A. KINDS OF SOCIAL CARE CONTEMPLATED
At first it seems like a hopeless task to try to bring harmony out of
the confused estimates of the proportion of the feeble-minded in modern
society. Authoritative estimates by commissions or by recognized experts
range from less than 0.2% to 5.0% that is, from 2 to 50 per thousand.
Further study of these estimates shows that they reflect not so much a
difference in expert opinion about the same problem as differences in
the problems which were considered in making the estimates. As soon as
we compare only those estimates that have been made to answer the
question, what percentage of low grade minds should be provided with a
certain form of social care? it is rather surprising how much less the
discrepancy becomes. An analysis of important estimates will therefore
be undertaken in order to try to discover some of the sources of
disagreement.
The most significant thing about an estimate is that the estimator is
thinking of providing for his group of deficients in a special way. This
is the purpose of the estimates. Three important groups of the mentally
deficient now demand attention. They are: (1) The group which, for moral
and eugenic reasons, society is justified in isolating for life or an
indefinite period. (2) The group which needs special simple industrial
training in order to get along with social assistance without isolation.
These deficients may be cared for in their home towns by special
schools, public guardians, and after-care committees. (3) The group
which needs special school assistance, but is socially passable after
leaving school. These individuals are incapable of competing in school
with their fellows, but they are able to get along in the simplest
employments without social assistance. We may designate these three
groups as those needing (1) social isolation, (2) social assistance, and
(3) only school assistance. The largest estimates of feeble-mindedness,
it will be found, include the third group, while the smallest intend to
include only the first group. The first and second groups are clearly
below the limit of feeble-mindedness designated by the verbal definition
of the British Commission. They are socially unfit. The language of that
definition is ambiguous enough to include the third group, but the plan
of the Commission, judged by its consideration of the number to be sent
to special schools, would regard only the first two classes as
feeble-minded. Following this common conception I have regarded those in
the third group as above the feeble-minded. It will help to find harmony
among the estimates if we estimate separately those mentally deficient
enough to need social isolation, social assistance, and only school
assistance. This discrimination of the retarded by the kind of social
care needed should also make the social definition more useful.
B. ESTIMATES OF THE SCHOOL POPULATION VERSUS THE GENERAL POPULATION
Before we consider the percentage estimates in detail for these
different forms of social care, let us note the effect on them of two
other considerations. The first of these is the discrepancy between
estimates of the proportion of feeble-minded among school children and
estimates as to the proportion in the general population. Since
feeble-mindedness is regarded as a permanent arrest of mental
development occurring at an early age and usually due to hereditary
causes, it is plain that a school child who is feeble-minded would be
expected to remain so for life. Nevertheless we find that estimates of
0.3% of the general population are accompanied by estimates of 1.0% or
2.0% of the school population as feeble-minded. I have not been able to
find any careful attempt to account for these discrepancies. The
excessive mortality among the feeble-minded is hardly adequate to
explain so great a difference.
It is interesting to note some of these comparisons. Goddard, for
example, considers it conservative to estimate that 2% of the school
population is “feeble-minded” (_112_, p. 6). In the same publication he
says: “There are between 300,000 and 400,000 feeble-minded persons in
the United States” (p. 582). Since the elementary school enrollment is
about 20,000,000 (_208_), the feeble-minded school children alone on his
first estimate would account for 400,000 feeble-minded in the United
States without allowing for any feeble-minded outside of the ages in the
elementary school.
The report of the British Royal Commission, published in 1908, forms the
starting point for many of the estimates made today. The commission
added together the number of school children which were thought to
require special classes with the number of defectives found in
institutions, prisons and almshouses, or reported by its medical
investigators. The total gave 0.46% of the general population as
“mentally defective persons,” not including certified lunatics. From
this amount should be deducted .06% who were insane but had not been
certified as such, leaving 0.4% mentally deficient. This was not
regarded by the Commission as an estimate, but was the number actually
“enumerated by the medical investigators” in sixteen typical districts
studied in England and Wales with a total population of 2,362,222 (_83_,
VIII, p. 192). Turning to the school children we find that in the areas
investigated there were 436,833 school children of whom 0.79% were found
defective. Since this was an enumeration and not an estimate, the
commission paid no attention to the discrepancy between 0.79% of the
school children and 0.31% of the rest of the population. Tredgold,
moreover, based his estimates of the frequency of the mental deficiency
in England and Wales on the data of the Royal Commission without
attempting to harmonize this discrepancy. This oversight has apparently
been one source of the not uncommon difference between the estimates for
school children and for the general population. One suspects that the
fact that the elementary school population is about a fifth of the
general population, has also mistakenly contributed to this error. The
discrepancy of three to five times as large a frequency of deficiency
among school children as in the general population certainly needs
clearing up.
There is an escape from this dilemma which seems more reasonable than to
attempt to account for the discrepancy by excessive mortality. When
estimates are made concerning the school population the estimator is
usually thinking of that group of feeble-minded which needs special
school training and probably social assistance afterward. When estimates
are made of the general population the estimator is likely to be
thinking of that group which must be cared for permanently by society,
mainly in institutions or colonies. For some time at least the state
cannot be expected to undertake the indefinite care of all the
deficients who should have, at once, simple industrial training, in
special local schools or classes in order to survive, even with social
assistance. This difference in the type of care contemplated seems most
naturally to account for the discrepancy found with many writers,
between their estimates for the school population and for the general
population.
C. DESIRABLE VERSUS IMMEDIATELY ADVISABLE SOCIAL CARE
A second source of confusion arises when one investigator is thinking of
the number of feeble-minded, the care of whom it is _desirable_ that
society should assume, and another is thinking of the feeble-minded, the
care of whom it is _advisable_ for society to assume at once. Considered
in connection with a specific case the distinction is quite obvious. It
is one thing to say that it would be desirable for the state to assume
the indefinite care of a particular person, it is quite another thing to
say that it would be advisable for the state to assume that care
immediately, when one remembers the crowded condition of the
institutions, the necessity of caring for the worst cases first, the
possibility of the person being cared for by his own family or in a
local school, the added public expense, the necessary neglect of other
movements for social welfare if society assumes this expense, etc., etc.
When you magnify this problem in the mind of the estimator who is
interested in the question of caring for the groups of feeble-minded,
the result is that his estimates of the size of the groups are decidedly
affected. For example, few would deny that the Site Commission of New
York appointed to locate the colony for mental defectives, now known as
the Letchworth Village, was emphasizing a program of permanent social
care when it estimated the number of feeble-minded in New York. The
Commission, “after taking into consideration the figures of the State
and National census, and other data collected from institutions,”
estimated that there were in New York state possibly 12,300 mentally
defective persons (Editor's Note, _205_, p. 84). This is less than 0.15%
of the population and very low compared with most estimates.
