ONCE upon a time, not many years ago, a distinguished French psychologist paid a visit to a Parisian public school. It was accounted an excellent school, and its principal beamed with pardonable pride when the visiting psychologist, Doctor Alfred Binet, explained that he would like to see the pupils at work. Forthwith his desire was granted, and for a time he attentively followed the exercises of a class of forty children. He said little by way of comment, until, toward the close of the lesson-hour, he abruptly inquired:

"Which of these pupils do you consider the most intelligent?"

"That boy yonder," the master answered, nodding toward a pleasant-faced youngster who was diligently reading his book.

"And, pray, how old is he?"

"He is twelve."

"That, I suppose, is the average age for the class?"

"Well, no. I should say that they are on the average ten years old."

"What, then, is this twelve-year-old boy doing among them? If he is so bright, why is he lingering among these little ones? My dear sir," the psychologist continued, while the principal stood in abashed silence, "would it not be nearer the mark to call him a backward instead of a bright child? And would it not be well to search for the cause of his backwardness and try to remedy it? Assuredly, this boy should constitute for you a delicate problem that insistently demands solution."

This, I say, happened not many years ago. For that matter, incidents quite like it occasionally happen even to-day, testifying to the inability of some teachers to appreciate the presence, let alone the significance, of the laggard in the schoolroom. But in the brief period that has elapsed since Alfred Binet began his epoch-making investigations in the schools of Paris, there has undoubtedly been a genuine and widespread awakening in respect to the tremendously important problem raised by the backward child. Especially is this true of our own land. Nowhere else, perhaps, have more diligent efforts been made to ascertain the extent and causes of backwardness among the school-going population, and nowhere else is greater activity being displayed in the beneficent task of transforming the backward child, as far as possible, into the normal one.

Certainly, too, it must regretfully be added that there is abundant reason for this activity. Researches conducted during the past ten years by American school authorities and by independent investigators, have revealed an appalling state of affairs. Doctor Oliver P. Cornman, a district superintendent of the Philadelphia schools, making a statistical survey of five city school systems, found 21.6 per cent. of Boston school children a year or more behind the normal grade for their age; 30 per cent. behind grade in New York; 37.1 per cent. behind grade in Philadelphia; 47.5 per cent. behind grade in Camden, New Jersey; and 49.6 per cent. behind grade in Kansas City. Doctor Leonard P. Ayres, acting in behalf of the Russell Sage Foundation, investigated fifteen New York City public schools, having twenty thousand pupils, and found a degree of retardation ranging from 10.9 per cent. to 36.6 per cent. Scrutiny of the school reports of more than thirty other cities revealed an average retardation of 33.7 per cent. Taking this as a fair average for the whole country, we have a total of between six and seven million American school children who are a year and more behind grade.

To be sure, this does not mean that all these children are intellectually deficient, for the term "retarded" is by no means synonymous with "dullards." Irregular attendance owing to illness or truancy accounts for not a little retardation. The education of a good many children is deliberately postponed by their parents, and as a result they are necessarily behind grade for some time after they enter school. In the case of many others, especially in cities like New York and Boston, where there is a large foreign-born population, ignorance of the English language is a sufficient cause for temporary retardation. Thus, I have received a letter from Doctor William H. Maxwell, superintendent of schools, New York City, in which he points out that many New York school children are recently arrived immigrants, coming from a foreign country, considerably above the age at which school-going usually begins. The personal inefficiency of teachers is also a factor to be reckoned with. Many a child becomes a "repeater" simply because he has had a poor teacher.

Nevertheless, when every possible allowance is made, the results of the investigations by Doctor Ayres, Superintendent Cornman, and their co-workers sum up to a deplorable showing. It is a showing, however, with one distinctly redeeming feature. Readers of my previous book, "Psychology and Parenthood," will remember it was there pointed out that the proportion of juvenile delinquents who are "born bad," and for whom no remedial measures will avail, is exceedingly small. There is reason for saying precisely the same thing with regard to the retarded child.

