THE CHILDREN THAT NEVER GROW UP
"It was perhaps an idle thought
But I imagined that if day by day
I watched him and seldom went away,
And studied all the beatings of his heart
With zeal (as men study some stubborn art
For their own good) and could by patience find
An entrance to the caverns of his mind--
I might reclaim him from his dark estate."
--SHELLEY.
"One man, at least, I know,
Who might wear the crest of Bayard
Or Sidney's plume of snow.
Behold him,
The Cadmus of the blind,
Giving the dumb lips language,
The idiot clay a mind.
Wherever outraged Nature
Asks word or action brave,
Wherever struggles labor,
Wherever groans a slave,--
Wherever rise the peoples,
Wherever sinks a throne,
The throbbing heart of Freedom finds
An answer in his own.
Knight of a better era,
Without reproach or fear!
Said I not well that Bayards
And Sidneys still are here?"
--WHITTIER'S tribute to Dr. Howe.
=The Defective Children.=--Not those who die young, full of promise,
to leave a memory of exquisite budding loveliness cut short by
untimely frosts, but those who live on from infancy to childhood and
from youth to physical maturity and even on to old age, yet never
become responsible adults--these are the children we must consider.
The demand of the eugenists that such, if obviously defective, should
be prevented from bringing forth after their kind is clearly the only
social wisdom. The statistics of social pathology all point to mental
defectiveness as the prolific cause of crime, immorality, vocational
incompetency, illegitimacy, family failure, and marital tragedy. In a
recent study of one hundred families in which feeble-mindedness was
obvious, a study carried on by the Massachusetts Society for the
Prevention of Cruelty to Children, immorality was found in 58 per
cent. of them; extreme filth and bad home conditions were found in 30
per cent.; and in 47 per cent. one or more members of these families
were public charges. Where the mother is subnormal there is almost
certain to be a line of feeble-minded progeny, and in this study,
while there were only 7 per cent. of the fathers hopelessly deficient,
in 25 per cent. the mothers were notably defective in mind.
Thirty-seven of these families showed illegitimate children--a far
larger number than the average of normal population. Physical
deficiencies also figured largely in these family records.
This particular study takes us into the region where Doctor Fernald,
Doctor Goddard and many others have prepared material for convincing
the public mind that no one thing so increases social degeneracy and
so adds to the sum of human misery as the unprotected freedom of
defectives to procreate and pollute the family currents.[14] This is
not a treatise on social pathology and elsewhere must be found the
details of investigation and information that justify this statement.
What is here attempted is only a study of what should be the attitude
of fathers and mothers toward feeble-minded children if such should be
their tragic problem.
=Custodial Care of the Defective.=--In the first place, the attitude
of mind of the parents, if they are themselves normal, is to be
considered. What gives us feeble-minded children from feeble-minded
parents is clear. The social prevention for carrying on known
degeneracy cannot be too strongly stressed, and hence the first duty
of normal parents is to consider the social danger of leaving a
feeble-minded child, especially a feeble-minded girl, to any chance of
parenthood. This leads to the question of removal from home of
feeble-minded children to permanent custodial care in institutions
provided especially for their segregation, possible teaching and
thrifty use of small work-power. Alexander Johnson, who has done so
much in the United States to make all philanthropy wise and effective
and particularly has helped to form public opinion concerning right
methods of care and training of the feeble-minded, tells us that
"one-half of the mentally defective can become one-third of a normal
person," can be made happy and useful to the extent of considerable
aid toward self-support if under constant supervision and given the
trained care of special teachers.
There are few private homes in which any feeble-minded boy or girl can
attain such a condition. The children who are "different," if having
the sole devotion of father and mother, may be protected and made
happy in the measure of their power for happiness. But if there are
other children in the family neither they nor the afflicted one are
comfortable. The measure of feeble-mindedness is usually the measure
of unhappiness when the normal and abnormal are in close
companionship. In most families it is not possible for either or both
parents to give entire time, strength and devotion to one subnormal
child. Where it is, there is no security that death will not prevent
the permanency of that devoted care. Hence, it is generally safer and
better for all concerned to place the feeble-minded in collective
homes where their own kind are cared for exclusively and where
segregated control can be complete and permanent through life. There
is no horror of such places for those who have seen what flowers of
happiness and what miracles of devotion may be found in "Training
Schools for the Feeble-minded."
