1. In our attempt to interpret the volume of results concerning tested
delinquents, we have accepted the common conception that the
feeble-minded are those who, through lack of mental development, are
_social deficients_. They cannot survive in society without supervision.
In the words of the English Mental Deficiency Act, “they require care,
supervision, and control for their own protection or for the protection
of others.” Our present scales of development tests do not detect those
deficients whose failure is not directly due to intellectual incapacity.
We have called those not detected by tests “purely conative cases,” to
distinguish them from the tested deficients, who were said to be
“intellectually deficient.” These conative cases would not be
feeble-minded except for their incapacity for prolonged acts of will.
Deficiency thus specialized in volition is so unusual, however, that the
study of tested deficients gives us a useful picture of the problem of
feeble-mindedness. To get a general view of the relation of deficiency
to delinquency we determined conservative borderlines with the Binet
scale and then reinterpreted on a common conservative basis the results
obtained in more than a score of investigations covering thousands of
objectively selected delinquents who had been tested. This has enabled
us very largely to remove the question of the frequency of deficient
delinquents from the realm of subjective opinion. We may now be certain
that under present conditions the problem of deficiency is most pressing
in institutions for female offenders. The evidence also points to the
greater frequency of deficiency among prostitutes and repeaters, rather
than among ordinary juvenile delinquents. We have thus been able to
restate the problem of the deficient delinquent more conservatively and
to modify some of the current conceptions. This enables us to direct our
efforts more intelligently, with greater foresight, and more hope of
success.
2. A still broader outcome of this interpretative study is to increase
the precision of the test scales for use in the diagnosis of social
deficiency. This has been accomplished by an extended reconsideration of
the borderlines of deficiency on test scales, particularly the Binet
scale. A percentage definition of tested deficiency is suggested for
determining the borderline below which an individual may be presumed to
be so deficient as to justify isolation, and for setting off a distance
above this on the scale for which the test diagnosis of social
deficiency should be regarded as uncertain. By this means it is hoped
that the developmental scale may be made safer and more useful as an
instrument for diagnosing feeble-mindedness.
A quantitative definition for tested deficiency has its main
justification in its success in discovering social deficients and in
predicting social failure. With this in mind the percentages suggested
as representing the social deficients or uncertain cases in the
community were chosen after a careful search through the evidence as to
the success of children who had been in special classes or institutions
and an extensive résumé and analysis of the best expert estimates of the
frequency of social deficiency. The conclusion was that these
percentages may tentatively be placed so that those who would at 15
years of age be in the lowest 0.5% in tested ability among a randomly
selected group, may be presumed to be so deficient as to justify
isolation. Above these the next 1.0% may be regarded as uncertain, since
the bulk of them would require some supervision or guardianship during
life. These two borderlines have then been located on the Binet scale
for both the immature and the mature so far as possible from the
available data. In particular these borderlines for the mature have been
found for the first time on the basis of a randomly selected group.
Besides the records of Minneapolis delinquents these Binet borderlines
for a typical random population of 643 15-year-olds is the main
contribution of new data in the study.
The practical consideration of these borderlines in Part One and their
location on the test scale emphasizes that a test diagnosis is only
symptomatic, that the suggested borderlines on the Binet scale are
determined from limited data which may not be verified in other
communities, that the scale itself is imperfect, and that the results
should be checked by other tests, especially by the school retardation,
a new example of which is given for the Minneapolis delinquents. The
plan of the percentage method of describing the borderlines readily
allows for adjustment to more complete data or better developmental
scales. The alternative to the use of a test record as symptomatic of
deficiency is dependence upon the history of the case or physical signs,
such as are found among Mongolians, cretins, epileptics, etc. These
signs have been found among only about 13% of the deficient children
(_141_). Expert opinion given on the history of the case is clearly less
reliable than such opinion checked by even a crude objective test
standard. In Part Two of this study the theoretical background for the
percentage definition is compared with that of other quantitative
definitions on the basis of the conceptions of mental measurement and
mental development.
3. In attempting to suggest methods for diagnosis and control, which our
summary of the scientific data makes necessary, we shall be led beyond
the evidence presented in this study. To those to whom these suggestions
may seem remoted from the foregoing pages, it may be said that they are
the result not only of a review of the available research work, but also
an outcome of several years observation of the practical handling of
this problem both in this country and abroad. In that study I was led to
visit several scores of institutions and schools for delinquent or
deficient children in Austria, England, France, Germany, Italy and
Switzerland. The methods suggested below for the case of the deficient
delinquent are only modifications of what has been observed in actual
operation.