He may be dull, stupid, to all appearance hopelessly defective, but the researches of the past decade, the fruits of the mind-developing experiments that have gone apace with the discovery of the extent to which backwardness prevails, leave no doubt that in most cases the child who is a true dullard may be brought almost, if not fully, to normal intellectual activity, provided he is taken in hand at an early day. In fact, even the most pessimistically inclined investigators admit that, at an outside estimate, not more than 2 per cent. of backward children are backward because of incurable defects of the brain. Many present-day authorities put the figure as low as 1 per cent., and my own belief is that even this is too high a proportion.

Undoubtedly—and especially since the invention of psychological tests to determine the mental state of dullards—many children have been erroneously pronounced feeble-minded when their backwardness is in reality due to remediable causes. The trouble is not with the tests so much as with the inexperience of those who apply them, some of the tests being seemingly so easy of application that in many instances they have been utilised by teachers and others having little or no training in clinical psychology. This is particularly true concerning the application of the much-talked-about Binet-Simon method of mental diagnosis, devised by Doctor Alfred Binet and his colleague in scientific child study, Professor Simon.

The Binet-Simon method is certainly simple enough, and, rightly used, is of great value. It was formulated by putting to hundreds of children, ranging in age from three to thirteen, a series of questions and commands of increasing difficulty, noting the results obtained, and selecting as "norms" for each age the questions and commands to which the majority of the children of that age were able to respond correctly. Thus it furnishes a convenient means for determining with considerable accuracy the degree of mental retardation of any particular child. Experience has shown, though, that its fixed standard, by which children are pronounced "mentally defective" if they fall three years behind the norm for their age, is not always an infallible guide. When the method is applied by the untrained investigator the result is sometimes absurd.

For instance, in one American city 49.7 per cent. of six hundred retarded children tested by the Binet-Simon method were reported as being "feeble-minded," while 80 per cent. of three hundred children in the special classes of another city school system were similarly stigmatised. On such a basis we should have, among the six million retarded children in our schools, from three to nearly five million who are feeble-minded. Even if the Binet-Simon testing is done by an expert, there is always the danger of incorrect diagnosis, with resultant serious injustice to the child tested, unless the indications drawn from the testing are verified by careful clinical and laboratory investigation. A few cases from the experience of a well-known clinical psychologist, Doctor J. E. Wallace Wallin, director of the Psycho-Educational Clinic, Board of Education, St. Louis, may well be cited to illustrate and emphasise this important truth.

There was once brought to Doctor Wallin a pupil in a private school, an attractive girl of seventeen, who was studying—or, rather, attempting to study—Latin, history, algebra, and English. Her teacher complained that she could remember little or nothing of what was taught her, that her attention flagged easily, and that in other ways she did not seem to be of normal mentality. And, in fact, tested by the Binet-Simon method she graded only eleven and a half years old.

Had the psychological inquiry into her condition stopped there, she would have been declared a fit subject for institutional care, according to the Binet-Simon rating. But Doctor Wallin insisted on additional and different testings, and presently made the significant discovery that her trouble lay, not in any structural brain defect, but in a functional weakness of the nervous system that caused her to become fatigued at slight mental exertion. She was, in short, a "psychasthenic," and needed only proper treatment by a skilled neurologist to be put into condition to profit from her lessons as her schoolmates did.

So, too, with a man of twenty-eight, who, tested by the Binet-Simon system, displayed the mentality of a boy of twelve. Had he been in the hands of an investigator who knew no more of the technic of psychological examination than the Binet-Simon scale, he would unhesitatingly been classified as feeble-minded. But, as Doctor Wallin said, in discussing the case:

"He did not impress me at all as being feeble-minded. His appearance, speech, and conduct suggested the polished and cultivated gentleman. I put him through approximately thirty sets of mental tests [other than twenty-five individual Binet tests] and thirty moral tests. These tests demonstrated that there was a considerable difference in the strength of his different mental traits. Some traits were on the twelve-year plane, some on the fifteen-year, and some on the adult plane. In some mental tests he did as well as college men. He passed correctly practically all of the moral tests.