The low estimates will generally be found to be influenced by
considerations of public expense rather than the social unfitness of the
lower group. Inasmuch as there are no sharp distinctions between
different degrees of mental ability this consideration of public expense
is perfectly proper. At the other extreme, however, are the eugenists
who are convinced that it is _desirable_ to isolate a large group at the
lower range of ability. The member of the legislature will be concerned
mainly with the question how much money will the public be willing to
appropriate now for the care of these unfortunates. The eugenist will be
thinking of an ideal rather far in the future towards which to work.
The diagnostician should take a conservative intermediate ground. He may
leave to the court or other authorized tribunal to decide whether the
public has the facilities available at present for caring for a
particular weak-minded person, but he must decide whether expert
scientific opinion at the present time will justify diagnosing this
degree of deficiency as suitable for the special care provided for the
feeble-minded. Whether it is advisable to care for the particular
deficient at home, in a special local school, or in a state institution
would be left to the legal authority to decide. Under present
conditions, the diagnostician may possibly indicate whether the
individual is deficient enough to justify social isolation, or merely to
justify sending to a local elementary day school for deficients.
D. PERCENTAGES SUGGESTED TO HARMONIZE THE ESTIMATES
It is from the point of view of the diagnostician that we shall attempt
to focus this question of the percentage of feeble-minded. We shall
tentatively suggest limits as to the degrees of _intellectual
deficiency_ which we might be justified in regarding, under the present
conditions of scientific knowledge as being low enough in intellectual
capacity to justify particular forms of social care. Such estimates will
be of value if they help to harmonize the conflicting opinions by
bringing them into relation with the above analysis. We shall,
therefore, compare the suggested percentages with a number of
authoritative statements of the frequency of feeble-mindedness. By
considering the differences in the nature of the estimations we may
approach nearer to an understanding of the problem.
Since the percentages to be suggested are chosen from the point of view
of diagnosis, they do not represent the number for which every community
should immediately make financial provision. The expense is a local or a
state question. It is so much affected by state conditions and by public
policy that it probably must be determined in any state by a special
commission. On the other hand, the laws already provide for caring for
the feeble-minded in institutions or colonies and in special schools or
classes, so that the estimates may help to guide diagnosticians who are
called upon to decide whether a particular person might be rightfully
regarded as deficient enough intellectually to justify committing him
for permanent care to a state institution. In the present practise it is
fairly clear that this distinction is made in the minds of different
diagnosticians. It may ultimately be desirable that this differentiation
between the types of social care be introduced into the law. Until then
it will remain the duty of the court to determine what degree of social
unfitness is intended by a particular law. The social concept of
feeble-mindedness is just now undergoing a rapid evolution so that it
would be impossible to predict how it may legally crystallize a
generation hence.
To begin with the lowest group of the feeble-minded, we should consider
those whom the state might be clearly justified in isolating
indefinitely on the basis of their tested lack of intellectual capacity,
the social isolation group. For purposes of comparison let us place this
degree of intellectual ability as that possessed by the lowest 0.5% at
fifteen years of age. Above these let us estimate a group of uncertain
cases so far as isolation is concerned, but cases which the
diagnostician would be justified in regarding as intellectually
deficient enough to justify sending to special local schools for
training the feeble-minded. After special training the majority of these
cases might be expected to require social assistance indefinitely. They
would form the social assistance group. Isolation would be justified for
none of them on the basis of their test records alone. Those in this
group who were persistent delinquents would, by that additional fact,
fall into the lowest group so far as social care is concerned. Let us
estimate this social assistance group tentatively as the next 1.0% at
fifteen years of age.
These estimates have been made as at fifteen years of age since the
effect of the excessive mortality especially among the isolation group
is uncertain and may need to be allowed for in a discussion of the
percentage deficient at different ages. If the mortality were as great
as has been described among institutional cases in the previous chapter,
a rough estimate of the percentage intellectually deficient in the
general population places it at less than 0.5%. This estimate may be
made by using the estimated deficiency at the median age of those under
15 years of age and at the median age of those 15 years of age and over.
According to the age distribution of the 1910 census, there were 32%
under 15 years with a median age of 6 years. At age six 0.67% would be
presumed as low as 0.50% at 15 years. The older group (68% of the
population) has a median age of 32 with a corresponding percentage in
the isolation group at that age of 0.30%, after allowing for differences
in mortality on the plan indicated in Table II. This rough estimate for
the lowest group indicates that 0.42% of the general population would be
of as low a degree of intellectual capacity as the lowest 0.5% at 15
years. Our plan presumes, therefore, that between 0.4% and 0.5% of the
population are unable to pass their entire lives outside of institutions
under ordinary conditions; _i. e._, make an honest living and live
within the law even with social assistance and supervision.
The corresponding estimate for those requiring only social assistance
would be between 0.8% and 1.0% of the general population above the
lowest group. This might vary from approximately 1.34% at 6 years to
0.59% at 32, the median age for those over 14 years. Since the mortality
is probably less among deficients not in institutions, as they average
higher in ability, the changes in the percentages are probably extreme
estimates. We should keep in mind, however, the possibility that with
the excessive death rate the lowest 1.0% at 15 may mean an ability
corresponding to the lowest 1.34% at 6 years and the lowest 0.60% at 32
years.
The next higher group in intellectual ability is so high as not to
require social assistance outside of school. When we ask how large a per
cent. we should be justified in placing in this group and separating
merely for special instruction in school, we reach a condition which is
at present so ill-defined even in the minds of educators that it seems
best to fall back on the general advice that our school systems should
provide just as nearly individual instruction as the public purse and
managing genius can devise. Mannheim, Germany, for example, takes care
of 18 per cent. outside of its regular school classes. The ideal is
individual instruction for all. School authorities would be justified in
providing special instruction for every degree of mental ability, if the
cost would not restrict other more important social undertakings. This
less degree of retardation in the group needing only school assistance
should not, however, be classed as feeble-minded. We shall see later the
percentages for which some authorities have considered it already
advisable to provide special school instruction. We need not attempt to
estimate the size of this group, as it is beyond the limit of
feeble-mindedness.
