dis- 
tinguished by their unruliness, their talkativeness, their 
lack of attention, and sometimes their wickedness. 

The Distribution of Defective Children in the Public 
Schools. In which school divisions do we find these several 
varieties of children ? Let us begin with the mentally 
defective. These are found chiefly in the junior division, 
as might be expected. Some manage to reach the inter- 
mediate division, but scarcely any reach the senior. The 
exact distribution is as follows: 75 per cent, in the junior 
department; 25 per cent, in the intermediate. 

Let us be more precise with regard to two points the 
age of the child and his school position. Some heads of 



16 



MENTALLY DEFECTIVE CHILDREN 



schools, not all, have taken the trouble to satisfy our 
demands, and have fixed to almost a year the mental 
retardation of the child as compared with normal children 
of the same age. The following table summarises these 
replies, and shows that the majority of cases present a 
retardation of three years: 

Mentally defective children with a retardation of 



1 year 

2 years 



According to a convention, of which we shall speak more 
fully later, we regard as defective hi intelligence a child 
who shows a retardation of three years, when he himself is 
nine years of age or more. The results shown above agree 
with this convention. Moreover, one may draw the con- 
clusion, which is of practical value, that one need not 
seek children of this group in the senior division of a 
primary school. 

The distribution of the ill-balanced in the divisions of 
the primary school is quite different. In the first place, 
one is surprised to find none, or practically none (only two 
out of forty-five) in the senior division. We did not expect 
this. A priori, we should have supposed that, in spite of 
their defect in character, the unstable were not without 
intelligence, and that a fair number oi them would succeed 
in passing the gates of the senior division. If none are 
found there, this shows clearly that instability must be 
associated with some mental defect, unless some indepen- 
dent condition, such as inveterate laziness, has checked the 
child on the way. The ill-balanced, like the simply defec- 
tive, are to be found in the intermediate and junior divi- 
sions, but their distribution is different. While 75 per cent. 



FEATURES OF THEIR PSYCHOLOGY 



17 



of the simply defective are in the junior division, and 25 per 
cent, in the intermediate, 45 per cent, of the ill-balanced 
are in the junior, and 50 per cent, in the intermediate: 
practically, they are divided equally between these two 
divisions. This indicates a degree of intelligence superior 
to that of the defective, as one would expect. But, on tho 
other hand, their absence from the senior division shows 
that the intelligence of the ill-balanced is in general below 
the average. As this conclusion is new, and may be open 
to question, let us examine it more closely : 

The amount of the retardation of the ill-balanced, as 
shown in our returns, is as follows : 

Mentally ill-balanced children with a retardation of 




1 year 

2 years 

3 
4 



14 
16 
14 
2 

1 



These figures show, in a novel form, that the mental 
retardation is much less clear in the ill-balanced than in 
the defective properly so called, since in the former group 
are to be found many pupils about a third who, in the 
opinion of their teachers, are not at all backward ; but the 
majority are backward, while none are m advance of their 
years. Consequently, the whole group shows a slight 
retardation, averaging about one year, which confirms and 
makes more precise our original conclusion. We may there- 
fore affirm that mental instability or want of balance is 
usually accompanied by an intellectual retardation of about 
one year. 

Age Distribution. It is worth while making another 
remark about the ages of these children. The simply 
defective are of all possible school ages, while the 
unstable are usually young children. Here is the dis- 
tribution : 



18 



MENTALLY DEFECTIVE CHILDREN 



Age. 


Defectives. 


Unstable. 


7 years 






2 ] 


1} 




8 








5 


9 




9 
10 
11 
12 








3 I Total, 31 

6 
10 J 


7 
10 
11 
5. 


Total, 43 


13 








9 1 


41 




14 
15 








% I Total, 15 

I 






Total, 4 


16 








ij 


oj 





The defectives remain in the schools till the end of the 
prescribed terms, whilst the ill-balanced hasten to leave 
before the time. Thus the defective, like an inert mass, 
become a dead weight which encumbers the school. They 
adapt themselves as well as they can to their environment. 
Their parents are apt to leave them at school as long as 
possible, because they do not know what to do with them, 
and probably the teachers do not complain very much, but 
are ready to put up with these defectives who do not inter- 
fere with discipline. The ill-balanced, on the other hand, 
find the school environment irksome, the discipline hostile. 
They do not wish to stay at school; their parents do not 
keep them there, owing to the constant complaints of the 
teachers; and the teachers do not want to have anything 
more to do with them. Conclusion : The ill-balanced leaves 
school early, and takes his place in society, where, owing 
to his character, he may very easily become a danger. To 
sum up, the simply defective remain at school, while the 
ill-balanced leave early. 

Another observation may be made. Since the ill- 
balanced are so numerous at ten years of age, and even at 
eight, we conclude that in many cases the mental instability 
is not the result of the perturbation which precedes puberty. 
This physiological explanation is not of such general 
application as is sometimes supposed. 



FEATURES OF THEIR PSYCHOLOGY 19 

The Frequency of the Mixed Type, at once Defective and 
Ill-Balanced. The third category of defective children 
which we have suggested includes those of a mixed type, 
who are at once mentally defective and ill-balanced. We 
shall not be surprised to find that these subjects have 
characters which are the mean of those of the defective 
and the ill-balanced, since they unite in themselves the 
two different forms of abnormality. Thus, as regards their 
intelligence, one finds that none of them are in the senior 
division; the majority are in the junior division (71 per 
cent.), and the remainder (29 per cent.) in the intermediate 
division, which proves that they are on the average less 
intelligent than the simply ill-balanced, and more intelli- 
gent than the simply defective. But we need not dwell 
on such details, which are easy to understand and even to 
foresee. The most important question is the number of 
the mixed cases. The groups of the two simple types are 
almost equal in number. 1 On the other hand, we find only 
twenty-one mixed cases in a population where the ill- 
balanced which have been notified to us amount to forty- 
four, and the defective to fifty-seven, so that the mixed 
cases represent only a fifth of the whole, whereas the simple 
cases form four-fifths. These very different proportions 
indicate that as a general rule mental instability and mental 
deficiency are quite distinct. They are not aspects of a 
single pathological condition, but are two quite independent 
pathological conditions which may coexist in the same 
subject, just as happens, for example, in the case of alco- 
holism and epilepsy, but which are none the less distinct, 
since as a rule they do not coexist. 

Psychological Description of the Mentally Defective. 
Now let us take a closer look at the children who are going 
to be pupils in our schools for defectives. In looking over 
the replies to our questionnaire, we are struck by the 

1 On the other hand, Dr. Abadie found 309 defective to 134 ill- 
balanced. 



20 MENTALLY DEFECTIVE CHILDREN 

recurrence of certain phrases, by which the teacher attempts 
to sum up the defective child. Here are some examples 
of such phrases. They represent only general impressions, 
but the frequency of similar impressions arrests one's 
attention. 

Charles does the best he can. 

Augustine is very attentive. 

Emile is very obedient and gentle. 

Paul is always making himself useful in little ways. 

Marcelle is obliging and polite. 

Jeanne blushes on the slightest occasion. 

Severity paralyses Ernestine and makes her lose what little 
wits she possesses. 

Camilla smiles whenever anyone speaks to her, and im- 
mediately does what she is told. 

Louis is very biddable. 

Angela does not answer back when her companions tease her, 
and takes the blame herself. 

Eugenie is affectionate and is loved by her companions who 
make her join in their games. Although she herself is fifteen, 
it was a child of eight who taught her to read and write. 

From all these remarks it appears that the defective is 
a likeable creature. He is so even in proportion to the 
degree of his defect. With this thought in mind, we have 
examined the various descriptions, and have reached this 
very curious conclusion: The more likeable the child is 
represented to be, the greater the amount of retardation 
one may safely attribute to him. Few, indeed, are the 
exceptions to this rule. 

The defective child is praised for his sweetness of dis- 
position. If he does not understand the work which is 
being done in class, at any rate he does not show his want 
of comprehension in any noisy manner. Sitting quietly 
in his place, he allows himself to be forgotten. The lesson 
can go on just as if he were not present, and usually that 
is just what happens. It w r ould not be just on this account 
to accuse of negligence a teacher who has charge of forty 
to sixty pupils. The sluggishness, both mental and 



FEATURES OF THEIR PSYCHOLOGY 21 

physical, of these children is a negative quality which an 
overtaxed master is sometimes weak enough to value. 
When the defective child becomes subject to discipline, 
we are told, he does not rebel ; for he is obedient, respectful, 
and probably suggestible. Sometimes the teacher may 
even recognise in him the presence of qualities of a more 
positive nature. Some defectives are pleased, and even 
eager, to do little services. They are kind to their com- 
panions, affectionate, and grateful for attentions paid to 
them. As they are usually older than the other children 
in their class, the teacher often trusts them with little 
commissions. So far as one can judge of the morality of 
natures whose intellectual level is so low, the source of the 
altruistic sentiments appears to be well represented in the 
defective, but it remains to be considered whether his 
docility and complaisance may not mislead us as to the 
true value of his sentiments; for one characteristic of the 
defective is his tendency to repeat the polite formulae or 
moral maxims which have been taught him. He has a 
surface morality, possibly purely verbal. As a last trait, 
it may be noted that the defective is influenced by rewards 
and punishments, but, owing to his defective intelligence, 
the effect is very fleeting. 

Psychological Description of the Ill-Balanced. This 
description contrasts curiously with the preceding. In 
this there is nothing to be surprised at. In school the 
ill-balanced child is a perpetual nuisance. The teacher has 
110 weakness for this naughty child, who is always dis- 
turbing the class and defying his authority. 

As we have done in the case of the defective, let us quote 
some of the phrases by which our correspondents sum up 
the unstable. 

Charles cannot sit still, nor keep in rank, an d his heed- 
lessness prevents reproof having any effect. 

Albert never obeys but with a baa grace. 

Martha always puts 011 an astonished look when she is 
checked. 



22 MENTALLY DEFECTIVE CHILDREN 

Maurice receives any criticism with impatience. 
Susan receives it with anger. 

Eugenie, by tossing her head. She mimics her teacher, and 
makes the others laugh, so that they have to hide their faces. 
Octavia replies, " What do I care I She bursts out laughing 
and continues to do what she has been forbidden. 

Leontine quibbles, answers back, and expresses aloud her 
bad humour. 

Baoul flies into a passion when he is reprimanded. He poses 
as a martyr, a victim of injustice, and sometimes even utters 
threats. Punishment makes him give vent to intemperate 
language. 

Victor assumes an attitude of revolt, turns pale, and refuses 
to obey when anyone checks him. 
Lucy broke her pen in a fit of temper. 

Helen in the same circumstances upsets everything in her 
neighbourhood. 

Louise strikes her elbows on the desk, and one day she even 
kicked her teacher. 

Leon is quarrelsome and his companions are afraid of him. 
George does nothing but tease his companions. He destroys 
their copybooks, tears pages from their books, and puts the 
blame on them. 

Charles, who is rendered obstinate by strictness and merely 
irritated by punishment, seems happy when one takes an 
interest in him. 

Eugenie , who is greatly excited by punishment and who smiles 
at rewards, loves to be flattered and picked out to do some 
little service. 

The three following traits are constantly met with in 
the descriptions of the ill-balanced: they are turbulent, 
boastful, and incapable of attention. To this may be 
reduced the psychology of the less strongly marked cases. 
They have an instability of body, of speech, of attention, 
which may result either from an excessively nervous dis- 
position, or simply from a nature whose restlessness rebels 
against sedentary and silent study. But in many cases 
other features are present. In addition to the preceding 
symptoms, there are found impatience of discipline and a 
tendency to annoy their comrades. The ill-balanced are 
spoken of as brutal, deceitful, cruel; and as to their 
obstinacy, the abundant details in the questionnaires show 



FEATURES OF THEIR PSYCHOLOGY 23 

that these children have left a disagreeable impression on 
the school staff. It is especially on their account that an 
outcry for special schools has arisen. The way in which 
these children react to discipline is very interesting. We 
are told that they are very little influenced by rewards, 
which they often receive with disdain, laughter, or irony, 
if they do not refuse them altogether. Punishments, on 
the other hand, produce a bad effect. The ill-balanced 
nearly always become angry, and rebel against punish- 
ment, so that the teachers strive to avoid coming into 
conflict with them. Here we have a trait which is very in- 
teresting for psychology, but very embarrassing for peda- 
gogy. How, then, can the ill-balanced be subjected to any 
discipline whatever ? This is an important question, 
which it will be all the more necessary to solve because it is 
the ill-balanced who profit most by special education; it 
is for them that one would have most hope. Our advice 
is that, in order to control these children, account should 
be taken, in the first place, of their dominant tendency. 
The study of the answers to the questionnaires shows us 
that the chief thing to which one can appeal in these 
cases is their amour-propre, their pride, their vanity in a 
word, the whole range of the egoistic sentiments. On 
natures of this stamp punishment cannot have much 
effect, seeing that it is opposed by an often indomitable 
pride. The end may be reached more directly, not by 
breaking the resistance, but by giving it a different direc- 
tion. It is better to praise the ill-balanced when he has 
done well than to punish him for his faults. It is desirable 
also to show him some appreciation, or even to trust him 
with some duty of a very modest kind, which he may 
perform under discreet supervision. 

Mental Aptitudes of the Defective. Having briefly 
sketched the moral aptitudes of the abnormal, let us now 
examine their mental aptitudes. We have here a very 
captivating subject of inquiry. The study of individual 



24 MENTALLY DEFECTIVE CHILDREN 

aptitudes ought to have been undertaken long ago in the 
interest of education. Everyone is crying out for it. No 
one, or almost no one, undertakes it. In the case of the 
abnormal there is even more urgent need that it should be 
undertaken, for the younger or less intelligent the pupils, 
the more depends upon educational methods. When a 
mind is of a superior kind, very little really depends upon 
the culture supplied to it. If a Berthelot or a Pasteur 
should even have had imbeciles as their first masters hi 
chemistry, they would none the less have turned out men 
of genius. It is those of average intelligence who have 
need of good methods of instruction. It is the young 
children who really require intelligent methods. Conse- 
quently we should give the defectives the best teachers. 
Every fault of method committed in their education may 
have consequences which will prejudice them later on. 

In order to discover the aptitudes of the mentally defec- 
tive, we have three means of interrogating our question- 
naires. In the first place these contain the following 
question : Does the child show any particular aptitude either 
at school or outside ? This question has evoked replies 
which vary very little, for amongst the aptitudes of the 
children scarcely anything is mentioned but bodily occupa- 
tions errands, domestic duties, gymnastics, sewing, and 
drawing. In the same questionnaire another question, 
placed on the following page, is almost identical in form 
with the first: Is there anything in which the child is par- 
ticularly interested ? The replies to this second question 
have been a little more numerous than to the previous one. 
It is true that the two differ by a shade the distinction 
between interest and aptitude. One may interest oneself 
in something for which one has no aptitude. The follow- 
ing table shows the distribution of the replies to the two 
preceding questions: 



FEATURES OF THEIR PSYCHOLOGY 



25 



TEE MENTALLY DEFECTIVE. 



Aptitudes. 



None .. 
Practical life . . 
Sewing 

Gymnastics . . 
Drawing .* 





Interests. 


Pupils. 


Pupils 


. 19 


None 






11 


. 7 


Writing 






8 


. 7 


Drawing 






7 


. 1 


Sewing 






6 


, 1 


Gymnastics 






5 




Arithmetic 






3 




Recitation 






3 




History 






2 




French 






1 




Music 






1 




Singing 
Beading 






1 
1 




Object lessons 




1 



These two lists are not superposable, but if we take them 
together we shall notice that sensori-motor occupations, 
such as gymnastics, " practical life/' sewing, writing, and 
drawing, are those which are most interesting to these 
pupils. Sewing, writing, and drawing are, indeed, their 
favourite lessons. We should have expected that singing 
would not have left them indifferent, for other investiga- 
tions have shown us that the majority have a good voice; 
but it is quite apparent that singing is less attractive to 
them than drawing. A very characteristic feature is the 
absence of any mention of composition. Some of the 
abnormal are fond of arithmetic; none shine in composi- 
tion. This fact, though negative, seems worth considera- 
tion. Speaking generally, we never find that a child who 
is good at composition is mentally defective. 

We have mentioned that there is a third method of 
weighing the aptitudes of defective children. In our 
questionnaire we asked the teachers to give marks showing 
the relative ability of these children in the different sub- 
jects. From these marks it appears that in four subjects 
they are more successful than in others. These are 
gymnastics, drawing, writing, and reading. We regret 



26 MENTALLY DEFECTIVE CHILDREN 

that we did not include in our list sewing, manual work, and 
object lessons. Here are our results in figures. These 
indicate for each pupil the two subjects in which he has 
obtained the highest marks. 



Pupils. 

Reading 23 

Writing 18 

Drawing . . . . . . 11 

Gymnastics .. .. 11 



Pupils. 

Arithmetic .. .. 6 

Spelling . . . . . . 5 

Singing 

Recitation . . 3 



It is not at all uncommon for a defective to take the 
first place in writing or in drawing. This is quite a 
remarkable fact, although we must hasten to add that 
in such cases the defective is usually the oldest child in 
the class. 

All these observations are sufficiently uniform, and lead 
to the same conclusion. The dominant features in the 
defective are the senses, the concrete perceptions, and 
motor ability. These are the faculties which are normally 
developed. His constant weakness in composition shows 
that the function of speech is quite evidently inferior to 
the sensory and motor functions. Let us weigh these facts 
and sum up. What a great mistake it would be to give to 
children of this kind the syllabus of instruction which has 
been made to suit normal children. 1 This syllabus har- 
monises with the development of all the faculties. How, 
then, could one make children follow it whose aptitudes are 
limited ? 

Inquiries by questionnaire have one defect which has 
often been noted. They bring together statements fur- 
nished by correspondents who are often unknown, and 
whose judgment and accuracy it is impossible to estimate. 
Each of their observations, taken by itself, has little 
authority. It is the sum of concurring observations which 
should alone be taken into consideration; and even then 
it is necessary to be cautious before drawing any practical 



FEATURES OF THEIR PSYCHOLOGY 27 

conclusion, because an agreement in the replies sometimes 
indicates nothing more than a general misconception. 

Such doubts, which are known to all investigators, led 
us to decide to make direct observations on our own 
account upon abnormal school-children, and to compare 
them with normal children of the same age a long and 
difficult task, as all pioneer work is. We have collected 
facts which we were not seeking, whilst we often failed to 
find what we expected. It would be impossible to sum- 
marise here everything which contact with reality has 
taught and suggested. We shall extract from our observa- 
tions only what concerns the aptitudes of the abnormal, 
and shall even limit ourselves to a single category of these. 
It happens that we have methodical observations relating 
to twelve defective children of between eleven and twelve 
years of age. These form a sufficiently homogeneous group 
from the point of view both of age and of mental ability. 
We shall inquire what are the best marked aptitudes and 
the most apparent deficiencies of this little group. Without 
denying individual differences or forgetting that defectives 
cannot easily be reduced to a single type, we have thought 
it more interesting for the present to emphasise their 
resemblances rather than their differences. Let us, then, 
compare them en bloc with a group of normal children of 
the same age and the same social position, attending the 
same schools, in the same district. This equivalence of 
conditions is necessary if we are to lay our finger on the 
distinctive characters of the defective child. 

We have subjected our twelve defectives to certain tests 
as speedy and precise as possible. 1 We devised these tests 
before studying the returns furnished to our questionnaires, 
and the latter were tabulated before our observations. 
There have, therefore, been two studies absolutely inde- 

1 At the Laboratoire de Pedagogic Normal, 36, Rue Grange-aux- 
Belles. For details of the work of this laboratory see Annie Psycho- 
logique, tome xiii., pp. 1, 233. 



28 MENTALLY DEFECTIVE CHILDREN 

pendent, both in their mode of execution, and in their aim. 
Consequently, any points in which they agree will be very 
significant. 

Our collection of tests of mental deficiency is already 
known to readers of the Annee Psychologique. 1 In vol. xi. 
we described at length the details necessary for making 
use of our method of experimentation. Since then Dr. 
Decroly, who specialises on defective children in Belgium, 
has tried our methods, and verified our conclusions. The 
end which we have constantly set before ourselves has 
been to bring to light the intellectual capacity of the child, 
taken by itself, as distinct from what the child actually 
knows. Our psychological examinations are consequently 
the very opposite of school examinations, which test 
chiefly the candidate's memory, his judgment very 
little. 

We have made numerous observations in this way. The 
best way to explain our method, and more especially our 
results, will be - to describe a few of the experiments. 

Memory of Pictures of Known Objects. The children are 
allowed to look for thirty seconds at pictures of thirteen 
objects, which they are then told to enumerate from 
memory. 

Comparison of Short Lines. Two lines for comparsion 
are drawn in ink side by side on the same sheet of paper, 
so that they can both be seen at a glance. We have a 
whole series of such pairs. Between the lines, whose 
average length is 30 millimetres, there is a variable dif- 
ference. 

Estimation of Weights. Five little boxes, weighing re- 
spectively 3, 6, 9, 12, and 15 grammes, are to be arranged 
in order of weight. 

Memory of Figures. This test consists in repeating a 
series of figures immediately after having heard them. 

* [See vols. xi., 1905, p. 191; xiv., 1908, p. 1; xvii., 1911, p. 145. 
Also Bull, de la 8oc. pour I'&ude de V Enfant. 1911, p. 187.1 



FEATURES OF THEIR PSYCHOLOGY 29 

Memory of Phrases. The child is asked to repeat a phrase 
of twelve to fifteen words immediately after having 
heard it. 

We do not wish to insist on the details of these observa- 
tions. They are still very incomplete. It will be necessary to 
experiment for a long time 1 before it will be possible to say 
exactly what it is that is wanting, or that is wrong, in the 
mental machinery of the defective. No doubt when the 
classes for defectives shall be under way, when a great 
many such children are brought together in conditions 
which suit the convenience of the experimenters, the 
latter will be able after persevering effort to see daylight 
in this matter. In the meantime we must be content with 
a general survey. But however superficial, however 
defective, our first attempts may be, they may at least 
give us a start. 

Let us see, then, what results have been obtained from 
our tests. These results clearly separate the tests them- 
selves into two groups. To the one set the defectives fur- 
nished replies practically equivalent to those of normal 
children. To the other, on the contrary, they gave answers 
which clearly exhibited their retardation, or rather their 
defect. This difference would be deprived of all signifi- 
cance if any of the tests presented no difficulty to a normal 
intelligence. But in all cases the difficulty was so great 
that even the normal made many mistakes, and we can 
affirm that, whilst for the one set the two groups of children 
were practically equal, for the other, on "the contrary, the 
inferiority of the defective is quite clear. 

The tests in which the defectives are on a par with the 
normal are (1) The comparison of short lines; (2) the 
memory of pictures. Let us give some details of the latter 
test, which appears to us typical. Each child individually 
was shown a sheet of paper, on which were pasted thirteen 

1 [The results of later observations are embodied in the tests pub- 
lished in 1911, which are given complete in the Appendix.] 



30 MENTALLY DEFECTIVE CHILDREN 

pictures of known objects. These pictures, drawn in 
black and very simple, almost reduced to outlines, repre- 
sented a nose, a head of hair, a rose, two cherries, a bed, 
a barrel, a nail, a key, an omnibus, some eggs, a bell, a 
sun setting in the sea, and a mouth. We have here a 
test of sense memory, for the child is asked to recall a 
visual impression. Something more, however, is neces- 
sary, for he must understand the picture and give it a 
name. But this constitutes no real difficulty, and the 
whole exercise is a test of sense intelligence. We were 
quite surprised to find that in this case our defectives were 
at the level normal for eleven years. The average of their 
replies is seven, which is exactly the normal value. This 
is shown in the following table, which gives the comparison 
between them and normal children of eleven : 

NAMING BY MEMORY THIRTEEN PICTURES. 

Number of pictures remembered 

Normal children . . . . 4, 5, 6, 6, 7, 7, 8, 9, 10, 10. 

Defective children . . . . 4, 4, 7, 7, 7, 8, 8, 9, 11. 

Have we not here a very interesting confirmation of 
what we have already learned from the questionnaires ? 
The exercise is one which certainly presents some difficulty, 
since the normal children forgot some of the pictures. If 
it had been too easy, one would not have been surprised 
at the fact that the two groups the normal and the defec- 
tive were equally successful. Now, in spite of the diffi- 
culty, the defective shows no inferiority as compared with 
the normal. Any commentary would diminish the elo- 
quence of this result. 

Without lingering over each of the other tests, let us 
select from the group one which forms a remarkable con- 
trast to the preceding. Just as striking as the equality 
between the defective and the normal in visual memory of 
pictures is the difference between them in memory for 
phrases. 



FEATURES OF THEIR PSYCHOLOGY 31 

The latter is a test of immediate memory. One repeats 
to the child a phrase of about twelve to fifteen words, and 
asks him to repeat it immediately afterwards. For this 
memory is necessary, and also voluntary attention, and 
some power of comprehension into the bargain; for if 
some of these phrases are quite easy to understand (e.g., 
Germaine has not been good; she did not want to work; 
she will be scolded), others, again, are a little involved 
(e.g., The chestnut-tree in the garden casts the quite faint 
shadow of its new leaves on the ground). The number of 
phrases which the defectives managed to repeat correctly is 
very small. It averages only two. Here are the figures: 

IMMEDIATE MEMORY OP PHRASES. 

Number of phrases repeated exactly 

| 7 years . . 1,2, 2, 3, 3, 3, 3, 4, 5, 5. 

Normal children 1 9 years . . 2, 4, 4, 4, 4, 5, 5, 5, 6, 6, 7. 

[11 years . . 3, 3, 4, 4, 5, 5, 6, 6, 7, 7. 

Defective children, 11 years . . 0, 1, 1, 2, 2, 2, 2, 2, 3, 3, 4, 4. 

If one examines these results, one is surprised to find 
that some of the defectives are superior to normal children 
of the same age, since they repeat four phrases, although 
some of the normal repeat only three. In all experiments 
on groups one finds exceptions of this kind. We are 
glad to give examples in order to show how complex every- 
thing is. In order to comprehend such anomalies, it is 
necessary to analyse the exceptional cases. One generally 
finds then that the defective who has broken the rule has 
made use of a pure sense memory, has repeated like an 
echo without understanding. If the repetition is delayed 
a little, he is lost. In other cases the defective is not far 
removed from the normal. Without stopping to discuss 
these exceptions, let us examine the group as a whole. 
When we do this we reach the important conclusion that 
our group of defectives resembles in a striking manner the 
group of children of seven years. On an average, they 



32 MENTALLY DEFECTIVE CHILDREN 

repeat practically the same number of phrases. The 
average for seven years is 3'1; that of the defectives of 
eleven years is a little less: it is 2'1. 

Now, to sum up, let us compare just these two extremes, 
the memory of pictures and the memory of phrases. Is 
not the contrast remarkable ? And does one not here hit 
upon one of the principal differences between the normal 
and the abnormal ? Give the defective a piece of work 
which interests him, which appeals to his organs of sense, 
and which is concrete. If the work is not too difficult, he 
will acquit himself tolerably well. If, however, the work 
involves words, phrases, composition in a word, abstract 
ideas expressed in speech the defective immediately 
reveals wherein his inferiority lies. Abstract thought, and 
all other mental operations that involve it, are to him a 
closed domain. The replies of the teachers to our ques- 
tionnaires had already led us to suspect this. Our tests 
are a confirmation, and even an exact demonstration, of it. 

The normal curriculum of primary education, as one can 
imagine, is therefore not suitable to the mental condition 
of the majority of defectives. Even by reducing it to its 
first elements, one would make only a bad fit, for if one 
were to diminish the abstract portion which is not intended 
for defectives, one would equally diminish the concrete 
portion, which, far from being reduced, when defectives 
are in question, ought to be amplified. It is necessary, 
therefore, to change the proportions of the different parts of 
the curriculum, and give the whole a special direction. 
We shall conclude our observations by remarking that, 
if we take the workshop in opposition to the class, as the 
symbol of concrete work opposed to the symbol of verbal 
work, the workshop ought in the education of defectives 
to become a more important place of instruction than the 
class. 

A slight reservation, however, must be made as to the 
value of this conclusion. In spite of the existence for a 



FEATURES OF THEIR PSYCHOLOGY 33 

number of years of institutions for the abnormal, we havo 
yet scarcely begun our researches. Everywhere we are 
up against the same ignorance, and shall be so for a long 
time to come. Our knowledge of these children is very 
imperfect. We do not pretend that anything we are about 
to say is in any way complete. 