"His was indeed a case showing more or less deficiency in respect to various mental traits. But, contrary to the Binet rating, the man was not feeble-minded. It eventually developed that a sexual complex was at the root of his trouble."

Again, with the express purpose of determining the reliability or unreliability of the Binet-Simon tests as sufficient indicators of the mental status, Doctor Wallin applied these tests to several successful farmers and business men. The results were surprising and amusing. He tells us:

"The 1908 scale was administered according to my own Guide,[1] and the 1911 according to Goddard's version, which is usually used in this country for diagnosing feeble-mindedness. The subjects were generously rated in the tests; i.e., full credit was given for some responses that did not quite meet the technical passing requirements. Measured by the standards of one of the best rural communities of the country, socially and industrially considered, and by my own intimate knowledge of the subjects tested during the greater part of my life, not a single one of these persons could by any stretch of the imagination be considered feeble-minded. Not a single one has any record of delinquency, or crime, petty or major, or indulges in alcoholic beverages. All are law-abiding citizens, eminently successful in their several occupations, all except one (who is unmarried) being parents of intelligent, respectable children. The heredity is entirely negative, except for a few cases of minor nervous troubles and alcoholic addiction. No relative in the first or second generation, so far as it was possible to get the facts by inquiry, was ever committed to a penal institution or an institution for the mentally defective or disordered."

Yet, given the Binet-Simon tests, every member of this group, if judged by the tests alone, would have to be rated as feeble-minded. Here is Doctor Wallin's account of one of these most illuminating cases:

"Mr. A., sixty-five years old, faculties well preserved, attended school only about three years in the aggregate; a successful farmer and later a successful business man, now partly retired on a competency of $30,000 (after considerable financial reverses from a fire); for ten years president of the board of education in a town of seven hundred; superintendent or assistant superintendent of a Sunday school for about thirty years; bank director; raised and educated a family of nine children, all normal; one engaged in scientific research (Ph.D.), one assistant professor in a state agricultural school, one assistant professor in a medical school (now completing thesis for Sc.D.), one a former music teacher and organist, a graduate of a musical conservatory, now an invalid; one a graduate of the normal department of a college, one a graduate nurse, two engaged in a large retail business, one holds a clerical position, all high-school graduates, and all, except one, one-time students in colleges and universities.

"Failed on all the new 1911 tests except six digits and suggestion lines (almost passed the central-thought test). In the 1908 scale, passed all the ten-year tests and some higher tests. Binet-Simon age, 1908, 10.8; retardation, fifty-four years; intelligence quotient, .17. According to the 1912 scale, 10.6 years."

Doctor Wallin fittingly comments:

"This man, measured by the automatic standards now in common use, would be hopelessly feeble-minded (an imbecile by the intelligence quotient) and should have been committed to an institution for the feeble-minded long ago. But is there any one who has the temerity, in spite of the Binet 'proof,' to maintain, in view of this man's personal, social, and commercial record, and the record of his family, that he has been a social and mental misfit and an undesirable citizen, and should, therefore, have been restrained from propagation because of mental deficiency (his wife is still less intelligent). No doubt, if a Binet tester had diagnosed this man forty or fifty years ago, he would have had him colonised as a 'mental defective.' It is a safe guess that there are hundreds of thousands like him throughout the country, no more intelligent and equally successful and prudent in the management of their affairs. Had he been a criminal when he was tested, the Binet testers who implicitly follow these standards would have offered 'expert testimony' under oath that he was feeble-minded and unable to distinguish between right and wrong, or unable to choose the right and avoid the wrong."

Truly, feeble-mindedness in an adult or child is not safely to be determined by relying merely on the results of a set of stereotyped mental tests. On the other hand, in deciding as to a child's actual mental state it is far more misleading to depend on unaided observation as a guide. Yet, since the beginning of scientific investigation into the causes of backwardness, cases have continually been coming to light in which teachers and even parents have mistakenly identified curable dullness with incurable feeble-mindedness, and have abandoned all effort at intellectual development. Sometimes, consequently, a condition closely resembling outright idiocy results from sheer neglect, as in one particularly striking case, for knowledge of which I am indebted to Doctor Arthur Holmes of Pennsylvania State College, well known for his work in clinical psychology.