The purely conative cases are not taken care of in the above estimates,
which are intended for tested deficients. If the conative cases
unaccompanied by intellectual deficiency should be regarded as frequent
enough to replace those in the social assistance group who ultimately
care for themselves, plus those subtracted by the excessive death rate,
we would have a total of 1.5% of the general population feeble-minded
enough to warrant social care of some sort. About 0.5% might justly be
isolated. The reasonableness of this program can be judged by comparison
with authoritative estimates now to be reviewed. The problem here is
whether this is an unreasonable program for the diagnostician to assume
as scientifically justified, remembering that these estimates are for
tested deficients at 15 years of age and do not include purely conative
cases which might occur above these intellectual borderlines.
E. COMPARISON WITH IMPORTANT ESTIMATES
_The Social Isolation Group._ We are now ready to consider some of the
important estimates which throw light upon the reasonableness of the
percentages we have named. First, what percentage would we be justified
in socially isolating? In the United States Census Report on the Insane
and Feeble-Minded in Institutions in 1910, we find that the number then
actually in institutions for feeble-minded was only about 0.02% of the
population. At the most frequent ages this rises to about 0.05%. It is
evident that the number actually isolated is of little significance
except as a check on the estimates. The report, however, refers to the
special estimate made by the public authorities in Massachusetts which
also included feeble-minded in state hospitals for the insane, other
asylums, those reported by the overseers of the poor and those
enumerated in the general population. The U. S. report says: “The census
was not regarded as being complete, but it is of interest to note that
if the number of feeble-minded in proportion to the total population was
the same for the entire United States as it was in Massachusetts
according to this census, the total number of feeble-minded would be
over 200,000. Probably this may be regarded as a conservative estimate
of the number of feeble-minded in the United States and would indicate
that not over one-tenth of the feeble-minded are being cared for in
special institutions” (_205_, p. 183). This estimate, which thus amounts
to about 0.2%, may probably be considered as a reasonable program of
expansion from the institutional viewpoint. The diagnostician who is
considering the individual and not the mass must supplement it by
considering who should be isolated if facilities were available. If the
census bureau can contemplate institutional care for ten times those at
present thus provided for, it gives us some indication of a reasonable
limit as to the increase in institutional care that can be assumed to be
reasonably contemplated at present.
Dr. W. D. Cornell, director of medical inspection of the Philadelphia
public schools, after the personal examination of those cases which in
the opinion of the teachers should be sent to institutions, places the
“institution cases” at a minimum of 15 per 10,000 school children. He
adds: “The number of evidently feeble-minded above 6 years of age may be
said to be 1 to every 500 of the population. These figures are
conservative and have been accepted by experts for years.” This then is
the minimum estimate and quite clearly refers to institutional cases.
A committee of the Public School Alliance of New Orleans, of which Prof.
David Spence Hill was chairman, reported in 1913 a careful census of the
public school children in that city the previous year made by the
teachers in co-operation with the Newcomb Laboratory of Psychology and
Education. Each teacher was asked to state her opinion as to how many in
her room were “feeble-minded or insane children who should be under
institutional or home care, rather than in the public schools.” Also the
number of backward children not in the above class “who urgently need
special educational methods in special classes within the special
schools.” About a fifth of the total of the 38,000 school children in
the city are colored. The grand total showed 0.28% in the first class
mentioned above, and 7.7% in the second. Speaking of those “thought by
teachers to be feeble-minded” and needing institutional care the report
says:
“The figure 0.28 of 1% coincides exactly with the estimate of the
Philadelphia Teachers' Association made in 1909 in a census of 150,000
school children. Secondly, while the teacher's estimates are open to
revision, nevertheless her judgment, as inevitably evidenced in her
attitude toward the child, is the _practically effective judgment_”
(_157_, p. 6). It is a well-known fact that teachers tend to
underestimate the frequency of mental deficiency, so that it would
certainly be a matter of regret if this were to continue to be the
“practically effective judgment.”
Another census of the institutional type of feeble-minded made by the
Director of Public Health Charities in Philadelphia and reported in 1910
enumerated 0.2% of the population as in this group. It included cases in
the institutions for feeble-minded, the insane hospitals, almshouses,
hospital, reformatories, orphanages and known to charity workers (_168_,
p. 13).
One of the most careful surveys of individuals who, because of mental
abnormalities, show such social maladjustment as to become the concern
of public authorities was made under the auspices of the National
Committee for Mental Hygiene in 1916.[5] It selected Nassau County as
representative of New York state. Part of the survey consists of an
intensive house to house canvass of four districts of about a thousand
population each. The result disclosed that 0.54% of the population of
this county were socially maladjusted because of “arrests in
development” and 0.06% more, because of epilepsy. This was in a
population of 115,827.
The Children's Bureau in the U. S. Department of Labor in 1915 made a
census of the number of “mental defectives” in the District of Columbia.
The census included only those whom we have termed feeble-minded. The
report states that 798 individuals, 0.24% of the population, were found
to be “in need of institutional treatment; and the number reported,
allowing for the margin of error in omission and inclusion, is probably
a fair representation of the number in the District who should have
custodial care” (_88_, p. 13). Over a quarter of the population of the
District is colored. The census was taken in connection with plans for
immediate care. The same Bureau also made in 1915 and 1916 a Social
Study of Mental Defectives in New Castle County, Delaware.[6] This
county had a population of 131,670 and the survey disclosed 212
“positive cases of mental defect” and 361 “questionable cases,” a total
of 0.44% of the general population in this county. Among the positive
cases, 82.5% were in need of public supervision or institutional care.
Among the questionable cases, information was obtained about only 175,
and 165 of these were either in institutions, delinquent or
uncontrollable, or living in homes where proper care and safeguarding
were impossible.
Two other important attempts to enumerate carefully all the
feeble-minded in definite areas in the United States have been made in
recent years. Lapeer County, Mich., was chosen for such a study, as it
was of average size and contained no large city. The census as reported
in 1914, showed 36 feeble-minded from that county in the state
institution and 116 others living in the county, a total of 1 from every
171 inhabitants (_145_). A special children's commission was appointed
by the state of New Hampshire to investigate the welfare of dependent,
defective and delinquent children. Its report in 1914 contained a
section by its chairman, Mrs. Lilian C. Streeter, on feeble-mindedness
(_40_). This comes the nearest to a complete enumeration for an entire
state which has ever been attempted. The commission tested with the
Binet scale the inmates of the State Hospital for the Insane, the County
Farms, the State Industrial School and the Orphanages within the state.