The affectional side of the nature of a mental defective may be of
unusual strength and may find special objects of love among those
still more handicapped than itself. Those visiting intimately in such
School-homes may see a higher-grade imbecile caring for a lower-grade
with patience and devotion; they may see the competitive element in
training, reduced in levels for the accommodation of the slender
stock of mentality, producing on that lower level the same good
results that normal children gain from trying to imitate and to excel.
Small attainments are sources of pride in a class of defectives which
if exhibited among the normal would give bitter experience of
contrast. By making the standard of behavior and of attainment suited
to their little power, the delight of conquest over difficulties need
not be denied to the feeble-minded.
Hence, again, it is far from wise and often far from most loving to
keep the child who can never grow up in the company of those who
follow the usual path from infancy to maturity. This means, of course,
if this idea of the more general use of special homes for the
subnormal is to be carried out, a large increase in provision of such
homes. Such large increase is often opposed by short-sighted economy.
The expense of establishing and maintaining such homes in adequate
number and of scientific and humane provisions is counted over and
taxpayers made alarmed at the sum total. What is lacking usually in
the count is the sum total of the enormous sums society now pays out
for the unregulated and socially dangerous neglect of this class of
unfortunates. Doctor Goddard's "Kallikak Family" and many other
accurate showings of what it costs to leave uncared for one
feeble-minded girl in unbefriended freedom should convince any sane
person that the most wasteful extravagance any community can commit is
such neglect of what Mr. Johnson has called "the divine fragments" of
humanity.
To make provision for the insane is seen to be a social necessity and
the family more than any other social institution profits by the
hospitals and asylums for the treatment and care of such. The relief
of having an insane relative taken away from the home, after months
and perhaps years of anxiety, fear, and suffering on the part of every
other member, cannot be too strongly pictured. The effort now making
to secure early treatment for the first symptoms of mental derangement
and to give even "border-line" cases and exceptionally "cranky" and
nervous people special treatment in mental hygiene marks the
beginning, we must believe, of effective preventive work in this line.
The feeble-minded, however, have a claim of perpetual childhood upon
the parental sympathy, and that, together with common ignorance
concerning their condition or numbers and the social dangers inherent
in their neglect, give us the alarming discrepancy in numbers between
the feeble-minded in suitable segregated care and those left to find
their way or lose it in the usual walks of life. Since Doctor Seguin
wrote his _Treatise on Idiocy_ in 1846 the verdict of science and of
philanthropy has been accumulating as to the need for the full and
complete protection of all who cannot manage successfully, even in the
simplest details, their own lives and the lives of those with whom
they are most closely related. Yet to-day, it is claimed by many
observers, we have only about fifteen per cent, of those requiring
special protection on this account adequately cared for by society.
The family must be relieved of personal care of its insane, its
lower-grade feeble-minded, and its moral idiots. It must be so
relieved for the sake of the normal members of the family. It must be
so relieved still more for the sake of lessening vice, crime,
degenerative tendencies, and actual waste of public money in public
court procedure and in other public institutional provisions.
To induce the state of mind in parents which will help on the better
and more adequate social care of these afflicted members of society,
the sense of shame and the keen suffering from social stigma in such
cases must be mitigated. It must be seen that although it may be the
fault of one or both parents that such a child has come into the
world, it is an added and deeper fault, even in many cases a social
crime, to leave that child in ordinary relations of life. It is true
that what Dr. Caleb W. Saleeby well calls "racial poisons" are often
the cause of the damaged germ plasm that starts the handicapped human
being along his devious course. Alcohol, syphilis, and other elements
of degenerative action may have doomed the child and in such cases the
father's or mother's sin or carelessness is the cause of the child's
tragical condition. In such cases the dullest conscience must feel
remorse. It is, however, not always the fault of the immediate
parents. It may be a far more remote inheritance that has started the
degenerative psychosis that results in either insanity,
feeble-mindedness, dipsomania, or "general debility of character."