Thus, having set forth a quite general principle relating 
to concrete, intuitive, sensory education, let us hasten to 
add that in practice this principle must be applied to 
children of widely differing temperaments, and that 
nothing is more complicated than the pedagogy of de- 
fectives, if one desires it to be adapted to the numerous 
ends which it is necessary for it to attain. One will cer- 
tainly bear in mind that a greater place must be given to 
intuition than to abstraction; one will bear this in mind 
in the detail of the education of defectives, as well as in 
its general direction, but without forgetting the numerous 
interests which it is necessary to satisfy. There is no 
question but that there will be admitted into the special 
schools and classes many children only slightly defective, 
who are destined to return as soon as possible to the 
ordinary school ; and one would put an obstacle in the way 
of this return, or even make it impossible, if, from the day 
the child entered the special class, a totally different direc- 
tion should be given to his education from that of the 
ordinary school. This would be both serious and trouble- 
some. The amount of abstract material in the lessons 
should be diminished simply in proportion to the mental 
deficiency. There is no reason why the slight cases should 
not be taught in the special class in accordance with a 
programme little different from that of the elementary 
school, except that it gives them the benefit of greater 
individual attention. Such individual attention is still 
more necessary in the case of the ill-balanced, of whom we 
have scarcely spoken in this chapter. It is not their in- 
subordinate spirit which sets them against anything 

3 



34 MENTALLY DEFECTIVE CHILDREN 

abstract, and ono would do them a very poor service by 
depriving the more intelligent of them of the ordinary cur- 
riculum, and all the more as the majority of the ill-balanced 
are destined to improve considerably. Thus there are 
many reasons why, in the case of certain classes of the 
abnormal, one should not lose sight of the usual curriculum. 
These reasons are as follows : the slight degree of the de- 
ficiency in certain cases, or the existence of instability 
without retardation, or the necessity of sending the children 
who improve most back to the ordinary schools. Such 
are the reasons which are important from the school point 
of view. There are others with a social bearing which are 
more important still. At the present day it is necessary, 
especially in towns, that everyone should be able to read, 
to write, and to express himself in suitable language. It 
has been remarked, and justly, that reading is the triumph 
of abstraction, and that a defective may require two years 
to learn to read by syllables, and very poorly even then. 
No matter: if the thing is possible, even with considerable 
effort, such a defective ought to learn to read. This is 
demanded, not by the state of the child's intelligence, but 
by the society in which he lives, where illiteracy would bring 
shame upon him. In questions of this kind the indications 
of psychology and pedagogy should be subordinated to the 
needs of life. Necessity makes the law. All instruction 
given to defectives must be dominated by the question 
of its practical usefulness. A pedagogy which should be 
fitted easily to the measure of their intelligence would be 
dangerous, in that it might result in making them useless. 
It is evident, therefore, that the problem is very complex, 
and it would be quite useless to attempt to express it by 
a single formula. The nature of each individual case must 
be taken into account, and one must aim at an essentially 
practical training, a pedagogy of ends rather than of 
abstract principles. Our advice, consequently, is that in 
the meantime no definite curriculum should be fixed upon, 



FEATURES OF THEIR PSYCHOLOGY 35 

but that the teachers of defective children should be 
allowed some freedom, under the cautious control of the 
primary school inspectors. We ask that all intelligent 
initiative should be accepted and encouraged, and that the 
teachers in special schools should frequently meet together 
in order that they may compare their experience. In 
short, we should give to the schools and classes for defectives 
such freedom and elasticity that the kind of education 
best adapted for such children would be able to evolve and 
perfect itself like a living organism. 



CHAPTER III 

PEDAGOGICAL EXAMINATION OF DEFECTIVE SCHOOL- 
CHILDREN 

WHEN legislation provides special schools and classes for 
the benefit of defectives, it will be imprudent to make use 
of legal force to bear down the will of the parents. It will 
be better, in the first instance, to have recourse to per- 
suasion. It will be pointed out to the parents that their 
children are behindhand in their lessons. The parents, as 
a matter of fact, know this quite well. It will be explained 
to them that classes of forty pupils are too large for children 
like theirs, and that the teacher cannot devote sufficient 
attention to them. It will be explained also that classes 
are being organised for ten to twenty pupils at most, in 
which it will be possible to give individual attention. 
Before instructing their child, it will be necessary to begin 
by awaking his intelligence, which involves the teacher 
devoting himself to him with method, order, and patience. 
One will appeal to the heart of these parents, and will 
surely manage to persuade them, especially the mothers. 
For such interviews we must rely upon the school teachers 
and the inspectors. It will only be necessary to warn them 
to avoid the use of certain expressions. It would never do 
to say to the parents that their child is an idiot, an imbecile, 
a fool, or even abnormal. The admission of their son or 
daughter into a special school should be represented to 
them as an advantage or even a favour. Their consent 
should not be demanded in too formal a manner. This 



PEDAGOGICAL EXAMINATION OF CHILDREN 37 

would make them think that it is they who are giving 
something, and many would refuse. In a word, much can 
be done by prudence, sympathy, and a little tact; and the 
personal experience that we have acquired has shown us 
that it is not difficult to gain the parents to the cause of 
special education. 

Composition of a Board of Examiners. We have now to 
consider how the selection of the children is to be made. 
It has been determined by statute that the examiners shall 
be three in number the head of a special school, an 
elementary school inspector, and a doctor. As to the 
manner in which this committee is to carry out its work, 
the law preserves an absolute silence. 

When the three examiners meet in order to judge the 
degree of retardation of the children who are presented to 
them, is this absence of a definite programme embarrassing ? 
We do not think so. A committee which is duly authorised 
always manages to do something. The work is done more 
or less empirically, perhaps, but it is done. Tell the jury 
to find defective children, and they are sure to find them. 
The only question is, What will be the value of their selec- 
tion ? and, above all, How can so delicate a quest be saved 
from empiricism and rendered exact ? It is to be hoped 
that at first there will not be too many mistakes. This 
would have a bad effect upon the new institution. It is 
unfair to a normal child to send him to a special school, 
just as it is unfair to a defective to keep him in the ordinary 
school. It is better to make such mistakes as seldom as 
possible. Moreover, it is of the greatest interest to try to 
forecast the exact way in which errors are most likely to 
arise. In every machine there is a point of least resistance 
which requires to be watched. In every human institution 
there is a detail of organisation where fraud and charla- 
tanism are most liable to occur. 

Since we have supervised the organisation of some classes 
for defectives, and have been able by some preliminary 



38 MENTALLY DEFECTIVE CHILDREN 

observations to take account of these dangers, we take it 
upon ourselves to give warning of them in advance. We 
fix buoys to the rocks that they may be avoided. 

It seems to us that the selection of defectives calls for 
three varieties of experience that of teachers, of doctors, 
and of psychologists. We shall proceed to indicate the 
services which these various persons may render. In this 
chapter we shall speak only of the pedagogical examina- 
tion. The duty of making the first selection among the 
school- children and indicating those who are suspected of 
being defective belongs partly to the teachers and partly 
to the school inspectors, whose respective roles, it seems 
to us, can easily be defined. 



A. THE ROLE OF THE TEACHER: TO SELECT THE CHILDREN 
SUSPECTED OF BEING DEFECTIVE. 

It is out of the question to make an entire school pass 
before a committee in order that 500 pupils may have their 
mental faculties analysed. Such a task, at once trouble- 
some and useless, would require several months. One 
should rather, in the first place, adopt a rapid method of 
picking out the children suspected of mental defect. It is 
quite sufficient that they should be suspected. Such a 
selection once made, the committee will have before it 
only a moderate number of candidates upon whom it will 
be possible to concentrate attention. 

Let us proceed to show how the teachers may make their 
selection : 

A retardation of three years indicates a child who 
should be regarded as a suspect. A child enters the 
elementary school at the age of about six years. Each 
year he ought to advance one class. From six to nine 
years he is in the elementary course; from nine to eleven 
in the intermediate course; from eleven to thirteen in the 
senior course. All are not quite regular. Some are a little 



PEDAGOGICAL EXAMINATION OF CHILDREN 39 

in advance, some are behind, but the majority conform to 
the preceding scheme. When a school is well managed, 
when the assignation of the children to their respective 
classes is made by means of suitable tests, and without too 
great regard to the demands of the parents, the classifica- 
tion which results is very good. There is then no better 
means of finding out whether a child is intelligent or not 
than to take into consideration his age and his class. 
Intelligence, so extraordinarily difficult to judge, is indi- 
cated in the above way with a really curious exactness. 
A child two years behind his age, when irregularities in 
attendance, absence on account of illness, etc., do not 
explain his backwardness, is very likely to be less intelli- 
gent than one who is in, or in advance of, the usual class 
for his age. This amounts to judging intelligence by the 
degree of instruction. Theoretically, such a method is 
open to plenty of meticulous objections, of which the most 
important is that we are confounding intelligence and 
memory. To this we shall reply that the stage of instruc- 
tion reached is not the result of memory alone. It pre- 
supposes also some degree of application, some facility of 
comprehension, quite a collection of diverse aptitudes. 
The child's success in his studies is, in fact, the best indica- 
tion we have of his capacity to adapt himself to the school 
environment. If the child is unable to keep up with the 
classes suited to his age,if he is unable to profit like other 
children from the education provided, this shows that he 
has not the same degree or the same kind of intelligence 
as his companions, and there is a presumption, if not an 
absolute demonstration, that his intelligence is inferior to 
the average, or that his character is different. 

From these statements, which we have expounded at 
length elsewhere, 1 it follows that not only the head-master, 

1 See Annie Psychologique, vol. xii., p. 1, and vol. x., p. 116. The 
method sometimes adopted, for other purposes, of asking the teacher 
to classify the children according to their intelligence is quite fallacious. 



40 MENTALLY DEFECTIVE CHILDREN 

but an entire stranger, can determine which are the less 
intelligent children, the less well adapted to that school, 
without taking the trouble to interrogate them all indi- 
vidually. It is only necessary to compare their position 
in school with their age. 

We thus obtain no merely subjective appreciation, but 
a simple statement of the actual condition of things. The 
only thing one must be careful about is to make allowance 
for irregular attendance. Backwardness in school instruc- 
tion is significant only when it coincides with regular atten- 
dance. At the present time the regulations as to school 
attendance are very little respected. In country districts 
there are children who do not go to school till they are 
eight or nine years of age. It is not surprising that they 
cannot read, when no one has taught them. Allowance 
must also be made for long illnesses. When the absences 
have been considerable, their total amount must be sub- 
tracted. A child of nine, who has come to school at the 
age of six i.e., the usual age and who has been absent 
for about 250 days, should, from the present point of view, 
be counted as eight. The school authorities will have no 
difficulty in making such estimates. That is their business, 
and they will quickly make up their minds even in a diffi- 
cult case. One will, of course, bear in mind that the 
number of classes differs in different schools, and that 
certain classes are parallel. Lastly, one must remember 
that a defective may, on account of his age, be placed in 
a class too advanced for his knowledge. This, indeed, is 
often the case. 

Exception may be taken to the role that we have assigned 

Teachers make no allowance for age. Recently an excellent teacher 
pointed out to us, as the most intelligent in the class, a child who had 
really, when his age was taken into account, a retardation of two 
years ; but in a class of younger children his age gave him an appear- 
ance of mental superiority. [Such facts vitiate much statistical work 
on the correlation of " brightness " in school -children with other 
Dualities. TR.] 



PEDAGOGICAL EXAMINATION OF CHILDREN 41 

to the teachers. We may be reminded that about two 
years ago, when statistics concerning defectives were being 
collected by circular, many of the head-masters replied in 
a notoriously unsatisfactory manner. Even in Paris one 
school was stated to contain 25 per cent, of defectives, 
whilst not a single one was acknowledged hi another in the 
same neighbourhood. This amounted, as M. Bedorez 
ironically remarked, to an average of 12 per cent. 

We shall reply, in the first place, by asking whether a 
mistake has really been committed. This cannot be taken 
for granted, since the proportion of defectives varies enor- 
mously from one school to another. But let us admit a 
mistake, and ask who is responsible. The master of the 
school understood badly what the circular had explained 
more badly still. In these circulars we actually read the 
following definition of defectives: " Subjects who are in a 
condition of mental debility, possessing only a limited 
intelligence and a limited responsibility, which do not 
admit of their acquiring, at the ordinary school and by the 
usual methods of education, the average elementary in- 
struction which the other pupils receive." If one inter- 
prets this badly constructed formula literally, it is evident 
that half the children of France must be defective, being 
of necessity below the average. If the teacher is to work 
intelligently, he must have more precise directions. After 
having explained to him that a defective child is one who 
does not adapt himself, or who adapts himself badly, to 
school life, one will tell him that the degrees of non-adapta- 
tion vary indefinitely; for it is quite exceptional for even 
a defective child not to adapt himself at all, and to learn 
absolutely nothing at the ordinary school. It remains, 
therefore, to decide what degree of retardation or of 
non-adaptation is to be recognised as determining a 
defective. 

According to a convention accepted in Belgium, which 
we modify slightly, the retardation which determines a child 



42 MENTALLY DEFECTIVE CHILDREN 

as a defective is two years when the child is under nine, and 
three years when he is past his ninth birthday. Here we 
have a very precise rule, easy to apply to all children, with 
the corrections already indicated relating to school attend- 
ance. The rule is, perhaps, a little rigid, we admit, but 
it will always be possible to make allowances when examin- 
ing closely the individual cases to which it will have to be 
applied. 

Thus, the method which we have just indicated permits 
the making of a first selection. 

This selection will be good, without being final. It will 
be good, for it is based upon a wide experience extending 
over several years. Just think what it means in the way 
of inattention and want of comprehension if a child is three 
years behind. For our own part, we consider this evidence 
from experience of the greatest value. It is the obvious 
point of departure. We can and should try to interpret 
it and to complete it, but we are not justified in taking no 
account of it. Let us even say boldly that if, by some 
unhappy chance, other finer methods should conflict with 
this, and indicate as defective a child who has shown 
himself well adapted to school life, it is school life which 
should be considered the more important test. How, 
indeed, could one call a child defective who succeeds in his 
studies and profits by the instruction in the normal way ? 
Thus we sum up by remarking that we possess a very 
simple method which enables us to recognise all the children 
whom we have any right to suspect of mental deficiency. 
This method consists in taking account of the retardation of 
the children in their studies. 

For the recognition of the ill-balanced children the rule 
is the same. The head-master must pick out those children 
whose undisciplined character has kept them from sub- 
mitting to the ordinary school regime, and has made them 
a continual source of disturbance. Whilst the simply 



PEDAGOGICAL EXAMINATION OF CHILDEEN 43 

defective fail to adapt themselves to school life by reason 
of their mental deficiency, the ill-balanced fail owing to 
their inco -ordination of character. In the second case, as 
in the first, there is a similar defect of adaptation, and the 
best proof that this defect is present in a particular child 
is the continued evidence of several years, the testimony 
of different masters, who declare that, with the best will 
in the world, they cannot break in the recalcitrant child 
to rule. But it must be recognised that the appreciation 
of want of balance is more delicate, more subjective, than 
that of retardation. The latter is indicated by a definite 
incontrovertible fact the insufficiency of instruction. On 
the other hand, lack of balance has only a slight effect on 
a child's intelligence and his success in his studies. It is 
indicated to outsiders especially by the complaints of the 
masters. And the latter, to tell the truth, may be led to 
exaggerate a little, especially if they see a means thereby 
of ridding themselves of children with whom they have not 
much sympathy. We shall see hi a little, when we speak 
of the role of the inspector, how the latter must check the 
statements of the head-masters. 

Distribution of the Pupils in a School. To put into 
practice the principle which we have just formulated, a 
circular is distributed to the schools asking the head- 
masters to arrange the children in each class according to 
age upon a blank table furnished to them. The work is 
easy, and the return should be required in a maximum 
period of eight days. Within this period twenty elemen- 
tary schools in Paris supplied us with the information which 
we asked for through their inspectors. We give one of 
these returns, which we shall examine briefly, insisting only 
on the essential points. 

We ask, then, that on the table, of which a blank copy 
is supplied, the head-master shall give the number of 
children who on October 1 that is to say, the first day 
of the session were of such and such an age e.g., six or 



44 



MENTALLY DEFECTIVE CHILDREN 



seven years. The normal ages for the different courses or 
standards are as follows: 



Preparatory or infant . . 
Elementary, first year . . 
Elementary, second year 
Intermediate, first year 
Intermediate, second year 
Senior, first year 
Senior, second year 



6 to 7 years of age. 

7 to 8 

8 to 9 

9 to 10 

10 to 11 

11 to 12 

12 to 13 



Thus a child is " regular " in instruction when he is found 
in the class named at the age indicated. 

The normal age for the infant class is from six to seven 
years. The children of that age are entered in the table 
in the appropriate column. Now consider the extreme 
ages between six and seven which obey this condition. 
On the one hand would be a child exactly six years of age 
on admission. Such a child is exactly normal as regards 
age. He is behind by years, months, days. At the 
other extreme would be a child exactly seven or, rather, 
one day less than seven on admission. Such a child 
would be behind by exactly one year. Consequently, the 
column headed six to seven years for the infant class con- 
tains children behind by day as a minimum, and one year 
as a maximum. The average will therefore be behind by 
six months (compared to the ideal). Analogous reasoning 
would show that the children of the infant class entered in 
the column headed five to six years would, on the average, 
be six months in advance of their age. Similarly, those 
shown in the column headed seven to eight years would be 
on the average one and a half years behind. 

Interpretation of the Tables. The next point is to sort 
out the defectives from these tables. Nothing is easier if 
we follow the rules already given. Turning to our tables, 
we would consider as suspects the children entered in the 
fourth and following columns for the infant class; in 
column five and following for the elementary course, first 



PEDAGOGICAL EXAMINATION OF CHILDREN 45 





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46 MENTALLY DEFECTIVE CHILDREN 

year; in column six and following for the elementary 
course, second year; in column eight and following for the 
intermediate course, first year; in column nine and follow- 
ing for the intermediate course, second year. If the reader 
will calculate the retardation implied in the columns which 
we designate, he will see that this retardation is equal to 
at least two years under the age of nine, and equal to at 
least three years above the age of nine. 

The number of children suspected of mental deficiency 
obtained by this method varies extremely from one school 
to another, independently of the mistakes which are made 
by the head-masters with lamentable frequency. We have 
found the proportions varying from 0'2 to 10 per cent., 
with all the intermediates represented. The average of 
suspects for ten girls' schools, with an average of 300 
pupils, was 3' 7 per cent.; for eight boys' schools in the 
same district, and strictly comparable to the preceding, it 
was 5*35 per cent. It must be clearly understood that 
these figures are provisional. They do not correspond to 
real defectives, but to children suspected of mental de- 
ficiency; and, moreover, they do not include the unstable, 
unless they are also defective. 

Having made these deductions, one writes to the head- 
masters, or perhaps summons them to a meeting, in order 
to ascertain the names of these children and various other 
particulars. 

These particulars will refer to three main points : 

1. Give the full names and date of birth of the backward 
children (by two or three years, according to the distinc- 
tions given above), and indicate also whether the retarda- 
tion is explained by irregular attendance, by want of appli- 
cation, or defective intelligence. 

2. Indicate the children who, although they do not 
belong to the preceding category, yet appear to be dis- 
tinctly abnormal. 

3. Indicate also the children who are ill-balanced and 



PEDAGOGICAL EXAMINATION OF CHILDREN 47 

rebellious to all discipline in the opinion of several teachers 
who have had them in their classes. 

We have already received replies which seem to us in- 
structive, and even carry us beyond the study of the 
abnormal, as they may throw some light on the psychology 
of those who are commonly called " dunces." As a general 
rule, the children classed as retarded are the victims of 
disease, constitutional debility, or malnutrition. We find 
included in our lists some who are the children of nomadic 
parents; some who have been kept from school; some who 
have attended a religious school, where they learned little 
but sewing and writing; some who have changed their 
school too often; some also who are foreigners, and under- 
stand little French; and, lastly, some who have been kept 
back in their studies by unrecognised myopia. Such causes 
are extrinsic to the child. The personal causes of retarda- 
tion are defective intelligence, sluggishness of mind, in- 
subordination, an eccentric and excitable nature, a con- 
stant want of attention, and, lastly, laziness. 

The complete and methodical study of the documents 
relating to 223 children with a retardation of three years 
has taught us a number of interesting facts. It is very 
rare for the cause of the retardation to be single. Usually, 
several causes were at work simultaneously. Feebleness 
of mind complicated by illness is noted in 20 per cent, 
of the cases. Insufficient school attendance (due to other 
causes than illness), in conjunction with feebleness of mind, 
is met with in 25 per cent, of cases. If, without taking 
account of those associations of causes, one enumerates 
simply the frequency with which each single cause of 
retardation is mentioned, one obtains the following per- 
centages : 

Feebleness of mind ... . . .-, . . 60 per cent. 

Insufficient attendance (without illness).. ..33 

Illness .. .. .. .. .. 25 

Lack of application, laziness . . . . . . 7 ,, 



48 MENTALLY DEFECTIVE CHILDREN 

If we admit, as a hypothesis, that the frequency of each 
of those four principal causes indicates its importance, we 
shall conclude that laziness very rarely explains a retarda- 
tion so great as three years, and that the most important 
factor is undoubtedly feebleness of mind. We should have 
expected the teachers to give much more frequently the 
banal reason of lack of application. They have not done 
so, and these results confirm in a quite unexpected manner 
the convention according to which every retardation of 
three years should make one suspect feebleness of mind. 

It would be interesting to know whether any children 
really defective in intelligence escape the revelation fur- 
nished by our tables. We have put this question in writing 
to the heads of the schools, and they have notified fifteen 
children, or 6 per cent., who seem to them to be clearly 
defective, although without a retardation of three years. 
On testing the statement, we found that mistakes had been 
made, and the sole residue of defectives who had escaped 
our census consisted of three subjects who wanted only a 
month or a few weeks to have shown clearly a retardation 
of three years. They were therefore on the border, and 
such exceptional cases are always to be found when one 
fixes an exact limit. There is no need to worry about 
them. 

Hostile Head-Masters and Teachers. It is important to 
state that the procedure for selection which we have out- 
lined can be carried out without the concurrence of the 
head-masters. As a matter of fact, one has to be prepared 
for everything, even the hostility of the school staff. It 
may be that a head-master who has a defective in his 
school refrains from mentioning the fact. It may be that 
he is indifferent, or does not believe in special education, 
or simply does not choose to put himself about; or, again, 
he may be timid and afraid of trouble, or may shrink from 
the recriminations of parents, behind whom he sees the 
hostile shadow of some town councillor or journalist. 



PEDAGOGICAL EXAMINATION OF CHILDREN 49 

Lastly, he may be an ignoramus who, even at this time of 
day, imagines that a child cannot be a defective unless he 
has incontinence of urine or a sugar-loaf head. We have 
already come across several fellows of this kind. The 
sceptical type is most common. We recollect a head- 
master who, in response to our inquiry, replied with irri- 
tating calmness: " I have five hundred pupils in my school. 
I am sure that not one of them is a defective. You are of 
a different opinion. Well, my school is open. Come and 
see for yourself/' And he added with a sceptical smile: 
*' The school doctor and myself will be very curious to 
learn how you manage the inquiry/' As a matter of fact, 
the proportion of defectives in his school was just the usual 
one about 2 per cent. 

At the time when the Government Commission was 
holding its inquiry as to the number of defectives, we 
found in the statistical tables which we had in our hands 
that whole towns, even as important as Fontainebleau, 
had replied " None," yet we knew by personal inquiry that 
that reply was wrong. 

The systematic reticence of the head-master is therefore 
already hi evidence, and will certainly turn up again even 
when the law is hi full operation. Doubtless wiser counsels 
will prevail in the long run, and opposition will become 
less. But it will never disappear entirely. However, one 
will not be affected by it in picking out the backward 
children, but the children who are abnormal, though not 
backward, and the ill-balanced children, will perhaps 
escape, unless the inspector visits the school, and, knowing 
the disposition of the head-master, takes the precaution of 
questioning the teachers as to the children in their class 
who give them the most trouble in regard to discipline. 
As a rule the masters have an interest in pointing out 
these pupils in the hope that they will be removed. 



50 MENTALLY DEFECTIVE CHILDREN 



B THE R6LE OF THE PRIMARY INSPECTOR: TO ACT AS 
REFEREE. 

In the pedagogical examination the inspector should 
exercise a measure of control. It is he who sets the 
teachers to fill up the schedules, who interprets the returns, 
and estimates their value. 

Work is better done when it is subject to inspection. 
The head-masters will take more care in the selection of 
the defectives if they know that all their cases will be 
examined by a person whose competence is equal to their 
own, and whose position is higher. The inspector, who is 
generally well acquainted with his personnel, will see at a 
glance what he ought to think of the returns which are 
furnished to him. He knows that one master is too severe, 
and another too indulgent. He has to restrain the over- 
zealous, to stimulate the indifferent, and encourage the 
despondent. When it is a question of estimating a child's 
want of balance, it is necessary to know the character of 
the judge. Some good teachers fail to gain the necessary 
ascendancy over one of their pupils, either because they 
are indulgent where strictness is necessary, or because by 
excessive brusqueness and severity they alienate natures 
which require to be humoured. The inspector will suc- 
ceed in taking all these things into account. He will 
interpret correctly the facts which are laid before him, 
because it is his business, his metier. 

Significance of Irregular Attendance. The inspector will 
begin, let us suppose, by examining the returns given con- 
cerning the backward children. From the notes sent to 
him he will be able to distinguish between the children 
whose backwardness is due to irregular attendance and 
those who may justly be suspected of mental deficiency or 
want of balance. He will thus make a first selection. 

Here are some examples of the notes referred to : 



PEDAGOGICAL EXAMINATION OF CHILDREN 51 

Eenne G , age thirteen years, is in the intermediate 

course, second year; she is therefore three years behind for 
her age. The explanation given by the teacher is as follows: 
"Had contagious ophthalmia ; not admitted to school 
till ten. Intelligence middling." If the return is correct, 
one is not surprised that the child has not made more 
progress. 

Suzanne M , age twelve and a half years (two years 

behind); always very delicate and frequently absent; of average 
intelligence. 

Yvonne D , age ten and a half years (two years behind) ; 

lived a long time on a boat without going to school; intelligence 
average ; very industrious. 

Eugenie V , age eleven and a half years (three years 

behind); educated at a convent school until October last; 
intelligence little developed; slow of comprehension; writes 
and sews pretty well; spelling poor. 

Suzanne B , age eleven and a half years (two years be- 
hind); an intelligent and industrious child, who has travelled 
much with her parents, and afterwards stayed in a little 
boarding-house. At school since October ; she has made great 
progress. 

Anna E , age eleven and a half years (two years behind); 

born in German Switzerland, brought up in England, and has 
been in Paris only a year and a half. 

Germaine G , age ten years (three years behind) ; very 

short-sighted. It was only last year that it was noticed that 
this defect of vision was keeping the child from learning to 
read. Since spectacles were provided she has made rapid 
progress. 

Marguerite L , age ten years (two years behind). This 

child has some affection of the eyes; she has been operated on 
several times. 

Without pretending to give a final opinion on the above 
cases, one may believe that the retardation is due to the 
ailment or to irregular attendance. If it were necessary, 
one might make further inquiries at the schools previously 
attended by the child, or find out at the present school the 
exact number of days of absence. 

In other cases it seems clear that it is the intelligence of 
the child that is at fault. For example 

Jeanne L , age ten years (two years behind); attends 

school regularly; stupid and lazy. 



52 MENTALLY DEFECTIVE CHILDREN 

Hortense G (two years behind); irritable temper ; very 

backward in arithmetic and spelling; intelligence mediocre. 

Marie E (two years behind); intelligence very mediocre ; 

inattentive; progress very slow. 

Blanche B (three years behind); intelligence much below 

the average ; has some slight aptitude for sewing and arithmetic, 
but very backward otherwise; incapable of giving a reply 
indicative of good sense and reflection. 

Jeanne B (two years behind); intelligence decidedly 

mediocre; none of her answers particularly sensible. 

When the inspector has read these notes and formed an 
opinion on the children, and obtained as far as necessary 
additional information about their school attendance, 1 etc., 
he will make his first choice. He will decide which children 
are to be examined, and will have them brought to him. 

Be it understood, then, that the child must now be 
presented, and that it is by questioning him that the 
inspector will form an opinion of his mental level. This 
examination is important. The inspector must observe 
the child, induce him to talk, watch the play of his features. 
In this way he receives a living impression which rarely 
deceives an experienced eye. He will even chat with him 
a little about something for example, the occupation of 
his parents. . . . After these preliminaries, the examina- 
tion proper begins. It includes the estimation of the 
degree of instruction and the degree of intelligence. 

Tests of Instruction. 

A child is presented to the inspector, for example, as 
belonging to the intermediate course, first year. Is this 
correct ? It may be that the child is at the foot of the 
class, or is even incapable of following the lessons. Thus, 
it may be that his class gives a very poor indication of his 
capacity. There are plenty of cases where the head- 

1 Teachers have a troublesome habit of saying simply " attendance 
regular " or " irregular." The inspector should demand an exact 
return of the absences. 



PEDAGOGICAL EXAMINATION OF CHILDREN 53 

master, in order to please the parents, puts a child in a 
class too high for him. A rapid examination will suffice 
to test the grading. This testing is absolutely necessary, 
and presents no difficulty to the inspectors. They have 
the fortnightly report brought to them, examine the pupil's 
marks and his exercises, whereby they form a first impres- 
sion. It is then necessary to ask some questions, and on 
this point we have something to say with respect to 
method. 

There are two ways in which the degree of instruction 
may be tested. There is what we may call the casual 
method, which consists in putting the first questions that 
come into the mind; and there is the systematic method, 
which consists in putting questions arranged in advance, 
whose difficulty is known, and for which we have a scale 
(p. 54), which shows the average number of errors to be 
expected from normal children of each age. The latter 
method takes no longer than the former, and is even easier, 
because it makes no demand on the imagination. More- 
over, we consider it quite indispensable for fixing in an 
objective mariner the degree of instruction of the defectives 
on the day of their admission to the special school. It is 
very important that this degree of instruction should be 
definitely known, because it will be necessary to refer to it 
every time one wants to find out to what extent the child 
is profiting by the special instruction. We shall return to 
this point in our concluding chapter. 