The borderline which it used for the scale was high. It counted all
those testing three or more years retarded and under XII as
feeble-minded. Taking its figures as they stand we find that they listed
947 as feeble-minded in institutions and 2,019 outside, a total of 0.69%
of the inhabitants of the state. Outside the institutions the commission
sent a questionnaire to all school superintendents and to chairmen of
school boards, physicians, overseers of the poor, county commissioners,
probation and truant officers, district nurses and charity workers
throughout the state, by which means they listed 792 additional cases.
This questionnaire gave the following description of the type of case it
was trying to list as feeble-minded.
“The high grade imbecile, frequently known as the moron, is one who
can do fairly complicated work without supervision, but who cannot
plan, who lacks ordinary prudence, who cannot resist the temptations
that are common to humanity. The high grade imbecile is most
dangerous because, except to the expert, he is apparently not
feeble-minded and is, therefore, usually treated as normal, and
permitted to multiply his kind, and to corrupt the community.”
This description would tend to include cases above our isolation group.
Besides the questionnaire the commission made an intensive study of 52
towns in which it says practically complete census returns were obtained
by consulting doctors, school and town officials. With these
supplementary cases it secured a list of 2,019 cases outside of
institutions, making a total of 2,966 recorded cases within the state or
0.69% of the population. When it estimated the proportion for the entire
state on the basis of the rate of canvass returns to questionnaire
returns, this proportion rose to 0.95%. The commission does not advocate
compulsory isolation for all of these people although it recommends
custodial care for the feeble-minded women and girls of child-bearing
age, apparently of the degree of deficiency represented by its criteria.
This enumeration of 0.69% of the people of a state as feeble-minded is
the most liberal general census of the feeble-minded in any large area.
It clearly shows the trend of diagnosis since the British Census.
The Extension Department of the Training School at Vineland, N. J.,
states regarding estimates of the number of feeble-minded in the general
population: “Conservative estimates give one in three hundred as the
probable present number.” Under the discussion of estimates of the
general population I have already cited Goddard's estimate which was
approximately 0.3 to 0.4% and the enumeration of 0.4% by the British
Royal Commission in 16 districts with over two million population. While
all of these estimators are speaking broadly of the feeble-minded, in
the general population, we shall not be far wrong in supposing that they
are considering mainly those deficients for whom the state might well
expect to provide care for life, isolating all those who cannot be
eugenically guarded at home. We shall later quote the estimate of Van
Sickle, Witmer and Ayres of 0.5% of the school population as
“institution cases.”
Our estimate of 0.5% in the group justifying isolation on the ground of
intellectual deficiency seems to be conservative and to harmonize fairly
this type of estimate.
_The Social Assistance Group._ Passing now to the next higher group of
deficients, those needing special training in order to get along with
social assistance, the estimates have been based almost entirely upon
the study of school children. Francis Warner was the moving spirit in
the early investigations in Great Britain, which were made without tests
from 1888 to 1894. The census which he directed included about 100,000
school children who passed in review before medical examiners. As cited
by Tredgold (_204_) the estimate growing out of this work was that 1.26%
of the school population should have instruction in special classes. Of
these 0.28% required special instruction because of physical defects
only (_204_).
About the same time Will S. Monroe (_155_) on the basis of a
questionnaire sent to California teachers, who reported on 10,842 school
children, found that they estimated 1,054 of these as mentally dull in
school, 268 feebly gifted mentally, and 6 imbeciles and idiots. He
summarized his conclusion as follows: “A long experience teaches that
every school of fifty pupils has at least one child that can be better
and more economically trained in the special institutions than in the
public schools.” In his estimate of 2% he was probably thinking of care
in special local schools and not permanent isolation.
A government inquiry of school teachers in Switzerland, who had charge
of 490,252 school children, reported that 1.2% were so feeble mentally
as to need training in special classes. Only about a tenth of this
number were then being instructed in separate classes (_181_, p. 17).
Great Britain first gave legal recognition to the class of feeble-minded
above the imbeciles in its Education Act of 1898, following a report of
a departmental committee of its National Board of Education growing out
of the inquiries of Francis Warner. This committee estimated the
proportion of this class as approximately 1% of the elementary school
population (_181_). In discussing the comparative estimates on the
general and school populations I have already referred to the estimate
of Tredgold based upon an elaborate analysis of the most extensive data
ever collected,—that gathered by the British Royal Commission on the
Care and Control of the Feeble-Minded. While the Commission's
investigators enumerated 0.79% among the school as mentally defective,
Tredgold's estimate based on his analysis of their report was that 0.83%
of the school population in England and Wales were above the grade of
imbecile but still feeble-minded (_204_, p. 157). The variability of the
estimates collected by the Royal Commission from various cities probably
indicates the subjective character of the standards of deficiency. They
varied from an estimate of 0.24% of the elementary school population in
Durham to 1.85% in Dublin (_204_, p. 159). The Commission says regarding
estimates as to communities other than those reported by their medical
investigator, for Newcastle the “number of feeble-minded children of
school age” (morons) was 0.25%, for Leeds the estimate was 0.80%, for
London 0.50% or 0.60%, for Bradford 0.50%, for Dublin about 1% and for
Birmingham about 1% of the school population. Dr. Francis Warner's
general estimate was 0.8%. We have thus variations in estimates from
0.25%, 0.5%, 0.80% to 1% and some 2% (_167_, p. 90). For the rural areas
the estimates were generally less.
A careful estimate has been made with a different method by Karl Pearson
on the basis of a classification by teachers of school children in Great
Britain into nine different classes each especially defined and
extending from the imbecile to the genius. This distribution of the
children was then fitted to the normal probability curve. On this basis
Pearson estimated that 1.8% would fall in the “very dull group,” defined
as having “a mind capable of holding only the simplest facts, and
incapable of grasping or reasoning about the relationship between facts;
the very dull group covers but extends somewhat further up than the
mentally defective.” Lower down would be 0.1% in the imbecile group. He
says further regarding this estimate: “It is deduced from three series
covering between 4000 and 5000 cases, and the three separate results are
in several accord. It will, I think, be possibly useful for other
inquirers, and it endeavors to give quantitative expression to our
verbal definitions of the intellectual categories” (_166_).[7]
In 1914 Pearson cites estimates of mentally defective children in
several cities by teachers and medical officers based upon the
recommendation of elementary school children for special schools and
classes. These were, for London: boys, 1.59%; girls, 1.09%. For
Liverpool: boys, 0.827%; girls, 0.618%. The corresponding figure for
both sexes in Stockholm is 1.23%. He concludes that “something between
1% and 2% is true for England. Dr. James Kerr, Medical Research Officer,
thinks that the final estimate will be nearer the latter value.”