An adequate diagnosis of deficiency involves not only the accurate
knowledge of the present mental condition of the individual, but an
understanding of the causes of that condition. This requires a complete
family and social history of the individual and a knowledge of the
medically removable handicaps. It would seem, therefore, that such a
diagnosis may be best made by a commission which shall include a
physician as well as a psychologist, or else by an _expert in mental
development_ who is provided with adequate facilities and assistance for
discovering other handicaps than innate incapacity. For the group of
uncertain and conative cases a final diagnosis should, if possible, be
made only after prolonged observation in a temporary home school.
Frankfurt a. M. in Germany seems to have been the first to provide a
specialized observation cottage for uncertain cases among children. This
was established in 1900 and is much used by the juvenile court. Although
it has a separate building and an isolated division of the grounds it
is, however, connected with the local hospital for the insane. An
improvement in this respect was made with the first provincial school
for psychopathic children under compulsory training established near
Leipzig at Kleinmeusdorf. This serves also as a distribution station and
has two observation divisions through which all _fürsorge_ children in
the province pass. Only the psychopathic cases remain indefinitely.
Detention homes for juvenile delinquents in this country quite generally
are used for temporary quarters for cases to be observed, although these
are not isolated from the other children. If an entirely separate
observation institution is not possible, a more definitely recognized
probationary period for observation of the uncertain cases should be
arranged within other institutions. The efforts for clearing-houses for
mental defectives such as that in New York City and the Ohio Bureau of
Juvenile Research will help to distribute individuals to their proper
institutions. The ideal is a separate observation home where all cases
in which the question of mental deficiency and mental disease is raised
may be sent before the individual is labeled. The effect of commitment
to an institution for the feeble-minded, insane, or delinquent can be
guarded against much better if the observation home is entirely isolated
from all other institutions. The separate institution, however, is more
difficult to obtain than a separate division or cottage in an existing
institution. The latter forms a valuable intermediate step and is better
than merely giving uncertain cases additional attention when other
duties permit.
As a matter of legal procedure, diagnosis raises the troublesome
question of expert advice in court. Two decisions have to be made about
each case. First, is the individual deficient enough to justify
isolation or guardianship? Second, considering the means of care
available in the particular community, how should the deficient be cared
for? The first is primarily a question which requires expert knowledge
in mental development and should be so handled. The second decision
requires knowledge about the individual's home and about the facilities
for guardianship or isolation. It should be left with the authorities
thus informed. This will usually be the court unless there is a
commissioner or a committee especially charged with this duty.
An important advance in the legal definition of criminal responsibility
of deficients should be made by avoiding all subtle questions of
psychological analysis such as would be involved in deciding, for
example, under the New York statute whether the accused “was laboring
under such a defect of reason as not to know the nature and quality of
the act he was doing or know the nature of the act as wrong.” Obsolete
legal descriptions could easily be cleared away by adopting the
statement of the law suggested by the Committee of the Institute of
Criminal Law and Criminology for criminal responsibility and insanity.
In substance such a law would then state that the accused was mentally
deficient “so as not to be responsible ... for his acts or omissions at
the time when the act or omission charged was made.” The New York law
places an emphasis on knowledge which should be placed on will, only one
feature of which is an understanding of the situation.
4. What should be the aim in the care and control of deficients and
delinquents after diagnosis also depends upon a proper understanding of
the causes of these conditions. We have summarized some of the best and
most recent investigations in which a notable advance toward solving
this problem has been made by means of the correlation method. This has
proved to be a new and vigorous force for directing social progress. By
no other method have we approached so near the solution of the cause of
delinquency. It enables us to restate the problem of criminality as
mainly a problem in the treatment of a hereditary criminal diathesis in
which mental deficiency is the largest factor. These recent scientific
measurements have deprived neither the eugenist nor the euthenist of the
opportunity for service. There is plenty of congenial work to be done by
those whose sympathies may exaggerate the influence of heredity,
contagion, or training. As in the control of tuberculosis, so with the
diathesis of delinquency, some effect is produced by predisposition, by
training, and by external influences. Unless the present evidence,
however, is outweighed by improved data obtained in the future, the most
strategic point for attacking persistent delinquency is through the
relation to deficiency, with heredity holding the heights.
