8. Did he have any record of juvenile delinquency?* What, in detail?

9. Was he ever an inmate of a children's home or institution? If so, under what circumstances? For how long? If he was in an institution or otherwise a public charge, at what age did supervision cease?* What was his reputation?

10. If foreign born, at what age and under what circumstances did he begin life in the United States?

11. At what age did he begin work? What kind of work was it? Was it of such nature as to have a bad effect on him physically or otherwise? (i. e., was it a dangerous trade, a seasonal trade, irregular work, etc.?)

12. What was his attitude toward his parents? Did he show neglect of filial duties in withholding wages, etc.? Was he actively abusive?

13. Did he work whenever possible, or did he show a tendency to loaf?

14. What in general were his habits? What were his recreations?

15. Is there record in lower or superior court of any charge or conviction? For what offense?*

II The Child's Mother

16. What were the characteristics and standing of the mother's parents and of her immediate family? The circumstances of her early home life? Was she herself a neglected child? What was her schooling? Was she regarded as a dull or difficult child? What work did she take up after leaving school? Did she ever have any training in her home or elsewhere to fit her for domestic life? What kind of associates did she choose? Was she ever committed to an industrial or reform school?* Was she known as a girl of “loose habits"? (For details that apply, see The Child's Father, 1 to 15.)

III The Family Life

17. Has either the father or the mother ever been married before?* If so, is former wife or husband living? If divorced, where and on what ground was divorce obtained?*

18. Has either parent any children by a former marriage or any illegitimate children? If so, how many are there, what are their ages and sexes, where are they, and what are their relations with their parents and stepparents? If any such children have died, what was the cause of death?* If any are living with the family, is marked partiality shown by stepparent to his or her own children? 19. Are the father and mother legally married? When, where, and by whom was the ceremony performed?* What were the circumstances of the marriage? Was it a forced one? How old were the parents at the time? How long had they known each other?

20. Are there any mental or physical defects in either parent that should have barred marriage?

21. Are there family difficulties between husband and wife due to racial or religious differences? To unwise interference by relatives? Are differences so serious that they are not likely ever to be overcome?

22. How many children have been born of this marriage? How many have died, and from what causes?*

23. What was the father's occupation at the time of marriage? Since? Was he then and has he since been earning enough to support a family? Has he given his family normal support? When did family reach its high-water mark and what were the conditions?

24. If the father is now working, what are his wages? What proportion of his total income does he give to his family? What is his employer's estimate of him? What is his attitude toward his fellow employes?

25. How does his present wage compare with that which he is capable of earninghis maximum wage? What is reason for lower wage? How does present type of work compare with work done at his best?

26. How does the home now provided by him compare with that which he is able to provide?

27. If he is not working, what is the reason? How long has he been out of work? 28. Is he a member of a trade union? What is his reputation in the union? Is he a member of any fraternal organization? Affiliated with any anti-social organization?

29. Is he, or has he ever been, a satisfactory husband and father? Fond of home life? Of his children? Or does he regard children as merely a means of support for himself, now or later?

30. If satisfactory at one time and now given to abuse or neglect, when did change take place? Was it apparently due to development of inherent bad qualities? To "easy disposition," bad companionship and surroundings? To discouragement over lack of work, long illness in family, debt, characteristics of wife as a homemaker?

31. What is the attitude of the children toward their father and mother? Have they real affection for them? Are they afraid of either of them? Are they controlled by either or both? How? By fear or otherwise?

32. Is the wife, or has she ever been, a good mother or satisfactory housekeeper? If her home standards were fair at one time and have since become low, what causes have contributed to lower them? Her own or her husband's habits? Her own illness or other illness in the family? Overwork? Too many children? Extreme poverty?

33. Is she obliged, or has she in the past been obliged, to contribute to the family support? To what extent? Has she had the burden of regular work away from home? Is this responsible for much of the neglect?

34. Is or has either parent ever been affiliated with any church? What is present relation to the church and clergy?

35. What are the habits of father and mother as affecting their family life? Does either drink to excess? (See Inebriety Questionnaire, p. 430.) In the home, or away from it? Does drinking bring dissolute companions into the home? Has either parent ever signed the pledge or has either any respect for it? Does

either use drugs? Is either immoral? Obscene in language or action before the children? Is father a loafer? Does mother neglect her household duties, spend much time away from home or in association with criminal or immoral persons? Has either an ugly or dangerous temper? Does either beat or otherwise abuse the children? Is either given to gambling? Dishonest? Quarrelsome? 36. Is either parent suffering from a disease that constitutes a menace to the family? Is there reliable evidence of this condition in hospital records or with a competent private physician? What is the date of this record?