After giving a table of the percentages at each age in the elementary
schools of Stockholm, Pearson says: “Judged from this table it would
seem that the most reasonable estimate of the prevalence of mental
defect is to be formed when all the mental defectives have been
definitely selected and the normal children have not yet begun to leave
school, _i. e._, at the ages 11 and 12. For Stockholm this leads up to a
mentally defective percentage of about 1.5” (_167_, p. 6-8). In another
place he says that the members of special classes are selected
practically for the same reason, _i. e._, because they are school
inefficients, the bulk of whom will, no doubt, unless provided for
become “social inefficients” (_164_, p. 48). Since some were not
selected because of intellectual deficiency, our social assistance group
should be somewhat smaller.
In 1909-10 the actual number in the schools for mental defectives
maintained by the London County Council was 0.9% of the enrollment of
the London elementary Schools (_143_). The 1912 report of the London
County Council shows 7357 children enrolled in its local schools for
mental defectives, which is 1.1% of the average attendance from
1912-1913 in the elementary county council schools and voluntary schools
of London (_144_, p. 44).
Following a discussion in the Australian Medical Congress of 1911 the
Minister of Public Instruction called for returns as to the number of
feeble-minded in the Australian public elementary schools between 5½ and
14 years of age inclusive. The questionnaire used the definitions of the
British Royal Commission as a description of the various degrees of
retardation and brought returns from 2,241 of the state schools, all
except 57. For their average attendance of 175,000 children, these
teachers classified 1.9% as backward from accidental causes, 2% mentally
dull, 0.42% feeble-minded imbeciles or idiots, and 0.6% epileptics. To
this would be added 0.19% for children in the idiot asylums. The report
states that “the teachers' estimates will thus be realized to be an
absolute minimum, dealing only with the intermediate grades, and not
including the gross cases (idiots, etc.) on the one hand and the less
marked high grades of feeble-minded on the other” (_70_).
The census made by the Bureau of Health of Philadelphia through the
principals of schools in 1909 covered 157,752 elementary school children
of whom 1.9% above the 0.28% who could “properly be in custodial
institutions 'were classed' as backward children who require special
instruction by special methods in small special classes” (_168_).
A survey of the school population in the Locust Point District of
Baltimore was made by Dr. C. Macfie Campbell.[8] The district surveyed
was, however, not considered typical of Baltimore, but was a sample of
an industrial district in which the majority of families are “close to
the poverty line, and too often below it.” Out of a school population of
1,281 children, 166 (13%) were “found to have special requirements on
account of their mental constitution.” Among these, 22 (1.7%) “showed a
pronounced mental defect, which eliminated any prospects of their
becoming self-supporting.”
The city of Mannheim (_147_), which perhaps cares for its exceptional
children better than any other in the world, was in 1911-1912 caring for
0.7% of the children in its _Volkschule_ in _Hilfsklassen_ which do not
take them beyond the fourth grade. There were 12% more who were backward
in school and being taught in _Forderklassen_ where they may reach the
sixth grade. Including the exceptionally bright who were also in special
classes, 18% all together of its school children were not in the regular
_Hauptklassen_ of the eight grades. To these would be added those sent
to special institutions. When we estimate, therefore, that we are
justified at present in sending 1% of the children in school to special
classes because their intellectual deficiency is such that the bulk of
them cannot get along without social assistance, we are naming about the
proportion already thus cared for in several foreign cities.
Among the authoritative estimates of the number of feeble-minded, which
have been made by estimators who had in mind the evidence from mental
tests, is that made by James H. Van Sickle, Lightner Witmer, and Leonard
P. Ayres in a bulletin published by the United States Bureau of
Education in 1911 (_209_). They state that, “if all children of the
public schools could be ranked, it is probable that a rough
classification would group them about as follows—Talented, 4%; Bright,
Normal, Slow, 92%; Feeble-Minded, 4%. The 4% may for administrative
purposes be divided into two groups. The lower one includes about
one-half of one per cent. of the entire school membership.... They are
genuinely mentally deficient, and cannot properly be treated in the
public schools. They are institution cases, and should be removed to
institutions. Ranking just above these are the remaining three and
one-half per cent. who are feeble-minded but who could be given a
certain amount of training in special classes in the public schools.”
The estimate of institutional cases practically coincides with that
adopted above in this paper. The extension of the term feeble-minded to
include the lowest 4% seems to be extreme. The authors do not suggest
what portion of these they think might require social assistance
indefinitely, but are interested primarily in provision for special
classes in the public schools. If the term feeble-minded were to mean
only unfit for regular school classes and not socially unfit, I have
already suggested that the limit for special instruction might be
increased indefinitely. In Mannheim 18% are not cared for in the regular
classes.
The only estimate of feeble-minded which I have found that is so large
as this 4% is that of Binet. It is also intended to cover all cases that
should be sent to special classes regardless of subsequent social
survival. His statement as to those who are so abnormal or defective as
to be suitable for neither the ordinary school nor the asylum is as
follows:
“As to France, precise information has not been available until the
last year, when two inquiries were held—one at the instance of the
Ministerial Commission, the other organized by the Minister of the
Interior. According to the former inquiry we find that the
proportion of defectives amounts to scarcely 1% for the boys, and
0.9% 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 arithmetic test, which we shall explain
presently, and reached the conclusion that 2% of the school
population of two districts were backward. If we were to include the
ill-balanced, whose number is probably equal to that of the
backward, the proportion would be about 4%. 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 neighborhood of 5. All these inquiries are
comparable because they deal with the school population” (_77_, p.
8).
In this estimate of 5%, Binet was considering those to be sent to
special classes regardless of whether or not they would require
indefinite social assistance after their schooling. It is therefore not
directly comparable with our estimate of 1.5% presumably or doubtfully
intellectually deficient.
The estimate of Dr. Henry H. Goddard, who has done the most to introduce
the Binet Measuring Scale in this country, is stated as follows: “It is
a conservative statement to declare that 2% of public school children
are distinctly feeble-minded, the larger part of them belonging to this
high-grade group which we call morons” (_118_). In another (_114_) place
he says: “The most extensive study ever made of the children of an
entire school system of two thousand has shown that 2% of such children
are so mentally defective as _to preclude any possibility of their ever
being made normal and able to take care of themselves as adults_.”[9]
The study to which he refers gives individual results with the Binet
1908 tests made on 1547 school children in the first six grades (_114_,
p. 43). Since the sixth grade does not include the better children who
are twelve years or over in age this group is clearly selected in such a
way that it would show an excessive percentage of mentally retarded
children. We find in the investigation referred to that he says: “Then
we come to those that are four years or more behind their age, and here
again experience is conclusive that children who are four years behind
are so far back that they can never catch up, or in other words, they
are where they are because there is a serious difficulty which can never
be overcome—they are feeble-minded. They constitute 3% of the children
in these grades.”
