CHAPTER VII. CHECKING THE BINET DIAGNOSIS BY OTHER METHODS
The Binet scale in its various forms provides only part of the objective evidence as to the mental inferiority of delinquents, although it affords the best means at present of interpreting the borderline of deficiency. Among the other investigations in which psychological tests have been tried with delinquents in comparison with normal subjects, the recent study of the Mentality of the Criminal Women by Weidensall is the most important so far as estimating the frequency of deficiency is concerned ([60]). It affords an admirable check upon our conclusions from the Binet examinations, since she gives in detail the results with a random group of 88 women inmates of the Bedford (N. Y.) Reformatory, which is quite comparable with the group of 200 which she tested with the Binet scale, and which we have already considered.
For our purpose, the most important comparisons are those between the group of women in the reformatory and the group of 15-year-old Cincinnati working girls tested by Woolley with the same tests. Weidensall's Table 92 shows for three tests the percentages of the Bedford women who tested below the lowest 1% of these girls. For the opposites test, 20% were below this borderline; for a test on the completion of sentences, 12%; for the memory span for digits, 29%. She also shows that 17% of the delinquent group were poorer than any of the working girls and 30.7% as poor as the poorest 5.7% of these working girls, when their mentality is measured by the number of the tests in which their ability is at or above that of the median working girl of fifteen. This 30.7% is probably most nearly comparable in ability with the lowest 0.5% of the general population.
Kelley's monograph on Mental Aspects of Delinquency, to which reference was made in the last chapter, gives the results with boys in the Texas Juvenile Training School for the completion test and his own construction test, as well as for a number of physical measurements, sensory and motor tests. He has used various data from which to provide norms for comparison. In connection with the Psychopathic Institute at the Chicago Juvenile Court, Healy and Fernald ([125]) have published an elaborate series of tests with suggestions as to how they may be employed for analyzing a child's mental ability and estimating his mental capacity. Schmidt has partially standardized these tests ([178]). Guy G. Fernald ([15]) tried out a dozen different tests and recommends seven of them for testing delinquents who are of adolescent age or older. Haines has sought the diagnostic value with girl delinquents of a dozen tests including Fernald's test of moral judgment. Weidensall ([218]), Smedley ([51]), Rowland ([49]), Porteus ([45]), and Whipple and Fraser (220, p. 663), have published results with certain tests tried with delinquents. With none of these tests can we adequately define the borderline of feeble-minded intellects.
There is no series of tests which has been employed outside the field of delinquency which diagnoses the borderline cases objectively so well as the Binet scale. The tests of Weyandt ([219]), Rossolimo ([175]), Rybakow ([176]), and Knox ([134]) are without definable limits based on unselected groups. Those employed by Dr. Norsworthy, while scientifically better scored for describing the borderline, were not arranged with this in view ([160]). Carpenter has published norms obtained with Squire's tests on 50 pupils of each age from 7 to 14. Single tests like the form board ([87]), Knox's cube test ([134]), the substitution test ([1]), and the A test ([160]) have been tried with delinquent or feeble-minded groups as well as with normal people. Under the direction of the New York Board of Charities an excellent beginning has been made in determining norms for eleven different tests ([158]). Stenquist, Thorndike and Trabue ([54]) have furnished developmental norms for several tests. Gilbert ([108]) and Smedley ([51]) at an earlier date provided age norms and deviations for certain tests. Mrs. Woolley has provided the percentile distribution for a series of mental and physical tests with 14-and 15-year-old children leaving the public schools to go to work ([222]) ([223]). In England a goodly number of different tests have been tried out on small groups or on children of particular ages ([84]) ([63]) ([224]). Pyle has obtained norms and variations with a series of group tests. It approaches nearest to the Binet as a developmental scale for the immature, but these tests have not been tried as individual tests and so could hardly be used safely for individual diagnosis. A graphic summary of the developmental curves for most of these tests on children will be found in Chapter XIII.
In no case do we find any tests except the Binet scales which have reached a stage of practical usefulness for the diagnosis of deficiency except as supplementary aids for checking the Binet indication with children of particular ages. The emphasis has almost universally been placed on determining the central tendencies of children of different ages and not on the lower limits of the distributions. Considering mental tests apart from the Binet scale, in all the extended literature which has been brought together in books like Whipple's Manual of Mental Tests ([220]), one may seek in vain for tests which have reached the position of defining the limits of serious mental deficiency. This indicates, of course, the difficulty as well as the newness of the problem, although the quantity of work that is being done shows the great interest aroused. From all of this mass of research on mental tests one may gather much that is useful in analyzing the character of a mental defect. Many of the tests admirably aid in elaborating the subjective impression of the examiner. The failure to do this systematically has been one of the main criticisms raised against the Binet scale. This and the incorrectness of the borderline described in the published scale seem to be the main objections made by Miss Schmidt to the Binet Method. She voiced the objection of the Juvenile Psychopathic Institute in Chicago to the tests as follows: “It has been the experience of the writer, and it may be added of all others who have worked in this laboratory, where practical results are demanded, that the Binet tests cannot furnish an adequate means through which to come to conclusions for the disposition, classification, or treatment of the cases which come for diagnosis” ([179]).
