The psychology of subnormal children

Front matter

YALE

| maw MEDICALJ^BRARY

Gift of

Preface

With the growth of the movement to establish special classes for children who are subnormal in intelligence there has grown the demand for teachers who are trained in the psychology and education of such children. It is my hope that this volume, which consists of lectures given for some years past in Teachers College, Columbia University, may in a measure serve the purpose of such teachers. It is addressed primarily to them, rather than to clinicians, for whom the majority of books on this subject have been hitherto especially prepared. The discussion is, therefore, confined largely to the educational psychology of mentally deficient children, with relatively slight emphasis on methods of identification and diagnosis. The illustrative matter, also, relates to the achievement of defectives, rather than to their clinical features.

There has been a very conscientious effort to base the discussion soundly upon the results of psychological research, as set forth in the references appended. The lists of references are selected, not complete, except in the case of chapters on the psychology of development and learning. On these subjects the purpose has been to refer to all published experimental research bearing directly upon defectives. It is

X PREFACE

unfortunately true that upon many points of interest for pedagogy no scientific data are available, and we have still to rely upon expert opinion and common observation.

It has been my experience that students who have mastered fundamental courses in educational psychology, and in the essentials of biology, profit much more by study of the material herein contained than do those who have not had such previous training. However, the aim has been to present the facts with a minimum of technicality.

As I formulated the book, I became increasingly conscious of what I owe to my years of professional association, first with Dr. M. G. Schlapp, Director of The Clearing House for Mental Defectives, The Post- Graduate Hospital, New York City, and later with Dr. Menas S. Gregory, Director of the Psychopathic and Alcoholic Services, Bellevue Hospital, New York City. Also, by way of that unconscious learning from each other which goes on among those long associated in clinical work, I have gained much from my colleagues at Bellevue Hospital, Dr. Melvin J. Taylor, Dr. Theron J. Vosburgh, Dr. E. J. Barnes, and Dr. Stephen P Jewett.

My thanks are due to Dr. Paul Monroe for editorial supervision of my manuscript.

Leta S. Hollingworth.

Teachers College, Columbia University.

Table Of Contents

PAGE

Preface ix

CHAPTER

Chapter I

This volume discusses the psychology and educational treatment of intellectually subnormal children. What concept have we of subnormality in children? What is a subnormal child? To speak of subnormal children implies at once the existence of normal or average children, for to be subnormal one must be so with respect to some norm or standard. Thus thought will be clarified by devoting a little time to a consideration of normality. What is a normal or standard child?

Variability. In psychological research we find that if a large number of individuals, selected at random, are measured or appraised in any given trait, either mental or physical, about half of them will fall within certain very narrow limits ; while the remaining half will distribute themselves about equally on either side. Furthermore, the farther we go from the confines of the middle fifty percent in either direction, the fewer become the individuals who fall there.

So that when we have finished measuring a thousand persons, and have tabulated and platted the measurements, we find that we have a curve approximately like this:

Fia. 1. — Normal distribution of 1000 individuals, chosen at random, and measured in a given mental or physical trait. (Schematic).

A concrete illustration will make this entirely clear. It is easier to think of this matter in terms of physical traits at first, because we can easily verify for ourselves the statement that human beings differ widely from each other in physical traits. No two human beings look exactly alike. Therefore, suppose we measure one thousand new-born infants in length, taking the measurement to a centimeter. We shall obtain a table like that on the following page.

About half of the infants measure between 49 and 52 centimeters, with all the remainder tapering off on either side toward two extremes. As the infants become shorter they also become fewer, until we find that only one infant is as short as 38 centimeters. And similarly, as the infants become longer they also become fewer, until at the length 62 centimeters we find only one infant. If we plat a distribution curve showing these facts graphically, it looks like this :

CD

60[-| 45

DISTRIBUTION OF

1000 NEW-BORN MALE INFANTS

LENGTH IN CM.

(Montague and Holllngworth)

1 I I T

165 150 135 120 105 90

- 75 80

- 30 15

Fig. 2. — Actual distribution of 1000 new-born male infants, chosen at random, and measured for length in centimeters. (From Montague and Hollingworth. Reproduced by courtesy of The American Journal of Sociology.)