=Heredity.=--Prof. E.G. Conklin says, "Heredity may be defined as the
appearance in offspring of characters whose differential causes are
found in germ cells." Doctor Galton says "the two parents between
them contribute on an average one-half of each inherited faculty, or
each parent one-quarter. The grandparents contribute between them
one-quarter, or each one-sixteenth." The responsibility for a poor
specimen of humanity, therefore, is not solely the parents'; they may
share it with a considerable group. Many a defective obviously owes
his condition to some remote ancestor, "to the third or fourth
generation," as the old Scripture said; and many a charming trait, for
which the immediate parents would like to take credit, is really a
gift from some great-grandparent.
This fact should make it easier for parents of defectives to bear the
burden and easier to make it seem less a shameful confession of
individual responsibility and more a sad confirmation of the fact that
we are all members one of another and no one lives to himself alone.
=Difficulties in Care of Morons.=--The case is clear as to treatment,
so all enlightened social workers and social students agree, in
respect to the obviously defective or insane. The difficulty is to
care protectively and yet justly for the higher-grade defective or
what is now called the "moron." Doubtless we should all see it best to
begin at the lower levels of defectiveness and abnormality for
pressure upon society to socially protect in segregated institutions
all the afflicted. The point at which compulsory methods should be
used might be placed at a widely differing level by many most
acquainted with the need for some form of social control of and for
this class. Parents in particular would resent any snap judgment and
should do so as to the mental condition of children not obviously
imbecile. It is certain that the high-grade moron makes much trouble
and gives social tragedies without number, but it is still more
certain that no social machinery has yet been devised ingenious enough
to really classify such persons and place them where they can do no
more harm. As Dr. Lightner Witmer well says in his warning against
careless diagnosis, "In training clinical examiners I advise them not
to diagnose a child as feeble-minded unless they feel sure they have
sufficient facts to convince a jury of twelve intelligent men that the
diagnosis of feeble-mindedness is the only logical conclusion to be
drawn from the facts." It is undoubtedly true that many high-grade
imbeciles or morons would be adjudged not feeble-minded by most
juries. It is also undoubtedly true that many youths who are
"peculiar" or "backward" or unusually susceptible to influence from
others or especially lacking in power of self-control are in social
danger and need some form of social protection more effectual than is
required in the case of the normal child and youth. Higher grades of
abnormality and those less understood must be approached, however,
both in matters of examination and of care, from different angles of
observation from those used in discovery and treatment of the
obviously imbecile.
In this connection mention must be made of the efforts to give
supervision of special sort and under official direction to those able
to earn their own living or partially so, at least, and who yet need
special protection and care. _The Proceedings and Addresses of the
Forty-fifth and Forty-sixth Sessions of the American Association for
the Study of the Feeble-minded_ contain specially valuable articles on
"Extra-institutional Care" and on education of the higher-grade
defectives. Two articles published in _Mental Hygiene_ of April, 1921,
on the vocational elements in such extra-institutional care are most
enlightening as to possibilities in this difficult field. The first of
these, entitled "Experiments to Determine Possibilities of Subnormal
Girls in Factory Work," by Elizabeth B. Bigelow, shows that certain
kinds of routine work may be followed successfully by girls who are
mentally under the normal. The second article, "Vocational Probation
for Subnormal Youth," by Doctor Arnold Gesell, of Yale University,
shows how the courts may use probation power and agency in the
interest of self-support and a helpful industrial relationship. The
new Children's Code recently recommended to the Connecticut
Legislature by a special Commission advocates giving Juvenile Courts
power at discretion to establish the status of "Vocational Probation,"
under the supervision of officers of the Court, in place of commitment
to an institution, provided helpfully supervised employment may be
found for the boy or girl in which they may become self-supporting.
