“It is in order to avoid this vagueness and uncertainty attaching to the term that we suggest a definite psychological concept. The lowest three per cent. of the community at large, that is, the lowest as determined by definitely standardized mental tests, are to be called feeble-minded. Such a definition will be unambiguous and the dividing line between this and other groups will become clearer and clearer as we increase the accuracy of our measuring scales and the adequacy of our standardizations. Furthermore, if evolution is raising the degree of intelligence the three per cent. at the lower end will still remain, for, whatever the degree of their intelligence may be, they will still be feeble-minded as compared with the normal.
“Such a definition will in addition restrict the term to such as are lacking in intelligence and will differentiate them from the moral defectives and the psychopathic personalities, which are at present often confused with the group that we propose to call feeble-minded. An individual may be at the same time a moral defective and feeble-minded, but there is reason to believe that moral deficiency may exist without such intellectual defect as to warrant a diagnosis of feeble-mindedness. The same may be said of the psychopathic personality.
“The further question, whether all those coming within the proposed definition of feeble-mindedness are to be confined in institutions, is purely social and will be determined by the social needs of each community and does not concern us here. It is obvious that many more in addition to the feeble-minded as defined by us will require the restraint of an institution, even though no real mental defect exists.
“It is immaterial for the purposes of this hypothesis whether three or a smaller or larger percentage be designated as feeble-minded. The important point is the agreement upon some fixed percentage, and we have chosen three per cent. as covering presumably all the cases of marked mental deficiency. A brief glance at the chief estimates of the number of feeble-minded in civilized communities would indicate that our percentage is somewhat higher than the conservative writers give, but we shall show later on that it is much lower than the results obtained from groups of children tested by intelligence scales” (44, p. 36).
With those who understand that deficiency is mainly a question of degree, it would seem that there might be some agreement as to the plan for defining tested deficiency. In order to make this plan more useful to those dealing with the social care of the feeble-minded, it would be necessary to supplement the bare percentage definition by relating it to expectations of social failure somewhat after the manner I have attempted. In particular it will gain its main value for diagnostic purposes, it seems to me, if the percentage is so chosen that it may receive the support of conservative scientific opinion. To be most useful it seems evident, also, that the percentages must be chosen with regard to the sort of social care which it is anticipated would be justified for the particular degrees of deficiency.
Let us recall the percentages suggested to harmonize the estimates: the lowest 0.5% to be regarded as presumably deficient enough to justify isolation and the next 1% as doubtful, but low enough to warrant special training and probably requiring indefinite social assistance. If these percentages for tested intellectual deficiency have been shown to be fairly conservative estimates in the light of the authoritative judgments with which they have here been compared, the laboriousness of this comparison has been worth while. Further light upon the social assistance group may be thrown by the study of the success of those children who have already had the advantage of training in local classes for the deficient.
F. The Ability of the Mentally Retarded, Especially Those Receiving Special Training.
That we are not justified in isolating all whom we class as feeble-minded is best indicated by the evidence as to the number of these sent to special local classes for deficients who are able to float socially with the assistance of capable after-care committees. A fair picture of the present situation may be obtained by thinking of these pupils in the help-classes and schools as representing about the next 1% above those who have been isolated in institutions. With this picture in mind let us see what has been the outcome of their special instruction and social assistance thereafter.
In his book on Les Enfants Anormaux, Binet collected the evidence available at that time (77, p. 140). He says:
“Mme. Fuster, after a stay in Germany, where she visited some Hilfsschulen and Hilfsklassen (literally, 'help-schools' and 'help-classes') made a communication to the Société de l'Enfant, from which it appears that in the case of 90 classes for defectives in Berlin, 70% to 75% of the defective pupils who were there became able to carry on a trade; 20% to 30% died in the course of study, or returned to their homes, or were sent to medical institutions for idiots.