Length (in Centimeters) of Infants at Birth

Centimeters

Frequency

Centimeters

Frequency

Centimeters

Frequency i i

The same scientific law is illustrated in the flight of large flocks of certain kinds of homing birds. Notice a flock of birds going south in autumn. The flock looks like this:

Fig. 3. — Flight of birds, illustrating variability in speed and endurance. (Schematic.)

This is, of course, simply the curve of distribution. The birds are not all equally swift, and are distributed by the test of their flight with respect to speed and endurance. About half of them are what would be called average in speed and endurance. They fly massed in the center, approximately together. But some are swifter ; and one is swifter than any of his fellows, and leads the flock. On the other hand, some are slower than the average; and one or two are so slow that they scarcely can keep the others in sight at all.

Those forming the central mass are the standard or normal birds. Those ranging on each end toward the two extremes are the exceptional birds. Normality, by definition, is what the greatest number of individuals can do. The birds who fly far behind might be designated the subnormal birds.

It is noticeable, too, that no two birds are exactly alike in ability to fly. If we could measure this ability to a millimeter, we should find them all differing more or less among themselves in distance from their goal.

These phenomena hold throughout organic nature, and the study of them is called the study of individual differences. When the traits involved are mental, we speak of the psychology of individual differences. It is one of the marvelous facts about human beings that of all the millions in the world no two are exactly alike in any given trait, save occasionally by chance. Not even twins are exactly alike. In twins who very closely resemble each other, mentally and physically, differences will appear if they are seen together. Human beings differ widely in physical characteristics, but they differ far more in mental traits. These myriad dissimilarities are mainly due to the operation of the relatively unknown laws of heredity and variation, upon which biologists and psychologists are at present spending much of their research time.

Children Vary Greatly in Mental Capacity. The interesting fact for us is that children do vary greatly in mental traits; that they differ widely in intellectual ability, by nature; and that a small proportion of them are extremely different from the average or norm. Those who deviate from the norm in the direction of inferiority, we call the subnormal children. They are to be the objects of special study here.

It is true that a child may be subnormal in anyone of many different respects. He may be below the average in emotional control, or in moral sense, or in a special function such as adding, subtracting, spelling, reading, or music. This volume does not attempt to treat fully all these various kinds of subnormality. About some of them very little is known. The discussion here is limited primarily to subnormality in general intelligence. We shall study the psychology of the feeble-minded and the dull, for whom special classes have been established now in many school systems.

Dr. .Terman has shown in his recent monograph how children are distributed with respect to general intelligence. The curve shows the same laws as those shown in physical traits. The majority of children cluster around a median point in mental ability. By gradual degrees they approach the idiot at the low extreme, and the genius at the high extreme. The curve is as shown in Figure 4.

Wherever we find a large unselected group of children, such as is represented in a public school system in the West or Middle West in the United States, where all the children except a few idiots and a few physical invalids are in school, this is what we find. If we measure the general intelligence of all the school children, we obtain Terman's curve of distribution. Most of the children are normal (average), for normal in the psychological sense means, by definition, what the majority can do. About two percent of them will fall so low on the curve that we call them feeble-minded. Just above them, and continuous with them in mental ability, are the dull and inferior, who in turn merge with the normal. At the other extreme, about two percent of the children will

IB

DISTRIBUTION OF INTELLIGENCE AMONG SCHOOL CHILDREN

(Terman)

n

56-65 66-75 76-85 86-95 96-105 106-115116-125126-135 136-145 IQ .33ft 2.3* 8.6* 20.1* 33.9* 23.1* 9.0* 2.3* .55* Fig. 4. — Actual distribution of 905 school children, chosen at random and measured for general intelligence. (From Terman. Reproduced from The Measurement of Intelligence, by permission of, and special arrangement with, Houghton Mifflin Company.)

fall so far above the average that they can progress through school approximately twice as fast as can the average child.