It has seemed to us that the test of instruction might 
bear upon three exercises, which are easily marked read- 
ing, arithmetic, and spelling. Here is a very simple table 
of tests (p. 54), of which we have made much use. It 
has been arranged with the help of M. Vaney. The table 
is suited to the elementary and to the intermediate course, 
and that is sufficient for examining defectives, since none 
of them are found in the senior division. It is scarcely 
necessary to say that this table of tests is the outcome of 



MENTALLY DEFECTIVE CHILDREN 



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PEDAGOGICAL EXAMINATION OF CHILDREN 55 

careful experiment. We have established for each age the 
average acquirements of all the children of that age what- 
ever their place in school. One might quite as well have 
taken into account only the results given by typical children 
in the class proper to their age, but on reflection we rejected 
this proceeding as arbitrary, because it is affected by the 
difficulty of the curriculum, which is constructed a priori, 
whilst the average furnished by all the children of a given 
age is less artificial and is an adequate expression of the 
reality. Let us remark in passing that these two methods 
of calculation do not lead to equivalent results. The aver- 
age furnished by the typical children is higher than that 
furnished by all the children, for, as we have shown above, 
more children are backward than in advance. Lastly, the 
time of year when the tests are made is not a matter of 
indifference. For spelling and arithmetic the time chosen 
was the end of February that is, the middle of the session. 
For reading we are obliged to make use of results a little 
more advanced, for they were furnished later, namely, in 
June. 

Let us now explain the details of the exercises shown on 
our table. 

Reading. The proceeding we adopt consists essentially 
in distinguishing five grades of reading : 

1. Sub-Syllabic. The child reads in syllables, but very 
slowly and with many mistakes. 

2. Syllabic. This consists in stopping at every syllable, 
but reading these pretty correctly. Thus the child reads' 
" The sol di er car ries a big gun." 

3. Hesitating. There are stops as in (2), but they are 
less frequent. The child reads by words or groups of 
words e.g., " The soldier carries a big gun." 

4. Fluent. There are no stops except at the marks of 
punctuation, but the reading is monotonous, as if the child 
does not understand what he reads. The voice may fall 
at the end of the sentences. 



56 



MENTALLY DEFECTIVE CHILDREN 



5. Expressive. The child shows by his intonation that 
he understands what he reads. 

We found it necessary, as may well be believed, to use 
not only the expressions syllabic reading, fluent reading* 
etc., but compound expressions, such as hesitating -fluent, 
fluent-expressive, and even compound expressions with 
accentuation of one of the epithets, as hesitating-/?wen. 
This is very useful in practice. 

We have stated that the scale of reading was founded 
on experiments made by M. Vaney at the end of the school 
year. We have modified it slightly in consequence of 
experiments made by ourselves in February. It may be 
of interest to give here the table arranged by M. Vaney. 
It has been arranged not by age, but by class. 





Number of Children who have the 






Following Grades of Beading. 








Totals. 




None. 


Sylla- 
bic. 


Hesi- 
tatiug. 


Fluent. 


Expres- 
sive. 




Infant 


12 


26 


2 


_ 


_ 


40 


Elementary (first year) . . 
,, (second year) 


n 


5 


32 
24 


4 
11 


2 


41 
37 


Intermediate (first year) 





, 


15 


18 


8 


41 


(second year) 


. 


. i 


10 


19 


9 


88 


(second year) 








8 


11 


15 


34 


Senior 


' 








5 


35 


40 


Totals 


12 


31 


91 


68 


69 


271 



We shall now give some hints as to the method of pro- 
cedure. 

Reading is a test which requires only a minute. One 
chooses a text which the children can understand easily, 
preferably a lively piece with dialogue, so that one may 
judge more easily whether the pupil can read with ex- 
pression. One should avoid prolonging the reading for 
more than forty -five seconds, for a young child tires quickly 



PEDAGOGICAL EXAMINATION OF CHILDREN 57 



and reads worse at the end of a minute than at the beginning. 
Instead of contenting oneself with judging that the child 
reads well or ill, which does not mean very much, it is a 
great advantage to adopt these five grades of reading, 
which are easy to distinguish with a little practice, and are 
less subjective than might be imagined, for two judges 
generally give the same mark. On referring to the scale, 
it will be noticed that children quickly pass from syllabic 
reading to hesitating reading, but the passage from hesi- 
tating to fluent reading is slower and more troublesome. 
One will notice this difficulty in practice. 

By way of example let us quote our judgment of the 
grades of reading in the case of some backward children, 
and our consequent estimates of the degree of retardation. 
We draw them from our own observations made in a class 
for defectives in Paris. 



Name. 


Age. 


Grade of Reading. 


Retardation. 


Coch 
Grio 
Sev 
CofE 






14 ye 

10* 

$ 


113 


Hesitating -fluent 
Hesitating-fluent 
Hesitating-fluent 
Syllabic-hesitating 


6 yei 

2* 
5 , 
4 , 


bra 


Ro 






12 




Syllabic-hesitating 


5 




Ostro 






12* 




Hesitating- fluent 


4 , 










. 



It will be noticed that in spite of their advanced age 
none of these children have attained the fluent grade of 
reading. 

In marking the reading one is sometimes at a loss owing 
to the absence on the scale of an exact description. Thus 
little Coff is judged syllabic-hesitating. The scale does 
not contain such a combination, which ought to figure 
between the syllabic reading of the infant class and the 
hesitating reading of the elementary class, first year. One 
may calculate the retardation either by admitting the 
existence of this intermediate term, or by marking CofFs 



58 MENTALLY DEFECTIVE CHILDREN 

reading " hesitating." The choice is of little practical 
importance, since its effect is a variation in the amount of 
retardation of only six months. 

Arithmetic. Although arithmetical ability depends upon 
special aptitude, and a child may be quite intelligent 
though backward in arithmetic, the tests here chosen are 
so elementary, and the ignorance one tolerates is so great, 
that failure is of serious significance. We follow here the 
directions of M. Vaney, who has taken the trouble to 
simplify them at our request. All the questions in arith- 
metic ought to be dictated. This may even be done col- 
lectively. It is essential not to interpose to ask the child 
what operation is to be done. Such help would make the 
work much too easy, and indeed that is the very problem 
which has to be solved in the very exact and carefully 
considered form in which it has been stated. It is the 
problem rather than the operation which requires intelli- 
gence. Moreover, it will be noted that the difficulty of 
our mode of expression is calculated. The words subtract, 
take away, remain, ought not to be replaced by synonyms, 
and still less should they be explained. Even when, as 
often happens, the child makes a mistake in the first 
problem (for example, 19 - 6= 12), he must not be allowed 
to stop there; his mistake might be due to carelessness. 
One must always try the higher problems until one obtains 
a clear demonstration that the child is incapable of solving 
them. M. Vaney has suggested a scale of marking for 
these sums. It enables one to take into account slight 
differences by the aid of a system of points. Here it is: 



Correction of Sums. 

First Sum (I point). 1 point for correct answer (vide p. 54). 

Second Sum (2 points). 1 point for subtraction; 1 point for 
correct answer. 

Third Sum (3 points). 1 point for 604 correctly written; 
1 point for subtraction ; 1 point for correct answer. 

Fourth Sum (4 points). 2 points for correct division (1 if 



PEDAGOGICAL EXAMINATION OF CHILDREN 59 



wrong); 2 points for the remainder (1 if obtained by long 
division). 

Fifth Sum (5 points). 2 points for the subtraction (1 if 
answer wrong); 3 points for correct division (2 if it is wrong). 

Sixth Sum (6 points). A dressmaker buys 8 yards of velvet 
at 9s. 6d. a yard and 25 yards of cloth; she pays for the whole 
6. Find the price of the cloth per yard. 2 points for the 
price of the velvet; 2 points for the price of the cloth (1 for 
subtraction, if answer wrong); 2 points for price of cloth per 
yard (1 for division if answer wrong). 

Seventh Sum (7 points). A merchant mixed 25 pints of wine 
at 2s. a pint with 60 pints at 2s. 6d. a pint; at how much per 
pint must he sell the mixture in order to gain 55s. ? etc. 

This scale enables us to determine by the total number 
of points obtained the level of the child in arithmetic, and 
at the same time we find out what sums can be done by 
the pupils of each age. This is shown in the table. 

RESULTS OF AEITHMETIC TESTS IN AN ELEMENTAEY SCHOOL 
IN PARIS. 



All the 
Children 
of- 


Average 
Points. 


Children 
in Proper 
Class. 


Average 
Points. 


All Children in Class- 


Average 
Points. 


6 years 


1-45 


6 years 


1 


Infant 


1-5 


7 


3-93 


7 


6 


Junior (first year) 


6-5 


8 
9 


7-00 
9-65 


8 
9 


7 
14 


,, (second year 
Intermediate (first 


6-83 
16-00 










year) 




10 


1547 


10 


23 


Intermediate (second 












year) 


22-42 


11 


2147 


11 


29 


Senior 


28-45 


12 


22-50 










13 


24-75 











It will be noticed in the table that the averages are a 
little less when calculated on all the children. We have 
indicated this difference already, and have explained the 
reason for it. We have based our scale upon the marks 
obtained by all the children. 

In practice we consider that M. Vaney's system of points 
is not indispensable. It is sufficient to find out whether 
or not the pupil can do the sum set. If he can, he is at 



60 MENTALLY DEFECTIVE CHILDREN 

that level; if not, he must be placed in the grade below. 
Some examples will show how we use these results. We 
select them from a class of defectives. 

Eager B , age ten and a half years, is asked orally, for 

he cannot write: " If I had 19 apples and ate 6, how many 
would be left !" He replies first 9, then 6. One then tries 
easier sums. Q. "I have 4 apples, and eat 1 ?" E. " Three 
are left." Q. " I have 12 apples, and eat 2 t" E. " There 
are 9 left." Q. " I have 8 apples, and eat 2 f ' E. " There 
are 7 left." Evidently this child does not clear even the first 
step. He has therefore four years and a half of retardation. 

In this connection let us remark that as Koger is a child 
whose attendance has been regular, it follows that in his four 
and a half years at school he has scarcely learned more than a 
normal child learns in two months. We recently met with a 
similar case at Bicetre. This was a child of twelve, who had 
begun to learn his letters at the age of four, and who did not 
yet know how to spell ! In presence of such cases one may well 
ask whether the teacher who has not managed in four and a 
half years or in eight years to teach a defective child what a 
normal child learns in a month has not wasted his own time 
and that of the defective. At this point let us call attention 
to a defect in the mechanical calculation of retardation. Little 
Roger, who is ten and a half years, and cannot yet read by 
syllables, has only four and a half years of retardation, if we 
apply to him the usual rule. It would therefore appear that 
he is at the same level of intelligence as a child of thirteen and 
a half, who belongs to the intermediate course, first year, for 
the latter has also a retardation of four years and a half. The 
error of this method of calculation is at once apparent. The 
real significance of retardation is proportionate to the class and 
course which the pupil has reached. We shall return presently 
to the exact estimation of retardation. 

Let us quote another example to show the application of 
the arithmetical test. 

Ostrow, twelve and a half years, replies correctly to questions 
1, 2, and 3. At the fourth he hesitates and begins by multi- 
plying 7 by 89, and obtains as answer 783, which is doubly 
inexact, because he ought not to have multiplied, and the multi- 
plication is incorrect. Then he draws back, and tries a division 
of 89 by 7; he obtains an incorrect answer (11), which does not 
satisfy him. Finally, he tries a multiplication: says 7 times 
10 makes 70. He next adds 7 several times to reach 89, but 
he becomes confused, and finishes by finding the number 13, 
which is almost correct. This child is therefore at stage 4; 
he does not clear it, but he attempts it. Look at the scale. 



PEDAGOGICAL EXAMINATION OF CHILDREN 61 

We give him full points for Problems 1, 2, and 3, plus 2 points 
for Problem 4, or a total of 8, which puts him at the level of 
children of eight and a half years, which amounts to a retarda- 
tion of four years. 

Spelling. The test of spelling is a piece of dictation 
given individually or collectively. The scale contains the 
first phrases of the dictation. We reproduce them all 
here, pointing out the grammatical difficulties which they 
contain, and the scale for marking faults which seemed 
to us most fair. [We quote the phrases in French, as a 
translation would not indicate the real difficulties. It will 
be observed that in many cases correct spelling implies 
grammatical knowledge. Tn.] 

Phrase 1. To write phonetically, without liaison, a phrase 
dictated in the ordinary vocabulary of the child. 

Example. fimile est un petit eleve biensage; il ecoute son 
papa et sa maman; il va a l'e"cole. 

Phrase 2. To put the s's of the plural to words chosen from 
the vocabulary of the child. 

Example. J'ai une tete, deux bras, deux jambes, une bouche, 
vingt dents, une langue, et dix doigts. 

Phrase 3. Plural of qualifying adjectives in simple cases; 
verbs to the third person plural, present indicative. 

Example. Le soleil brille deja de ses plus gais rayons. Les 
homines partent en chantant. Les bergers sont heureux de la 
belle journee qui se prepare : ils suivent au paturage le grand 
troupeau des vaches pesantes. 

Phrase 4. Feminine of the qualifying adjectives without 
phonetic indication ; verbs with the plural endings ons, ont, ez, 
aient. 

Exercise. Le garQon de ferme, de son pas lourd, entrait 
dans la grange encore obscure, ou nous reposions. Les boeufs 
mugissaient tout has. Dans la cour le coq, les poules, le 
chien, allaient et venaient. 

Phrases 5, 6, and 7. Finals of verbs in the singular of the 
different tenses of the four conjugations. Past participle with 
or without avoir. Infinitive in er, and past participle in e. 

Example. Joyeux merle, ne viens pas dans le bocage. 
Prends garde a ce mechant qui veut te saisir et Venfermer. 
Pendant que je te parle, tu viens picorer les raisins que 1'oise- 
leur a disposes comme un piege. Ils sont garnis de glu : si tu y 
touches, e'en est fait de ta liberte. 



62 



MENTALLY DEFECTIVE CHILDREN 



Method of Marking Mistakes. 

One mistake for a letter omitted. 

One mistake for a letter too much. 

One mistake for a letter substituted for another. 

There may therefore be several mistakes in the same word, 
but the number of mistakes for any word cannot be greater 
than the number of letters in the word. A word omitted 
counts as many mistakes as it has letters. 

The liaison of two words counts for one mistake. Failure 
to join the two parts of a word also counts one mistake. 

It is to be noticed that we do not speak of grades of 
spelling that is to say, of different phrases which the 
children of each age should be able to write without mis- 
take. No doubt such could be found. But we have been 
content to count the mistakes ; it is by the number of mis- 
takes that the children of each age are distinguished. 

The dictation given in February by M. Vaney in his 
school and corrected by the teachers there has enabled 
us to draw up the following table, which shows the number 
of mistakes committed, counted by the method indicated 
above: 1 









* 


I 


<D 


OJ 





Age of 
Children. 


Class. 


Course. 


1 


jj 

K 


1 


1 


& 










1 


g 





6 








3 


<N 


M 


"^ 


>o 


6 to 7 years 
7 8 


1 

2 


Preparatory 
Elementary (first 


13 
6 


22 
15 


32 





~ 






year) 












8 , 9 ,, 


3 


Elementary (second 


2 


10 


19 


20 









year) 












9 10 


4 


Intermediate (first 





2 


6-6 


6-9 


17 






year) 












10 11 


5 


Intermediate (second 








4 


4 


12 






year) 












11 12 


6 


Senior 








0-6 


0-7 


5 



1 There are two methods of stating the representative value of a 
group, the average and the median. Everyone knows the average. 
The median is obtained by arranging the values in linear series from 
the smallest to the greatest and taking the middle one. When should 
one use the average, and when the median ? It is not easy to give a 



PEDAGOGICAL EXAMINATION OF CHILDREN 63 



To show how we classify a child from the point of view 
of spelling, let us take an example. We shall choose 
Ostrow, the defective whom we have already tested in 
arithmetic. He writes the first phrase with one mistake, 
the second with one mistake, the third with eight mistakes ; 
he is at the level of a child of nine to ten (vide Table, p. 54). 
He has therefore a retardation of three years. He must 
be reckoned as slightly feeble-minded. 1 

We now understand the manner of judging the capacity 
of a child in arithmetic, reading, and spelling. Which of 
all these tests is of the greatest value ? We shall reply to 

general rule, but in this case of spelling, we have a good example. If 
we wish to calculate the number of mistakes for each age, to take the 
average might be a disastrous proceeding. A single child who made 
a hundred or so mistakes would obviously make the average unfairly 
high. The median is affected much less by such aberrant cases, and 
consequently is more suitable for very heterogeneous series, in which 
the difference between the maximum and the minimum is very great. 
1 By way of comparison, the following dictation was given to ninety- 
two children in an Edinburgh school. The progressive difficulties 
depend upon the non-phonetic spelling and the lesser familiarity of 
words. Most of the children came to school in their sixth year. 

1. Tom is a good boy. He has a book and a bat. He can run fast. 

2. The dog is bigger than the cat, but he cannot climb so well. He 
would if he could. 

3. The farmer walked through the wood till he came to the field. 
It was a fine day for sowing the corn. He hoped it would not rain 
till he had finished his work. 

4. The weather was very stormy. The boughs of the trees were 
blowing to and fro in the wind. Clouds were chasing each other across 
the sky. The crows were watching the ploughman in the field. 

Mistakes were marked according to the directions in the text. Thus 
" bows " for " boughs " counted three mistakes. The results were 
as follows : 



Age of Children. 


Average Mistakes in Test Sentences. 


1. 


2. 


3. 


4. 


6 to 7 years 
7 8 
8 9 


0-32 

0-22 
0-2 


2-64 
1-77 
0-36 


3-45 
1-68 


6-18 
5-91 



64 MENTALLY DEFECTIVE CHILDREN 

this question by giving a summary in a few words of the 
tests we applied to twenty children in a special class. 
The amount of retardation varied considerably from one 
child to another, and for the same child from one test to 
another. On the average, the amount of retardation was 
3' 3 years for spelling, 4 years for reading, and 4' 5 years 
for arithmetic. These children did not do so badly in 
spelling; there was even one who was at the normal level. 
It was especially in the problems that their deficiency was 
noticeable, because the problem requires not only memory, 
but some understanding. They have great difficulty in 
defining what is the proper arithmetical operation. When 
addition is necessary they have a tendency to subtract, 
and if they ought to divide they will more readily multiply. 
These mistakes lead to absurd results, which usually do 
not put them about, unless their attention is drawn to the 
absurdity. A defective will admit quite readily that if I 
have 604 apples, and sell 58, I shall have 662 left. These 
results show that in the ordinary school they do, we will 
not say too much spelling, but too little arithmetic in 
comparison to the amount of spelling. Finally, we again 
insist upon the evidential value of methodical tests. We 
demand that the elementary school inspector should have 
these tests carried out without assistance to the pupils, 
without intervention to indicate the solution or the step to 
take. He must neither assist nor do the lesson, but simply 
note the result achieved. He must therefore reduce him- 
self to the easy role of a benevolent spectator. 

Retardation and Knowledge Percentage. We said above, 
in estimating retardation, account should be taken of the 
course to which the pupil belongs that is to say, the 
grade of instruction to which he has already attained. A 
child of nine years of age who has a retardation of three 
years has learned absolutely nothing ; on the other hand, a 
child of twelve years who has a retardation of three years 
has learned something, since he has reached the inter- 



PEDAGOGICAL EXAMINATION OF CHILDREN 65 

mediate course, first year. The difference between the 
two pupils is apparent; probably it will increase still more 
as years go on. To understand the matter clearly, it is 
necessary to compare the amount of retardation with the 
period of school attendance. The latter may be repre- 
sented by the figure 100. Thus, our child of nine, who has 
learned nothing, has a retardation of three years in three 
years at school that is to say, a percentage of 0; our 
child of twelve, who is in the " intermediate course, first 
year," has made in six years half the normal progress; he 
has therefore a " knowledge percentage " of 50. Such 
figures have evidently a quite different significance from 
those of the amount of retardation. Our opinion is that 
it suffices to make use of the simple calculation of retarda- 
tion in selecting the defectives, for it is an easy and useful 
method; but when one is in the presence of a child, and 
desires to estimate his knowledge, not only for the actual 
moment, but with reference to his future and his capacity 
for learning, it is necessary to note also, and more especially, 
his " knowledge percentage/' 

We suggest the following schedule to be filled up after 
the examination of the child : 



Examination of Instruction of a Child proposed for 
Special Class. 

Date of examination: 
Place of examination: 
Full name of pupil: 
Date of birth of pupil: 

This child has attended school, class. 

Attendance regular or irregular ? 
Has he been able to follow his class ? 
What is the amount of his retardation t 
Reading. 

(Syllabic, hesitating, fluent, expressive, intermediate e.g., 
fluent-expressive. ) 

Observations on reading: 

I 



66 MENTALLY DEFECTIVE CHILDREN 

Arithmetic. 

The pupil can do the problems noted without mistake 
(Kefer to scale.) 

Observations on arithmetic: 
Spelling. 

Phrase dictated: 

Number of mistakes : 
Conclusion. 

Retardation in reading (taking account of school attendance) : 

Retardation in arithmetic (ibid.): 

Retardation in spelling (ibid.): 
Knowledge percentage: 
Name and position of examiner: 

In spite of the lengthy details into which we enter, it is 
evident that all this work of examination can be done 
pretty rapidly. The arithmetic alone is a little long, 
because it is necessary to allow time to put the child at his 
ease. We may put the total examination at fifteen minutes. 
Often it will be possible to abridge the time. The inspector 
is now in a position to estimate the retardation of the pupil 
and his knowledge percentage. He has several means at 
his disposal the evidence of the teachers, the notes con- 
cerning the pupil, the examination of his copybook, observa- 
tion of the attitude of the child, his physiognomy, etc., and, 
above all, the exact and personal test which he has made. 

Is this enough ? When the inspector has established 
the retardation and determined its causes, may he, should 
he, give his opinion immediately ? In most cases, with- 
out doubt, a further inquiry is not necessary. But in 
other cases the need of further inquiry is felt. Instruction 
is not everything, and there are some children who have 
difficulty in assimilating school knowledge owing to want 
of aptitude, to inattention, to laziness, who are yet quite 
intelligent. It is the intelligence of these children that 
one would like to determine, and for this it is necessary 
to make use of some tests of intelligence. We propose, 
therefore, for the inspectors a last examination, a psycho- 
logical one. Let no one accuse us of complicating the 
examinations. We do not impose them, we do not even 



PEDAGOGICAL EXAMINATION OF CHILDREN 67 

advise them in all cases. But these tests are none the less 
very valuable tools to which one is very happy to have 
recourse when one feels embarrassed. 



PSYCHOLOGICAL EXAMINATION. 

This consists in putting the following questions/ which 
have been grouped in such a manner that the four first 
can be answered by normal children at seven years of age, 
the five following by normal children at nine years of age, 
and the four last by normal children at eleven years of age, 

Tests of Intelligence. 

Seven Years. 

1. If you were late for school, what would you do ? 

2. If you lost a train, what would you do t 

3. If one is lazy and does not want to work, what happens 1 

4. If you were tired and had not enough money to take an 
omnibus, what would you do ? 

Nine Years. 

5. If one needed sixpence, how could one get it ? 

6. Why should we not spend all our money, but put a little 
past t 

7. If you break an object that does not belong to you, what 
should you do t 

8. If a companion should strike you without meaning it, 
what should you do ! 

9. If you require some good advice, what should you do ? 

Eleven Years. 

10. Before taking part in anything important, what should 
you do ? 

11. Why do we forgive a bad deed done in anger more readily 
than a bad deed done without anger *? 

12. If anyone asks your opinion about a person whom you 
know very little, what would you do f 

13. Why should one judge a person by his acts rather than 
by his words ? 

1 The complete set of tests as revised in 1911 is given in the Appen- 
dix, with notes regarding their subsequent use in Br.tain and America. 



68 MENTALLY DEFECTIVE CHILDREN 

These questions present various difficulties, both in 
thought and in vocabulary. We have tried them upon a 
great number of school children, and they correspond 
pretty exactly to the level of children at the ages indicated. 

The answers of the children may be good, passable, 
mediocre, or negative (the child makes no reply), or even 
absurd or unintelligible. In marking the replies one does 
not take account of a wrong word or an awkward phrase, 
but considers the meaning and whether the child has really 
understood. It may seem that marking these replies 
would be rather delicate and arbitrary, but in practice the 
difficulty is not great. Here are some examples: 

(10) The reply, " Ask some capable person, a master, a 
parent/' is a good reply. " Ask it/' " Listen for it," are 
passable replies. 

(7) The reply, " Pay and apologize/' is good. " Pay for 
it," is passable. 

(8) The reply, " Forgive him," is better than the reply, 
" Don't tell tales." 

(1) The reply, " Hurry up," is better than, " King the 
bell," " Hurry to-morrow," " One is kept in." 

(3) The reply, " One remains ignorant," is better than, 
" One is punished." 

(4) The reply, " Take a rest, then walk," is better, being 
more explicit, than simply, " Walk." 

We mark the good replies 3, the passable 2, the mediocre 
1, the absurd and silence 0. Silence sometimes makes 
one hesitate. It may result from timidity, or even from 
prolonged reflection. It is necessary, without changing 
the form of the question, to encourage the child and 
to press him to reply. With a little practice one can easily 
see who is trying to find an answer and who does not 
understand. 

We have stated that normal children of eleven years 
of age replied to the questions 10 to 13. It must be under- 
stood that by this we mean that the majority replied. 



PEDAGOGICAL EXAMINATION OF CHILDREN 69 

There are no tests which can characterise all the subjects 
without exception of a given group. There are always 
failures. By way of example, we shall quote the observa- 
tions we made in an elementary school with our questions 
10 to 13, which we put to all the children of eleven, who 
were distributed, according to their ability, in the different 
classes. There were thirty-six of these pupils. The maxi- 
mum of marks obtainable was 12, since there were four 
questions, and a good reply was worth 3. We then ob- 
tained the following averages : 

Tests of Intelligence put to Normal Children of Eleven 
Years of Age. 

Average Marks. 

Senior, first year .. .. .=. ..11 

Intermediate, second yoar . . . . . G 

Intermediate, first year .. ... ... 4*7 

In the " intermediate course, second year/' there were 
two children who obtained and 1. In the " intermediate 
course, first year," there were four who got 0, and one who 
got only 1. What were these pupils, who had certainly 
not reached the average intellectual level of eleven years ? 
Two are said to be defectives by the head- master. Let us 
subtract them, and there remain five, and these work 
sufficiently well to remain in their class and to follow the 
lessons. Their success is a very important fact. A child 
may not have very much intelligence, but if he has a good 
memory, application, and will, he is regular in his studies, 
and this compensates for the mental feebleness. We have 
often noticed this. If a child is regular in his school work, 
the question whether he is a defective does not present 
itself. It only presents itself if the case is reversed. Sup- 
posing he is very clearly backward, by two years, by three 
years, with a sufficient school attendance. If, in spite of 
this retardation, the psychological examination shows that 
he is all the same quite intelligent, this is a favourable 



70 MENTALLY DEFECTIVE CHILDREN 

circumstance of which he should have the advantage. In 
other terms, the psychological examination is capable of 
showing that he. is normal, even when he is behindhand 
in his studies. This examination cannot, in any case, 
serve to make him be regarded as defective if he is regular 
in his studies. This is why we place this examination last. 
Here are some very good replies from normal children : 

10. It would be necessary to consider where the affair 
would lead us. 

11. Because when a bad action is done without anger one 
knows what one is doing, while when one is angry one does not 
know what one is doing. 

12. One should say nothing. If one does not know the 
person one cannot tell what he is. 

13. By his words he may deceive us. By his acts we can 
tell what he is. 

G : 

10. It is necessary to think what one is going to do. 

11. Because when one acts without anger one has thought 
beforehand, and is more to blame; while, on the other hand, 
it is an act of passion, and afterwards one regrets what one has 
done. 

12. I would say that it would be necessary to know him 
first and then afterwards to judge him, not to say anything 
bad or good about him without knowing him. 

13. Because there are people who say words and often do 
not do them. 

Here are some replies which are mediocre or absurd : 

12. You should try to ask the particulars of the person you 
do not know. (Mediocre.) 

13. Because his acts are more terrible while his words arc 
less threatening. (Mediocre.) 

11. Because the action which has been done in anger is not 
so violent. (Mediocre.) 

13. Because you must not speak after the person who 
speaks. (Absurd.) 

In a class of defectives of eleven years of age we obtained 
from seven children an average of replies equal to T3. 
This figure, therefore, is considerably less than that of the 



PEDAGOGICAL EXAMINATION OF CHILDREN 71 

normal children regular in their studies, and even than 
that of the normal with a retardation of two years. Let 
us note in passing a very curious fact. We had had to 
examine these defectives before their admission into the 
special class. Now, the teachers sent us as defective two 
children who were clearly intelligent, for one of them 
obtained five marks and the other eight. Let us give the 
replies of the latter, whose name was Cler, age eleven years : 

10. You would have to think. (Good.) 

11. Because anger is less serious. (Absurd.) 

12. Say nothing bad about him, because I do not know him 
well. (Good.) 

13. Because words are not correct. It is not certain that he 
will do it. (Passable.) 

These replies are evidently not very brilliant, but they 
are so superior to the level of a defective that we have sent 
this child back to the ordinary school. We have since 
learned a fact which was not originally communicated to 
us. This child came from the country, and he did not 
begin to go to school until the age of ten. 