Since we have a random selection of school children in his table for
only those children who are 6 to 11 years of age inclusive, I find that
only 1% at these ages are retarded four years intellectually. On his own
basis, therefore, 3% is evidently too large an estimate. Later he seems
to have reduced his estimate to 2% of the school population. Of those
who test in the lowest 1.5% including our doubtful group, I believe that
there is no clear evidence that more than 1% will require even social
assistance as adults.
Many more estimates of the number of feeble-minded among school children
might be cited, but they would add little to these authoritative
samples. At the present time an estimate by health officers or teachers
who are not familiar with the results of mental testing has little
significance, as the whole complexion of the problem has been changed
since the work of Binet and Simon.[10] We may, however, cite three
estimates based upon familiarity with test results, which fairly cover
the range of estimates among school children. In connection with the
Springfield, Illinois, survey conducted by the National Committee for
Mental Hygiene under the direction of the Russel Sage Foundation, we
find that three typical schools with a total of 924 pupils were studied.
The report states that “the mentally defective children” constituted
3.8% of the number in attendance in March. The number of children in the
schools examined, for whom instruction in special classes would be
desirable, is about 7% of the entire enrollment of these schools (_203_,
p. 10).
In connection with the Stanford Version of the Binet Scale, Dr. Lewis M.
Terman says: “Whenever intelligence tests have been made in any
considerable number in the schools, they have shown that not far from 2%
of the children enrolled have a grade of intelligence which, however
long they live, will never develop beyond the level which is normal to
the average child of 11 or 12 years.... The more we learn about such
children, the clearer it becomes that they must be looked upon as real
defectives (_57_, p. 10). Again in placing the borderline for
feeble-mindedness” with the Intelligence Quotient used, he suggests that
“definite feeble-mindedness” lies below an I. Q. of 70 which with 1000
quotients was found to exclude about the lowest 1%. Above this is a
group with I. Q.'s 70-80 which he describes as “borderline deficiency,
sometimes classifiable as dullness, often as feeble-mindedness.” This
group would include, as judged by the results of these tests, over 4%
more.
Dr. Wallin, who has had wide experience in testing both school children
and defectives, states: “I will venture the assertion, after years of
teaching in the public schools and clinically examining public school
cases, that the oft-repeated statement that 2% of the general school
population is defective (if by this is meant feeble-minded), exaggerates
the real situation. The actual number is probably about 1%” (_211_, p.
149).
After reading a paper on “A Percentage Definition of Intellectual
Deficiency” before the American Psychological Association in 1915
(_151_), I was pleased to discover that Prof. Rudolf Pintner and Donald
G. Paterson were also about to propose a percentage definition of
feeble-mindedness for those who are dealing with mental tests (_44_).
While their idea seems to be fundamentally similar, their paper shows
that their conception is to be sharply distinguished in several
particulars from that which I am advocating. They would limit the use of
the term “feeble-mindedness” to individuals who test in a rather
arbitrarily chosen lowest percentage of the population. As opposed to
this I suggest continuing the present social definition of
feeble-mindedness and supplementing it, for the purpose of aiding in the
diagnosis, by indicating the social significance of those testing in
certain lowest percentages. Such tested deficients I designate as
“intellectually deficient.” It is important to consider their statement
and to note what percentage they have chosen to regard as feeble-minded.
They say:
“It is in order to avoid this vagueness and uncertainty attaching to
the term that we suggest a definite psychological concept. The
lowest three per cent. of the community at large, that is, the
lowest as determined by definitely standardized mental tests, are to
be called feeble-minded. Such a definition will be unambiguous and
the dividing line between this and other groups will become clearer
and clearer as we increase the accuracy of our measuring scales and
the adequacy of our standardizations. Furthermore, if evolution is
raising the degree of intelligence the three per cent. at the lower
end will still remain, for, whatever the degree of their
intelligence may be, they will still be feeble-minded as compared
with the normal.
“Such a definition will in addition restrict the term to such as are
lacking in intelligence and will differentiate them from the moral
defectives and the psychopathic personalities, which are at present
often confused with the group that we propose to call feeble-minded.
An individual may be at the same time a moral defective and
feeble-minded, but there is reason to believe that moral deficiency
may exist without such intellectual defect as to warrant a diagnosis
of feeble-mindedness. The same may be said of the psychopathic
personality.
“The further question, whether all those coming within the proposed
definition of feeble-mindedness are to be confined in institutions,
is purely social and will be determined by the social needs of each
community and does not concern us here. It is obvious that many more
in addition to the feeble-minded as defined by us will require the
restraint of an institution, even though no real mental defect
exists.
“It is immaterial for the purposes of this hypothesis whether three
or a smaller or larger percentage be designated as feeble-minded.
The important point is the agreement upon some fixed percentage, and
we have chosen three per cent. as covering presumably all the cases
of marked mental deficiency. A brief glance at the chief estimates
of the number of feeble-minded in civilized communities would
indicate that our percentage is somewhat higher than the
conservative writers give, but we shall show later on that it is
much lower than the results obtained from groups of children tested
by intelligence scales” (_44_, p. 36).
With those who understand that deficiency is mainly a question of
degree, it would seem that there might be some agreement as to the plan
for defining tested deficiency. In order to make this plan more useful
to those dealing with the social care of the feeble-minded, it would be
necessary to supplement the bare percentage definition by relating it to
expectations of social failure somewhat after the manner I have
attempted. In particular it will gain its main value for diagnostic
purposes, it seems to me, if the percentage is so chosen that it may
receive the support of conservative scientific opinion. To be most
useful it seems evident, also, that the percentages must be chosen with
regard to the sort of social care which it is anticipated would be
_justified_ for the particular degrees of deficiency.
Let us recall the percentages suggested to harmonize the estimates: the
lowest 0.5% to be regarded as presumably deficient enough to justify
isolation and the next 1% as doubtful, but low enough to warrant special
training and probably requiring indefinite social assistance. If these
percentages for tested intellectual deficiency have been shown to be
fairly conservative estimates in the light of the authoritative
judgments with which they have here been compared, the laboriousness of
this comparison has been worth while. Further light upon the social
assistance group may be thrown by the study of the success of those
children who have already had the advantage of training in local classes
for the deficient.