Let us note again what was said previously, — that children differ far more in mental traits than they do in physical traits. The tallest child of a given age is not more than twice as tall as the shortest child, among ten thousand. The longest infant in a thousand is not quite twice as long as the shortest infant. But the most intelligent child among ten thousand is many times as capable as is the dullest. It is possible to find children whose intelligence is approximately zero, — vegetative idiots ; and to find, on the other hand, children whose intelligence measures 180 or more, as compared with the average of 100. Two children, one boy and one girl, of more than 180 intelligence quotient have been found in recent years in the Horace Mann School. Miss Coy furnishes us with an account of the school career of a girl whose intelligence quotient is given as 167. Thus in mental traits there is great variability.

A Few More Will Be Found among the Feeble- Minded than among the Very Gifted. It is true that if we included not only school children in our measurement of the juvenile population, but all children born into the community under consideration, we should find our curve slightly weighted at the lower end. This would be the case because disease and accident can operate to reduce a mentality that was potentially normal or superior. But we know of no external influence that can operate to raise a low or mediocre mentality to higher levels. A small percentage of feeble-mindedness is caused by pathological conditions which affect the nervous system. This matter will be discussed more fully in a subsequent chapter. For the present we shall merely state that the great majority of subnormal children result just as the mediocre and the superior result, from the operation of the laws of heredity and variation. Our concern is with those unfortunate deviates, who fall at the extreme lower end of the distribution curve for general intelligence.

Feeble-Mindedness as Related to Sex. It has sometimes been stated that there are more feeble-minded boys than feeble-minded girls. This statement has been based on erroneous inferences, from the statistics of institutions for the detention of the feeble-minded. These statistics nearly always show that there are more males than females among inmates. The following figures, taken from Dr. Kuhlmann's researches, are fair samples:

1. Results of 1915 Questionnaire, returned from seven states:

In Institutions for the Feeble-Minded

Males Females

2. U. S. Report for 1910.

In Institutions for the Feeble-Minded

Percent 53.8 462

It is true that institutional statistics almost invariably show more males than females detained as feeble-minded. It would, however, be unscientific to conclude from such data that there are more feeble-minded males in the population at large ; that more feeble-minded males are born. Institutional statistics may be merely an index of the degree to which it is easier for one sex to survive outside of institutions, than it is for the other.

That such is indeed the case is well shown by a research made at the Clearing House for Mental Defectives, in New York City, in 1913. One thousand consecutive cases of intellectual defect were taken from the files of this institution. In all cases the chronological age and the intellectual status (mental age) were carefully noted. Of the 1000 individuals thus tabulated, 568 were males and 432 were females. Of individuals brought for diagnosis before they were sixteen years old, 490 were males and 273 were females. Of individuals brought after they were sixteen years old, 78 were males and 159 were females. Of individuals over thirty years of age there were three times as many females as males. These facts are shown graphically in Figure 5.

The research also showed that the males brought to this clinic for diagnosis and commitment were of distinctly higher mental status, age for age, than were the females. The figures proved, for instance, that a girl or woman with a mental age of six years survives outside of institutions about as well as does a boy or man with a mental age of ten or eleven years.

The reason for this state of affairs is not far to seek. To interpret the facts we have but to reflect en our social organization. Women and girls as a class do not follow competitive careers. The work of

U5

DISTRIBUTION BY AGE OF 1000 MENTAL DEFECTIVES PRESENTED CONSECUTIVELY FOR DIAGNOSIS

(Hollingwonli)

■MALES -FEMALES

AGE IN YEARS J I I I I I I I I l_

"H-niirr— JI"rj...Ljn...j..-i-Lj-;

Fig. 5. — Distribution by age of 1000 mental defectives, 568 males and 432 females, presented consecutively for diagnosis ; showing inequality of social and economic pressure upon the two sexes. (From Hollingworth. Reproduced by courtesy of William Wood and Company.)

the majority is in the house, domestic service and child-bearing, performed in isolation, and not in competition with others for a wage. Moreover, in our society, sex as such may be a commercial asset to girls and women, opening to them ways in which they may survive without much regard to intellectual status. The various psychological studies of prostitutes make this fact clear beyond a doubt.