To sum up, we offer the psychological examination as a 
means of rehabilitating a child who has a marked degree 
of retardation. That is its sole utility. Never, in any 
case, must this examination be used to label as defective 
a child who keeps up with his lessons. 

A last word regarding the necessity of these examinations. 

We know that, after having read the preceding pages, 
more than one inspector, more than one teacher, will ex- 
claim, " What is the use of all this ? I am quite accus- 
tomed to questioning children, and I don't require such 
precautions in order to distinguish between those who are 
intelligent and those who are not. By two or three ques- 
tions which are quite familiar to me I can judge the state 
of instruction." 

We have paid homage to the ability of the teachers and 



72 MENTALLY DEFECTIVE CHILDREN 

inspectors sufficiently often to be permitted to maintain 
here against those who would contradict us the necessity 
of our methods or of others of a similar kind. In order to 
determine the degree of intelligence or the state of instruc- 
tion of a child one would require to have in mind the normal 
levels. Now, frankly, who knows what these are ? Let 
any inspector, any teacher, glance over our test questions. 
He will be very much at a difficulty to say whether it is at 
nine years or at seven years that a child ought to be able 
to reply suitably to a particular question. We will go even 
farther. Let an inspector look at our scale, and say at 
what age reading is " fluent/' at what age a child should 
write the third phrase with less than ten mistakes. Just 
let him try, and he will find the result. Let us add that 
people who are neither inspectors nor teachers will be still 
more embarrassed. We recollect that at the recent opening 
of a special class some eminent people appeared much 
astonished at the intelligence of the pupils. They were 
surprised at children of twelve years who made replies of 
which in reality normal children of eight should have been 
capable. It is impossible to form a correct judgment about 
matters so delicate unless one makes use of exact tests. 
We insist upon this because we foresee that all who visit 
the class for defectives will be subject to this illusion. All 
the more will they have an optimistic tendency to over- 
estimate the intelligence and instruction of the children 
since they know in advance that they are going to see 
defectives, and consequently have a preconceived expecta- 
tion of seeing degraded imbeciles with low foreheads and 
dirty habits. They will be quite surprised to find that 
the great majority of defectives do not answer to this 
description, and seeing that they have fallen into an error, 
they will correct themselves as usual by falling into the 
opposite mistake. 

Estimation of Want of Balance. If it is easy to determine 
backwardness by a direct examination of a child's state 



PEDAGOGICAL EXAMINATION OF CHILDREN 73 

of instruction, the difficulty of establishing a lack of mental 
balance is, on the other hand, very great. Such want of 
balance is indicated by breaches of discipline, inattention, 
naughtiness, lying, violence, brutality, etc. But it would 
be a very unruly child who would not behave quietly when 
taken apart by the inspector. Isolated in the examination 
room, surrounded by strange, grave people, the child 
shrinks into himself. He has little occasion or desire for 
a display of rebellion or naughtiness when his comrades 
are not there to admire him. Possibly an exact estimation 
of his reactions, of his motor ability, of his power of atten- 
tion, would indicate the presence of some anomalies; but 
this is not certain, and is not to be relied upon. There 
may be some hope in that direction for the pedagogy of 
the future, but scientific investigations cannot help us 
to-day. In short, mental want of balance cannot, in the 
majority of cases, be the object of direct examination. 

How, then, can it be estimated ? Indirectly, by the 
evidence of others. 

The inspector, then, must be content to accept the 
facts which are given to him by the teacher, but he must 
not accept them altogether on trust. Are these facts 
correct ? Are they probable ? Is any evidence of them 
to be found ? Have they been altered in the telling ? 
Such will be the first queries to awaken the critical spirit 
of the inspector. Then it must not be forgotten that he 
can question the parents, and hear their replies before 
letting them know the opinion of the teacher, and that 
everything they say will help him to judge not only the 
child, but the family circumstances in which he lives. 
The ill-balanced are often spoiled, or only children, or 
children not looked after, or children whose father has 
disappeared. The sons of widows form a considerable 
contingent. Now, the inspector will gain a good deal of 
information from the school history of the child. The ill- 
balanced is a nomad. He has attended several schools. It 



74 MENTALLY DEFECTIVE CHILDREN 

is important to find out what impression he has left behind 
him. The proof of want of balance is not to be taken 
from a single teacher. If three teachers, at least, whose 
pedagogic reputation is good, agree about a child, the 
chances are that their estimate is correct. The inspector 
will resort to such controls, and if he is not satisfied, and 
if the alleged facts are not very serious, he will remove the 
child to another class or another school rather than send 
him to a class for defectives. 

Elimination of Hospital or Asylum Cases. Only defectives 
likely to improve are to be admitted to the special schools. 
That is only common sense. Everyone knows that the 
epithet " defective " does not belong to a single type. 
There are various categories which extend between two 
extremes: the purely vegetative idiot who cannot speak, or 
walk, or even feed himself ; and the slightly feeble-minded, 
who may easily be taken for normal. In spite of all our 
sympathy for these poor creatures whom Nature has 
treated so cruelly, we could not think of supplying them 
without distinction with all the benefits of education. It 
is certain that the worst affected would not profit much 
thereby. It is pure folly to devote six or eight years to 
teaching the letters to a child who will never be able to 
read, or who, if he should manage to read a little, will not 
understand what he reads. To such an unfortunate it is 
quite enough to give lessons in walking, feeding, dressing 
himself, and in simple occupations, such as dusting or 
sweeping. Such cases do not require schools so much as 
places where they can be taken care of. These will cost 
less to establish, especially in the country. Educational 
efforts should be concentrated on the defectives who are 
less profoundly affected. It is they alone whom one 
should try to instruct. This is the practice which is 
rightly followed abroad. For administrative purposes the 
defectives of different grades may be divided into two 
groups, medical cases and educational cases, or preferably, 



PEDAGOGICAL EXAMINATION OF CHILDREN 75 

in order to obviate the use of the equivocal term " medical/' 
we may speak simply of hospice cases and school cases 
to show the difference in their destination. The exact 
terms employed matter little so long as we understand 
what we mean by the words. 

We have just pointed out the importance of reserving 
the schools for defectives for improvable cases. But it is 
necessary to correct this word " improvable/' because all 
defectives can be improved more or less. Their asserted 
arrest of development is not complete, and the expression 
is equivocal. It would be better to replace the word 
"improvable" by the following more precise phrase: 
" Capable of being taught to gain, in part, their own living/' 
Which of them are in this position ? Unfortunately, we 
do not know. All such questions should have been solved 
long ago, since thousands of defectives have passed into the 
hospices. It would have been enough to have followed 
them up, to have found out what became of them, and to 
have drawn conclusions. But this has never been done 
methodically, and for the present we are reduced to con- 
jecture. The nearest estimate we can form is that the 
social value of any individual case, not epileptic, is in 
inverse proportion to the degree of deficiency ; the imbecile 
would seem to be more improvable than the idiot, and the 
feeble-minded than the imbecile. But this is simply 
hypothesis, and we accept it quite provisionally, until 
exact investigations have been made which will permit us 
to replace conjecture by demonstrated truth. Conse- 
quently we shall open wide the doors of the school to the 
feeble-minded and close them to the idiots, while as to the 
imbeciles, we shall have to find out whether the proper 
place for them is the school or the hospice. It will be 
necessary to find out in what measure, and at the price of 
what effort, an imbecile can be instructed to the p oint, say 
of being able to read. There are two other indications 
which may help us. Cases of acquired mental deficiency 



76 MENTALLY DEFECTIVE CHILDREN 

that is to say, cases who have become defective as the 
result of something which affected them after birth are 
usually less improvable than congenital cases, or cases 
where the deficiency is due to some cause acting before 
birth. And, secondly, cases affected by epilepsy, with fits 
or frequent attacks of vertigo, usually undergo a progressive 
mental deterioration. 

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

With regard to mental deficiency, we think it possible to 
formulate precise definitions which will enable all competent 
persons to agree as to the diagnosis of idiocy, imbecility, 
and feeble-mindedness. We are aware that in making 
this statement we are running counter to the general 
practice of medical alienists. When these, in an admission 
certificate, call a child " idiot/' " feeble-minded/' or 
" imbecile/' they are rarely in agreement with the confrere 
who, a few days later, examines the same child, and makes 
a new diagnosis. We have made a methodical comparison 
between the admission certificates filled up for the same 
children with a few days' interval by the doctors of Sainte- 
Anne, Bicetre, the Salpetriere, and Vaucluse. We have 
compared several hundreds of these certificates, and we 
think we may say without exaggeration that they looked 
as if they had been drawn by chance out of a sack. This is 
a fact which many alienists have already suspected, and 
Dr. Blin 1 has expressed himself frankly on the subject. 

1 * Les Debilites Mentales," Bev. de Psychiatric, 1902. 



PEDAGOGICAL EXAMINATION OF CHILDREN 77 

What is the cause of such contradictions ? They result 
in great measure from the use of ill-defined terms. To the 
majority of alienists, the idiot is one who is profoundly 
affected in his mental faculties, the imbecile is a little less, 
and the feeble-minded less still. What mean these words : 
" profoundly/' " a little less/' " less still " ? No one defines 
them. They are taken to be indefinable. It is no wonder 
they are understood so differently. All this trouble would 
disappear if the following definitions were adopted : 

DEFINITION OF AN IDIOT. 

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

DEFINITION OF AN IMBECILE. 

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



78 MENTALLY DEFECTIVE CHILDREN 

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



DEFINITION OF A FEEBLE-MINDED CHILD. 

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

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

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

True and False Defectives. We shall formulate a rule 
which will surely meet with no objection. It is that none 
but defectives should be admitted to schools for defectives. 

The moment we begin to apply this rule in practice, 
however, we meet with difficulties. There are normal 
children who are very backward in their studies. They 
cannot profitably follow the proper class for their age. 
Such children are numerous, and of great interest socially. 



PEDAGOGICAL EXAMINATION OF CHILDREN 79 

As they are really intelligent they can certainly be helped 
to make up for lost time. Various terms have been applied 
to them, but it will be simplest to call them " backward " 
or " ignorant/' In Belgium many such " ignorant " chil- 
dren were admitted to the first school for defectives. In 
fact, they formed the majority, and one can understand 
how easily the teachers collected them. These are the 
cases which give such grand results, and are sometimes 
exhibited as genuine defectives who have been improved by 
teaching. In France it has been agreed that the ignorant 
are not to be admitted to the classes for defectives. The 
principle is sound. But let us not confuse the questions 
by approaching them both at once. Let us consider the 
defectives first, the ignorant or backward next. Even 
when we are agreed as to the principle, we find difficulties 
in practice. In the first place, there are the doubtful 
cases, children of whom we cannot say, even after pro- 
longed examination, whether they are defective or back- 
ward. Demoor, in the return he published concerning the 
pupils of the first school for defectives at Brussels, noted a 
considerable number of these doubtful cases. 1 What 
should be done with such cases ? The best thing to do is 
to admit them to the classes for defectives, writing on their 
schedule a large mark of interrogation in order to guard 
against future deception. Again, it is not always easy to 
establish irregular or insufficient attendance when this is 
the cause of the backwardness. The child may have been 
at several schools, and at some the teaching may have been 
faulty. There are some schools which practically produce 
mediocrity. In the next place, it is necessary to discover 
the causes of defective attendance. Sometimes these 
causes are completely extrinsic to the nature of the child 
frequent removals, constant domestic disturbances, laxity 
of the parents, an infirm parent to be taken care of, etc. 

1 Annie Psychologique, vol. vii., 1901, p. 296. 



80 MENTALLY DEFECTIVE CHILDREN 

In such cases the interpretation presents no difficulty. 
But sometimes the case is more embarrassing. It may be 
a thin child, who has been out of sorts for a long time. 
Without being, properly speaking, of defective intelligence, 
he is weakly, anaemic, and consequently incapable of 
sustained attention. Would it not be advisable to admit 
such a case, at least as a temporary measure, into the class 
for defectives, until his system had recovered tone ? 
Should we not also open the door to cases retarded by 
adenoids ? And if we enter upon this work of charity, shall 
we not also accept some of those physically abnormal 
children who, affected by Little's disease or Pott's disease, 
are so little at their ease among their more robust com- 
panions ? And what, lastly, is to be done with children 
retarded in their studies by an unrecognised myopia ? 
It is evident that the question ceases to seem simple and 
easy when regarded closely. We may rigorously exclude 
from the class of defectives the child who is simply ignorant, 
but there is a whole series of complex cases intermediate 
between the ignorant and the defective. The inspector, 
let us say in anticipation, will consult his colleague the 
doctor with advantage about all these border-line cases. 
No breach of principle is involved here. It is necessary to 
be guided by circumstances. The essential point is to mark 
distinctly upon the child's schedule the special reasons for his 
admission, in order to prevent ultimate deception in the shape 
of presenting the child as an average defective who has been 
improved by tuition in the special class. 

We now come to the normal, the really normal cases. 
There can evidently be no doubt as to what is to be done 
with them. They are provided for. They have only to 
remain in the ordinary school. We hope they will be kept 
there. We hope it; we even demand it with all our power. 
But we are not certain that it will be possible to save them 
from the special schools. How many vital interests are 



PEDAGOGICAL EXAMINATION OF CHILDREN 81 

leagued against the keeping of that rule ! And interests, 
when they are not looked after, are like the millions of ship- 
worms which slowly and silently corrode the most solid 
barriers. 

In the first place, there is the interest of the parents. 
When it is a question of secondary education, of rich or 
middle-class parents, there is nothing to fear. The bour- 
geois do not love their defectives; they are ashamed of 
them. They send them to a distance, to some private 
institution. They never speak of them to anyone ; they do 
not visit them; they abandon them. But the common 
people have more heart or less prejudice. They will not 
be afraid of the special school for defectives any more than 
they are of the hospice. When they have a really defective 
child in the hospice, they never cease to visit him. We 
can imagine the results which such a state of mind will 
bring about. If these fathers and mothers of the working 
class were to hear of the existence of a boarding-school 
where children receive board, lodging, and clothing, they 
would flock to obtain admission even for their normal 
children, although it were well known that the school 
admitted only the feeble-minded, defectives, and fools. 
If necessary, they would get municipal councillors to back 
up their demands. This abuse was practised recently in 
the case of a reformatory, which was rapidly filled with 
ordinary children, whose sole characteristic was this that 
their parents had political backing. 

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

And this is not all. It is not only the parents who will 
try to deceive. Think also of the heads of the schools for 

6 



82 MENTALLY DEFECTIVE CHILDREN 

defectives. What is their interest ? Take note of it, for 
it is important. One should always try to foresee the 
results of human frailty. In every new school which is 
started one should watch that part of the organisation 
which gives most scope for charlatanism. 

The head- masters and the teachers of the defectives will 
certainly have a tendency to show off before visitors 
children who have never been mentally defective, or who 
have been so to a very slight degree. They will take good 
care to say nothing about the condition of the child on 
admission. Or, if necessary, they will tell lies pious lies, 
told in a good cause, and for the honour of the school ! 
These children will be shown off as advertisements, which 
will be just as illegitimate as if the schools for deaf-mutes 
were to present to visitors the semi-deaf-mutes, or the 
deaf who had formerly been able to hear, and to claim the 
entire credit for the facility with which these pupils could 
read the lips or pronounce words. 

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

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



PEDAGOGICAL EXAMINATION OF CHILDREN 83 

school children as an audience. Think of those libraries, 
where the staff, uneasy at the desertion of the public, pays 
a gratuity to an industrious reader for show ! 

We strongly insist that the inspectors should be alive 
to this danger. They will be seated by the side of the 
manager of the special school. Let them take note that this 
manager has a direct vital interest to admit normal 
children. It is upon the inspectors that we rely to see 
that everything is done honestly and correctly. 

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

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



PARTICULARS. 

SUPPLIED BY THE OBIGINAL SCHOOL. 



Concerning Admitted , 

to ihe special class at .... t school. 



84 MENTALLY DEFECTIVE CHILDREN 

GENERAL PARTICULARS. 
Original school: 
Full name of child: 
Date of birth: 

Standard to which he belongs : 
Is the child considered mentally defective ? 
Is the child considered ill-balanced I 

FAMILY HISTORY, 

Names of father and mother: 

Address of parents: 

Occupation of parents: 

Particulars of family which it would be useful to know : 

SCHOOL ATTENDANCE. 

How long has the child attended school f 

What standards has he passed through, and how long was 
he in each ? 

Eegularity of school attendance: How many days was he 
absent each year f 

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

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

INSTRUCTION. 

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

What do you know of his memory I 

In which subjects does he do least badly ? 

In which subjects is he weakest ? 

How many years behindhand do you consider him in school 
instruction compared with average children of the same age t 

Annex to the present sheet one of his exercise- books and 
samples of his drawing and manual work. 

CHARACTER AND DISCIPLINE. 

Conduct in class. Does the child keep his place t Is he 
sleepy, unruly, talkative t Does he laugh without apparent 
cause f Does he disturb the class t 

Application. Is he attentive in class f Does he do his exer- 
cises I Does he learn his lessons t To what extent does his 
family assist him with the school work ? 

What is his attitude towards the teacher t How does he 
leceive remarks ? Does he pay attention to them ? How 
often ? Is he indifferent ? Is he restive t 



PEDAGOGICAL EXAMINATION OP CHILDREN 85 

What are his relations with Ms companions ? Is he kind, 
docile, compliant ? Does he make himself liked 1 Is he the 
object of marked attention ? Or is he indifferent ? Does he 
keep apart from others t Is he bullying, brutal, irascible, 
untruthful, dishonest, wicked f Has he any special vices ? 



PEDAGOGY. 

What moral influences are most successful for guiding him ? 

What is the effect of punishment ? Of severity ? 

What is the effect of rewards t Of praise ? 

Do you require to take any special measures with regard to 
him in class or in the playground ? 

What are the most successful methods for advancing his 
instruction ? 

STATE OF HEALTH. 

What do you know of his state of health ? Has he incon- 
tinence of urine ? Any motor affection ? Any defect of 
speech ! Fits ! Has he been examined by a doctor, and do 
you know the doctor's opinion ! Was any medicine pre- 
scribed 1 What t 



Date Signature , 

Position . . 



All the terms of this schedule are readily intelligible to 
the teachers. They have filled up a hundred samples in a 
very satisfactory manner, and we thus have in our pos- 
session a veritable mine of valuable information. It is to 
be hoped that the teachers in the special school may enjoy 
the same advantage. The plan has been found of value in 
other countries. The bulletins which are used in Rotter- 
dam, for example, scarcely differ from ours except that 
they are more laconic. We have included in our question- 
naire all that is likely to interest not only the inspector, 
but the doctor and the psychologist. 

And now to sum up, here are the steps we advise to be 
taken in collecting the defectives : 



86 MENTALLY DEFECTIVE CHILDREN 

First. The inspector has the pupils of each age in the 
schools arranged according to the " standard " or " course " 
they are in. 

Second. By examining the tabulated results, the inspec- 
tor picks out the backward, and demands particulars 
regarding the school attendance of those who have a 
retardation of two years (when they are under nine years of 
age), and of three years (when they have passed their ninth 
birthday). In the same circular the inspector asks the 
teachers to name any of their pupils who appear to be 
mentally ill-balanced that is to say, who, according to 
the testimony of at least two teachers, are rebellious to 
discipline and an annoyance in the class. The particulars 
with regard to want of discipline should be stated in each 
case. 

Third. After examining the returns relating to school 
attendance and to the faults alleged against the children 
supposed to be wanting in balance, the inspector will make 
his first choice. 

Fourth. The direct examination of the child bears 
specially upon his state of instruction and degree of intelli- 
gence. The inspector comes to a positive decision with 
regard to each child, and asks the opinion of the doctor, as 
well as of the head of the special school, who assists. 

Fifth. The inspector has a schedule of particulars 
regarding the children finally accepted for the special school 
filled up by their teachers in the schools from which they 
came. 

The medical examination will be considered in the next 
chapter. 

Let us add, in conclusion, that all the decisions arrived 
at are to be regarded as provisional ; the children are to be 
admitted to the class for defectives on trial, to be kept under 
observation, 



CHAPTER IV 
THE MEDICAL EXAMINATION OF DEFECTIVES 

HITHERTO we have been studying the defective from the 
point of view of his school relations. This point of view is 
incomplete, and should not make us forget that there is 
another the medical. It is quite certain that in the 
organisation and the practical working of the special 
schools the doctor has a role, and an important role, to 
fill. All foreign countries recognise this, and give him a 
large place. It is even regretted in some countries that 
doctors detach themselves too much from such questions, 
and are content to make a rapid and superficial examination 
of children on their entrance to school, instead of collabor- 
ating actively in the important work of the teacher. 

After this declaration of principles, it may not be without 
interest to fix precisely the role which belongs to the doctor 
and the services which he can render. It seems to us, in 
fact, that there is often some confusion as to his attributes, 
and two opposite tendencies may be recognised. According 
to one, the more widespread, the defective are often, if not 
always, invalids, and belong to him by right. It would be 
an encroachment upon his privileges to concern oneself 
with them. The opposite opinion consists in not com- 
mitting to him any particular authority in the matter. 
This is the case in Germany, where there are schoolmasters 
who carry things with a high hand in the special schools. 
Let us add that the doctors themselves have done nothing 
to bring about an entente. Speak of defectives before them, 

87 



88 MENTALLY DEFECTIVE CHILDREN 

and they say, " That is our business/' and they are per- 
fectly right ; but having affirmed their right, they pay very 
little attention to the territory they defend. 

It seems to us that the field is sufficiently great for every- 
one to glean, and the efforts of all will not be too great to 
clear it. There are some questions which escape the doctor, 
unless he is also an educationist and a psychologist. But 
there are also some, in our opinion, for which he has special 
competence, and where no one can take his place. To 
define his role is not to lessen it ; on the contrary, it is to 
assure him an authoritative position. It is not his business 
to select the abnormal from the normal. But from the 
children picked out as abnormal he will differentiate 
certain types and prescribe certain measures with regard 
to their care and treatment. 



THE DOCTOB NOT TO PICK OUT THE DEFECTIVES FROM 
AMONGST THE CHILDREN IN SCHOOL. 

There is a general misunderstanding with regard to the 
special knowledge and aptitude of the doctor. One tends 
to credit him with a kind of omnipotence and infallibility 
against which he protests in vain. He is made to judge 
questions which do not belong to his special province 
namely, the medical, and upon which he expresses opinions 
which are neither more nor less valuable than those of any 
other intelligent person. Recently, at various congresses, 
we have seen doctors with the best intentions laying down 
educational programmes, comparing the educative value 
of science with that of letters, and expressing a variety of 
opinions, no doubt very sensible, but with which the 
medical art had nothing whatever to do. As regards the 
selection of defectives, one is influenced by the same 
prejudice. We have discussed this with many people, and 
especially with educationists, and when we have insisted 
on the difficulties of examination, they usually reply, 



MEDICAL EXAMINATION OF DEFECTIVES 89 

" That is the doctor's business." The prejudice we have 
noted is very tenacious, and will doubtless be difficult to 
overcome, for there are many people who have interests 
to maintain of a pecuniary nature. Let us consider this 
question from two points of view the estimation of 
educational retardation, and the physical examination of 
defectives. 

Estimation of the Degree of Mental Inferiority. We have 
seen how easily, in spite of the commonly accepted opinion, 
experienced teachers and inspectors accomplish this part 
of their task. If a doctor were charged with it his embar- 
rassment would be great. Just imagine a doctor introduced 
into a school of 300 children in order to pick out 
the defectives by strictly medical methods. No doubt 
every doctor, especially if he is an alienist, is called upon to 
estimate the intellectual level of children, and to sign 
certificates of idiocy, imbecility, and feeble-mindedness. 
But just consider how things are managed at the consulta- 
tion. The parents bring the child. They know very well 
that he is " not like others/' They bring him for that very 
reason, and consequently the doctor does not require to 
distinguish the child from a normal one. He only requires 
to sit and listen to the parents, who give him a crowd of 
particulars. When he questions and examines the child, 
it is only to verify what he has learned, and to add his own 
personal impression. As a general rule the case is a severe 
one; the deficiency is so evident that any sensible person 
would notice it. The task of the doctor is therefore 
narrowed. He has only to certify the mental deficiency of 
the patient, stating in technical terms the diagnosis which 
the parents have brought to him ready made. Even his 
estimation of the gravity of the case, apart from special 
investigations on his part, is not very different from that 
of ordinary people who readily distinguish between the 
idiot who cannot speak ; the imbecile, who can make himself 
understood, though he cannot be educated; and the feeble- 



90 MENTALLY DEFECTIVE CHILDREN 

minded, who can do some work, but is not able to provide 
for his wants, or to behave himself sensibly. 

When the doctor thus certifies the intellectual level of the 
patient, does he try to do so with precision ? By no means, 
for it is not expected of him. The parents do not come to 
him in order to ask him, " Is my child backward in his 
mental development ?" Alas ! they see it only too well, 
and little it matters to them whether his backwardness 
amounts to six months or a year. But they do come to 
ask, " Why does this child not make the usual progress ? 
Is there not some medicine, doctor, which can help his 
development ?" When they come to the doctor, it is not 
even with the hope that some medico -pedagogical treat- 
ment will cure their child. They know very well that the 
devoted care which they have always bestowed upon him 
from his infancy is superior to anything which can be given 
to him at a dispensary for children; but their indomitable 
hope leads them to seek chimerical measures. In all this, 
let us repeat, the doctor does not require to estimate the 
degree of mental deficiency with any delicacy. But if he 
should try to do so, what methods would he use ? 

Here is a child of nine years of age, who has been selected 
for a class for defectives because he cannot follow the usual 
lessons in the elementary school. You, however, doctor, 
put to him some of your usual questions. You ask the 
child his name, his age, the occupation and address of his 
parents; the date, day, month, year; some details about 
his life; you even ask him to read or count. The replies are 
given to you quietly and correctly. Are you going to 
refuse to admit him to the special school, and by what 
right ? You have the notes of one, of two, or of three 
teachers. He cannot follow; he is still with children of 
seven years of age, in spite of having been at school for 
three years. It is evident that he is not an idiot, nor an 
imbecile, nor even feeble-minded to any great extent. 
But you have been notified that he is behind other children 



MEDICAL EXAMINATION OF DEFECTIVES 91 

of his age. There is therefore something peculiar about 
him. It is not a medical question whether he ought to 
remain in the ordinary school. The doctor cannot go 
against the opinions which have been given to him, in 
order to verify whether the retardation is genuine. To 
do so, it would be necessary for him to make a comparison 
with the normal condition. Now this varies according to 
age. The doctor does not know exactty, to two or three 
years, the normal condition of the mental faculties; nor, 
after such and such a period of school attendance, the 
habitual level of instruction reached. That, however, in 
such special conditions, is the very problem which faces 
him. We do not hesitate to express the opinion that, in 
such circumstances, the doctor would be incapable of 
estimating the intellectual level of the child. He has no 
more experience in this matter than any other person. 
Let a doctor seek to pick out a feeble-minded child from 
a number of normal ones, and he will find how little he is 
prepared to make the selection. 

Physical Examination of Defectives. But it may be 
asked: "Is not mental debility associated with physical 
signs which the doctor alone is able to appreciate ?" 
About this question three kinds of facts may be considered : 
those pertaining to anthropometry, the stigmata of de- 
generation, and physiognomy. Let us consider in order 
what help may be derived from these. 

Height and Head Measurements. Numerous papers have 
been published upon height and cephalometry. The object 
of some has been to compare the less intelligent school 
children with those who are better endowed. Other 
authors have taken as their subject the study of asylum 
or hospital cases. The absence or paucity of results of the 
earlier studies seems to be due to a cause which we have 
referred to elsewhere (p. 39). The mistake has been 
made of judging the intelligence of the children by sole 
reference to the opinion of the teachers, although account 



92 



MENTALLY DEFECTIVE CHILDREN 



should have been taken of the relationship between the 
age and the stage of instruction. The comparison between 
the height and head measurements of the hospital cases 
and those of school children is not subject to the same risk 
of error, and striking differences between the two have 
been noticed. But there is yet another factor which must 
be taken into account if the figures so obtained are to yield 
all they are capable of teaching. If one confines oneself 
to comparing the averages of the two sets of children, one 
finds them almost identical. We have shown that the 
only suitable method to use here is the method of arranging 
the figures in series. This proceeding has suggested to one 
of us a better method still, that of "frontiers/' There is 
for each age a height limit below which the defectives 
become clearly more numerous. There are limits in the 
head diameters, upon each side of which are grouped the 
abnormally small and the hypertrophied heads, which are 
frequently associated with mental deficiency. We give 
here the table which one of us has published of the pro- 
visional frontiers for height and for the two cephalic 
diameters. 

THE FRONTIERS OF ABNORMALITY (BOYS). 



Age. 


Height. 


Antero-Posterior 
Diameter. 


Transverse 
Diameter. 


Sum of 
Diameters. 




Centimetres. 


Millimetres. 


Millimetres. 


Millimetres. 