=The Colony Plan.=--The Report of Dr. Anne T. Bingham, Psychiatrist of
the New York Probation and Protective Association, based upon 839
mental examinations of girls and women coming under notice because of
breaking the laws or because manifestly in moral danger, is an
important study. Doctor Bingham highly recommends the "Colony Plan"
for the care of the higher-grade feeble-minded. In this plan small
groups of those who show mental deficiency or any special need of
social care are established under necessary supervision and control in
colonies, near their own homes if possible, and given suitable work in
the profit of which their families may share if destitute. The natural
homes of such girls and women are often lacking both in helpful
discipline or moral protection and to leave them in full charge of the
parents is often the worst possible neglect. This Colony Plan is
described in an article by Charles Bernstein, entitled "Colony and
Extra-institutional Care for the Feeble-minded," published in _Mental
Hygiene_ for January, 1920. The needed supervision, protection and
care for higher-grade morons is difficult to secure unless some form
of official control is initiated. That official control is often only
available for those who have already suffered some serious consequence
of their abnormal condition. What we need to work out is a better and
more effective means for helping the family to do what is needed for
the mentally handicapped child.
=Mental Hygiene.=--No adequate treatment of this vital movement can be
given here, but the family need for social provisions along this line
must be urged. Few families can afford the money, few parents have the
wisdom, to secure the right sort of special treatment for minds not so
diseased as to be legal subjects for insane hospital care or for
institutions for the feeble-minded, which yet make the family life
miserable and the family success difficult. There is growing a
conception of the need, especially in our complex modern life, that so
often unsettles or overburdens the mind, to have all manner of free
clinics and economical methods of care for those who can not well care
fully for themselves. This movement will go on until the mental
invalid of every sort will find as ready social sympathy and as
adequate social aid as does the physically weak, ill, or crippled.
Such a serviceable little pamphlet as that of Mr. Brady's on "Mental
Hygiene in Childhood" gives useful suggestions. Meanwhile, the family
interest is keen and must become more active and commanding in ridding
society of the inducing causes of diseased germ plasm. The whole
"social-hygiene" movement, so-called, is in the direction of cutting
off the supply of the defective and making every family less likely to
have children who never grow up.
The call during the War, and a call heeded by many who had been
ignorant of all the facts taught them in training camps, was "Keep Fit
to Fight," The call of peace, and may it be heeded as the facts of
inheritance are better known by all, is, Keep Fit for Parenthood. The
sins of youth, so often sins of ignorance, carelessness, and unbridled
passion, which doom childhood to blindness, to congenital deficiency
of all kinds, to permanent twist of mental powers, or to lack of
ability to meet life's demands--these sins of youth will be less in
evidence when education is fitted to life's full responsibilities of
choice instead of being side-tracked in narrow lines of scholarly
acquirement alone.
Meanwhile, for the parents whose children number one or more of the
handicapped there is the comfort of securing for such all that science
and special arts of teaching and institutional provision can give to
make the life of those who can never grow up at least comfortable and
free from exploitation by evil influences. That some of the noblest
and best of men and women are giving their lives in wise and loving
ministration to these least among the children of men is proof of the
overmastering power of human sympathy. Meanwhile, again, we are
finding out that the more discriminating observation of children and
their more truly scientific rating will take many children from the
lists of the "backward" and the "difficult" and even the supposed
feeble-minded into the ranks of the educable toward full normality.
=Special Rooms in Public Schools.=--The special rooms in the schools
and the special schools in the school system and the school nurses and
school doctors and the visiting teacher, with her power of making
connection between the home and the school and playground, all show
that we are coming to a point where every child will have a better
chance for having his mental and moral as well as his physical
diagnosis correctly made. And such a diagnosis we have already learned
often shows that no congenital doom marks the child labelled
"different," but rather some curable bad condition in his life that
needs only wisdom and economic power to correct. The "Observation
Cards" to which allusion has been made as helping toward discovery of
the specially gifted may also, if used with discriminating judgment,
show that many whom we thought lagged behind their mates from native
disability can be made to keep up with the procession if they are
rightly fed, have enough sleep, get a chance at fresh air, and are not
made the victims of industrial exploitation.