Men, on the other hand, form a highly competitive class, working in rivalry with each other for a wage. The boy who cannot compete becomes an object of concern, is brought to the clinic, and is directed toward an appropriate institution. The girl who cannot compete is not so often recognized as defective, since it is not unnatural for her to drop into the noncompetitive life of the home, where she can " take care of " small children, peel potatoes, scrub, and perform other routine household tasks. If physically passable, as is often the case, she may marry, thus fastening herself to economic support. Indeed, it is not at all uncommon for the ignorant parents of a feeble-minded girl to object strenuously to her commitment, on the grounds that she already has " a nice fellow," and will soon marry. Social and economic pressure bears very unequally upon the sexes in the matter of commitment to institutions for the feeble-minded.

The reports made by inspectors of ungraded classes also nearly always show more boys than girls in such classes. For example, in a recent survey of the ungraded classes of the Bronx, in New York City, there were found 258 boys and 103 girls on the register. The inspector, however, does not fall into the error of concluding that this means more feeble-minded boys than girls in the schools at large. She says, " The fact that more boys than girls are found in these ungraded classes permits of explanation other than that of greater variability in males. One of these is based on the fact that boys have greater freedom, are less restrained than girls. Because of this, they come into conflict with their school environment. This maladjustment makes it imperative that some notice be given to them, and some explanation sought."

Dr. Sylvester makes the same general observation, in discussing the fact that more boys than girls are found in ungraded classes in Philadelphia. He says, " Sex distribution is of little importance. For reasons not of interest here, a relatively small number of girls are placed in the special backward classes. It is a matter of observation confirmed by these results (in mental tests), that the girls of these classes, as a group, are more backward than the boys. . . . Obviously the girls of a mental grade corresponding to the brighter boys in the backward classes were left in the regular classes."

Dr. Terman found that when pupils are measured at random, in a wholly objective way, by means of mental tests, there is no sex difference in numbers of feeble-minded identified.

The conclusion, therefore, is that there are as many feeble-minded girls as boys in the schools, but that the former are not so frequently selected for ungraded classes, where subjective judgment enters at all into the choice. The subjective standard of what constitutes normal intelligence is apparentlylower for girls than it is for boys.

Feeble-Mindedness as Related to Race. The few investigations which have been made in the matter of race differences in intelligence have indicated that, on the whole, Indian and negro children have a somewhat lower average intelligence than do white children. This would mean, then, that a greater proportion of negro or Indian children would be far behind the norms in mixed communities, than would be the case with white children. A greater percentage of negroes and Indians would find their way into the ungraded classes, where the norms of performance are determined or partially determined by whites. White children of various nationalities seem to be very much alike in respect to the proportion of feeble-minded among them. Mental tests seem, on the whole, to give about the same results when used on English, German, Russian, and Italian children. A great many more comparative studies of races will be necessary before absolutely conclusive statements can be made on the subject. It may be that a comparison of the black race and the white race, based on negroes found in the United States, is misleading, for we cannot be sure that their ancestors formed a wholly unselected sampling of negroes.

Possibly those who could be caught and led into slavery were on the average more stupid than those who were not caught. If this were true, a comparison between the white race and the black race, based on negroes found in the United States, would be as misleading as a comparison of native Americans with Italians or Portuguese found in the United States.

Feeble-Mindedness as Related to the Environment. It is quite true that we find inferior children originating most often in inferior homes. The majority of the feeble-minded come from families with inferior incomes, living in an inferior environment. It is very easy to misinterpret this state of affairs, and to infer that the low-grade environment is the cause of the children's inferiority. It has even been suggested that we should obtain norms for the various social classes, as though all could not be related to one norm for the population chosen at random. If carried out to its logical conclusion, this would mean that by measuring the inmates of schools for the feeble-minded, we might obtain a norm which would be applicable to such inmates, on the basis of which they could then be classified as " normal " !

The most reasonable interpretation of the relationship which is found between feeble-mindedness and low-grade environment is that the former is the cause of the latter. Feeble-minded parents produce feeble-minded children, and they also maintain inferior homes.

1. Hollingworth, L. S., The Frequency of Amentia as Related to Sex. Medical Record. Oct., 1913.

2. Kuhlmann, F., The Part Played by the State Institutions in the Care of the Feeble-Minded. Journal of Psycho-Asthenics. Sept. and Dec, 1916.

3. Montague, H., and Hollingworth, L. S., The Comparative Variability of the Sexes at Birth. American Journal of Sociology. Nov., 1914.