6 


100 


164 


134 


298 


7 


105 


166 


135 




8 


110 


169 


136 


305 


9 


111 


171 


137 




10 


120 


172 


138 


310 


11 


124 


173 


139 




12 


130 


174 


140 


314 


13 


135 


176 


141 




14 


140 


178 


142 


320 


15 


142-5 


179 


143-5 




16 


154 


180 


145 


325 


17 


147-5 


181 


146 




18 


150 


182 


147 


329 



MEDICAL EXAMINATION OF DEFECTIVES 93 

What this table means is this : If we measure 100 children 
in an elementary school, we find only a small number 
(at most 10 per cent.) whose measurements are less than 
those indicated ; if, on the other hand, we measure idiots and 
imbeciles, the proportion of those whose measurements are 
inferior is greater, amounting to over 25 per cent. Amongst 
120 abnormal children we found not a single one who was 
below these frontiers in two measurements, whilst 10 per cent, 
of defectives were below. Certain measurements, therefore, 
are distinctly suggestive, although, no doubt, not absolutely 
diagnostic without reference to the subject examined. 

The Stigmata of Degeneration. Everyone has heard of 
the physical malformations which are called the stigmata 
of degeneration. Some of these are very apparent, such 
as a sixth finger on the hand, or a hare-lip, or those defor- 
mities of the head, which are called plagiocephalus 
(obliquely oval cranium), scapJiocephalus (boat-shaped 
cranium), etc. Other stigmata are less apparent, such as 
abnormal shapes of the ear, irregular growth of hair, of the 
teeth, alterations in the eye, etc. Some doctors, not all, 
have made a study of these various stigmata. But school 
directors and teachers know nothing about them except 
what the present-day widespread popularisation of medical 
knowledge has permitted them to know. Evidently it is 
no part of their business to take up the study, although 
no State diploma will prevent their doing so if it is their 
good pleasure. There is no law against it. But they would 
expose themselves to grave risks of erroneous interpreta- 
tions owing to their ignorance of the manner in which 
stigmata are produced, and the ignorance of doctors on 
this subject is still great. The determination of the stig- 
mata, their enumeration, and their description, belong, 
therefore, at any rate by preference, to the doctor. God 
save us from wanting to dispossess him ! 

But what help could their study render us in the question 
whether a particular child ought or ought not to be ad- 



94 MENTALLY DEFECTIVE CHILDREN 

mitted into a class for defectives ? There is an opinion 
which is very widespread, especially amongst teachers and 
ordinary people, a souvenir of the doctrines of Gall, that 
the physical stigmata are signs of the original character, and 
that the possessor of a certain shape of head is certainly 
defective. " I have taken my son/' a worthy mother said 
to us, " to consult Dr. P., because he was learning nothing 
in his class. He was sent away from every school I sent 
him to, and he is unbearable at home. The doctor felt all 
over his head. He evidently saw that there was something 
particular wrong with the boy/' We do not smile at 
this good mother. Plenty of other intelligent people hold 
her opinions, if they are not so naive in their language. 
They expect that the moment defective children are 
brought before them, they will find something peculiar, 
something ugly, in their physiognomy. And there are 
plenty of doctors, let us say frankly, who are equally naive, 
and, more serious still, allow themselves to be influenced by 
unconscious suggestions. If, like our worthy mother, we 
present to the doctor a child as defective, the doctor will, 
as a general rule, have no difficulty in demonstrating that 
he must be so. How many of us are there without stig- 
mata ? None of us is built upon the model of the ideal 
man. It is always possible to discover some anatomical 
detail which will give support to a preconceived opinion. 
But the same doctor who, on seeing a defective child with 
adherent ear lobes, will say that that was just what he 
expected, will abruptly change his opinion if he discovers 
a whorl of frontal hair on a child who is presented to him 
as normal, and will refuse to attach to the fact any impor- 
tance whatever. As a matter of fact, these questions have 
not yet been studied as they ought to be, by a comparison 
without parti pris between normal and abnormal children 
of the same age and in the same environment, and we do 
not yet know how stigmata should be interpreted. We 
can only suggest some provisional conclusions. 



MEDICAL EXAMINATION OF DEFECTIVES 95 

The first of these conclusions is that the presence or 
absence of a definite stigma has no exact significance for 
the individual who bears it ; for on the one hand one meets 
with all kinds of malformations in average normal children, 
and on the other hand, some who are definitely abnormal 
are quite normal in their conformation. The stigma, 
therefore, has not the value of a definitely pathognomonic 
sign like the crepitating rale of pneumonia, or the transient 
unconsciousness of epilepsy; but if we compare a group of 
normal children with a group of abnormal, the total number 
of the stigmata will be much greater in the second group; 
and, moreover, the multiplicity of stigmata in a single 
individual constitutes a strong probability that that in- 
dividual is abnormal. Here are some facts which support 
these two propositions : 

Recently we made a rapid examination of the heads of 
fifty-eight school children, and noticed that eighteen of 
them had some stigma, especially an abnormal shape of 
the ear. We therefore find stigmata amongst children at 
the average school level. But of these fifty-eight school 
children only one had four abnormalities malformed ears, 
strabismus, prognathism, and slight scaphocephaly. The 
others had a maximum of two. The first child alone is 
certainly defective. 

In a class of nine defective children subjected to a similar 
examination, we found only one who had but one stigma, 
another had two, four had three, and three had five. Of 
the three last, one had a very high degree of retardation ; 
another was mentally ill-balanced to no less a degree. 
Let us compare these two groups, the one of fifty-eight 
average children, the other of nine defectives, and group 
to group, the difference is very clear. The stigmata are 
usually more numerous when the children are mentally 
defective. The existence of stigmata is a presumption of 
deficiency, and this presumption is greater, the greater the 
number of stigmata. 



96 MENTALLY DEFECTIVE CHILDREN 

If we consider which are the stigmata that are most 
commonly met with, we find that asymmetry of the face 
is almost constant, but we also find it sometimes in normal 
children. Malformations of the ear come next. We are 
often struck by the frequency of badly defective speech 
three times in nine defectives, whilst we did not find a single 
example in the fifty-eight school children taken by chance. 

Here, then, is a " group fact " which is of interest from 
a scientific point of view. But what use can be made of it 
for individual diagnosis ? This is much more delicate, 
for even if one could state it as a general rule that defectives 
have more stigmata than the normal, this rule is subject 
to important exceptions. 

One of our abnormal cases had only one stigma, another 
had two, and in both cases the anomalies were of a very 
ordinary kind slight want of symmetry of the face and 
sticking out ears. Children with stigmata few in number, 
and little marked (though as a rule we note the presence 
of stigmata without measuring them), may therefore not 
be of normal intelligence. The same is true sometimes of 
children with no stigma at all. 

We may therefore conclude that stigmata may be taken 
into account when we are making an examination, but they 
should never be regarded as of fundamental importance in 
diagnosis. 

Physiognomy. In addition to stigmata, we have to note 
another feature which is of more definite significance. 
Methodical studies made by means of a collection of sixty 
photographs of children, normal and abnormal, photographs 
taken by M. Bertillon in conditions comparable in all cases, 
have shown us that an intelligent teacher can scarcely go 
wrong in judging physiognomy. The photographs were 
beautifully taken, and the expression of the faces appeared 
extremely lifelike to anyone who was used to observing 
children. We asked various teachers to examine these 
portraits, and to express their opinion as to the mental 



MEDICAL EXAMINATION OF DEFECTIVES 97 

capacity revealed. Mistakes were made, as was to be 
expected; but the correct estimations were always in the 
majority, and some teachers exhibited a truly remarkable 
talent for observation ; they were practically never deceived. 
Let us say in passing that our list included a number of 
doctors amongst the teachers. They were far from dis- 
tinguishing themselves. Their percentage was not so good 
as that of the schoolmasters. This difference in compe- 
tence, which perhaps may appear surprising, suggests the 
following anecdote: One day, at the meeting of a com- 
mission, we had thrown upon the cloth a collection of 
photographs of children, the very one which we had been 
using for our methodical experiments. Everyone looked 
at the portraits and expressed his opinion. By way of a 
joke we tackled a medical alienist who had a seat on the 
commission. He was mistaken in his opinion as often as 
his colleagues who were most ignorant of medicine. 

It seems to us, and the facts mentioned support us, 
that stigmata are only one part of the complicated whole 
which constitutes a physiognomy. A physiognomy in- 
cludes many other things, especially the expression, 
lively or sluggish, strong or weak, intelligent or lacking in 
intelligence; there is the fineness or coarseness of the 
features, the beauty or ugliness of the countenance, the 
ordinary or unusual appearance of the face. All this 
forms an ensemble which the eye does not analyse, but 
judges en bloc by instinct, without considering the elements 
separately, and, above all, without being able to give 
reasons for its judgment. Will it be possible some day to 
analyse, to dissociate, and to describe all these very 
various elements ? We do not know. In the meantime 
we think that every examiner, as a matter of fact, allows 
himself to be influenced by the general appearance of the 
subject, and that the impression so formed is not entirely 
without value. 

Let us sum up regarding the physiognomy. There does 

7 



98 MENTALLY DEFECTIVE CHILDREN 

exist between the intellectual level of a subject and his 
physical development a real correlation, but, unfortunately, 
it is slight. With regard to the stigmata our knowledge of 
their significance is still very slight. We have no figures 
which allow us to place any definite value upon them either 
singly or in combination. There still remains the general 
appearance, whose significance is apparently indubitable, 
but which, at present, is too dependent upon individual 
estimate to be utilisable. Let us add that these relations 
between the mental and the physical appear to be of 
greater significance the lower the mental condition. Now, 
in a school it is the feeble-minded who are in the majority, 
and it is they who have to be recognised much more fre- 
quently than the idiot or the imbecile, and this lessens the 
importance of the physical examination. We may there- 
fore conclude with this practical rule : a physical examina- 
tion can never allow us to dispense with a direct examina- 
tion of the intelligence. Anthropometry, stigmata, and 
physical appearance must take a second place as means for 
discovering in school the feeble-minded and the ill-balanced. 
Failing direct recourse to the teacher, these methods could, 
and ought, to be made use of. But in most cases, thanks 
to the assistance of the teacher, we have better means. 
In cases on the border-line they might help to incline the 
balance. Their principal use is not to assist in selecting 
children for special classes for defectives; their significance 
is quite different, as we shall see immediately. 



MEDICAL EXAMINATION OF THE CHILDREN PRESENTED. 

We must now define the active role of the doctor. In 
many foreign countries a scheme has been drawn up for 
the medical examination, which is often extremely com- 
prehensive, almost interminable. We give an example of 
this kind, though questioning the appropriateness, from 



MEDICAL EXAMINATION OF DEFECTIVES 99 

our point of view, of certain questions. If one does not 
simplify the work, the practitioners will simplify it in their 
own way by neglecting it. If you ask them to do too much, 
they will do nothing. 

SCHEME FOR MEDICAL EXAMINATION 

Heredity of the Child. Note the name, the date, and the 
place of the birth of the father and the mother, and find out, 
by direct interrogation, whether the parents have a pathological 
heredity. Consider first the two great hereditary influences 
alcoholism and insanity. Next inquire concerning nervous 
ailments, tuberculosis, etc. Make inquiries concerning the 
direct ascendents and their collaterals. Note the number of 
brothers and sisters, their illnesses, their mortality, and the 
position of the child in the family. 

Previous History of the Child. This is the second part of 
the medical examination. It includes many questions. Has 
the child had convulsions t At what age did it begin to cut 
its teeth t At what age did it begin to walk ? When did it 
show habits of cleanliness I When did it speak t What 
illnesses had it in infancy ? Has the child always appeared 
different from others, or did it only become so at some definite 
time, or, in other words, is the mental deficiency congenital or 
acquired ? 

Present Condition. Under this heading are included the 
general appearance of the subject, his attitude, the form and 
size of his head, etc. 

We have no objection on principle to medical investi- 
gations of this kind, and if a doctor desires to collect such 
information, he ought to be encouraged. We recall in 
passing that Dr. Ley, of Antwerp, who was for some time 
medical specialist to a school for defectives, has made a 
very complete study of the heredity and personal ante- 
cedents of hundreds of defective children. But before 
compelling doctors to fill up conscientiously a schedule 
containing all these questions, one should consider without 
prejudice what use the work is going to be when it is 
done. 

Let us distinguish between pure science and what is of 
immediate practical utility. No doubt one ought to give 



100 MENTALLY DEFECTIVE CHILDREN 

a warm welcome to everything which helps us to understand 
the child better; but the above observations upon his 
heredity do not bear upon the question of whether he is 
a defective, and throw only the dimmest light upon his 
character and the manner in which one should treat him. 
If he is to be counted abnormal, he must be either ill- 
balanced or of deficient intelligence. Even if he should 
have an alcoholic heredity, that would be of no importance 
if he were able to follow his class and to profit by the 
ordinary instruction. At most, the discovery of a patho- 
logical heredity might incline one in a doubtful case 
towards a diagnosis of mental deficiency; but yet one 
should be extremely cautious about permitting oneself to 
be influenced in this way, for we are ignorant to a most 
incredible degree concerning the heredity and antecedents 
of normal children, and as our ignorance in this respect 
is so complete, we are unable to say precisely what is really 
pathological in the heredity and the antecedents of those 
who are abnormal. Information of this kind, therefore, 
is not directly useful. 

What, then, are the first problems to be solved ? Let us 
consider just exactly where we are in the examination. 
Here are the children picked out by the teachers. The 
inspectors themselves have checked the selection and 
referred back some of those selected, but very few, if they 
have carefully directed the methods of choice from the 
beginning. The children presented are backward in their 
studies. Inquiries regarding their school attendance have 
shown that the retardation is not due to irregular attend- 
ance. The examination of their intelligence has confirmed 
this judgment. 

It still remains to discover whether, amongst all these 
children who are unable to follow the ordinary school 
curriculum, there do not exist some who are not, properly 
speaking, mentally deficient, but who are suffering from 
some illness. May we not find amongst them some who 



MEDICAL EXAMINATION OF DEFECTIVES 101 

require medical treatment rather than special teaching 
e.g., cretins ? And, lastly, may there not be some children 
whose mental deficiency complicates some other disease, 
such as epilepsy ? These are problems which are essen- 
tially medical, and which it is necessary to solve before 
admitting a child to a special school. Let us consider them 
in order. 

1. Is the Case one of Mental Deficiency, or of an Inter- 
current Mental Affection ? To tell the truth, there is not 
often any doubt. However, there are two circumstances 
in which doubt may arise. In the first place, an arrest in 
a child's mental development may be the expression of a 
state of depression which indicates a psychosis in the course 
of evolution, or it may be the first sign of decadence in one 
of those degenerates of whom Morel speaks, who seem to 
have " a limited mental existence." Such cases, which 
some authors describe under the name of " dementia, 
precox," require a medical regimen. 

In the second place, it is possible that the etiological 
factor is alcohol. Alcoholism in the parents is frequently 
the cause of mental deficiency. But the effects of drinking 
do not always stop there. The child itself may be made 
to drink, and consequently the doctor may sometimes 
find symptoms resulting from direct intoxication night- 
mares, or tremor of the hands. Such intoxication may be 
responsible partly, if not entirely, for the want of progress 
at school, and also for the irritable temper which the child 
shows in class. It would be necessary in such cases to 
see the parents, and to advise a different hygiene for their 
child at any rate, if they themselves cannot be persuaded 
to give up their bad habits. In this way one may be able 
to avoid sending the child to a school for defectives. It is 
apparent that even if the child were sent to such a school, 
it would be necessary to put a stop to the administration 
of alcohol. The rarity of such cases makes their exposition 
of almost theoretical interest. 



102 MENTALLY DEFECTIVE CHILDREN 

2. Would the Mental Deficiency respond to Medical 
Treatment ? Cannot the doctor prescribe something to 
cure the mental deficiency or want of balance ? Let us 
give some consideration to this question. Medicines act 
either upon the symptoms of a disease, or upon the organic 
changes which produce them, or, lastly, upon the very 
causes of such organic changes. Quinine, for example, 
has a selective action on the parasites of malaria ; mercury 
produces an undoubted effect upon syphilitic growths; 
treatment by cold baths keeps the temperature of typhoid 
fever below a certain level during the whole of the illness. 
Cannot analogous results be hoped for in mental deficiency? 
A brief resume of what we know concerning the causes of 
mental deficiency and the anatomical lesions which accom- 
pany it will determine our answer. 

The dominant etiological feature is that mental deficiency 
and want of balance depend upon hereditary conditions, 
or conditions acquired in the earliest stages of development. 
By hereditary conditions must be understood strictly those 
which result from alterations hi the germ cells of the 
parents. An intoxication alone seems capable of ex- 
ercising upon the latter a sufficiently general action to 
reach the germ cells, and by far the most frequent poison 
is alcohol. By acquired conditions must be understood 
the results of diseases of the foetus or of infancy, and 
especially the cerebral complications of the infectious 
fevers e.g., meningitis in the course of an eruptive fever. 
In all such cases, with rare exceptions to be mentioned 
immediately, by the time the mental deficiency is disco vered* 
its causes are no longer active, and consequently cannot be 
affected by medical intervention. 

The statements we have just made with regard to the 
causes of mental deficiency lead to some practical con- 
clusions. The ultimate evolution of the congenital cases 
differs from that of acquired cases, and this renders a study 
of the early history of the child important. If the develop- 



MEDICAL EXAMINATION OF DEFECTIVES 103 

ment of the child has been normal at first, and has then 
been abruptly interrupted, for example, by an attack of 
meningitis, of which we can obtain by inquiry a definite 
history, the prognosis is not good. For it is a well-recog- 
nised fact that cases of acquired mental deficiency are not 
likely to make a fresh start. If we were hesitating whether 
to send an imbecile child to an asylum or to put him in a 
class for mental defectives, a history like the above would 
lead us to give the preference to the asylum; but let us 
say once more, we do not find here an indication for treat- 
ment. 

As to the changes which are found post-mortem, these are 
nanifold and of an unalterable kind. They are as follows: 

(1) The results of the rupture of a cerebral vessel e.g., 
from asphyxia at birth or a delivery by forceps. Blood 
has been poured out into the nervous tissue. The latter 
has been destroyed over a greater or less extent, and there 
is found in its place a cyst filled with sero-sanguineous 
fluid. 

(2) The obstruction of an artery e.g., by septic throm- 
bosis has prevented the blood from reaching a part of the 
brain, with similar results to those mentioned. 

(3) In other cases are found the more or less extensive 
changes produced by meningitis or meningo-encephalitis. 
The inflammation of its envelopes has interfered with the 
brain, and consequently with its functions. 

(4) An increased secretion of cerebro -spinal fluid has led 
to a compression of the nervous system or a distension of 
its cavities, notably of the lateral ventricles of the cerebral 
hemispheres, and has led to a separation of the bones of 
the cranium, thus producing the large globular head of 
hydrocephalus. 

(5) There may be found simply defects of development 
whose causes are known (micro cephalus, or extreme small- 
ness of the cranium relatively to the face; microgyria, or 
marked thinness of the convolutions). 



104 MENTALLY DEFECTIVE CHILDREN 

(6) Lastly and this is frequently the case in the worst 
degrees of deficiency the post-mortem, and even micro- 
scopic examination of the organs may show no change 
at all. 

Let us add that the nature of the lesions just mentioned 
does not seem to have any relationship to the condition 
of the mental faculties. An anatomico-pathological group- 
ing of the cases and a grouping according to the mental 
condition, far from being parallel, are frequently decidedly 
different. On the other hand, the extent of the lesions is 
of more importance. Diffuse lesions affect the mind more 
than those which are circumscribed that is to say, limited 
to a certain part of the brain as if the mental functions 
required the co-operation of the entire cerebral cortex. 
One will often find, for example, sound judgment in the 
subject of a marked paralysis, whilst it is very rare to find 
that good intelligence co-exists with any degree of micro- 
cephalus. 

Let us emphasise the last fact we mentioned, the absence 
of any lesion. Some authorities have maintained that all 
conditions of mental deficiency and want of balance found 
in children are connected with definite diseases of which 
they are the symptoms. The question is unsettled. For 
our own part we adopt the following provisional state- 
ment: Mental deficiency and want of balance are peculiar 
mental conditions which it is often impossible to connect 
with definite pathological changes. 

Thus, we do not know of any medical treatment which is 
likely to act upon the preceding lesions when they arc 
present, and we do not think it is even possible to act upon 
them. 

An exception must, however, be made of conditions due 
to insufficient secretion of certain glands. The type of 
these is cretinism. Marked cases of this condition are easy 
to recognise. The very appearance of the children is 
sufficient for an experienced eye the stunted growth; the 



MEDICAL EXAMINATION OF DEFECTIVES 105 

rough, wrinkled skin; the swollen eyelids half -concealing 
the eyes; the prominent belly; and the mental apathy. 
One also comes across abortive cases, where the above- 
mentioned characters are less marked; the sluggishness also 
is less. These latter cases are amenable to the same treat- 
ment as the former namely, the ingestion of thyroid 
glands from the sheep. 

This treatment stimulates growth and makes the child 
more lively; but what ultimately becomes of the cases so 
treated ? The amelioration usually ceases whenever the 
treatment is dropped. But how far does this amelioration 
go ? To what extent does the child profit by it ? Lasegue 
has jocularly remarked that the average duration of an 
attack of typhoid fever (six weeks) represents the maximum 
time during which medical attention could be brought to 
bear upon a patient. One feels disposed to think he is 
right in face of the slight satisfaction one can obtain from 
the literature regarding a point of such importance. 

Other cases of mental deficiency may be due to an 
alteration in the pituitary gland. It is for the doctor to 
find out whether there are any symptoms by which mental 
deficiency of such an origin can be recognised, and whether 
it is possible to prepare a suitable substance for replacing 
the absent secretion. 

The number of cases amenable to treatment of this kind 
is, unfortunately, very limited. 1 We may even say that, 

1 For the sake of greater completeness, let us refer to a type of 
imbecile with very characteristic features namely, the Mongol. A 
little round head, chubby cheeks, rosy as if painted with rouge, oblique 
eyes, a nose broad at the base and with a tip like a little ball, skin 
slightly yellow the whole appearance of the child is such that one 
doubts his European origin, and thinks of a Chinese doll, with limbs of 
india-rubber, so great is the looseness of the joints. During his first 
year the Mongol is rather drowsy and quiet too " old-fashioned," as 
the mothers say. In the second or third year he becomes lively. 
His countenance acquires a comic and jolly expression, and his imita- 
tive instincts become curiously developed, and as a general rule he is 
very sweet - tempered. They all resemble one another, and all 
" promise much and achieve little," for they never cease to be iml>e- 



106 MENTALLY DEFECTIVE CHILDREN 

as a general rule, we did not find amongst the school 
children we examined any cases of obesity or infantilism 
such as are sometimes described of a truly remarkable 
nature. Even children who were abnormally short looked 
their age. We have still, however, to mention one last 
influence namely, poverty. Its part in the production 
of mental debility is scarcely defined. What are the exact 
effects upon intelligence of prolonged deficiency of nutri- 
tion ? How can its action be isolated from that of other 
agents, such as alcoholism, which too frequently accom- 
panies it ? The complexity of such social studies suffi- 
ciently explains their present incompleteness. Let us 
recall the results we obtained from an inquiry of this kind ; 
the children of parents in extreme poverty are retarded in 
their physical development more frequently than those 
whose parents are in easy circumstances. It is interesting 
to add that analogous inquiries with reference to intelligence 
have furnished similar results. 

Apart from the preceding cases, the best that can be 
done is to treat the symptoms. The two principal agents 
at the disposal of the doctor are the bromides and hydro- 
therapy. Unfortunately, if the bromides are undoubtedly 
efficacious in certain casee of epilepsy, that is far from 
being the case in simple want of mental balance, in which 
cases they are at best useful adjuvants. As to hydro- 
therapy, and especially cold douches, their principal in- 
dication is in certain nervous affections, where their effect 
is to enable the subject to master the emotional reactions 
which are habitually exaggerated. 

Lastly, the doctor can exert his moral influence to assist 
the educative work of the teacher in the special school. 
His less frequent intervention, the different motives of his 
advice, will often give him even more authority than the 
teacher. The suggestive effects of his intervention should 
be obtained, in our opinion, without resort to hypno- 
tism. 



MEDICAL EXAMINATION OF DEFECTIVES 107 

3. Does the Mentally Defective suffer from any Definite 
Illness ? If the illness such as we have referred to affects 
those parts of the cerebral cortex which govern the muscles 
of a limb, one will find, in addition to the mental condition, 
paralysis with atrophy and contracture. But in addition 
to such very marked cases, there exist others in which 
sensory or motor affections, although slight, may hinder the 
progress of education. 

It goes without saying that if a child does not profit 
from the school work, an examination of his sight and 
hearing should be made as a matter of course. Perhaps 
that may have been done already by the teacher himself 
by such methods as he is able to use. But this first ex- 
amination is not sufficient. The doctor must correct, as 
far as possible, the want of acuity noticed. No doubt the 
defect may not explain the mental deficiency of the child, 
but one must take care that in the school for defectives a 
pronounced myopia or catarrh of the middle ear does not 
prove an obstacle to the efforts which are to be made to 
bring about development. 

In the same way it must be considered whether the con- 
dition of the muscular system is such as to permit the manual 
work which one wants to teach the child, and whether there 
exists any paralysis or tremor which would prove an 
obstacle to work of this kind. One must consider whether 
any symptoms present are transitory, like chorea; or per- 
manent, like infantile hemiplegia ; and what kind of efforts 
may be made without risk to the health of the child. 
Such are the problems which the doctor has to solve. 

In the last place, it is necessary to take into account the 
coexistence with the mental deficiency of other affections. 

Epilepsy. Epilepsy frequently coexists with mental 
deficiency. Now, epilepsy does not always reveal itself 
by severe fits with crying, falling down, loss of conscious- 
ness, convulsions, stiffness followed by jerking of the 



108 MENTALLY DEFECTIVE CHILDREN 

Limbs, foaming at the mouth, biting of the tongue, and 
involuntary passage of urine. It is revealed also by 
symptoms of a less striking nature, which have been de- 
scribed under the name of petit mat. Such are loss of con- 
sciousness, vertigo, or simply mental perturbations. Loss 
of consciousness occurs without the tremor of a muscle, 
the child suddenly turns pale, loses consciousness for a 
moment, and then continues whatever he was doing for 
example, walking or writing. There is nothing more 
impressive to notice when the fit occurs as one is talking 
to the little patient. One sees, as it were, the passing of 
a veil. But nothing could be more fugitive, nothing could 
more easily escape the notice of anyone who was not a 
good observer. Often the parents know nothing about it. 
The attacks are so short, the consequences apparently so 
slight, that even if the parents have chanced to notice 
them, they do not always think of mentioning the fact. 
The teacher of defective children ought to be instructed 
in the characteristics of this affection. He is going to 
spend several hours daily with the children. He will have 
the best opportunities for noticing the occurrence of attacks, 
which may be rare, but which, when they occur, are very 
significant. 

Although the symptoms are a little more marked, vertigo 
also is of brief duration. To the pallor and the loss of 
consciousness of the preceding condition there is added a 
little muscular relaxation. The child totters, supports 
himself by anything in his neighbourhood, slips down in 
his seat, or drops his pen. Sometimes there is a slight spasm 
of the muscles of the face, the mouth is drawn to one side 
by slight jerks, or performs some movements of mastication 
or deglutition. And that is all no convulsions of the 
limbs, no passage of urine, scarcely an interruption to the 
work which is being done. 

Whether the doctor discovers these symptoms by in- 
terrogation of the parents, or whether the teacher some time 



MEDICAL EXAMINATION OF DEFECTIVES 109 

afterwards describes them to him with sufficient detail to 
permit of a certain diagnosis, a double gain results. In the 
first place, there is an indication for treatment; and in 
the second, the possibility of supervision. As a matter of 
fact, it too frequently happens that these symptoms, little 
dramatic as they are, reveal the existence of epilepsy, which 
will ultimately result in progressive mental decadence. 

And yet this is not all. A few days or a few hours before 
such symptoms occur, or immediately after them, or, 
lastly, according to some authorities, entirely independently 
of them, the patient may develop a peculiar condition of 
irritability, in which he will transgress against discipline, 
make insolent remarks, or even give way to violence. 
Such actions ought not to be suppressed by punishment, 
because they are of morbid origin. 

All such symptoms possess this characteristic, that they 
leave no trace on the memory of the child. He himself 
knows nothing about them, or knows them only by what 
he has heard from other people. There can now be no 
need to insist with what care inquiries must be made, 
especially of the parents. 

Are epileptics to be admitted into the special class ? On 
principle they are refused admission to the ordinary school. 
They are, however, to be found there. There are those 
whose attacks occur very rarely, or are so slight as to cause 
no disturbance. There are probably also unrecognised 
cases of epilepsy in which the symptoms occur during the 
night, or on awakening, but never in class. Only the severe 
forms are turned away. Probably the same state of affairs 
will recur in the classes for the abnormal at any rate until 
the time when provision for epileptics is more extensive 
than it is at present. It will therefore be necessary to 
recognise these cases, to supervise them with special care 
during certain kinds of manual work, and, if possible, to 
treat the nervous symptoms suitably while the patients 
are receiving instruction. 



