Handicaps of Childhood

by H. Addington Bruce

"The front of the house looked out on a board fence which divided a double alley. In the rear was a small back yard. One hydrant at the entrance sufficed for the different families. There was underground drainage, but an offensive odour came from the closets. This was the soil in which Fannie had struggled to grow for eight years. When the school nurse visited the house, Fannie sat crouched in a corner, her eyes sullen and dead, her mouth hanging open, her skin showing the poorly nourished condition. Her eyes were crossed, her teeth irregular, the whole face devoid of life or interest.

"Fannie had been two years in the first grade of a Philadelphia school, and had made in that time so little progress that there was no possibility of promoting her to the next grade at the end of that school year. During the first year her attendance had been somewhat irregular, but despite the regular attendance of the second year she had profited little, and had come to be overlooked because she was thought to be too feeble-minded to progress in a school for normal children."

Taken to the psychological clinic, she was given a thorough physical and mental examination. She was found to be afflicted both with adenoid growths and enlarged tonsils, and was sent to a hospital to be operated on for these. Later she was entered in the hospital school connected with Professor Witmer's clinic at the University of Pennsylvania. Here she remained a year, part of that time attending also one of the city's public schools. Both mentally and morally she made satisfactory progress. Her sullenness rapidly disappeared under sympathetic handling. Though "at first she did not seem to understand affection," by the end of six weeks "she was the most demonstratively affectionate child in the school." Professor Witmer adds:

"During the first summer she appeared extremely sluggish. She showed very little tendency to play, and preferred to sit more or less motionless. As good food, better air, sunlight, and kindly treatment began to take effect, she burst forth with such excessive vitality, such exuberant spirits, that once when I had her before the psychological clinic one of the teachers asked if the lively movements were not the result of St. Vitus's Dance. This first outburst of vitality gradually subsided, leaving her a normally active child."

Undeniably, of course, even though a vicious household environment was chiefly responsible for this girl's backwardness, the adenoids and enlarged tonsils were also responsible for it in some degree. Parents cannot too keenly appreciate the hurtful effect bodily defects like these may have on mental development. Doctor Ayres, who has made an exhaustive study of this factor in retardation, estimates that it alone accounts for about 9 per cent. of the laggards in our schools, and clinical psychologists are disposed to put the percentage still higher. On the other hand, their experience with retarded children has led them to the important conclusion that, helpful as spectacles, the ear syringe, and the surgeon's knife may be, "after-treatment" in the form of careful individual training usually is indispensable, if only for the reason that while handicapped by the bodily defect the child may have acquired faulty mental habits which need to be corrected before education by ordinary schoolroom methods can count for much.

This means, manifestly, that many agencies must co-operate in the regeneration of the curable dullard. How many are sometimes involved may perhaps be sufficiently indicated by detailing another case from Professor Witmer's extensive experience, the case of an eleven-year-old boy who was brought to the University of Pennsylvania's psychological clinic with a history of five wasted years in school.

Any suspicion that this boy might belong to the ranks of the truly feeble-minded was dissipated by the results of the exhaustive mental testing through which Professor Witmer put him. This showed not only that he was naturally intelligent, but also that he was of an affectionate, generous, and thoughtful disposition. When, however, a physical examination was made, ample reason for his dullness was discovered, for it was found that he was suffering from adenoids, enlarged tonsils, weakness of vision, and dental trouble, his teeth being decayed and unclean, with tartar pushing back the gums, which were inflamed and swollen. In addition, he was stoop-shouldered, had an irregular heart action, and showed signs of being poorly nourished.

"Before anything can be done to improve your boy's mental state," it was explained to his mother, "his physical condition will have to be improved. He should be put under treatment without delay."

Then began a distressful period for the hapless youngster. First of all, a throat specialist operated on him for the removal of the adenoids and the hyper-trophied tonsils. After this he was sent to the eye clinic, where he was fitted with glasses. Next, he was taken to the dental clinic, where his teeth were cleaned and filled. All the while a trained social worker kept in touch with his parents to make sure that he would receive the hygienic care which had hitherto been wanting. In the meantime, he was allowed to return to school, from which, after the beginning of the summer vacation, he was transferred to a special school for backward boys. Here he remained most of the summer, being given individual attention with regard to his mental and physical needs.

It was noticed at first he was inclined to be quick-tempered and disorderly; but under the tactful handling he received he soon settled down. From being puny and delicate, he became an active, vigorous boy, excelling in the swimming-pool and the gymnasium. At his books he also made such progress that, on returning to regular school in the autumn, he was promoted through two grades in less than six months, being then only one grade behind normal and giving every promise of catching up with the boys of his own age in another six months.