4. Morse, J., A Comparison of White and Colored Children Measured by the Binet-Simon Scale of Intelligence. Popular Science Monthly. 1914.

5. Phillips, B. A., The Binet Tests Applied to Colored Children. Psychological Clinic. 1914.

6. Report on the Mental Examination of Certain Pupils in the Thomas Indian School, Iroquois, N. Y. Eugenics and Social Welfare Bulletin No. XL Bureau of Analysis and Investigation, State Board of Charities. Albany, N. Y.

7. Reports on Special Classes. Nineteenth Annual Report. Sex Distribution of Children in Ungraded Classes in the Bronx. Department of Education. New York City, 1916-17.

8. Rowe, E. C, Five Hundred and Forty-Seven White, and Two Hundred and Sixty-Eight Indian Children Tested by the Binet-Simon Tests. Pedagogical Seminary. 1914.

9. Strong, A. C, Three Hundred and Fifty White and Colored Children Measured by the Binet-Simon Measuring Scale of Intelligence. Pedagogical Seminary. 1913.

10. Sunne, D., A Comparative Study of White and Negro Children. Journal of Applied Psychology. 1917.

11. Sylvester, R., The Form Board. Psychological Monographs. Volume XV, No. 4. Sept., 1913.

12. Terman, L. M., Sex Differences. The Relation of Intelligence to Social Status. (Stanford Revision and Extension of the Binet-Simon Scale for Measuring Intelligence.) Warwick and York. Baltimore. 1917.

13. Thorndike, E. L., Individuality. Houghton Mifflin Company. New York. 1911.

14. Whipple, G. M., Classes for Gifted Children. Public School Publishing Co., Bloomington, 111. 1919.

Chapter II The Scientific Study Of Mental Defectives

What Reasons Have Educators and Society at Large for Studying Subnormal Children? Let us reflect for a moment upon the significance of such children for the social life of their day, and for the future history of civilization. We have our distribution curve, representing, let us say, the intelligence of all adults at any given time. We have the average, the majority of mankind, working along and conserving the traditions of the race. They live with average ability and in average happiness. They present no special problem. They determine the normal life of their time by sheer force of numbers. They tend neither to degenerate, nor to advance markedly beyond traditions.

At the extremely low end of our curve we have the undesirable and unfortunate deviates, the dull, the subnormal. They constitute a great burden, economically and socially. They tend to draw the whole mass of mankind downward. This influence works in a great variety of ways. By intermarriage with the more intelligent, the subnormals tend to de- k grade all the social body. By marrying or cohabiting c 17 among themselves they produce a numerous offspring, and increase the financial burden on public and private charity. Psychologists working in penal institutions and courts have shown conclusively that crime and delinquency of all kinds are closely related to mental subnormality. Alcoholism is closely bound up with mental deficiency, many feeble-minded persons being chronic drunkards. Disease easily originates among the unintelligent, and is spread broadcast by them. The problem of the unmarried mother is to be understood more clearly in the light of mental inferiority. Since subnormal children grow up into subnormal adults, there is certainly sufficient reason here for studying them.

The Proportion of Mentally Deficient among Delinquents Is Very Great. In California, where the problem of subnormality has been studied by psychologists and educators with special care, it is stated that on the most conservative reckoning, more than twenty-five percent of the inmates of reform schools are feeble-minded; that the proportion is fully as high among those brought into the juvenile courts; and that a fourth, at least, of the convicts in the prison of St. Quentin are either defective or just above definite deficiency. In New York, psychologists give the percentage of feeble-minded in reformatories and prisons as approximately twenty-five percent. In the Bedford Reformatory for Women about a fourth of the inmates were found to be feeble-minded ; in Auburn Prison the same proportion ; and in the Westchester County Penitentiary the percentage rises to one third.

In Illinois, the figures are about the same. It would be merely wearisome to multiply statistics. As psychological investigation progresses, the problem is shown to be nation-wide; indeed, world-wide. There is no longer any question of the fact that delinquency and mental subnormality are causally related.