With the immediate campaign against delinquency centered against the
propagation of the social deficients, we have the atmosphere cleared so
that it is possible to turn attention to the best means of attaining
this end. Sterilization, isolation, or guardianship, by force or by
consent, which of these methods promises best? This is not a question
for detailed discussion here. We may, however, call attention to the
strides that have been made by such legislation as the British Mental
Deficiency Act of 1913 and to the summary of the laws of the several
states in our country published at the University of Washington,
Seattle. The question whether sterilization is desirable must at present
be settled apparently by the judgment whether the benefit in reducing
the propagation of the unfit outweighs the danger to morality through
the temptation of known sterility. The question of isolation of the
sexes by either sterilization or segregation resolves itself into the
question of accuracy of diagnosis and prognosis. Our review of the
uncertainties of diagnosis should make us cautious. When we consider the
social survival of many of those trained in the public school classes
for deficients and when a dozen girls discharged from the Massachusetts
institution for the feeble-minded succeeded in getting along in society
(_164_, p. 49), it would seem wise to place the emphasis on first
isolating those about whose danger to the community through delinquency
or propagation of deficiency there would be the least question. This
would mean those of uncertain mentality who were already repeated
delinquents or in imminent danger and those who were of the lowest
grades of deficiency, not the morons who were of uncertain moral and
mental ability. Among the clearly deficient there is no question but
that the emphasis should be to isolate first the girls and women of
child-bearing age, since their chance of obtaining mates is greater than
that of the deficient males. With doubtful cases public guardianship,
such as that provided by the British Mental Deficiency Act of 1913,
affords a promising remedy. Even those who are of uncertain ability
should, when in danger, be provided with whatever protection
guardianship can give. In this connection a suggestion of Dr. Goddard in
the Survey, March 2, 1912, may be utilized. A court in returning an
individual who is of uncertain ability to his family or guardian may
well warn them: “We shall leave him in your custody, but we insist that
you shall care for him, shall be responsible for him throughout his
life, shall see that he does not get into mischief, and above all that
he does not become a parent. Whenever the time comes that we find you
are incapable of performing or are neglecting this duty, then we shall
take him and place him in a colony.”
The question where to isolate the deficient delinquent, whom Kuhlmann
says is “equally well placed or misplaced in the institution for the
feeble-minded and the reformatory,” (_140_) is answered in substance by
Supt. Murdoch of the State Institution for the Feeble-Minded in Western
Pennsylvania. He suggests that in large states the deficient delinquents
might be cared for in an institution which should bear the same relation
to the state institutions for the feeble-minded and the penal
institutions as is now held by the asylums for the criminal insane.
Where a separate institution is not possible the affiliation with the
institutions for either the delinquents or the deficients may be tried
by means of colonies especially set apart in them. In Massachusetts
these divisions for the deficient delinquent are connected with the
institutions for delinquents.
5. Turning to external influences upon delinquency, we find that their
effect has been measured mainly in connection with the tendency to
repeat criminal acts. It has been shown by Goring that even such
important influences as the example of criminality in the home, kind and
amount of schooling, irregularity of employment, alcoholism, size of
family, low standard of living, early death of mother, etc., have
generally been found not to increase notably the tendency to recidivism
while they do correlate decidedly with deficiency. Nevertheless, it has
not been determined whether these external factors may not have an
important influence upon the first manifestation of the criminal
diathesis even though they tend only slightly to increase recidivism.
Should these external influences prove to be not more than a fifth as
important as deficiency and heredity, which now seems to be indicated,
we need to hunt for other outer influences which may really prove to be
more important.