110 MENTALLY DEFECTIVE CHILDREN 

Hysteria. Although hysteria has not the same gravity, 
it is no less advisable that cases should be tracked out. 
This neurosis is being discussed to-day as never before. 
Without setting forth at length what we think should be 
included under this term, let us point out a characteristic 
of hysteria which is commonly recognised, and which is of 
such importance that it indicates the line of treatment to 
be followed. The two principal manifestations of the 
affection, hysterical fits and the recital of lying tales, 
require for their complete development the presence of a 
public, of a gallery. Inversely, their disappearance is 
assured by isolation or apparent inattention. 

The discovery of such tendencies before entrance to the 
school will allow the doctor to forewarn the teacher, and 
point out to him the best way of dealing with such children. 

There are still three affections about which we must say 
a few words rickets, adenoid vegetations, and scrofula. 

Rickets. The chief characteristic of this condition is 
defective ossification. Instead of possessing their usual 
rigidity, the bones become curved, and multiple deformities 
result. The legs become bowed, and the knees cannot be 
brought into contact when the feet are placed together ; the 
thorax becomes constricted or gibbous, etc. In addition 
to the nutritive disturbance, which appears to be at the 
root of all these disorders, there may be, according to some 
authors, an affection of the entire system, and especially 
of the nervous centres. Unfortunately, as rickets is a 
disease of the earliest years of life, one often finds oneself 
in the presence of the sequelae which have been left, and 
which simply must be made the be; , of. 

Adenoid Vegetations. Everyone has now heard of cases 
of this kind where the appearance is so characteristic. 
The lips are always half open, the appearance is sleepy- 
looking, the respiration is difficult. If one looks at the 
throat, or if one introduces the finger into the child's mouth 



MEDICAL EXAMINATION OF DEFECTIVES 111 

in order to explore the pharynx behind the soft palate, one 
will see or feel the large tonsils or the fleshy masses which 
obstruct the posterior orifice of the nasal fossa. One 
would like to find in these vegetations the cause of the 
habitual torpor of the children, and of their want of pro- 
gress. It is true that there is a connection between mental 
backwardness and adenoids. The removal of the swellings 
by a surgical operation will make more free the respiration, 
whose obstruction prevented sustained attention, and will 
also frequently cure the deafness, which was due to an 
obstruction of the Eustachian tubes. The operation may 
therefore result in a marked amelioration of the mental 
condition as well as of the general health. If the ameliora- 
tion is sufficient, the child can be sent back to the ordinary 
school. 

Scrofula, Tuberculosis. A child with a lymphatic appear- 
ance, whose tissues are infiltrated with serum, and whose 
glands readily become enlarged, requires plenty of country 
air and a nutritious diet. If he is admitted to the special 
school, it will be advisable to attend to his health before 
subjecting him to any particular educational methods. 

The doctor, then, will notice in passing the existence of 
such conditions as rickets, adenoids, and scrofula in the 
children who are submitted to him. Affections of the 
lungs and tuberculosis of the bones will also attract his 
attention. But such affections in abnormal children have 
no other significance than in the case of children of 
average intelligence. They furnish no special indication 
regarding the admission or non-admission of the child into 
a special class. Their severity alone determines the course 
to follow with respect to their treatment. 

We shall, however, say a few words about another in- 
firmity incontinence of urine. If there is presented for a 
class for defectives a subject, eleven years of age, who cannot 
control himself in this respect, the course to follow is: 
submit the child to examination by a specialist, who will 



112 MENTALLY DEFECTIVE CHILDREN 

decide the nature of the incontinence. If it is curable, give 
the condition the necessary attention, or give instructions 
at the school for training the child properly; but if there 
is an incurable weakness of the sphincters, supply the child 
with the same kind of apparatus as is used in such cases 
by ordinary people. 

Here, then, are a number of important points upon which 
the doctor may be called to give his opinion. It is he alone 
who is able, by his special knowledge, to enlighten the 
other members of the jury. If the mental condition is 
doubtful and requires further observation, it is for him 
to point it out. One will thus avoid the mistake of placing 
in a class for defectives a lunatic, or a child poisoned by alco- 
hol, who would not find there the kind of care required. 
If the bodily condition discovered complicates or aggravates 
the mental deficiency, as adenoid vegetations may do, he 
will prescribe the proper treatment. If he suspects the 
coexistence of some neurosis, he will give directions by 
which the condition may be recognised, and consequently 
treated. The doctor therefore has to recognise the 
physical and mental ailments by which the defective may 
be affected. He makes this diagnosis for two reasons. In 
the first place, in order that mental deficiency may not bo 
confounded with conditions of illness of a different kind; 
and, secondly, in order to relieve or cure if possible co- 
existing affections which may aggravate the condition of 
the children and interfere with the work of the school. 

We shall conclude here what we have to say about the 
role of the doctor, since in this volume we are specially 
concerned with the recognition and segregation of the 
children. To discuss the role of the doctor quite fully 
would take us too far. 

The details we have given show that the part of the doctor 
with regard to defectives is quite different from that of 



MEDICAL EXAMINATION OF DEFECTIVES 113 

the teacher. It is not so much to determine the child's 
precise mental level as to diagnose the condition of his 
brain, and to discover, by analysis of all the symptoms, 
the original responsible agent. That, however, is the 
second part of the doctor's work, and is of scientific in- 
terest ; whereas the first part, which consists in diagnosing 
the ailments which co -exist with the mental deficiency, 
is of immediate practical utility. 

Let us note, in conclusion, the scientific trend of the 
present day. A large proportion of medical work is of 
scientific interest rather than of direct utility for the 
patient. A concrete example will explain our meaning. 
A severe shivering, a sudden elevation of the temperature, 
a dulness on one side of the chest, the presence in the same 
position of crepitant rales, a rusty, sticky expectoration 
such is the syndrome by which a practitioner recognises 
an attack of acute pneumonia. He knows its duration; 
he knows the relief which will be produced by the applica- 
tion of poultices. To ideas such as these may be reduced 
all that is indispensable for the doctor to know in order 
to exercise his art. The post-mortem examination of the 
hepatised lung, its increase in density, the histological 
study of the engorged air cells and bronchioles, the re- 
searches upon the pneumococcus, its culture, its vitality 
all this constitutes a search into etiology and pathogenesis, 
whose aim is quite different. 

The same distinction may be made in the medical study 
of defective children. And from this point of view the 
results which at first seem of secondary importance reappear 
in the foreground. This is the case, for example, with the 
stigmata of degeneration. It would be unreasonable to 
attribute to them an individual value, and to utilise them 
for arranging children serially in the order of their mental 
deficiency; but in the work of synthesis they are decidedly 
significant, since their study leads one to consider them 
either as the effects of, and therefore as witnesses to, altera- 

8 



114 MENTALLY DEFECTIVE CHILDREN 

tions in the nervous system, or as the consequences of causes 
sufficiently powerful to have modified that system. 

One would not deny all practical bearing to such in- 
vestigations of pathogenesis. It is a mistake of Tolstoy 
to regard them as the pastime of refined dilettantes. When 
the biological study of defectives leads to this idea, that 
the mental weakness of the defectives, like the peculiarities 
in the character of the ill-balanced, is the result of degenera- 
tion the result, for instance, of the alcoholisation of a 
people it will quickly result in measures of social hygiene. 

The point is, however, that this second part of the work 
cannot, in our opinion, be carried out under the same con- 
ditions as the first. One would like to believe that, in 
making observations upon heredity and stigmata, the 
doctors are collecting, in their daily work, materials for 
a great scientific work which will be produced by degrees. 
No doubt all their schedules may some day be extracted 
from the drawers in the office where they will sleep for a 
long time; but with what object will they be taken out, 
if not to compile statistics of doubtful value ? The truth 
is that scientific investigation cannot be carried on auto- 
matically and collectively. There is always a personal 
element which is independent of all administrative pre- 
scription. What use can be made of observations which 
are often merely a collection of paper ? If we are some 
day to understand the role of heredity, of alcoholism, of 
insanity, of poverty, in the production of defective children, 
it will be necessary for someone, who wants to do a really 
good piece of work, to set aside all these equivocal docu- 
ments, and go straight to the facts, collecting his informa- 
tion at first hand and in a critical spirit. Scientific work 
can be done in no other way. When it is done otherwise 
it is worth nothing. 

We therefore suggest the following schedule for the 
medical examination of defective children. The schedule 
includes two parts one part optional, because it is only 



MEDICAL EXAMINATION OF DEFECTIVES 115 

of indirect interest; another part which is obligatory. 
None of the questions in this part should be left un- 
answered, and the doctor will also give the instructions 
which he thinks ought to be followed. 

MEDICAL SCHEDULE. 

Date of examination : Height : 

Name and date of birth of child : Weight j 

Part I. Obligatory. 

(i.) Has the child any mental symptoms other than mental 
deficiency 1 Signs of alcoholism, etc. ? 

(ii.) Is there reason to think the child has any weakness, 
congenital or acquired t Cretinism ? 

(iii.) Are there any (a) Sensory defects sight ? 

hearing f 
(6) Motor defects paralysis ? 

tremor, etc. ? 

(iv.) Is the child epileptic ? What symptoms are present 
convulsions, vertigo, loss of consciousness 1 ? Their frequency, etc. ? 
(v.) Has the child adenoids ? 
(vi.) Is the child hysterical ? 
(vii.) Any other ailments ? 
(viii.) What directions are to be given to the schoolmaster ! 

Part n. Optional. 

A. Cephalometry and stigmata of degeneration. 

B. History: Birth. 

Convulsions. 

Age at commencement of dentition. 

, control of bladder 

,, and bowel. 

walking. 

, speech. 

Infantile diseases. 

C. Heredity. 

Father Brothers and Sisters- 
Name : Number : 
Date of birth : Age : 
Place of birth : Mortality : 



( syphilis. Health of survivors : 

< alco 



Illnesses < alcoholism. Etc. 

( insanity. 
Mother: Ibid. 



116 MENTALLY DEFECTIVE CHILDREN 

To sum up, we do not think that the doctor will often 
have to reject a child, but he will often furnish indications 
which will help to direct the efforts of the teacher. He will 
proclaim the opinion, at once so just and so humane, that 
the symptoms of mental deficiency and want of balance 
in abnormal children do not arise from laziness or naughti- 
ness, but require no methods of treatment except such as 
are likely to relieve them. And this conviction which 
animates him he will impress little by little on the teacher. 
He will accustom the latter not to regard a defective child 
at fault like a normal, responsible child, whom he is some- 
times tempted to punish in anger, but rather as a patient 
whose faults should be overcome by persevering patience. 



CHAPTER V 

THE EDUCATIONAL AND SOCIAL RETURN OF SCHOOLS 
AND CLASSES FOR DEFECTIVES 

An Inquiry in the Hospitals. Two years ago one of us 
betook himself to M. X., an important official in one of 
our ministries, in order to ask him to join a Ministerial 
Commission which was going to pay a visit to one of our 
asylum-schools. M. X. shrugged his shoulders, and replied 
energetically: " No, no, no ! I have had enough of such 
visits. I will go neither to the Salpetriere nor to Bicetre. 
What would I see there ? An idiot who allows his saliva 
to collect in his open mouth; another who has epileptic 
fits; a third who can say nothing but * Ba, ba !' What 
would that prove ? The only way in which one can find 
out whether a school for bad cases of mental deficiency is 
good for anything, is to find out the mental condition of 
those who leave. How many defective subjects are there 
who, after having been treated at the Salpetriere or at 
Bicetre, are able to gain their own livelihood ? That is 
what one would like to know, and that is what no one ever 
tells us 1" 

The listener to these incisive and sensible remarks replied, 
after a moment's reflection: "I entirely agree with you. 
The information which you desire is of the greatest im- 
portance for judging the value of a school. I imagine that 
such information would be difficult to obtain. But one 
can try. I am willing to make the attempt." 

A few days later the two authors of the present work 

117 



118 MENTALLY DEFECTIVE CHILDREN 

took the field. The long preliminary conversations which 
they had had together about this subject had convinced 
them that they would encounter opposition. But they 
decided to treat the question as one treats a scientific 
matter with perseverance, with courage, and without 
parti pris of any kind. 

Let us subdivide the question to make it more plain. 
We proposed to discover the value of a school. To make 
such an inquiry really complete, it would be necessary to 
consider the question from two points of view the one 
educational, the other social. 

The educational return consists in the degree of instruc- 
tion which the institution succeeds in giving to its pupils, 
after so much time, and with so much expense. In the 
case of an institution for the sick, the return will take the 
medical form of a cure or improvement of health. In order 
to estimate such various returns, it would evidently be 
necessary to be in possession of various data: (1) A know- 
ledge of the state of instruction or the state of health of 
the subjects on their admission to the school; (2) a know- 
ledge of their state of instruction or of health on leaving, 
so that one would be able to estimate by comparison what 
they owe to the school ; (3) a knowledge of the cost for each 
pupil, whether for instruction or for medical expenses. 

The social return consists in the place taken by the pupils 
in society. This depends in part, it is clear, upon the 
educational return, but only in part. One could imagine 
a school, and there are some of the kind, which only cares 
about producing graduates, without thinking of what will 
become of them in life, even if they go to the dogs. Every 
class, every school, for defectives ought to aim at rendering 
its pupils socially useful. It is not a question of enriching 
their minds, but of giving them the means of working for 
their living. This is an important question. Upon this 
depends our complete and final judgment of the utility of 
special education. 



UTILITY OF SPECIAL SCHOOLS 119 

And be it understood this is not a simple question. 
Nothing is simple in the sphere of sociological phenomena, 
and one cannot get hold of an atom of truth except by 
inquiries bristling with difficulties of all kinds inquiries 
whose rules, moreover, are not yet known, but which will 
certainly be known some day. It is quite necessary. 

In order to discover the social return of an institution, 
school, or hospital, there are many data to be brought 
together. Here are some of them. What is the number 
of those who are ultimately able to look after themselves ? 
For how long a time are they able to do so ? To what 
extent have they been assisted by what they acquired at 
school ? And, lastly, what becomes of the failures ? 

But whatever the social or educational return may be, 
it would be most important to know what would have 
become of similar cases who had received no such instruc- 
tion, or, rather, who had been instructed or treated by 
different methods. 

A single example will show the importance of these 
reservations. Recently an alienist wanted to prove that 
all the idiots, without exception, who had been treated 
in his asylum had been improved. He published copious 
notes upon these children, which had been taken during 
several years by different people the physician, resident 
doctor, attendant, teacher, etc. On reading these observa- 
tions one learned that one child, who on admission was 
unable to walk, by-and-by began to do so. He had grown ; 
he had also begun to speak, etc. In all this there was 
nothing surprising, and we imagine that, in spite of his 
optimism, the doctor, who is the author of these observa- 
tions, would not pretend to credit an increase in size to 
his medico -pedagogical treatment. As to the rest of the 
development of the faculties we know nothing. It is 
possible that an idiot who has ceased to be dirty, or who 
has learned to dress himself, would have done so in any 
case without object-lessons. It would be necessary to 



120 MENTALLY DEFECTIVE CHILDREN 

understand the natural development of idiocy in order to 
estimate exactly the service which had been rendered by 
the medico -pedagogical treatment. Otherwise sceptics will 
suspect that three-quarters of what is claimed to be the 
result of treatment is really due to nature. 

After these preliminaries, let us now turn to our inquiry. 

At the Salpetriere. Here we were received most kindly. 
The superintendent of the hospital introduced us to a most 
excellent woman, Mme. Meusy, who was at that time 
head- mistress of the school for defectives at the Salpetriere 
This is a little school with about 140 girl pupils. It is part 
of the clinique of Dr. Voisin. The school is divided into 
four classes, each of which is under a lady teacher. It is 
a modest school, and, we think, little known. Elementary 
education is given there, and, be it understood, the teachers 
make a point of object-lessons and the training of the 
senses. But this education has no original feature. It 
simply follows what is done elsewhere. There is a work- 
shop where the patients skilfully manufacture artificial 
flowers. Dr. Voisin has for a long time been asking for a 
laundry, for the sake of the patients who require physical 
exercise, but he has not been able to get it. 

Mme. Meusy had prepared us to some extent for the 
work which she had done in the school by intelligent 
organisation. It was a pleasure to us to see with our own 
eyes the notes she had kept regarding each of her pupils. 
All the schedules were in perfect order, regularly filled up 
to the day. They contained all the medical information, 
as to diagnosis and treatment, which Mme. Meusy had 
been able to procure from the doctor by reiterated requests. 
They contained also full particulars as to the state of in- 
struction of the child, her character, her aptitudes, and 
the amount of her school attendance. Such notes were 
repeated periodically, so that it was easy to find out approxi- 
mately whether or not the child had progressed during her 
stay in the school. Finally, her history after discharge 



UTILITY OF SPECIAL SCHOOLS 121 

was noted. It is only just that we should here express 
once more to Mme. Meusy how much we admired the care, 
the order, and the intelligence with which she had kept 
these individual histories. It is an example to be fol- 
lowed. 

Mme. Meusy readily placed before us one after another 
all these documents, and allowed us to extract from them 
the notes which seemed of most value for our work. 
While one of us was taking the notes, she contributed 
much valuable information in a lively voice ; for she knew 
her pupils admirably, she followed them after they left 
school, and often received visits from them. But, although 
she clearly understood the importance of our inquiry, she 
could not keep to herself a distressing thought, which was 
that a large number of these unfortunate girls had obtained 
no benefit from the instruction received at the school 
during a long series of years. The majority, on leaving 
school, had been transferred to asylums for adults. It 
saddened her to acknowledge such impotence officially. 
However, neither she nor her devoted staff of teachers 
was responsible, for if their educational success was 
restricted, that was due to the fact that the administration 
had for some time been sending her the epileptic defectives, 
while reserving for the Fondation Vallee the privilege of 
having the non-epileptic defectives. Now, everyone knows 
that when epilepsy, with repeated fits, is present, it pro- 
duces a mental decadence against which the best teacher 
is powerless. 

The information which we have collected about the work 
of the school of the Salpetriere bears upon 117 children, who 
had left the school during the period of four years. Now, 
this is how these children are distributed, if they are classi- 
fied according to their condition on leaving : 

1. Children who had improved. Some of these had 
returned to their families; they lived at home, and were 
employed, more or less, and the directress states that they 



122 MENTALLY DEFECTIVE CHILDREN 

had improved in their mental condition. These numbered 
eight. Others had become capable of following a calling, 
either in the asylum as attendants, or outside as seam- 
stresses, ironers, laundresses, domestic servants, etc. These 
numbered twelve. (None was employed in making artificial 
flowers, for which there was a workshop in the school.) 
The total number who had improved, therefore, was twenty. 

2. Doubtful cases children who had returned to theii 
families, but concerning whose mental state and employ- 
ment precise information was lacking. These numbered 
twenty. 

3. Those who had got worse. These are the cases who 
had been marked " transferred/' They are to be found 
in the lunatic asylums, where they are destined to pass 
the rest of their existence. Of these there is a formidable 
number namely, sixty. 

4. Those who had died, of whom there were seventeen. 
From all these calculations we obtained a figure to 

remember, and also an opinion. 

The figure is that the school for defectives at the Salpe- 
triere returns to active life 12 per cent, of its pupils. 

The opinion is what one might have known in advance, 
that in the majority of these cases the education given was 
a waste of effort, for none of the pupils who had acquired a 
calling had been affected by the worst degree of mental 
deficiency, idiocy, or imbecility. Moreover, none of these 
was epileptic as well as mentally defective. In other words, 
the two worst degrees of mental deficiency do not permit 
any hope that the child will be made capable of following 
any calling; and even a lesser degree of deficiency that 
is to say, feeble-mindedness is equally cut off from hope 
when the feeble-mindedness is complicated by epilepsy. 

Before drawing from this first inquiry any practical con- 
clusions, we should like to reach a comprehensive view of 
the question. We shall give our conclusions after we have 
synthetised all our results. 



UTILITY OF SPECIAL SCHOOLS 123 

After the Salpetriere, Bicetre. 

BicStre. The reader would be wrong to imagine that 
in these visits to the hospitals we are forgetting the school 
cases of mental deficiency; we are at the heart of the 
question. Whether we are dealing with hospital cases or 
school cases, there are details of organisation which are the 
same for all, and there are similar mistakes which we must 
try to avoid. 

The asylum-school of Bicetre, which owes its origin, in 
1892, to the General Council of the Seine, and its organisa- 
tion to Dr. Bourneville, has a world-wide reputation. 
Dr. Bourneville has set himself to demonstrate, by every 
possible means, that idiots can be improved if they are 
treated methodically and progressively. It is thanks to his 
initiative that the medico-pedagogical treatment of idiocy, 
a treatment which has been much vaunted by the doctors, 
is now known everywhere. His clinique has constantly 
been cited as a model. This model has been imitated in 
France and more especially abroad. The asylums of 
Saint-Yon, of La Roche-sur-Yon, of Clermont, of Sainte- 
Gemme, and of Auxerre, have been inspired by the example 
of Bicetre, and have followed its methods. The State 
supports 440 boys in the asylum-school of Bicetre, and 
230 girls at the Fondation Vallee. 

We have no intention of describing here at length the 
organisation of these establishments. All who are interested 
may join in the Saturday morning visits, when Dr. Bourne- 
ville goes round the whole of his clinique. We shall content 
ourselves by saying that the children in the asylum-school 
of Bicetre are divided into three groups : 

1. The group of invalids children who are idiotic, dirty, 
epileptic, demented. In this group are those who are 
regarded as incurable, and some who, although completely 
idiotic, are capable of some slight improvement. By 
means of a swing or see-saw their limbs are strengthened, by 
means of a go-cart they are taught to walk, and by means 



124 MENTALLY DEFECTIVE CHILDREN 

of the parallel bars they are taught to keep themselves 
upright. 

2. The healthy children of the little school, all of whom 
are able to walk alone. These undergo treatment for un- 
cleanly habits. Special chairs are kept for the dirty, who 
are placed at stated times upon conveniences in order to 
regularise their functions. Then come strengthening exer- 
cises, which are gymnastics of a very simple kind; toilet 
lessons to teach them to wash themselves; table lessons , to 
teach them to feed themselves, with spoon, fork, and even 
knife ; the training of the senses ; and, lastly, training in 
speech. 

3. The third group includes children in the big school. 
These are less defective than the preceding. They are fit 
and healthy. But, on the other hand, there are found here 
a great many abnormal children (perverse and ill-balanced) 
who are not wanting in intelligence. The big school 
includes four classes, each under the charge of a professor. 
The education, especially in the last class, is carried pretty 
far, and many of the pupils possess their certificate of 
study. 

For reasons upon which we will not insist, we were not 
so delighted with the hospital of Bicetre as we had been 
with the Salpetriere. We might have dispensed with this 
visit. The medical superintendent of the school for de- 
fectives at Bicetre has taken the trouble for a long time to 
publish regularly every year a volume of several hundred 
pages, which contains the most diverse statistical informa- 
tion about everything that goes on. We have studied the 
volumes bearing upon four years only the years 1899, 1901, 
1902, and 1903. Moreover, we profess that we have some 
knowledge of the school at Bicetre, having not only joined 
several times in the Saturday visits, but having on several 
occasions carried on there researches in cephalometry; 
and, in the last place, we have had the pleasure of following 
in their inspection two members of the ministerial com 



UTILITY OF SPECIAL SCHOOLS 125 

mission, who had had the idea of finding out how the 
teachers in the big school were fulfilling their functions. 

It will be remembered that we made a distinction be- 
tween the educational and the social return. This dis- 
tinction is not recognised by everyone, and many good 
people take into account only the social return. There 
are those who would judge the school of Bieetre by one 
thing only the number of patients who are made useful 
to society. This is a question of great interest, but it is 
wrong to think that it is the only one to be considered. 
It would be unjust to confine oneself to it. The injustice 
can be understood by supposing that one is considering an 
institution which receives idiots only. Would one judge 
such an institution by asking how many of its patients 
become capable of winning their livelihood ? Certainly 
not. It is possible to be of real service to the patients 
without raising them to such a level. The cure of dirty 
habits, for example, is not a thing to be disdained. Not 
only does it result in an economy of linen and washing, 
but it makes the patient less disgusting, less difficult to 
take care of. Here we have material and moral improve- 
ment which, even for those who consider expense only, 
cannot be considered negligible, for in the end the result 
is pecuniary economy. But, having stated this principle, 
it would be necessary to find out what is the value, what 
is the duration, what is the frequency of such improve- 
ments. It would be necessary to know what is their cost, 
and to compare the cost with the results in order to find 
out where one was. This kind of stock-taking, both 
financial and medical, has no place in the publications of 
the Bicetre, and cannot be replaced by isolated observa- 
tions on the treatment and improvement of idiot children. 
There is here, therefore, a first lacuna. We note also with 
regret the absence of any inspection of the teachers in the 
schools, who are left to themselves without any super 
vision but that of the doctor. Now, the doctor is not 



126 MENTALLY DEFECTIVE CHILDREN 

usually an educationist, and it is to be regretted that he 
does not himself recognise his incompetency in pedagogy, 
but that, on the contrary, his nature, often prone to take 
offence, will not submit to any collaboration in his work. 
Having said this, we are going to confine ourselves to the 
social return of the school of Bicetre, since it is affirmed 
that such a return exists. 

We would like to know exactly how many boys and 
girls have been able, after their discharge, to work at a 
trade and to maintain themselves. Upon this point of 
capital importance the publications of Bicetre tell us 
nothing absolutely nothing. It is, therefore, impossible 
to find out the real value of this institution, so richly en- 
dowed, where the visitor perambulates palatial buildings, 
is saluted by a fanfare, and admires museums of natural 
history which would be the envy of many a public educa- 
tional establishment. The publications give a number 
of particulars as to the number of dancing lessons, the 
walks to the Jar din d'Acclimatation, and the cost of 
laundry, etc. ; but we are left in entire ignorance as to what 
all this is good for, and what is the practical tangible benefit 
which society receives from it. 

Everyone knows, however, that the director of the 
school for defectives at Bicetre is an enlightened philan- 
thropist, who has devoted himself with remarkable zeal 
and activity to procuring for his old pupils situations which 
they are capable of filling. He has understood, and was 
one of the first to do so, that the question of the education 
of defectives will never be settled until one has settled that 
of the social usefulness of these children. 

We have even learned indirectly that he has made many 
endeavours to induce employers to engage his defectives 
as workmen; but it is likely that these suggestions have 
not met with the success they deserved, for the employers, 
threatened by the new law regarding accidents at work, 
hesitate to saddle themselves with workers who, being 



UTILITY OF SPECIAL SCHOOLS 127 

liable to attacks of epilepsy, or affected by motor inability, 
would lay upon them a very heavy responsibility. On 
the other hand, the school education has had a good deal 
of success since it has happened, as we have already 
remarked, that several of the pupils obtained their certifi- 
cates of study. 1 But the only publications which we have 
consulted say no more about these certificates of study 
than about the trades followed by the defectives after 
leaving school. This silence is very significant. In spite 
of oneself, one puts a bad interpretation upon it. One has 
an irresistible tendency to believe, not that all the effort 
at Bicetre has been in vain, but that it has been dispro- 
portionate in relation to the result achieved. 

We have no difficulty in admitting that idiots have been 
improved, but to what an extent this amelioration loses 
in importance if the majority of these idiots are destined 
to pass the rest of their life in an asylum, where they will 
be nourished in absolute idleness, and where, consequently, 
the heedless administration will gain nothing for what 
has been taught them at the price of such great efforts ! 

Let us try, however, to interpret the silence of the text. 
In four years 240 boys have left the school at Bicetre. In 
studying the school of the Salpetriere we distinguished 
three classes of children the improved, the stationary or 
doubtful, and those who have got worse. We have con- 
sulted the statistical tables of Bicetre, and we have not 
found a single one marked worse, although one-third of 
the entire contingent are epileptic. Now, this is very sur- 
prising, since we know that epilepsy with repeated fits 
inexorably results in mental decadence. It is an enigma, 
which we explain in the following manner: Those who are 
really decadent have been marked stationary by medical 

1 In trying to explain this success, one must, no doubt, take 
into account the comparatively advanced age of the children, the 
probable leniency of the examiners, and, above all, the fact that the 
ill-balanced subject is a moral rather than a mental defective. 



128 MENTALLY DEFECTIVE CHILDREN 

or pedagogical optimism. If our interpretation is correct, 
it recoils forcibly upon the expression improved, which is 
applied frequently to those discharged. To the interpreta- 
tion of this word improved we are, therefore, obliged to turn 
our attention. 

What, then, must be understood by improved when this 
word is found in the publications of Bicetre ? First of all 
we must subtract a certain number of subjects who have 
been marked transferred. We know what is meant by this 
little word transferred when it is applied to the children. 
It is lugubrious. It amounts to a sentence for life. A 
subject transferred is one who, his time at school come to 
an end, is removed to an asylum for the insane, where, in 
all probability, he will stay to the end of his useless exist- 
ence. If we eliminate the transferred, and if we keep 
amongst the improved only those who, having been so 
designated, have returned to their families, we get a pro- 
portion of 58 in 290 that is, 20 per cent, of boys. 

This proportion seems to us too large, on account of the 
optimism which these documents exhibit. It is to be 
noticed, however, that children are sometimes marked very 
much improved, or notably improved. If, for the sake of 
prudence, we consider as improved only those who are 
designated in this way, we have only eighteen, or 7 per cent. 