Dr. Merrill of the Seattle court also seems unfriendly to the Binet scale when he says: “Any system of tests by which alone[[30]] it is attempted to classify the child as being of a given mental age involves the fallacy of pseudo-exactness, and needs carefully to be avoided” ([148]). Nobody would seriously urge that real exactness of definition leads to confusion. It is just the looseness of definition of borderline with the Binet Scale which has led to most of the mistakes with it. Perhaps Dr. Merrill has not discovered that the scale works just as well when used as a graded series of tests without the designation of mental ages at all. The latter is merely a convenience. On the other hand, we should agree when he says, that “no scale of tests can give a valid measure of the child's intelligence unless supplemented by a consideration of his history,” especially if he includes in the child's history a medical diagnosis.
The objection that the Binet tests do not analyze the source of the child's mental defect is of course important if one were considering whether a better scale might not be devised. It is rather beside the point, however, when one remembers that it is not the purpose of this scale to determine the causes of deficiency, but only to say whether a deficiency in general intelligence is present and to what degree. The causes of the disturbance must then be determined by an expert. Moreover, if one classifies the Binet tests as Meumann has done one may often get valuable clues as to whether the deficiency is mainly in information or in mental process. In seeking the causes of the disturbance, the expert should not overlook the standardization of the Rosanoff and Kent Association Test which has been available for delinquent, feeble-minded and normal children ([174]). It is one of the most important supplementary means for mental analysis which has yet been standardized for practical use. The most complete tables on children's reactions for this test have been published in a Psychological Monograph by Woodrow and Lowell.
The importance of more accurate psychological tests in studying mental disturbance is well illustrated by comparing the results that may be obtained with the Binet tests with the desultory, unstandardized tests such as one finds in Dr. Schaefer's Allgemeine gerichtliche Psychiatrie für Juristen, Mediziner, and Pädagogen ([177]), or Dr. Cimbal's Taschenbuch ([91]) prepared for physicians and jurists. Suggestive as these books are for disclosing different mental activities, they give no means of evaluating the disclosures. They show the puerile stage in diagnosis which had been reached before standardized tests were available.
Among those who are engaged in practical clinical work for determining mental development the Binet Scale has advocates who are quite as ardent as critics we have noted. Goddard, Kuhlmann ([139]), Wallin ([213]), and Towne ([201]), have all used it in the practical examination of hundreds of cases and heartily commend its use in connection with delinquents, as does Healy for the earlier ages (27, p. 80). On the other hand there is a growing sentiment that the examinations should only be entrusted to experts in mental development. It is felt that the physician who has not had enough training in a psychological laboratory to understand the snares of mental tests, and very few have had this opportunity, ought to refer this question to a clinical psychologist as the best physicians now do when such experts are available. Perhaps nobody is so well equipped to judge a child's mental development without diagnostic tests as his school teacher, although Terman has shown that the teacher's judgment may be seriously at fault when he has not learned to dissociate mental capacity from the age and size of the child ([196]). In an editorial in the Journal of Criminology, Dr. Gault (106, p. 322) expresses the opinion that “dissatisfaction with mental tests as a means of diagnosis” is traceable to the fact “that what the lay mind recognizes as palpable errors are often made by half-trained 'investigators,' 'research directors' and even by men and women whose only qualification is that they have been trained for six weeks in a psychological clinic.” Dr. Wallin demands that the tests should be used for diagnosis only by the psychologist with clinical experience.
The American Psychological Association has cautioned against diagnosis by those inadequately trained and adopted the following resolution at its 1915 meeting:
“Whereas, psychological diagnosis requires thorough technical training in all phases of mental testing, thorough acquaintance with the facts of mental development and with the various degrees of mental retardation.
“And whereas, there is evident tendency to appoint for this work persons whose training in clinical psychology and acquaintance with genetic and educational psychology are inadequate:
“Be it resolved, that this Association discourages the use of mental tests for practical psychological diagnosis by individuals psychologically unqualified for the work.”
Binet's suggestion as to the diagnosis of mental development seems to be best. He says that “the selection of defectives calls for three varieties of experience—that of teachers, of doctors, and of psychologists” (77, p. 38). These three points of view may be combined in a committee as in France, or the decision may rest with a specialist in mental development whose judgment should only be given after he has all the information which the medical, educational, and social diagnosis can provide to supplement his test records and his evaluation of the causes of the condition found.
Those who are considering the legal isolation of the feeble-minded, especially defective delinquents, and superintendents who wish a safe rule for transferring school children to special classes or schools for the mentally retarded should keep a committee plan in mind. A legal requirement embodying an examination by such a commission could easily be framed. In my opinion the expert in mental development should be required at least to have the equivalent of a year of graduate work with his major time in testing. On the other hand very desirable information as to children that require examination may be obtained by a teacher who uses a mental scale intelligently. In the hands of an amateur it may perform an analogous service to that of a vision chart in discovering children who require expert examination of their eyes. The danger lies in the novice not knowing his limitations. Few who have had experience with tests can doubt, however, the much greater danger of inadequate diagnosis of mental development on the part of physicians who give opinions about mental deficiency without having had experience with test scales.
[30]. Italics mine.