Alcoholics Are Often Mentally Deficient. The problem of chronic alcoholism, which has always been such a burden on society, is much more clearly seen when viewed in the light of psychological data. Dr. V. V. Anderson found that of one hundred drunken women a large proportion were not of normal mentality. Dr. H. H. Goddard has laid stress on feeble-mindedness as a cause of alcoholism. The present writer has seen how great a part low intelligence plays in filling the alcoholic wards of Bellevue Hospital, in New York City. To study subnormal children is therefore to study, in some measure, the problem of alcoholism.

There Are Many Feeble-Minded Women among Unmarried Mothers. Dr. Jean Weidensall has reported the percentage of mental defectives among an unselected series of the unmarried mothers, from the obstetrical service of the Cincinnati General Hospital. The mental examination of these women showed that between 54 percent and 58 percent of them were definitely feeble-minded. " From 40 to 45 percent of the unmarried mothers are almost without question so low-grade mentally as to make life under institution care the only happy one for themselves, and the most economical and the only safe arrangement for society." The findings of Dr. Grace Fernald in California are in harmony with these results. The illegitimate child is very frequently the offspring of a feeble-minded mother.

Many Prostitutes Are Feeble- Minded. Studies made at Bedford Reformatory, in New York, by the New York Probation and Protective Association, at the Magdalen Home in New York City, and in other places prove that there are many mentally defective prostitutes. The proportion among the girls who are detained in these institutions does not, of course, fairly represent the proportion of feeble-minded among prostitutes in general, for only the more stupid are likely to be apprehended. The brightest are not available for mental examination. Nevertheless, it is quite evident that prostitution gains hundreds of recruits annually from the numbers of the intellectually subnormal.

Chronic Unemployment Is Often Due to Mental Deficiency. Tests of one hundred and fifty migrating, unemployed men, commonly called " hoboes," who passed through Palo Alto, California, in the spring of 1915, gave a proportion of feeble-mindedness as high as that found among convicts. Of unemployed men who came for shelter to the Municipal Lodging House in New York City during the winter of 1914, one in every eight was shown by mental tests to be definitely feeble-minded. No record was kept of the number who tested just above the border-line, but the number must have been very great. One of the commonest complaints made of feeble-minded individuals, in reply to the question, " Why do you bring him here? " is, " He cannot hold a job."

The Cost of All This Anti-Social Conduct Is Very Heavy. Dr. Terman estimates that feeble-minded criminals and misdemeanants cost California annually about $2,000,000. " When there is added to this the loss accruing from the part played by feeble-mindedness in alcoholism, pauperism, prostitution, and disease, it is reasonable to conclude that the mentally defective inhabitants of California entail a burden upon the state in excess of $5,000,000 a year."

The State Commission of Prisons of New York estimates that it costs $1,000 to detain, indict, try, and dispose of the average felon. In the year 1917, 2,279 felons were received into the State prisons, costing the public treasury $2,279,000. Of these individuals eighty-seven percent had served previous terms. By their release into the community, and their return to their former habits, the State had to spend about $2,000,000 to dispose of them again.

Each time this great group of repeaters has to be retried, the same great amount of money must be expended again.

What California and New York spend is not more than has to be spent by other states. The burden is, however, not only financial. Misery and disease are generated by the mentally defective. Normal persons are often the victims of their crimes. Normal persons are contaminated by the diseases which they carry. Nothing can be more certain than that low-grade intelligence constitutes one of the heaviest social burdens with which we have to reckon.

Nearly All of the Mentally Defective Pass, as Children, through the Schools. Under our compulsory school laws all except the lowest grade of feeble-minded come under the supervision of the teachers. The defective paupers, criminals, unmarried mothers, alcoholics, prostitutes, hoboes all have school histories. When these histories are elicited, it is found that they were the chronically " left back," the truants, the disciplinary problems. Typically they drift through school as repeaters, till at the age of sixteen years they have reached the 5th or 6th grade. They then drop out, being no longer within the limits of compulsory school age. Young adults, who have passed through school since ungraded classes have been established, sometimes have a history of having attended these classes. All subnormal individuals should be identified and studied while yet they are children, in order that they may be trained in useful specific habits up to the limits of capacity; and in order that those who are incapable of any social adjustment may be protected from miserable and delinquent careers. We must discover the subnormal child, who is potentially a social menace.