In this case the daughter of a well-to-do professional man failed to show normal growth in infancy and was supposed by her sorrowing father to be weak-minded. Left to her own devices, on the theory that it would be useless to try to mend the work of Providence, she remained until the age of eight in a state of seeming imbecility. She could not read or write, could not speak more than three words, and spent most of her time gibbering in a corner. Then, as good fortune would have it, she came under the observation of an expert investigator of mental conditions and was subjected for a year to careful training. At the end of that time she "could speak in simple sentences, answer ordinary questions intelligently, read in a primer, write a few words, and conduct herself in the manner of a little lady."

In other words, she had been taken in hand in time to save her from a life of incompetency, misery, and mental darkness. Is it not reasonable to infer, in the light of this and similar cases on record, that our institutions for the feeble-minded would be far less crowded than they are to-day had regenerative measures been likewise applied to their inmates in early childhood? Indeed, with Professor Lightner Witmer, dean of American clinical psychologists, I am prepared to affirm:

"I believe that a child may be feeble-minded in one environment—for example, in his own home—and may cease to exhibit feeble-mindedness when placed in a different environment. I also agree with those modern students of insanity who assert that the development of some forms of insanity may be averted by a proper course of discipline and training. Analogously, I contend that because a child of sixteen or twenty presents a hopeless case of feeble-mindedness, this is no evidence that proper treatment instituted at an earlier age might not have determined an entirely different course of development."

Also, as in the case of the criminal alleged to have been "born bad," mental backwardness has again and again been found to depend on comparatively slight physical defects—defects of eye, ear, mouth, nose, throat, teeth—the correction of which often results in a spontaneous and remarkable intellectual awakening.[2] Or the dullness mistaken for feeble-mindedness may be due to a generally weakened physical condition, the result of unhygienic home surroundings, lack of outdoor exercise, poor food, and so forth. Here is a case in point, reported by Professor Witmer. It is the case of a little Philadelphia girl, Fannie, the eight-year-old daughter of Russian-Jewish parents, whose two-room home is thus described by Professor Witmer:

"The living-room had one window, and contained a table, a few chairs, a stove, a lounge, dirty clothes piled in one corner, a barking cur, and many flies. The table was covered with a piece of black oilcloth, and on this were usually to be found pieces of brown bread and glasses of tea. No meals were prepared and the family never sat down to table. Their diet consisted chiefly of bread, tea, and sometimes fish. The bread was always on the table for the flies to crawl over and the children to eat when their hunger drove them to it.

"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.

Altogether, the services of half a dozen specialists in psychology, medicine, and education, and the expenditure of much time, effort, and money had been required to get this boy straightened out. Nor is his by any means an uncommon case. Moreover, like the case of the gibbering girl of eight, it illustrates another point in connection with the problem of retardation which should indeed be emphasised—the part played by parental ignorance and thoughtlessness in swelling the army of the retarded.

Had the parents of this boy appreciated the close relationship between bodily health and the health of the mind, had they taken alarm at the first signs of malnutrition and sought the advice of a competent physician, instituting developmental measures in accordance with his counsel, their son might not have become an educational "lame duck," and all the tedious and costly restorative work of later years would then have been avoided. To be sure, it must immediately be added that maintenance of his physical health would not of itself have unfailingly operated as a guarantee against retardation.