F. THE ABILITY OF THE MENTALLY RETARDED, ESPECIALLY THOSE RECEIVING
SPECIAL TRAINING.
That we are not justified in isolating all whom we class as
feeble-minded is best indicated by the evidence as to the number of
these sent to special local classes for deficients who are able to float
socially with the assistance of capable after-care committees. A fair
picture of the present situation may be obtained by thinking of these
pupils in the help-classes and schools as representing about the next 1%
above those who have been isolated in institutions. With this picture in
mind let us see what has been the outcome of their special instruction
and social assistance thereafter.
In his book on Les Enfants Anormaux, Binet collected the evidence
available at that time (_77_, p. 140). He says:
“Mme. Fuster, after a stay in Germany, where she visited some
_Hilfsschulen_ and Hilfsklassen (literally, 'help-schools' and
'help-classes') made a communication to the _Société de l'Enfant_,
from which it appears that in the case of 90 classes for defectives
in Berlin, 70% to 75% of the defective pupils who were there became
able to carry on a trade; 20% to 30% died in the course of study, or
returned to their homes, or were sent to medical institutions 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% of
the children were sent home or to asylums; 11% were apprenticed; 62%
worked at occupations which required no knowledge and yielded little
pay (laborers, crossing-sweepers, ragmen). If we add together these
two last groups, we reach a proportion of 73% of defectives who have
been made, or who have become more or less useful....
“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.... Finally, then, out of nineteen
feeble-minded subjects, regarding whom particulars have been
supplied, one-half, or 50%, have been apprenticed, or more than
half, 75% if we count the defectives who 'work....'
“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.... If we
subtract 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%.... Now this proportion is, by an unexpected agreement,
identical with that obtained in the classes of Berlin and Brussels.”
A more recent report concerning the _Hilfsschulen_ in Berlin by Rector
Fuchs is in close agreement. It indicates that from 70% to 80% of the
former pupils of these schools make a living after they leave school.
To compare with these reports indicating that about three-fourths of
those leaving the special schools of Paris, Berlin and Brussels by
social assistance attain occupational classifications, we have less
favorable reports from Great Britain. Shuttleworth and Potts (_181_, p.
23) say:
“At the Conference of After-Care Committees held in Bristol on
October 22, 1908, a paper read by Sir William Chance, Chairman of
the National Association for the Feeble-Minded, dealing with the
reports of the After-Care Committees of Birmingham, Bristol,
Leicester, Liverpool, London, Northampton, Oldham and Plymouth. The
combined statistics from the nine centers showed that 22% of those
who had attended special schools for the mentally defective were in
regular work, and 6.8% had irregular work.... To illustrate the
necessity for continuous supervision and the futility of temporary
care, we cannot do better than quote the records of the Birmingham
After-Care Committee, as embodied in their report for 1908, after
seven years work. It was found that, 'out of 308 feeble-minded
persons who have left school and are still alive, only 19.8% are
earning wages at all, and only 3.9% are earning as much as 10 s. per
week'” (_181_).
Tredgold summarizes other data on this question of industrial success as
follows:
“We may next turn to the reports of 'After-Care' Committees
regarding feeble-minded (moron) pupils of the special schools. In
_London_ the proportion of pupils known to be in 'good or promising'
employment was 37.5%. Two years previously it had been 45.7%, and
Sir George Newman, the Chief Medical Officer to the Board of
Education, attributes the falling off to two causes—_firstly_,
insufficient after-care; and _secondly_, the two additional years.
He remarks: 'The longer the test the more severe it is.' In
_Birmingham_, the 'After-Care' Committee compiled information
regarding 932 cases which had passed through the schools during the
previous ten years. Of these, excluding the normal and dead, 272, or
34%, were engaged in remunerative work. At _Liverpool_, of 712
children passing through the hands of the 'After-Care' Committee
during a period of six years, 85, or 11.9%, were doing remunerative
work.
“Finally we may refer to some figures concerning 'After-Care' work
compiled by Sir William Chance from the returns of the National
Association for the Feeble-Minded. These were based upon an inquiry
made of sixteen centers of the Association, and referred to a total
of 3,283 persons. Of this number, 798 were doing remunerative work,
89 were 'doing work, but not reported;' 202 were useful at home; and
941 were returned as 'useless members of society.' If we exclude 340
who were transferred to normal schools (not being feeble-minded), we
have 27% engaged in remunerative work.
“With regard to the term 'remunerative work,' however, it is to be
remarked that the person employed is not being paid the standard
wage. On the contrary, it is my experience that this is practically
never the case, and this is corroborated by the observations of the
secretary of the Birmingham center, who says: 'Although some of our
cases have been at work for more than ten years, only 34 of the
whole number (173) earn as much as 10 s., 2 d., per week. Of these
only 6 earn as much as 15 s., and only 2 earn 20 s., which is the
highest wages earned.... While it is not very difficult for some of
our higher-grade cases to get work when they first leave school, it
is almost impossible for them to retain their situations when they
get older, and the difference between them and their fellows becomes
accentuated. Uncontrolled and often quite improperly cared for, they
rapidly deteriorate, the good results obtained by the training and
discipline of the special school being under these circumstances
distinctly evanescent.... There are few workers over twenty years of
age'” (_204_, p. 425, 435).
The 1912 report of the London County Council (_144_) covers those who
left its special schools for mentally defective children during the
years 1908-1912 inclusive. These schools have accommodation for about 1%
of the elementary school enrollment. Of 2010 children who left these
schools during these five years, and who were still alive, 1357 were
employed and 311 more employed when last heard from, a total of 79%
employed at last accounts. Those out for five years show about the same
proportion employed. This is a more favorable showing and fairly in line
with the results of other European help-schools. The average weekly
wages of those employed ranged from 4 s. 6 d. for those just out to 10
s. 10 d. for those leaving five years before. A considerable proportion
who live at home thus have been meeting their necessary living expenses
as the result of this special training and subsequent assistance.