The new gospel of environmental change in the interest of better
physical, mental, and vocational opportunities for all, includes not
only the better care of all incompetent for self-control,
self-support, and self-direction, it also is coming to include a far
more searching investigation of the causes of degeneracy and
backwardness, and many children are thereby lifted from the hopeless
classes to the group of those requiring only special care and teaching
to be able to be classed as normal.
=Training the Nervous System.=--Professor James said, "The great thing
in education is to make the nervous system the ally, not the enemy.
For this we must make automatic and habitual as many useful actions as
we can and carefully guard against growing into ways which are likely
to be disadvantageous." His advice for self-discipline is to "seize
every first possible opportunity to act on any resolution made, and on
every emotional prompting in the direction of habits one aspires to
gain." Professor Thompson, in his book on _Brain and Personality_,
says, "We can make our own brains, so far as special functions or
aptitudes are concerned, if only we have wills strong enough to take
the trouble." These and many other admonitions in the direction of
more effective mental training show the trend of modern education. How
many a will has been weakened by bad methods of family influence! How
many nervous systems made the enemy of education rather than its ally
by bad family conditions!
The Parent-Teacher Associations are doing valiant service in bringing
to the home the best thought of the school and in bringing to the
school the best feeling of the home. It is not too much to hope that
when the jointure between real education and pure affection is made
more complete we may lessen the toll of incompetent personality and
raise the social standard of human powers. In this connection one
vital thought must not be over-looked, namely, the social advance we
may reasonably expect from the new power of women to select the
fathers of their children. Doctor Sumner said, "During the ages of the
man-family men could not make up their minds what they wanted woman to
become." If that be so, it is still more true that now, as the age of
the man-and-woman-family begins, women are undertaking to make up
their own minds as to what they want to be and to do and are attaining
a freedom of sex-selection such as they have not had before in the
civilization we call our own. Doctor Todd says truly, in his _Theories
of Social Progress_, that "from now onward the centre of selection is
shifted from without to within, from passive adaptation to active
self-determination;" and he adds, "To rationalize sexual selection and
make it serve progress will be to revise the 'mores' and inject into
them new principles." While women had no real power to select their
mates in marriage; while their economic helplessness led them almost
universally to marry as a means of support even when no real affection
softened and sanctified the process; while they had no power over laws
or customs, or knowledge of actual life outside the household, and
hence had to take wholly on trust the character and protestations of
the man they married; while women were in this subject condition they
could not contribute to family life either a high standard of choice
of parental quality or a forceful demand for previous purity and right
living in the husband. Hence, women have up to a recent time been more
sinned against than sinning if they passed on defective germ plasm or
doomed their children to suffering lives.
=Responsibility of Women in Marriage.=--Now the case is different. No
woman of usual physical strength or natural ability or average
vocational efficiency is necessarily tempted to make "marriage a
trade." If she has any strength of character she can make her own way
and find many good things in life for herself. She can, therefore,
exact such a standard of character and attainment from any man who
seeks her in marriage as he may well demand of her and can pass by as
incompetent to family demand all who do not measure up to the
requirements.
This may mean (in some circles of society, it is already coming to
mean) what Wallace indicated when he said, "Woman is to be the great
selective agent of the future." This cannot be, however, unless women
hold themselves to the best standards that men in the past have
exacted of their sex and so holding themselves (where the race needs
that they should stand) hold men also where the race needs that men
should find their place. The defrauded children of every generation
call with pathos of unique appeal upon men and women that the "racial
poisons" shall be abolished, and evil inheritance be checked, and that
every potential father and every potential mother shall hold sacred
the torch of life to pass it on the brighter for their handling.
Meanwhile, such agencies as "The Committee on Provision for the
Feeble-minded," with its central office in Philadelphia, and the
"National Committee for Mental Hygiene," with its headquarters in New
York City and its important quarterly publication, together with local
associations of similar type, are at work, as is well stated by one
national body, "to disseminate knowledge concerning the extent and
menace of feeble-mindedness and to suggest and initiate methods for
its control and ultimate eradication from the American people." On
such social effort afflicted parents of a defective child may depend
for aid and direction.