For, quite conceivably, he might have been surrounded by an intellectually deadening home environment, receiving from his parents neither proper disciplining nor encouragement and stimulus to mental activity, with the result that when the time came for him to go to school he would display little capability for, or interest in, the tasks of the classroom. So frequently is this actually the case that students of retardation are inclining more and more to rate faulty home training as perhaps the chief cause of mental backwardness. Thus we find one keen observer, Professor P. E. Davidson, declaring in an address at an educational convention in California:

"Parental neglect as a cause, resulting in emotional and volitional disorder, is emphasised in our cases. Learning in school is conditioned largely by what Witmer calls 'pedagogical rapport,' wherein a deference to the prestige of the teacher and the school and a sensitiveness to its rewards and punishments are such as rapidly to produce a habit of voluntary effort or active attention. Confirmed wilfulness at home and undisciplined impulsiveness must undoubtedly figure in the matter of learning. If the child's organic habit, after five or six years of poor home training, makes avoidance of the painfulness of effort the usual thing, we may be sure the teacher in the first grade will have unusual difficulty in inducing a disciplined attention, and a bad beginning on this account may establish a backwardness which later may not be overcome without the individual attention that is impossible in the teaching of large classes."

Professor G. W. A. Luckey, of the University of Nebraska, listing the causes of retardation, puts at the foot of his list "bad inheritance, unredeemable defects, physical and mental," and at the very top, "ignorance and indifference on the part of parents." Most investigators would evaluate these contrasting causes in precisely the same way. The inference, needless to say, is that we need never hope to bring about an appreciable diminution in the number of retarded children until parents are more fully enlightened as to their duties and responsibilities. It is therefore good to find that a nation-wide campaign of enlightenment is well under way, together with an ever-increasing extension of agencies for the work of rescuing the retarded and fitting them to achieve success in the school and in the world.

Eight years ago there were in all the United States only three "clearing-houses for retarded children." These were the psychological clinic of the University of Pennsylvania, established by Professor Witmer in 1896; a civic psychological clinic, opened in 1909, in connection with the schools of Los Angeles; and the psychological clinic of Clark University, at Worcester, Massachusetts, established in the same year as a department of that university's splendid Children's Institute.

To-day, as part of the regular activities of universities and normal schools, there are psychological clinics in more than a dozen States, including California, Colorado, Connecticut, Iowa, Kansas, Louisiana, Massachusetts, Michigan, Minnesota, New York, Ohio, Pennsylvania, and Washington. At least four States—Indiana, Massachusetts, New York, and Pennsylvania—have psychological clinics in operation as adjuncts of hospitals. California, Illinois, Missouri, New York, and Pennsylvania have similar clinics in direct connection with the public school system. Ohio has one connected with a vocational-guidance bureau. And in some States—such as Connecticut, Illinois, and Massachusetts—psychological clinics are also in operation for the special purpose of aiding in the proper disposition of cases brought before the juvenile courts.

Even more rapid has been the development of ear, eye, throat, and dental clinics for the needs of school children. As an outgrowth, too, of the discoveries of the past few years, there has been a widespread movement in the direction of establishing special schools and classes in which the retarded may receive the care necessary to enable them to make up for lost time, or, when this is out of the question, to equip them for as happy and useful a life as is possible under their exceptional mental limitations. Unquestionably a splendid beginning has been made in the warfare against retardation—a beginning not surpassed by similar effort in any foreign land, and certain to prove of great value to the American nation.

But, if it is to prove of the utmost possible value, there must be active co-operation by the public generally and by parents in particular. Society must insist on every child being given hygienically decent surroundings, and parents in the mass must become increasingly alive to their responsibilities and opportunities in developing the mentality of their young. To reiterate:

It may be considered as definitely established to-day that the vast majority of cases of mental backwardness are the result, not of organic brain defects, not of true feeble-mindedness, but of remediable physical conditions or faulty training in the home.

It may be considered as established that even seemingly incurable cases will often yield to expert treatment.

And it may be considered as established that, of the cases which cannot be successfully handled, a large proportion are cases which could have been successfully handled had they been recognised and given expert treatment during early childhood.

Let every parent of a dull child act, and act promptly, to ascertain from some expert just why his child is dull, and what can and should be done to overcome the dullness. Let every parent of every child make it his business to learn and heed the laws of physical and mental hygiene as applicable to his child, with a view to insuring that the child shall not be afflicted with preventable mental backwardness. This is one of the prime duties of parenthood.