This new proportion, if small in absolute value, still seems 
to us an exaggeration, because it is reached only by in- 
cluding a certain number of children affected with epilepsy. 
It must, therefore, be believed that their epilepsy has im- 
proved. But the amelioration or cure of epilepsy is not 
a matter of education; it cannot be considered as a success 
to be credited to active medico-pedagogical treatment. Let 
us therefore put the cured epileptics aside. There will then 
remain only seven who have undergone a notable ameliora- 
tion and have returned to their families. What percentage 
is this ? The total contingent upon which we have been 
making our calculations numbered 290, but it is right to 



UTILITY OF SPECIAL SCHOOLS 120 

exclude all the epileptics, for the reasons we have men- 
tioned. This brings the number down to 216, and the 
number of children really improved, calculated upon 216, 
amounts, for the boys, to from 3 to 4 per cent. 

By similar calculations, into the details of which we will 
not enter, we have shown that the improved amongst the 
girls are more numerous namely, 20 per cent. But 
Vallee contains relatively far fewer epileptics than Bicetre. 
We do not know, also, how many of them have become 
capable of working at a trade. 

We therefore conclude with the following propositions: 

1. At the school of the Salpetriere, 20 per cent, of defective 
girls improved, and 12 per cent, are able to work at a trade. 

2. At the Fondation Vallee, also, 20 per cent, of defective 
girls have improved. No return has been furnished as to their 
future employment. 

3. In tJie case of Bicetre, the number of defective boys im- 
proved is from 3 to 4 per cent. It is not known how many 
of these defectives are employed after leaving school. 

Some Conclusions. It seldom happens that one finishes 
an inquiry without experiencing some disappointment. 
One starts with great ambitions, intending to make every- 
thing plain, but on the way one is forced to lower one's 
flag. The truth escapes one. Sometimes it is the facts 
which conceal it from us, sometimes it is man who has an 
interest in concealing it. But the disappointment which 
has attended our inquiry would surpass the foresight of the 
most sceptical. On the other hand, if the school for defec- 
tives at the Salpetriere has enabled us to collect valuable 
information, we owe this good fortune entirely to the 
intelligent initiative of a woman. It was the directress of 
the school who, apart from all intervention, medical or 
other, had had the idea of instituting these very complete 
schedules, which enabled us to discover the economic return 
of her school. The management deserved none of the 

9 



130 MENTALLY DEFECTIVE CHILDREN 

credit. As to the school of Bicetre, we have studied it 
only through its annual publications, and we have man- 
aged with great difficulty to obtain only an infinitesimal 
amount of information of very doubtful value. 

What lessons are we to draw from these examples as 
to the future organisation of our schools for defectives ? 
We had hoped that the study of these institutions would 
have provided us with ready-made experience as to the 
measures to be taken for founding schools for defectives 
under good conditions. The contrary has happened. The 
example of these institutions has taught us one thing the 
faults which we ought not to repeat. 

Every impartial mind ought to be with us when we ex- 
press the view that henceforth the activities of the schools 
and hospices should be made plain by precise information. 
For this it would be necessary to take the following 
measures : 

1. That the definition of the grades of mental deficiency 
should not vary from one doctor to another, but that one 
should know what is meant by the word idiot, the word 
imbecile, and the word feeble-minded. A purely conven- 
tional but precise definition would be infinitely better than 
the present want of any; and we refer to the convention 
which we have suggested above. 

2. That upon entrance and leaving, the mental con 
dition and the state of instruction of the pupils should be 
precisely noted, so that by comparison of such notes, 
rather than by arbitrary estimates, one should be able to 
determine in what way the pupils have changed during 
their stay in school. 

3. That on leaving the institution, the children, whether 
they return to ordinary life or are transferred to asylums 
for the insane, should be followed up, and that particulars 
regarding their condition should be transmitted to, and 
centralised in, the office of the school, so that the masters 
may be able to judge the ulterior destiny of these children 



UTILITY OF SPECIAL SCHOOLS 131 

whom they have surrounded with so much solicitude during 
a period which often amounts to twelve or even fifteen years. 

By such organisation one would at last know exactly, 
or at any rate approximately, what are the services ren- 
dered by such an institution. One would compare these 
services with the expenses, and one would see whether the 
receipts were sufficient to justify the expenditure, or 
whether, on the contrary, the money had been foolishly 
squandered, as we have reason to fear may be the case. 
We would also see upon what children educational effort 
should be directed, in order to obtain the maximum return. 
It would be possible to find out, for example, whether it is 
worth while continuing for five years, eight years, or more, 
to give lessons in reading to a child who, after two years, 
is still unable to spell. We will also consider very seriously 
whether a child who is unfortunately subject to repeated 
attacks of epilepsy, which no medical treatment has im- 
proved, and who is destined to descend progressively and 
inevitably through all stages of mental decadence, should 
be kept in his place in a class ; and whether the teachers 
would not be doing better to leave the child at peace than 
to teach him laboriously the rules of arithmetic and gram- 
mar, which will certainly be forgotten soon afterwards in the 
cloud which will obscure the intelligence. 

One day, when we were walking through a residential 
school, we were struck by the spectacle of a poor epileptic. 
This was a little girl of about fifteen years of age. She was 
wearing her school apron, and upon her head was the little 
osier cap which epileptics are made to wear, to avoid the 
danger of falls upon the head. It was lesson-time. Pale 
and thin, the little patient was sitting quietly in her place, 
listening to the lesson of her mistress, who was explaining 
the rule of the agreement of the participle. Did she 
understand ? We hope so, since she belonged to one of 
the higher classes the second, if we remember rightly. In 
any case, she was making a great effort to follow the gram- 



132 MENTALLY DEFECTIVE CHILDREN 

matical explanation, and her forehead was thrown into 
wrinkles. All at once she gave a slight sigh, slipped down 
in her seat, and fell. The attendant took her in her arms 
and carried her into a corner of the room. The lesson 
continued with general indifference. The children pay 
little attention to such accidents, because they are so used 
to them. Now one, now another, has her attack of 
epilepsy. After a few minutes our little scholar came to 
herself. She appeared quite dazed. The attendant spoke 
to her with kind indifference. " Come, now, that is better. 
It is nothing. It is all over/' The child did not reply, 
but docilely allowed herself to be led to her seat. She took 
up her former position, appearing to listen vaguely; and on 
her pinched face, with its drawn features, the lesson in 
grammar continued to fall. The people, visitors and pro- 
fessors, who were present at that scene, and thought it 
quite natural, surely did not understand the heart-break 
of it. Some time afterwards we made inquiries about this 
pupil, being curious to know how she was, and what she 
was doing. We were told: " She is a poor little thing, who 
has forgotten a great deal. Formerly she was a bright 
child. Now she is going back every day. By-and-by she 
will no longer be able to read. This is nearly always the 
way with our epileptics \" 

This sad story, which we have just recalled, we give as a 
striking illustration of our statistical calculations regard- 
ing the ultimate fate of these institution cases. Be it 
remembered, we had reached this very important con- 
clusion : that epileptics, whether feeble-minded, or imbecile, 
or idiotic, never become capable of working at a trade. 
This somewhat vague conclusion it would be of great in- 
terest to examine more closely. Our little epileptic, who 
is gradually falling back, is an example. She has already 
reached the height of her development ; she is fifteen years 
of age, and she is beginning to decline. We foresee the 
time when she will no longer know how to read. Is there, 



UTILITY OF SPECIAL SCHOOLS 133 

then, any use in wearying the poor thing by teaching her 
an abstract grammar rule ? 

Let us turn now to our school cases. Our conclusions 
may be divined. We expressly demand that the utility 
of the schools shall be rigorously established, and that the 
teachers and inspectors shall be bound to take exact notes 
of the mental condition and the state of instruction of the 
pupils on entrance and on leaving. In this way one will 
act like any good shopkeeper, who considers it one of his 
chief duties to keep accounts of what he is doing. His system 
of book-keeping shows his position in a way which is indis- 
pensable if he is not to lose his money. He knows at what 
price he buys, at what price and under what conditions he 
sells, and whether, in consequence, his profits are sufficient 
to encourage him to continue to deal in such and such articles. 

In the same way, in a well-managed school for defec- 
tives, it is necessary to know the exact details concerning 
the condition of the pupils on entrance and on leaving, 
in order that one may be able to judge the services 
rendered by the school; in order that one may be able 
to find out whether the educational methods employed 
are good, bad, or indifferent; whether they are better 
than those of another school, where different methods 
are followed, and so on. Such control is equally neces- 
sary in order to find out whether a particular category 
of children gives greater degrees of success than another; 
whether certain degrees of mental deficiency are capable of 
improvement only to an infinitesimal extent. Such things 
cannot be known in advance, and should not be decided 
lightly in credence of an a priori opinion, but should be 
determined by accurate scientific methods, in the interest 
of the schools, in the interest of the pupils, and also in the 
interest of the tax-payers, who bear the cost. It will not 
do to content oneself with admiring in abstracto the good- 
ness of the methods and the progress of the pupils, but it 



134 MENTALLY DEFECTIVE CHILDREN 

must ever be remembered that the aim of the schools 
should be to fit the defectives to take a useful place in 
society. The school should not aim at turning out brilliant 
pupils, stars in competition, but individuals capable of 
looking after themselves and gaining their own livelihood. 
This should be the constant pre-occupation of the teachers. 
They should not shut themselves up within the four walls 
of their school, saying, " The life outside is no concern of 
ours." It is their imperative duty to consider the school 
life as a preparation for life outside. They ought, therefore, 
to pay attention to the needs of the immediate school 
environment, in order to know what are the industries 
which require workers, to take account of which of them 
are accessible to defectives, and to direct their education 
accordingly. Domestic service in the country, for example, 
which requires but little initiative, would seem to be an 
excellent refuge for feeble-minded girls with good in- 
stincts. Agricultural labour supplies an excellent outlet 
for the boys, for in the country life is less complicated, and 
adaptation is more easy, than in the towns. There is a 
certain, practical, even easy way of finding out whether 
the teacher has been trying to keep in contact with real 
life, and whether his school for defectives is well managed. 
It is to find out what becomes of the defectives on leaving 
school, and what percentage he has been able to place in 
situations with a suitable salary. 

Such measures of control are so logical that they only 
require to be formulated to obtain the immediate assent 
of all sensible minds. Yet one may ask whether, as a 
matter of fact, in the schools managed by the State, the 
inspectors occupy themselves sufficiently with this prac- 
tical side of education, and do not even make the mistake 
of judging the education by itself, according to a conven- 
tional, literary, or scientific ideal. We are not speaking 
of public schools, colleges, and lycees. These establish- 
ments are attended by normal children, and it may be 



UTILITY OF SPECIAL SCHOOLS 135 

admitted that it is not, strictly speaking, the business of 
the State to prepare these for social life. As a matter of 
fact, that is not our own opinion, but that does not matter. 
What is certain is that the duty of the State becomes more 
precise and more pressing when it is a question of assuring 
the lot of the defectives. Has it always been kept in mind 
that their education should put them in the way of an 
occupation, and that one should teach them nothing use- 
less, so as not to make them lose their time ? We do not 
think so. We hope that the schools for the blind take 
care to know whether the Braille which they teach their 
pupils is a method of reading and writing which will be 
useful to them in life; whether the manual arts, such as 
caning chairs, the making of brushes and mattresses, are 
the best means which they can teach to the non-musicians 
whereby to gain their bread. We equally hope that in the 
schools for the deaf and dumb, which are teaching their 
pupils by the oral method with what effort, what expense, 
and what devotion one may imagine they have inquired 
what percentage of their pupils attained the ability to 
communicate verbally with people other than their teachers, 
and also what is the percentage of pupils who, ten years 
after leaving school, still use that method and find it advan- 
tageous. All these questions should be asked, and con- 
scientious minds should try to find an answer to them by 
impartial inquiry, in order to find out whether the methods 
are useful, and whether the school is directing its energies 
well. What is being done about this with respect to the 
schools for defectives ? 

We must do this justice to the legislation at present 
projected with regard to defectives, that it is not indifferent 
with regard to this question of control. The Ministerial 
Commission, in which one of us took part, heard many 
demands for guarantees of this kind. Its mistrust was 
awakened, and it made a number of suggestions which have 
been included in the Bill. 



136 MENTALLY DEFECTIVE CHILDREN 

Thus, an elementary school inspector is trusted with 
the duty of taking account of the educational progress of 
each child. A little book must be kept recording full 
particulars of each individual case. The principle of super- 
vision by a Care Committee after leaving school has been 
adopted. All this is excellent. The law cannot enter into 
minute details. Administrative rules must be drawn up 
to provide against the two causes of error, prejudice and 
negligence. 

Let us consider this question from our own point of 
view, and distinguish clearly between the educational and 
the social return. 

The Educational Return of the Special Schools and 
Classes. In the first place, in order to gauge the advantages 
of special education, it is necessary to find out what becomes 
of defectives when they are left in the ordinary schools. 
It is quite clear that special education should be condemned 
and suppressed if it does not do more than the ordinary 
schools. We have seen that, in the latter, the defective 
is a dead weight, and the ill-balanced is a nuisance. Never- 
theless, one must not jump to the conclusion that these 
children are in no wise modified by the school influences, 
and do not profit in any degree by the instruction. We 
have already pointed out some very touching facts : a little 
defective girl has learned to read, thanks to the persevering 
help of one of her normal companions. This proves, at 
least, that association with normal children may be good 
for something, but let us leave such anecdotes and attempt 
to reach a comprehensive view of the situation. 

We have been able to collect in the primary schools of 
Paris, thanks to the kind assistance of M. Belot, particulars 
which are very valuable, though restricted in amount. 
These particulars we have examined in every possible way, 
and we always reach the same conclusion : the defective 
makes very slow progress in the ordinary schools. 

Let us consider, for example, en bloc, forty-five defectives 



UTILITY OF SPECIAL SCHOOLS 137 

of whom we possess records, and see to what extent they 
are behind at different ages. We get the following table : 

Age. Retardation. 

7 2 years) 

8 2 \ about 2 years. 

9 H 

10 3 

11 3i 

12 3 

13 3i 

14 6 

15 5 



J 

}.;... 



Thus, the amount of retardation increases with the years. 
It is at first two years, then three, then five. But this 
augmentation in the amount of retardation, which is the 
first fact to strike the attention, ought not to conceal from 
us that there is real progress in the mental condition and 
in the studies; in fact, we may remark that if a defective 
child, in passing from the age of eight to eleven, has an 
augmentation of retardation of one year with respect to 
his companions, this proves that in the same time he has 
progressed two years with respect to himself. It is like 
an omnibus which goes more and more slowly, yet advances 
all the same. To be more precise, let us say that, since the 
defectives reach, as an upper limit, the intermediate course, 
and that in the proportion of two-thirds, one may conclude 
that they make nearly half the progress of the normal 
children. Be it understood, this is only roughly tine, and 
many reservations must be made with regard to details. 
But the indication which these documents afford is, never- 
theless, very instructive, for it shows us that the majority, 
two -thirds at least, of the defectives appear regularly to 
duplicate each class, or to take two years to pass a stage 
which the normal child passes in one. It is important to 
remember this, for the teachers do not always give the facts 
their true value. They have a tendency to compare the 
slow progress of the defective with the more rapid progress 



138 MENTALLY DEFECTIVE CHILDREN 

of the normal, and to conclude from this comparison that 
the defective remains stationary. This is a pure illusion, 
which may be compared to what one experiences when 
looking out of the window of a train in motion. One sees 
another train going in the same direction but more slowly, 
and imagines that the second train is not moving. Let 
us retain, therefore, provisionally, the following important 
idea : Only half the defectives in an ordinary school reach with 
difficulty the intermediate course, first year, passing through 
the different stages in double the normal time. No doubt one 
would find many examples of slower progress still, three or 
four times the normal. On the other hand, the teacher 
sometimes points out a defective who has improved very 
rapidly, as if his intellect awoke from a long sleep. Such 
cases exist, but they are very rare, and they are open to 
the suspicion that an error in diagnosis has been made, and 
that the child who has improved so greatly was wrongly 
considered defective. 

With regard to the ill-balanced, the success of the ordinary 
school is much greater. A recent inquiry taught us that 
in the course of two years half the children noted as ill- 
balanced were regarded by the teachers as improved. This 
figure speaks for itself. 

From this we may conclude in a general way that it is 
essential that the special schools and classes should bring 
more than half of their defective pupils to the level of the 
intermediate course, and improve more than half of the 
ill-balanced, if they are to render public services superior 
to those of the ordinary schools. 

This must be the aim. How are we to know whether it 
is attained or not ? Ity supervision exercised in the most 
serious manner, by well-kept individual records, in which 
are noted only facts which can be controlled. 

We remember, a dozen years ago, having turned over the 
records of young defectives in an asylum-school which had 
the reputation of perfect organisation, a reputation other- 



UTILITY OF SPECIAL SCHOOLS 139 

wise deserved, for everything that was shown to the public 
on visiting days was perfect. But a distinction must be 
drawn between what one sees and what one does not see. 
The records were kept with surprising negligence. They 
were dirty in appearance, torn, disordered, falling to bits. 
On reading them one only met with vague estimations, 
loosely expressed, about children who, as was repeated to 
satiety, " would make progress if they would work better." 
The less we say the better about contradictory diagnosis, 
such as one we noticed on a certificate of discharge: " Com- 
plete idiocy very much improved " ; or the too optimistic 
prognosis, really very naive, if the writer has not had the 
bad taste to be ironical: " Vicious child would make an 
excellent housemaid/' If documents could be kept in 
this way, it is quite clear that those who so kept them felt 
pretty sure that nobody would ever read them. 

We demand that the notes which show the educational 
progress of the pupils should be written under the constant 
fear of control, in order that they may be guaranteed against 
negligence and interested optimism. The manner of con- 
trol is very simple, and may be summed up in three para- 
graphs. 

1. The estimation of the progress of the children should 
be made by the professors themselves, since they know each 
child well. The professor will always keep in mind that 
his notes will be checked by the inspector. With regard 
to instruction, notes will be kept with regard to reading, 
writing, arithmetic, spelling, according to the methods 
which we have indicated, and such remarks as " good/' 
" very good/' " passable," each signifying absolutely 
nothing, will be avoided. With regard to the manual 
work, it goes without saying that the record would have 
to be made in a somewhat different way. 

2. The inspector will examine a certain number of cases 
chosen haphazard. He must carry out this control with 
an open mind and without prejudice. 



140 MENTALLY DEFECTIVE CHILDREN 

3. He will make use of methods of control of a strictly 
impersonal nature. 

Social Return. We are surprised to find that abroad 
there have been published very few particulars concerning 
the social return of the schools, although they have been 
in existence for a long time, some of them for forty years. 
Statistics are rare, without commentaries, and some of 
them are apparently prejudiced. In order to find out what 
they are worth, we think it would be necessary to live in 
the country, and to observe carefully for oneself the work 
of the schools. The official documents do not teach very 
much, and one may suspect that every public service which 
is not supervised in the most intelligent manner, and incited 
by competition, will slip into routine and empiricism. We 
demand an inquiry on the two following points : How many 
defectives are provided with a trade when they leave the 
special schools ? How many defectives are provided with 
a trade when they do not leave the special schools ? 

Such an inquiry, we may be certain, has never been 
seriously undertaken. Here are some statistics. Mme. 
Fuster, after a stay in Germany, where she visited some 
Hilfschule and Hilfsclasse (literally, " help-schools " and 
" help-classes ") made a communication to the Societe 
de TEnfant, from which it appears that in the case of 
90 classes for defectives in Berlin, 70 to 75 per cent, of 
the defective pupils who were there became able to carry 
on a trade; 25 to 30 per cent, died in the course of study, 
or returned to their homes, or were sent to medical institu- 
tions for idiots. 

According to a more recent inquiry, made under the 
auspices of M. de Gizycki at Berlin, and published in a book 
by Paul Dubois, 22 per cent, of the children were sent home 
or to asylums; 11 per cent, were apprenticed; 62 per cent, 
worked at occupations which required no knowledge and 
yielded little pay (labourers, crossing-sweepers, ragmen). 
If we add together these two last groups, we reach a pro- 



UTILITY OF SPECIAL SCHOOLS 141 

portion of 73 per cent, of defectives who have been made, 
or who have become, more or less useful. 

We shall quote a last document, to which we attach 
more importance than to the preceding, for we have full 
confidence in the author. Dr. Decroly has kindly arranged 
at our request a few figures relating to the occupational 
classification of the girls discharged from a special class in 
Brussels. He states that the class was opened only in 
1903, that education in Belgium is not compulsory, that 
many of the pupils leave the class too soon all circum- 
stances which explain the smallness of the success. He 
firmly believes in the educational value of special instruc- 
tion, provided one does not expect miracles. He has a 
good critical mind. We cannot publish here the whole 
table. We shall summarise it thus : 

Of three idiots, practically nothing is known; of eight 
imbeciles, one is employed at home, one unemployed (?), 
and one is messenger to a shoemaker. One can scarcely 
expect any real return in the case of imbeciles and idiots, 
and the merit of Dr. Decroly's statistics lies in the fact of 
distinguishing between such children and the feeble-minded. 
Let us speak more fully of the latter. They are thirty in 
number. Concerning nine there are no particulars. Two 
have entered a Catholic school, and nothing more is known 
about them. If we subtract these eleven, there remain 
nineteen. Some of these are " kept at home/' or " occu- 
pied at home "; of these there are five. We do not know 
exactly what they are doing. There are others who 
" work/' but it is not stated whether this is outside, or 
whether the work deserves to be taken into account. 
Four belong to this category. There remain the appren- 
tices (tailors, cigarette-makers, sewers, etc.), of whom 
there are nine. Perhaps the last figure is the only one 
which deserves to be taken into account. Finally, then, 
out of nineteen feeble-minded subjects, regarding whom 
particulars have been supplied, one half, or 50 per cent., 



142 MENTALLY DEFECTIVE CHILDREN 

have been apprenticed; or more than half, 75 per cent., 
if we count the defectives who " work/' We are not, 
therefore, very far from the figures collected by Mme. 
Fuster for the special classes of Berlin, nor from those 
published by Gizycki. 

We do not think enough of the oidinary school, and of 
the service it renders to the defectives; or, rather, we are 
too ready to assert that it does nothing for them. Yet, 
all the defectives who leave it do not turn out badly. 
There are journalists who try to attract the attention of 
public bodies by declaring that defectives, left to them- 
selves, inevitably fall into mendicancy and crime. What 
do they know about it ? Absolutely nothing, since no 
serious inquiry has ever been carried out. Even we, for 
several years, allowed ourselves to be influenced by such 
suggestions, until the day when one of these journalists 
went rather too far. We refer to an alienist who published 
in a morning paper a series of articles on the defectives. 
After having estimated their total number at 40,000, he 
called them " the madmen of to-morrow," truly an excellent 
title for a sensational article. But, little as one might 
think it, of all that was written nothing was really proved. 
Those who think that the defectives are destined to become 
lunatics are just as much in a dream as those who declare 
they will become criminals. The fact is that we are in 
complete ignorance, because one has always recoiled from 
an inquiry which promised to be as long as it would be 
troublesome. And it is a disgrace, let us say frankly, that 
no State has ever undertaken it. 

Through the intervention of an inspector, M. Belot, we 
have inquired of twenty heads of schools what has become 
of the defectives whom they notified to us two years ago. 
We have made these inquiries with regard to sixty-six 
children only. Poor figures, indeed, arid we would not 
give them, but that a little is better than nothing. These 
sixty-six children may be classified thus: Thirty-five are 



UTILITY OF SPECIAL SCHOOLS 143 

defective, twenty-six ill-balanced, and three both defective 
and ill-balanced. Retardation is quite plain in the unstable, 
amounting to from one to two years; it is very marked in 
the case of the defectives (one alone has a retardation of 
two years, the others have a retardation of three, four, six, 
and even seven years). We give these figures only that it 
may not be imagined that we are dealing with cases of slight 
feeble-mindedness with a retardation of one or two years. 
It is necessary to understand these details in order to form 
a correct idea of the value of the figures. 

The particulars regarding the ultimate destiny of these 
sixty-six children are as follows : 

1. No Return in the Case of Fourteen Children. Some left 
the district without giving an address. Some even left 
school with insults from the parents directed against the 
teachers. 

2. Children still at School. These number twenty-two. 
We have already spoken about this little group, and have 
remarked that some of them have improved. 

3. Children sent Home or placed in Asylums. There are 
three who have been sent to asylums. We know one of 
them, an imbecile, but he had bad instincts, and who 
knows but that he might have been made useful ? With 
regard to the others, who have been sent home, we have 
only very vague particulars, and the interpretation of their 
condition is quite arbitrary. Some of them seem to be 
useful. Some girls help at home. Some boys assist their 
fathers at their work, but are said to be wanting in balance 
or to require constant supervision. We have thought it 
well to include them in this third category, which stands for 
the social waste. They number ten. We repeat that the 
limits of this group are extremely ill-defined. With a little 
optimism one might have passed three-quarters into the 
following group; with a little more strictness, on the other 
hand, the present group would have been larger. We 
emphasise the difficulty of limiting the frontier impartially. 



144 MENTALLY DEFECTIVE CHILDREN 

It would be a good thing to make use of a criterion, good 
or bad, but exact. One will, no doubt, be found, but in 
the meantime we have none. 

4. Children who have, become, Useful. These are they 
who have become capable of following some calling. It is 
evident that one should take account of the nature of the 
calling followed; many are misery in disguise. A little 
time should also be allowed, for a child may not find definite 
occupation immediately on leaving school. In fact, the 
only particular we have regarding this last group of children 
is, that they have entered on an apprenticeship. Girls are 
apprenticed to dressmakers or laundresses. Boys are 
apprenticed as hairdressers, tinsmiths, gilders, printers, 
carpenters, etc. These children number seventeen. These 
results have impressed us rather favourably. We did not 
expect that the majority of defectives from the ordinary 
school would enter an apprenticeship; but, in fact, the 
majority did so. If we abstract the two first groups, those 
about whom the particulars are wanting, and those who 
have not yet left school, there remain twenty-seven children, 
of whom seventeen have been apprenticed, or 76 per- 
cent. 

From these statements the following conclusion is 
reached namely, that, contrary to an opinion which 
attempts are being made to spread abroad, the ordinary 
school does render real service to the defective child. We 
have already seen, a propos of the educational return, that 
the ordinary school carries a proportion of the defectives 
as far as the intermediate course. All these facts are 
mutually confirmatory. 

Is it possible to go farther ? We have just seen that the 
ordinary school permits the occupational classing of 76 per 
cent, of the defectives. Now, this proportion is, by an 
unexpected agreement, identical with that obtained in the 
classes of Berlin and Brussels, whence an opponent of 
special instruction would hasten to argue that such in- 



UTILITY OF SPECIAL SCHOOLS 145 

struction is useless, or that, at least, it could not prove its 
usefulness except on the condition of insuring occupational 
classing superior to 76 per cent. We do not think, after 
mature reflection, that this proposition would be justified. 
All our figures show is that the majority of defectives who 
pass through the ordinary school had not entirely lost their 
time, since they reached the stage of entering upon an 
apprenticeship. But it will not do to take account only 
of the proportion of children classed as workers ; it would 
be necessary also to take account of the duration of such 
classing, and especially of its quality. A defective enters 
upon an apprenticeship. That is good, but how long does 
he retain it ? Will he be discharged as incapable at the 
end of a few months ? If he is kept, will he remain in the 
lowest employments for example, unskilled labour ? In 
connection with all trades, there are minor occupations 
in which defectives stagnate. Our figures do not take 
account of these differences, which are of considerable 
interest, nor do they give any fuller ideas with regard to 
the utilisation of the defectives. And it would be necessary 
for the statistical method to be carried out with greater 
perfection to enable us to measure the services rendered by 
special instruction. It is probable that the special school 
would render greater services than the ordinary school, 
because it has greater advantages : teachers experienced in 
the training of defectives, a curriculum better fitted to the 
aptitudes of the latter, and, most important of all, the 
possibility of individual instruction. 

Let us stop here. In the meantime this is all that we 
can say with regard to the organisation and control of 
special education. If we were to attempt to go farther we 
could do so only on a priori grounds. The time has come 
for experiment. The new classes which are being formed 
in Bordeaux, Paris, and elsewhere, must be carefully 
watched. We shall v grope, we shall make attempts, cer- 

10 



146 MENTALLY DEFECTIVE CHILDREN 

tainly we shall commit mistakes, which will not matter 
very much if only we have the mind to recognise them 
and the courage to put them right. The essential thing is 
for all the world to understand that empiricism has had its 
day, and that methods of scientific precision must be intro- 
duced into all educational work, to carry everywhere good 
sense and light. 



APPENDIX 

[N.B. Throughout the Appendix Roman numerals refer to ages 
e.g., IV. 2 = second test for children of four years.] 

PART of the interest of this work on defective children con- 
sists in the fact that in it we find the origin of those ideas 
and investigations which culminated in the formation of the 
Binet-Simon Scale of Intelligence, now so widely known 
throughout Europe and America. 

The ideal that Binet set before himself was the formation 
of a scale which should measure intelligence in something 
the same way as the foot-rule measures height. The first 
difficulty was the unit. If we regard intelligence as the 
power to cope with a situation, we see that this power in a 
general way increases with the experience of the child, or, 
we may say, with his age. A child of nine should have more 
intelligence than one of eight, a child of eight than a child 
of seven, and so on. We may suppose, then, that there is a 
normal intelligence for each age just as there is a normal 
height for each age, although in the first case, as in the 
second, many children fall below and many rise above the 
standard. It is clearly by no means so easy to establish a 
norm for intelligence as for height, nevertheless, the method 
should be the same ; that is, we should begin by finding out 
what the intelligence of children of different ages actually 
is, and from these results we should derive averages which 
might be used as norms. 

