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!