Among bad external influences as yet unmeasured is maladjustment to
school among those of passable ability. We have given some evidence as
to this which we found among a group of delinquent boys at a county farm
school, when their test records were compared with their positions in
school. As a possible serious source of delinquency, bad adjustment to
school work should be studied further, since it is a matter that could
be easily corrected by the assistance of special teachers. With the
earlier discovery of deficient children by means of mental tests, it
should also be possible more definitely to direct the training so as to
build up resistance to worldly temptations. How much could be done in
this direction we cannot yet say. We have undoubtedly wasted much effort
in the past in trying to create intellectual capacity in those who are
innately deficient in intellect. Fortunately we are now directing our
attention to training them to acquire passable ability in simple
occupations, or to adjust themselves to the life of a colony. In the
education of the mentally weak the most promising field is undoubtedly
with the conative cases with passable intellects. At Templin, outside of
Berlin, there has been established the first home school devoted
entirely to the training of such unstable and inert boys. This
specialized institution for conative cases, which was founded by a
philanthropic society at the suggestion of Prof. Thiedor Ziehen, marks a
most important advance step in the problem of training the mentally
deficient. The results of specific training for the social adjustment of
the intellectually and of the volitionally deficient will be awaited
with great interest.
6. Shall the public authorities have the power to compel isolation and
special training at local or state schools? These powers have already
been provided by laws in a number of states. Thus far the law has not
outstripped scientific knowledge. How far the authorities should use
their discretion under these laws to force isolation is a question which
calls for the utmost good judgment on their part. In case the parents or
guardians of the socially deficient can be convinced of the desirability
of such isolation, this procedure is undoubtedly to be urged. When the
guardian has once consented to the isolation of his charge, he should
not be permitted to remove the individual from such care without the
consent of the proper public authority, which would of course be
reviewable in court. During this period of uncertainty as to the
prognosis of social deficiency, such a procedure would perhaps be
preferable to forced isolation in most cases, since the authorities
might be less troubled by the frequent annoyance of legal actions begun
by parents who had their children forcibly removed to institutions. In
some states unscrupulous attorneys have deliberately stirred up parents
to try to get back their children who had been taken away by force, thus
seriously interfering with the administration of laws for compulsory
isolation. Without the possibility of compulsory isolation of the
socially deficient for an indefinite time, we shall perpetuate the
disgraceful spectacle now observable in many states which cannot legally
prevent a feeble-minded parent removing a feeble-minded girl from an
institution to which she may be brought back a few years later with one
or more illegitimate, feeble-minded children. Our legal omissions should
not thus handicap the wisdom of society. The 1917 codification of the
Minnesota laws relating to defective, delinquent and deficient children
should be seen by those who are interested in the legal aspects of these
questions. It was brought about by the Minnesota Child Welfare
Commission, of which Judge Edward F. Waite was chairman.
7. In case we suddenly segregate for life all those who are so deficient
that we are justified in isolating them, would that solve the problem of
delinquency for the next generation? Although this would be the most
important attack which could be made on the most important known cause
of delinquency, we must still answer that the results would hardly be
comparable with a jail delivery. There is nothing to be gained by
turning our backs upon the facts. Goring has estimated that 7.2% of the
male population of England and Wales commit crime before death. We could
not possibly suppose that more than 1% of the male population could be
justly isolated for deficiency. Even if all the deficients committed
crime, at least six-sevenths of the criminals in these countries, about
which we have the best means of estimating, are presumably individuals
who could not be isolated for deficiency.
Moreover, Goring's estimates regarding the British convicts enable us to
judge that only about 25% of the criminals of this generation inherit a
predisposition to crime from parents who were the criminals of the last
generation (_20_, p. 336). Nobody has suggested isolating all persistent
delinquents. We could not expect that the isolation of both the
deficients and delinquents would completely remove the diathesis of
delinquency from society. The predisposition is received not only from
the deficients and delinquents, but also to some extent from those above
the borderlines. We could not raise the borderlines of deficiency
without isolating many whose social deficiency or delinquency it would
be presumptuous to predict. We should not look forward, therefore, to
the sudden elimination of the problem of delinquency even when it is
attacked at its most vital spot. On the other hand Dr. Hart, in a
bulletin of the Russell Sage Foundation, has worked out a practical plan
which would isolate the lowest 0.3% of the girls and women of
child-bearing age in this country within five to ten years. Some similar
plan for isolating all deficient delinquents would materially lessen the
cost of recidivism in the present generation.
The most hopeful sign is that we are no longer content merely to guess
at the relative importance of the sources of delinquency and deficiency,
but our efforts to promote social welfare are directed by scientific
investigations which are utilizing new and more efficient methods of
research.
PART TWO THEORETICAL CONSIDERATIONS