In the course of his work with defectives, Binet, as we have 

H7 



148 MENTALLY DEFECTIVE CHILDREN 

seen, had gathered a number of questions which he had 
found useful as tests of intelligence. He now, in conjunc- 
tion with Dr. Simon, proceeded to extend the number of 
these tests and to assign each to its appropriate age. The 
method he adopted was this : He tried each test on a great 
number of normal children of the same age. If a large 
majority answered satisfactorily, he set the test down as 
suitable for that age ; if a majority failed, he moved it to a 
more advanced age, and tested it again on older children. 
When we consider his scale then, we must remember that 
the arrangement is no arbitrary one, but has been derived 
from actual experiment. 

In 1908, after having been tried on over two hundred 
Parisian school children, the tests were published in the 
form of a scale, giving a measure of intelligence graded from 
three to thirteen years of age. By this scale it was held a 
child's mental age, which, of course, was often not the same 
as his chronological age, could be determined. 

In 1911 there was published a revised scale in which, 
owing to the results of further experiment and criticism, a 
considerable number of alterations in the grading of the tests 
was made. This revised form of the scale is given below. For 
convenience in use the exact words to be said to the child 
are placed first, the particular directions for each test being 
given afterwards . General directions regarding the tests and 
the method of marking will be found at the end of the scale. 



Tests of Intelligence. 

Three Years. 

1. " Show me your eyes/' " Show me your nose." 
" Show me your mouth." 

Count the child correct if he indicates in any way that he 
understands. 



APPENDIX 149 

2. " I am going to say two numbers. Say them after 
me 3, 7."" Again, 6, 4/' " Again, 0, 5." 

The examiner must say the figures slowly ; an interval of 
half a second should be allowed between the two. The 
child passes if he is successful once out of the three trials. 

3. " Here is a picture; tell me what you see/' 

The child passes at this level if he simply enumerates 
objects seen in the pictures (Figs. 1, 2, 3). 

4. " What is your name ?" 

For a pass the surname must be given, but if the child says 
his Christian name only, the examiner may press him by 
asking " What else ?" 

5. " Say this sentence after me * I am cold and 
hungry/ " 

If the child is timid, he may be tried first with shorter 
sentences. He is not allowed to pass unless his enunciation 
is perfect. A sentence containing six syllables should be 
remembered at this level. 



Four Years. 

1. " Are you a little boy or a little girl ?" 

If necessary, this question may be divided : " Are you a 
little boy ?" " Are you a little girl ?" 

2. " What is this ?" " And this ?" " And this ?" 
The examiner shows the child successively a key, a penny, 

and a knife. 

3. "I am going to say three numbers. I want you to 
repeat them. Listen. 2, 7, 5."-" Again, 9, 0, 4/' 
" Again, 3, 8, 1." 

One success suffices. 

4. " You see these lines. Tell me which is longer/' 
See Fig. 7. 

No hesitation or uncertainty is satisfactory. 



150 MENTALLY DEFECTIVE CHILDREN 



Five Years. 

1. " You see these boxes. Tell me which is heavier." 
The examiner places two boxes precisely the same in 

appearance, but weighing respectively 3 grammes and 12 
grammes, before the child. He repeats the test with similar 
boxes, weighing respectively 6 and 15 grammes, and then the 
first pair is again presented. The boxes should be arranged 
so that the heavier one is alternately at the right and at the 
left side. Very young children nearly always indicate one 
of the boxes by chance without testing them. In this case 
the examiner is allowed to say, " You must take the boxes 
in your hand and weigh them/' 

2. " Copy this picture for me." 

The examiner shows the child a card on which is drawn 
a square, the side of which measures an inch and a hah 5 . 
The child is given pen and ink, an unfamiliar instrument to 
him at this age. He passes if his square can be recognised 
as a square. 

3. "Listen to this, and repeat it after me: 'My name is 
Charlie. Oh ! the naughty dog !' " 

Memory of a sentence containing ten syllables is required. 

4. " You see these pennies. Now count them with your 
finger." 

Four pennies are placed before the child. They are 
juxtaposed, but not superposed. In order to pass, he must 
count them, touching each with his forefinger as he says its 
number. Some little children begin to count before they 
touch the first penny; thus they may reach five or six or 
even more. 

5. " Put these pieces together so as to make them look 
like this." 

The examiner has two oblong cards postcards do very 
well one of which is cut in two pieces along the diagonal. 
Before giving the direction to the child, he places the intact 



APPENDIX 151 

card on the table, and, nearer the child, the two pieces of 
the other card arranged so that the two hypotenuses form 
i right angle. 1 

Six Tears. 

1. " Is it morning or afternoon now ?" 

As many little children tend simply to repeat the ex- 
aminer's last words, it is better to reverse the terms " morn- 
ing " and " afternoon" when the examination takes place 
in the afternoon. 

2. " What is a fork ?" " What is a table ?" " A 
chair ?" " A horse ?" " A mamma ?" 

Three levels of intelligence may be distinguished in the 
responses. The lowest is that of silence, or repetition of the 
term, or designation by gesture. The second, which should 
be attained at the age of six, is that of definition by use, as : 
" A fork is for eating with/' The third level is attained by 
the ninth year; the child at this level attempts to describe 
the object or to say what it is made of. The type of the 
majority of the definitions determines one's judgment of the 
level attained. 

3. " Copy this picture for me." 

The examiner shows the child a card on which is drawn a 
diamond, of which the side measures an inch and a half, and 
the acute angles 60 degrees. The drawing must be done 
with pen and ink. 

4. " Count these pennies." 

1 The directions for this test, given in 1908, are to arrange the two 
triangles so that the hypotenuses are as far distant as possible from one 
another. In the 1911 article the directions are as above. It seems to 
the writer that both directions are ambiguous. In certain experiments 
in which she followed the 1908 directions she placed the triangles 

thus \ I [\ , so that the children had to lift one across the other to 
effect a solution. A very small percentage of five-year-old children 
succeeded. If the triangles are placed thus l\ ^^\ the task would 
probably be easier. 



152 MENTALLY DEFECTIVE CHILDREN 

Thirteen pennies are placed on the table in a group (not in 
a line) touching one another, but not superposed. 

5. " Which is the prettier of these two faces ?" " And 
of these ?"" And of these ?" 

See Fig. 4. 

Three correct responses required. 

Seven Years. 

1. " Show me your right hand/' " Show me your left 
ear." 

2. " Here is a picture. Tell me what you see." 
Description of picture required (Figs. 1, 2, 3.) 

3. " Do you see this key ? Go and put it on that chair. 
Then close the door. Then take the box which is lying on 
the chair near the door and bring it to me. First put the key 
on the chair, then close the door, then bring me the box/' 

No help or suggestion by word or look must be given 
during the execution of this task. 

4. " How much money is there here altogether 1" 
Three pennies and three halfpennies are placed on the 

table before the child. 

5. " What is this colour ?"_ " And this ?" " And this ?" 
" And this ?" 

The examiner shows the child successively the four 
colours red, yellow, blue, and green. 

Eight Years. 

1. " You know a butterfly ?" " And you know a fly ?" 
" Are they like one another ?" " Well, in what way are 
they not alike ?" 

The same questions are asked about wood and glass, and 
paper and cardboard. Two comparisons at least must be 
given correctly. 

2. " You can count, can't you ?" " Well, will you count 
for me backwards from twenty to nothing ? Begin 20, 
19 '" 



APPENDIX 153 

One error is allowed, but the task must be finished in 
twenty seconds. 

3. " What is missing in this picture ?" The child must 
not be allowed to see the figure in the diagram until he has 
answered the questions regarding the heads. Otherwise, 
when shown a head, he may say, being influenced by 
suggestion, " It has no body." See Fig. 5. 

The same question is put for each of the four pictures. 

4. " Can you tell me what day it is 1" " And will you 
tell me the date also ?" 

The year must be given; three or four days' latitude is 
allowed in the day of the month. 

5. "I am going to say five numbers. Listen and repeat 
them after me. 5, 8, 2, 9, 1." " Again, 3, 7, 5, 2, 0." 
" Again, 1, 3, 7, 2, 9." 

One success suffices. 



Nine Years. 

1. " Would you like to play shop ? You be shopkeeper. 
I will buy from you this box. It costs twopence/' Here 
the examiner hands the child a shilling. " Now, will you 
give me change out of this money here ?" 

In order to give the change the child is provided with one 
of each of our current corns sovereign, half-sovereign, 
crown, half-crown, florin, shilling, sixpence, threepence, 
penny, halfpenny and in addition five halfpence and six 
pennies. 

Note. Binet gives the child a franc for an article valued 
at 20 sous, and the child has to select his change from the 
following coins: 8 coins of the value fr. 05, 4 of the 
value fr. 10, and 1 of each of the others viz., fr. 25, 
fr. 50, 1 fr., 2 fr., 5 fr., 10 fr., 20 fr. 

2. " What is a fork ?" " What is a table ?" " A 
chair ?" " A horse ?" " A mamma ?" 



154 MENTALLY DEFECTIVE CHILDREN 

For a pass three at least of the definitions must be given 
in a form superior to the " use " type. 

3. " What is the name of this coin ?" " And of this ?" 
" And of this 1" 

The examiner in this way goes through in irregular order 
all our current pieces of money. Coins like one another 
should not be shown in immediate succession. 

4. " Will you tell me the names of the months in 
order ?" 

One omission or one inversion is allowed to pass. 

5. " What would you do if you missed a train ?" " What 
would you do if one of your playmates should hit you with- 
out meaning to do so ?" " What would you do if you broke 
something belonging to someone else ?" 

For a pass two at least of these questions must be 
answered sensibly. 

Ten Years. 

1. " You see these little boxes. They are not all the 
same weight. Some are heavy and some are light. Place 
the heaviest one here, and at its side the one which is a little 
less heavy, then the one still a little less, and finally the 
lightest of all." 

The boxes in question weigh respectively 6, 9, 12, 15, and 
18 grammes, and all look the same. They are placed in a 
pile before the child, and as the examiner gives the directions 
he indicates with his finger the place he appoints for each 
box. Three trials should be given, the boxes being mixed 
after each trial. In order to pass the child must be correct 
at least twice. The time should not exceed three minutes. 
The material for the test can be easily made from match- 
boxes. 

2. " Now I am going to show you two drawings. You 
may look at them for ten seconds, which is a very short 
time. Then I will ask 3^011 to draw them from memory." 

For the drawings see Fig. 6. The child is counted correct 



APPENDIX 155 

if he reproduces the whole of one drawing and half the 
other. 

3. " I am going to read you some sentences, each of which 
contains something foolish. Listen attentively and tell me 
each time what is foolish." 

The examiner reads the sentences impressively, but with- 
out any special emphasis on the part the child should com- 
ment on. Each time when he finishes he changes his tone, 
and demands, '.' What is foolish in that ?" 

Sentences. (1) An unfortunate bicycle rider fell on his head 
and was killed instantly ; he was taken to a hospital, and they 
fear he will not recover. 

(2) I have three brothers, Paul, Ernest, and myself. 

(3) The body of an unfortunate young girl, cut into eighteen 
pieces, was found yesterday on the fortifications. It is thought 
that she killed herself. 

() There was a railway accident yesterday, but it was not a 
bad one ; the number of dead is only forty-eight. 

(5) Someone said: If I should ever grow desperate and kill 
myself, I will not choose Friday, because Friday is an unlucky 
day, and will bring me unhappiness. 

Three satisfactory answers are required. 

4. " What would you do if you were delayed in going to 
school ?" " What would you do before taking part in an 
important affair ?" " Why is a bad action done when one 
is angry more excusable than the same action done when 
one is not angry ?" " What would you do if you were asked 
your opinion of someone whom you did not know well ?" 
" Why should one judge a person by his acts rather than by 
his words ?" 

Three sensible answers must be given. 

5. " I am going to read you three words, and I want you 
to make a sentence and use in it the three words. The 
words are Paris, fortune, stream/' 

The expression " make a sentence " must not be further 
explained, but the instructions may be repeated. The child 
is given a pencil and paper, and, if necessary, should be 



156 MENTALLY DEFECTIVE CHILDREN 

urged to write something. For a pass the sentence should 
be well co-ordinated. At this stage it may contain two dis- 
tinct ideas, but not three ; at the higher level it must contain 
only one idea (see XII. 2). One minute is the time allowed 
for writing. 

Twelve Years. 

1. " Which is the longer of these two lines ?" " And of 
those ?" " And of those ?" " And of those ?" " And of 
those ?" " And of those ?" 

This test is aimed at the suggestibility of the child. For 
the material see Figs. 8-13. The first three pairs of lines 
differ in length, the longer being at the right hand ; the last 
three pairs are equal. It is sufficient if the child correctly 
judges two of the last three pairs to be equal. 

2. "I am going to read you three words. I want you to 
make a sentence and use in it the three words. The words 
are Paris, fortune, stream." 

For directions see XI. 5. 

3. " I am going to allow you three minutes, and I want 
you to say as many words as you can think of. Some 
children have said more than two hundred. Let us see how 
many you can do. Ready ? Start/' 

In order to pass the child must say over sixty words. 

4. " What is Charity ?" " What is Justice ?" " What 
is Kindness ?" 

Two correct responses are required. 

5. " Put these words in their proper order and find the 
sentence which they make/' 

Three cards are successively presented to the child, on 
each of which is very clearly written or printed one of the 
folio whig sets of words arranged in three lines. 

(1) For an the at hour early we 
country started. 

(2) To asked exercise my I teacher 
conect my. 



APPENDIX 157 

(3) A defends dog good his master 
bravely. 

One minute is allowed for each sentence, and two 
correct answers are required. 



Fifteen Years. 

1. "I am going to say seven numbers to you, and I want 
you to repeat them after me. Now, 5, 2, 7, 9, 1, 6, O/' 
" Again, 6, 4, 1, 3, 9, 7, 5."" Again, 8, 0, 4, 2, 7, 3, 6." 

One success suffices. 

2. "Do you know the meaning of the word 'rhyme* ? 
Two words are said to rhyme when they have similar end- 
ings, such as hour and flower, or candy and dandy. Do you 
understand ? Now, find all the words which rhyme with 
day/' 

The child is required to find three rhymes in one minute. 

3. "I am going to say some sentences to you, and I want 
you to repeat them exactly after me. Ready ? ' The 
other day I saw on the street a pretty yellow dog. Little 
Maurice has stained his nice new apron/ ' 

The examiner is advised to have ready a series of sentences 
formed of words easy to understand. He should begin with 
one somewhat shorter than that suggested, which consists of 
twenty-six syllables the length required by Binet at this 
age. 

4. " Here is a picture. Tell me what you see/' 

At this level interpretation of the picture is required. 
Mere description of the activities represented is not suffi- 
cient. 

5. " Listen to what I am going to read to you : A 
woman was walking through a park in Chicago. Suddenly 
she stopped, dreadfully frightened. She ran to the nearest 
policeman and told him she had seen hanging to the limb of 
a tree " after a pause " a what ?" 

" Again: My neighbour has just received some singular 



158 MENTALLY DEFECTIVE CHILDREN 

visitors : one after another a doctor, a lawyer, and a priest 
called. What is happening at my neighbour's ?" 
Both problems must be solved satisfactorily. 

Adult. 

1. " Here is a paper folded in four. Suppose that hero " 
(pointing to a small triangle that has been drawn in the 
middle of the edge which presents a single fold) " I cut out 
this little triangle. Now, if I unfold the paper, how would 
it look ? Draw the paper as it would appear if unfolded 
and show how and where it would be cut." 

The paper is square to begin with, and is folded twice so 
as to show a square one quarter of the original size. The 
required drawing will show two diamonds drawn in line with 
each other, and each in the centre of one half of a square, 

2. " Look at this card. Suppose I lift this lower part 
and place this edge (tracing the edge A C with the finger) on 
this edge (the diagonal of the upper piece). Suppose also 
that this point (C) is placed just on this point (B). Now 
I will take away the piece, and do you draw the whole figure 
as it will appear when the proposed change is made. Begin 
by drawing the upper part." 

a 



o 

A right angle must be represented at B, and the edge A C 
be shown shorter than the edge A B. 

3. " What is the difference between laziness and idle- 
ness v" " What is the difference between event and ad- 
vent ?" " What is the difference between evolution and 
revolution ?" 

Two correct answers required. 



APPENDIX 159 

4. " There are three principal differences between a King 
and a President of a Republic. What are they ?" 

Required answer: Royalty is hereditary, the tenure of 
office is for life, and its powers are very great ; the President 
is elected, his tenure of office is for a limited time, and his 
powers are less extensive. 

5. " Listen to what I am going to read to you. When I 
have finished I shall ask you to give me the sense of the 
passage : ' Many opinions have been given on the value of 
life. Some call it good, others call it bad. It would be 
more just to say that it is mediocre, for on the one hand our 
happiness is never so great as we would have it, and on the 
other hand our misfortunes are never so great as others 
would have them. It is this mediocrity of life which 
makes it just, or rather which prevents it from being 
radically unjust/ *' 

Directions to Examiners. In the use of the Binet scale 
there are various pitfalls that await the beginner. Tn the 
first place he is almost certain to array himself on the side 
of the child and to declare in some instances that the test is 
not a fair one the child could have passed had he under- 
stood what was wanted. One frequently sees this attitude 
towards the puzzle test. (V. 5.) For example, the examiner 
is dissatisfied when the child simply moves the pieces of card 
about in a meaningless way, and he tries to explain more 
clearly what is wanted. I have seen one examiner go so 
far as to show the child the solution, and then give him a 
pass when he repeated it. The examiner must always 
remember that a child who has reached the required level 
of intelligence will himself see what is wanted. This com- 
prehension is indeed the very thing we are testing for. 

Secondly, the examiner is apt to show by his manner 
when he is dissatisfied with a child's answer. In some cases 
this may lead him to correct himself e.g., VII. 1. The 
examiner must bear constantly in mind that all answers are 
equally pleasing to him ; he is not there to instruct the child, 
but to test him. When meaningless or absurd responses 



160 MENTALLY DEFECTIVE CHILDREN 

are given, as they frequently are, the examiner must accept 
them cheerfully, even in some cases with praise, and record 
a failure. The record, of course, must never be visible to 
the child. 

Again, the examiner must not suppose that the scale can 
be applied mechanically. Both experience and judgment 
are necessary before the results can be correctly gauged. In 
certain tests e.g., the absurdities a child's manner tells 
as much as his words. The children on whom I have tried 
this test nearly always laughed when they really grasped 
the point. Before he lays much stress on his results an 
examiner should have tested at least twenty children. 

There is another factor which prevents any mechanical 
use of the scale leading to satisfactory results, and that is 
the variability of the child's responsiveness. With an un- 
sympathetic examiner, or with an unfortunate start, he will 
do himself less than justice. It is the business of the ex- 
aminer to keep the child in that state of mental exhilaration 
which enables him to do his best. Words of encouragement 
and praise should in some cases be freely used, but, of 
course, care must always be taken to avoid, whether in 
word, tone, gesture, or facial expression, the slightest sug- 
gestion of the correct solution. The happy state of mind 
must be secured at the very beginning, and for this purpose 
the choice of the first test is very important. I call to 
mind a bright child of eight who was confronted first with 
a simple puzzle test. For some reason, probably over- 
anxiety to do well, she did not see the solution, and being 
too intelligent not to perceive her own failure, she burst into 
tears. Such unfortunate accidents are, however, rare. 
The children usually enjoy the interview. 

To secure a good start one must begin with a test which 
the child will regard as easy and pleasant. One soon knows 
almost at sight of the child what it is best to try first. One 
usually begins with tests for an age at least a year younger 
than that of the little subject, and works upward. 



APPENDIX 161 

The examiner should be alone with the child except for 
the presence of someone whose business it is to make notes. 
In such tests as the description of a picture, the definition 
tests, the questions of everyday life, the child's full answers 
should be written down. The examiner should, however, 
record his own judgment as to whether the child has passed 
or failed at once, as there are various factors which tend to 
make an immediate judgment both more certain and more 
accurate than a delayed one. 

So far as the aotual testing is concerned, the examiner 
should confine himself to the words given in the text. He 
will find himself tempted sometimes " to draw the child 
out." For instance, in the picture test, when the child has 
given him a brief enumeration of objects and then stopped, 
he will find himself saying, " But what is this man doing ?" 
The child can probably tell ; but he must not on this account 
be accorded a pass on the descriptive level ; he has already 
shown that his level is that of simple enumeration. 

Some of the tests (definitions, comparisons, suggestion) 
bring out a tendency to automatism which is present in 
many children. Thus, a child having replied correctly that 
a butterfly is bigger than a fly, may go on to state that wood 
is bigger than glass, and paper than cardboard ; or having 
found that " It is a fork " is well received as a definition of 
that implement, he may give similar replies to the other 
queries in the definition test. This automatism should not 
be checked: it should be recorded. The more intelligent 
children begin to exhibit a certain dissatisfaction with their 
own answers, however readily they are accepted. 

It is not always easy to follow the working of the childish 
mind, and it is not usually advisable to press for further 
explanation. Such a course is apt to puzzle the child, and 
render the conditions less favourable. If you are not certain 
that he should be allowed to pass, you may be practically 
certain that he should not. Sometimes one gets interesting 
glimpses into the subject's mentality. A little boy once 

H 



162 MENTALLY DEFECTIVE CHILDREN 

told me he had never seen a butterfly. Nevertheless, I 
asked the comparison question, and he gave what is a very 
usual answer: " A butterfly is bigger than a fly/' " How 
do you know/' I said, " if you have never seen a butterfly ?" 
" It's a bigger word/' he replied. Another time a little girl, 
who also declared she had never seen a butterfly, gave 
another answer which is also very common : "A butterfly 
is yellow, and a fly is black." The source of this knowledge 
was not discovered; but one of my students told me later 
that a child whom she questioned about a butterfly said: 
"I have seen one; it was blue, but it ought to have been 
yellow." On being asked why, she responded: " Butter is 
yellow." The test, of course, is not for the knowledge of 
the things, but for the power of making a comparison. 
Occasionally one has to mark a child as doubtful. Thus, 
in defining abstract terms (XII. 4) Binet records that out of 
forty-five nine-year-old children, four" passed, thirty-six 
failed, and five were doubtful. This test, however, gives an 
unusually large percentage of doubtfuls. 

Method of Marking. The examiner should have a large 
sheet of paper or a note-book with the names of the tests 
written in column at the left-hand side. Opposite each in 
a second column he should enter a sign indicating his 
judgment. Binet recommends the use of the following 
signs: + ! excellent, + pass, + ? almost a pass, ? doubtful, 
silence, ? almost a failure, - a failure, - ! a bad failure. 
Later this record should be supplemented from the notes 
taken by the secretary, also by information regarding the 
child's personal history, and by comments on his behaviour 
during the examination. The mental age assigned to him 
is determined in this way : one finds the age-level at which 
he passes all the tests, and adds a year for every five tests 
that he passes above that level. Thus, if a child of seven 
passes all the tests for seven years, three of those for eight, 
and two of those for nine, he has a mental age of eight years. 
Binet allows the use of fractions, one-fifth of a year for 



APPENDIX 163 

very test passed, but he admits that this gives an appear- 
ance of a degree of exactitude which is probably not attained. 
Should a child's mental age show a retardation of three 
years as compared with his chronological age, and should 
there be no evident explanation of this, such as ill-health, 
neglect of school attendance, etc., he is reckoned as de- 
ficient mentally. 

Biiiet's scale has been criticised from various points of 
view. Generally speaking, it seems to be found too easy 
at the lower end and too difficult at the higher end. It 
seems certain that some of the tests have not yet found their 
proper level, or, indeed, that the proper level may vary from 
country to country, from school to school, and from one 
social rank to another. Thus, the writer has found that 
practically all the five-year-old children present in a certain 
school during the past two or three years are able to pass 
the colour test assigned by Binet to seven years of age. 
These children, however, probably belong to a higher social 
class than the five-year-olds tested by Binet. An ex- 
aminer very quickly learns which of the tests beyond his 
age it is advisable to put to the particular child he is 
dealing with, and owing to the method of marking it does 
not matter much if one or two tests are misplaced* with 
reference to a particular group of children. The important 
thing is that there is a general consensus of opinion on the 
part of those who have tried the scale as to its value as a 
mental probe and register of mental attainment. Re- 
visions and elaborations of it have already been published, 1 

1 See Journal of Educational Psychology, 1912 : " A Tentative Revision 
and Extension of the Binet-Simon Measuring Scale of Intelligence," by 
Terman and Child. For an excellent brief review of the experimental 
work which has been done with the tests, see the same volume, pp. 101- 
110. The 1911 scale, with detailed instructions for the application of 
each teat, appeared in the Bulletin de la Societe Libre pour I' Etude Psycho- 
logique de VEnfant, Nos. 70 and 71, April, 1911. This article has been 
translated bv Clara Harrison Town (Chicago Medical Press). See also 
Meumann, Vorlesungen Z. Einfuhrung in die experimentelle Padaqoaik. 
Leipzig, 1913. 



164 MENTALLY DEFECTIVE CHILDREN 

but in view of its simplicity and brevity, and the valuable 
analytical work of which it has proved itself capable, the 
1911 form will probably remain a standard for at least 
some years to come. 

For the complete series of tests the examiner will require 
the following material in addition to the diagrams: 

Three suitable pictures. 

Key, penny, knife. IV. 2. 

Weights. V. 1 and X. 1. 

Drawing of square. V. 2. 

Drawing of diamond. VI. 3. 

Rectangular card and divided rectangle. V. 5 and 
Adult, 2. 

Colours. VII. 5. 

Cards with mixed sentences. XII. 5. 

Square of paper. Adult, 1. 



DIAGRAMS 

FOE the picture tests Binet used the following : 

Fig. 1. Man and boy pulling a barrow with furniture. 

Fig. 2. A poor old man and a young woman sitting on a 
seat outside on a wintry day. 

Fig. 3. A prisoner standing on his bed to look out of the 
window of his cell. 

The student should choose pictures which contain 
familiar figures and objects, and which " tell a story " 
capable of sympathetic interpretation. They should not 
be too childish. 

The following pictures, all in the Tate Gallery, may be 
suggested : 

The Doctor, by Luke Fildes. 

The Blind Beggar, by J. L. Dyckmans. 

The Wedding, by Stanhope A. Forbes. 

A Hopeless Dawn, by Frank Bramley. 

The Man with the Scythe, by H. H. La Thangue. 

Mark the pictures chosen Figs. 1, 2, and 3. 



165 



160 MENTALLY DEFECTIVE CHILDREN 






iT^ 3 *, 



"~ '&& 3 
V>^ 



% 





Fia. 4. 



DIAGRAMS 



167 




FIG. 6. 



168 MENTALLY DEFECTIVE CHILDREN 



J 




q 






Fia, 8, 



FIG. 7. 



169 



171 



173 



175 



177 



Si 

I 



179 



INDEX 



ABNORMAL children, 5 
Abnormality, frontiers of, 92 
Adenoids, 110 
Alcohol, 102 
Appendix, 146 
Aptitudes, 23 et seq, 
Arithmetic, 58 
Asylum cases, 74 
Attendance, irregular, 50 

Bicetre, 6, 123 
Bromides, 106 

Cretin, 104 

Curriculum, 14, 26, 32, 131 

Definitions: 

abnormal, 5 

defective, 7 

feeble-minded, 78 

idiot, 77 

ill-balanced, 6 

imbecile, 77 

Distribution of defectives, 15, 43 
Doctor, role of, 88 et seq. 
Dunces, 47 

Employment, 126, 129, 134 
Epilepsy, 7, 107 
Examination: 

pedagogical, 36, 65 

physical, 91 

psychological, 67 

Feeble-minded, 78 
Frontiers of abnormality, 92 

Heredity, 99, 102 
Hospital cases, 74 
Hydrocephalus, 103 
Hydrotherapy, 106 
Hysteria, 110 

Ill-balanced, 6, 8, 15, 21, 72, 138 
Inspector, role of, 50 et seq, 
Instruction: 

scale of, 54 

tests of, 52 
Intelligence, tests of, 28, 67, App. 



Knowledge percentage, 64 
Laboratory of pedagogy, 9, 27 

Medical examination, 91 (Chap. 

IV.) 

Medical schedule, 115 
Mental deficiency, v. Definitions 
Microcephalus, 103 
Microgyria, 103 
Mongol, 105 
Moral deficiency, v. Ill-balanced 

Pedagogical examination, 36, 65 
Physical examination, 91 
Physiognomy, 96 
Picture tests, 30 
Psychological examination, 6? 

utility of, 71 

Psychology of defective, 19 
of ill- balanced, 21 

Reading, 55 
Retardation, 16, 38 

Salpetriere, 6, 120 
Scale of instruction, 54 
Schedules : 

instruction, 65 

medical, 115 

suspected mental deficiency, 

85 
School, special, 7 

educational value, 118, 136 

social value, 118, 140 
Spelling, 61 
Statistics, 7 
Stigmata, 93 

Teacher, role of, 38 et seq. 
Tests: 

instruction, 52 

intelligence, 28, 67, 148 

marking of, 162 

material for, 164 

method of conducting, 159 

Unstable, v. Ill-balanced. 



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