Dr. Walter E. Fernald reported to the British Royal Commission on the
Care and Control of the Feeble-Minded concerning the inmates of the
institutions for feeble-minded in the United States. These institutions
receive a much lower grade of cases on the whole than the local
help-schools abroad: (_83_, Vol. VIII, p. 159)
“Some of the institutions where only the brightest class of
imbeciles are received, and where the system of industrial training
has been very carefully carried out, report that from 20% to 30% of
the pupils are discharged as absolutely self-supporting. In other
words at other institutions, where the lower grade cases are
received, the percentage of cases so discharged is considerably
less. It is safe to say that not over 10% to 15% of our inmates can
be made self-supporting, in the sense of going out into the
community and securing and retaining a situation, and prudently
spending their earnings.... But it is safe to say that over 50% of
the adults of the higher grade who have been under training from
childhood are capable, under intelligent supervision, of doing a
sufficient amount of work to pay for the actual cost of their
support, whether in an institution or at home.”
The wages of the women at the Bedford Reformatory before entering
prostitution as given by Davis (_133_, p. 210) have a direct bearing on
the earning capacity of the higher grade feeble-minded. The Binet tests
of Bedford women by Weidensall indicate that about 38% of the successive
cases admitted to Bedford test in the lowest 0.5% intellectually, and
75% in the lowest 1.5% intellectually. Davis' table shows that for 110
whom she classes as mentally low grade cases at the reformatory, the
median wage of those in domestic service, as claimed by the women, was
nearly $4.50 before entering prostitution. These feeble-minded women, if
their statements of earnings can be accepted, are therefore
feeble-minded by reason of their low intelligence plus delinquency, and
not by reason of inability to earn the necessities of life. The best of
these mentally low grade cases earned as high as $5.00 in addition to
board and lodging in domestic service and $25.00 outside of domestic
service.
In this country we have fewer studies of the results of training the
mentally retarded in special local classes and schools. Miss Farrell has
made a preliminary report of 350 boys and girls out of the 600 children
formerly in the ungraded classes in New York City during the preceding 8
years (_102_). Omitting seven whose status was unknown and 10 who had
died, only 6% were known to have failed to survive socially with
assistance. These were in penal or other institutions. On the other hand
a strict analysis of her returns shows only 28% earning $5.00 a week or
more and thus possibly surviving independently. Of the above group of
333, 86 were at home, 192 employed, 31 unemployed and 3 married.
In Detroit among 100 children over 16 years of age who had attended its
special classes and been out of school not over 5 years, 27 had been
arrested, but 39 of the boys had been at work and received an average
wage of $7.00 per week, while 16 girls had averaged $3.75 in weekly
wages, although few held their positions long (_97_).
Bronner (_6_) compared a random group of thirty delinquent women at the
detention home maintained by the New York Probation Association with an
intellectually similar group of 29 women all of whom had been earning
their living in domestic service and none of whom had been “guilty of
any known wrong doing.” The delinquents were 16 to 22 years of age while
the servant group was somewhat older. Only two or three of the
delinquent group were worse than the poorest of the servant group in any
of the five intellectual tests, so that, if more than this number were
intellectually deficient, they were no more deficient than those who had
survived in society. No Binet scale records were published so that we
have no means of determining how many of these delinquents might fall
within either of our deficient groups.
The principal deduction from this evidence on the earning capacity of
those of low intellectual grade is a caution against demanding the
social isolation of all the intellectually weak until we have more
definite information as to what portion of them are able to live moral
lives, as well as earn their living with social assistance, without
being cared for entirely in isolation colonies. That a significant
number of the lowest 1.0% intellectually next above the lowest 0.5% have
led moral lives and have shown considerable earning capacity after
attending special schools, when they are given proper after-care, has
probably been demonstrated. They should, therefore, be treated as an
uncertain group whose feeble-mindedness would never be decided purely on
the ground of the intellectual tests. Most of them will, however,
probably be found mentally deficient enough to need at least social
assistance and protection.
In concluding this summary on the estimates of the frequency of
feeble-mindedness, it need only be added that so far as concerns the use
of the percentage definition for fixing the borderline in any particular
system of tests the percentages chosen are not essential to the plan.
The principles of the method apply whatever percentages might be
adopted. For such important purposes as the comparison of the relative
frequency of deficiency in different social groups and harmonizing the
investigations with different mental scales, agreement upon a particular
percentage is not essential. In diagnosis, of course, it is a matter of
fundamental importance in order that injustice may not be done
individuals. For this reason the estimate should be conservative,
possibly more conservative even than our tentative 0.5% at 15 years of
age. Any investigator who disagrees with the above estimates of the
degree of tested deficiency justifying isolation may substitute X per
cent. with a doubtful region extending Y per cent. further. Provided
such a census were legally authorized and funds available it would be
not impossible to get a reliable determination by a house to house
canvass showing the number of adult deficients, say 21 years of age, in
typical communities, who were not able to survive socially without
assistance. This number would then give the key for a conservative
percentage and the movement for early care would be immensely advanced.
With the recent introduction of psychological tests into the cantonments
of the national army, the goal of symptomatic borderlines as determined
by objective tests seems to be almost at hand. Since the men are brought
practically at random to the camps by the draft and are under military
command, it may be possible to find out the social history of a large
enough group at the lower limit of tested ability to establish the
question of the necessary capacity for independent moral and social
survival. These borderlines could then be transferred from the army
tests to positions of equivalent difficulty in other test systems.
The remainder of this study will show some of the advantages of the
percentage definition for fixing the borderlines with a system of tests
and the result of applying such an interpretation to the particular
problem of delinquency. The advantage in increased definiteness should
already be evident. When a person is classed as presumably deficient it
will mean that he is in the lowest 0.5% in intellectual development or
within the lowest 1.5%, if he is a persistent delinquent.
-----
Footnote 5:
Aaron J. Rosanoff. Survey of Mental Disorders in Nassau County, New
York. Publication No. 9, National Committee for Mental Hygiene, 1917.
Footnote 6:
Emma O. Lundberg. A Social Study of Mental Defectives in New Castle
County Delaware. U. S. Dept. of Labor, Children's Bureau, Publication
No. 24, 1917, pp. 38.
Footnote 7:
This statement in 1906 seems to be the earliest attempt at a
quantitative definition of deficiency. As I discovered it after the
present monograph was practically completed, it furnishes evidence of
the natural tendency of attempts at more exact definition to take the
percentage form.
Footnote 8:
C. Macfie Campbell. The Sub-Normal Child—A Study of the Children in a
Baltimore School District. Mental Hygiene, 1917, I, 96-147.
Footnote 9:
Italics mine.
Footnote 10:
The report of the Massachusetts Commission on Mental Diseases (Vol. I,
p. 198) shows that social agencies systematically using mental tests
reported 19.2% as mental cases, while those using examinations only
for obvious cases reported 1.3%.