In Whittier's tribute to Samuel Gridley Howe, the pioneer in this
social care of defectives, one false hope is pictured, namely, that
"the idiot clay" could "be given a mind." That hope could not be
realized. The gates of destiny close at birth for many of the children
of men. What we can do and are now beginning to try earnestly to
accomplish is to prevent so many idiots from burdening the currents of
life, to wipe out the social disgrace of leaving neglected wanderers
on the highways of human effort who are unable to find the path of
safety and of success, and to make a protected place of guidance and
possible training for all the weak-minded and abnormal. We can, now we
increasingly understand, do more than this; we can help with ever more
ingenious and devoted care to give the merely slow and backward a
better chance at life's opportunities and help to make these least
able to adjust themselves easily to the common ways of the world more
amenable to life's discipline and happier in life's restrictions.
=The Call for Preventive Work.=--The new call for social service for
the children that never grow up is along new lines of preventive work
as truly as in demand for more tender care of all who cannot be helped
radically toward self-control and self-direction. The family, once
overwhelmed by tragedies of abnormality, can now be aided as never
before in lessening or in bearing the burden of such troubles. For the
less seriously handicapped yet specially in need of social
consideration--the blind, the deaf, the crippled, those of cardiac
weakness, and the children born tired who might become rested and
strong--the family has helps in education, medical treatment and work
opportunities suited to the particular need, such as no previous era
could furnish. Agencies for finding employment for the handicapped now
show ingenuity of the highest sort in fitting the work to special
needs, and the way in which the blind are taught to rise above their
misfortune in happy use of the faculties and powers they actually
possess is marvelous. The deaf have as yet been able to triumph over
their misfortune in less degree, but the art of reading from the lips
and other educational devices used in their behalf make their
condition so superior to that of the deaf-mutes of old that it is
cause for gratitude to every parent of a deaf child. The crippled
children now are seen not to be different from other children in their
educational rights and as needing only more consideration of physical
requirements to be fitted for useful work.
The significance of the removal of educational provisions for the
blind, the deaf, the crippled, and the invalid children from the
provisions of Boards of Charity and their assignment to departments of
state and local Boards of Education, is great. It shows that we are
becoming as capable in the community-at-large of understanding the
radical difference between those who are defective in mind and those
who are merely handicapped by loss of some special sense or some
physical power as loving and wise parents have been when either
defective or handicapped children have called upon them for special
care. The children that find it harder than most of their age and
station to grow up to full enjoyment and use of life's opportunities,
because of some weight of affliction, are, we now know, entitled to
all the training that the normal child receives and whatever else of
special education their condition requires. The children that can
never grow up to mental maturity, even with all that educational
ingenuity can offer, are the permanent members of Society's Infant
Class.
QUESTIONS ON THE CHILDREN THAT NEVER GROW UP
1. What is the modern social program in respect to the care and
training of the feeble-minded?
2. What should fathers and mothers of the feeble-minded do to help
realize that program?
3. How far should social control compel the segregation or
sterilization, or both, of those obviously unfit to become
parents?
4. What can be done by mental hygiene to lessen the numbers of the
insane, the "queer," the weak-willed, and the slow-minded?
5. The consensus of experts seems to indicate that the first need
is to segregate in suitable institutions under permanent
custodial care all the markedly inferior who cannot be
self-supporting and who lack power of self-protection against
the grossest forms of exploitation; the second need is to
introduce new methods of supervisory control and humane
protection and training in the care of those who are not normal
but who, under favorable conditions of vocational guidance and
direction and with a new home environment suited to their
peculiar needs, may become wage-earners and fairly useful
members of society. In the town for which you seek better
conditions, which of these efforts is most needed at the
present time? Is it to meet the needs for institutional care or
for supervision adequate and well applied for those left either
in their own homes or placed in colony-care?
FOOTNOTES:
[14] See "Mental Diseases in Twelve States," as reported in 1919 by
Horatio M. Pollock, Ph.D., Statistician New York State Hospital
Commission, and Edith M. Forbush, Statistician of National Committee
for Mental Hygiene, published in _Mental Hygiene_ of April, 1921.