37. Does the bad example of either parent show in the conduct of any of the children? Do they imitate parental vices?

38. Is either parent known to the police of the district, and what is his or her reputation with them?

39. Has either a court record?* Has the father been accused or convicted of offenses against his family-of desertion, non-support, assault, cruelty, criminal abuse? Has the mother?*

40. Is either parent by reason of mental or physical defects, disposition, or habits unfit to have the care of children? On what grounds? Is there medical authority for this? Has either ever been pronounced mentally irresponsible? Would mental examination now be likely to result in such a decision?

IV Particular Form of the "Neglect"

(a) Desertion or failure to provide for home

41. Have the parents, or either of them, deserted? How long ago? Under what circumstances? Is this the first desertion? If not, what is history of previous desertions? (For other questions on desertion, see Deserted Family Questionnaire, p. 395.)

42. How many rooms in the home? Is there overcrowding beyond that which the law or decency allows?

43. Is the home furnished sufficiently for decent living and privacy?

44. What are the sleeping arrangements? Is there a decent supply of bedding? How many sleep in each bed? Are children forced to sleep with parents, adult members of family, or lodgers? Do children sleep in a dark room?

45. Are the children decently clothed? How does their clothing compare with that of other children of the neighborhood?

46. Have the children sufficient food? How is it prepared and served? What did the children actually have to eat at certain meals? If there is an infant, how is it fed?

47. What is the testimony of the teacher or school nurse in regard to these facts? 48. How long has this condition of neglect existed?

(b) Neglect to provide medical care

49. Are any of the children suffering from physical defects or diseases such as deformities, rickets, persistent cough, chorea or other nervous affection, anemia,

malnutrition, adenoids, skin disease, carious teeth, pediculosis, defective eyesight-which can be remedied by proper medical care which the parents have been able but have failed to provide?

50. Has any one of the children syphilis or gonorrhea? What was the probable source of infection? Is he receiving treatment for this? Is his condition a menace to other children? Is there past history of these diseases?

51. Is either parent or any frequenter of the home suffering from venereal or other contagious disease? Is there medical authority for this? Of what date? Are conditions such that the children are inevitably exposed to contagion from this? 52. Is there record of the physical ills of the children with the school nurse or doctor, district nurse or physician, hospital or competent private physician? With the board of health?*

53. What efforts have been made through other agencies to persuade the parents to secure proper medical care for the children? With what results?

54. What is the testimony of these agencies? Is further effort by them likely to be successful?

55. Has the school physician power to act in the matter?

56. Is the neglect of such nature that the board of health has power to act?

57. Was the diagnosis of the neglected condition specified in the complaint made by a recognized medical authority whose word would be taken in court?

58. Is it likely that any other recognized medical authority would disagree with the first?

59. Have any children of the family died? When and from what causes?* Do the deaths show probable medical neglect? Were such children insured?

(c) Lack of control

60. Is there lack of ordinary parental guidance? Are the parents able or do they try to control the children?

61. Do the difficulties of a new country press upon the parents? Do the children take advantage of this?

62. What is the school record of the children, especially as to attendance and behavior? Are they truant? In their language or habits at school do they show the lack of salutary control?

63. Are the children constantly on the streets and late at night? Do they frequent low picture shows, visit saloons or other places likely to lead to an idle and dissolute life?

64. Has the lack of salutary control reached the point where wrong-doing is a habit and the child is delinquent? Is there record of habitual truancy? Theft? Immoral conduct or association with immoral persons? Frequenting houses of ill repute? Street walking? Begging or vagrancy? Use of vile language? Relative incorrigibility?

65. Have any of the children any juvenile or other court record?*

66. Have any of the delinquent children been pronounced defective? If so, has custodial care been refused by the parents or not been provided by the community?

(d) Exploitation

67. Are the children overworked in home duties?

68. Are they illegally employed? Before the legal age or at illegal hours?

69. Are they made to contribute to the family support by sweatshop work in the home? By unreasonable help in the business of their parents?

70. Are they sent upon the streets to beg? Are they sent out ostensibly to sell articles on the street, but really to use this as a means of begging?

71. Is there deliberate exploitation of the children for immoral purposes?

(e) Cruelty, physical injury, or abuse

72. Is parental discipline rigid to the point of cruelty? Is punishment given by parent when in anger, or is self-control exercised? Is punishment frequent, oversevere, of unnatural or cruel form, dictated by perverted religious ideas, etc.? Is there abusive treatment not associated with the idea of punishment? 73. Are the older children permitted to punish or abuse the younger? 74. Do the children show evidence of such abuse or punishments?

(f) Moral neglect

75. Is the neighborhood of bad reputation? Are there people of bad reputation in the same house? Are the sleeping arrangements of the home such that decent privacy is impossible?

76. Are the children exposed to lead an idle and dissolute life by the drinking of the parents? By liquor selling in the home? Have the police knowledge of liquor selling? Are the children exposed to moral contagion by the immorality of the parents? By obscene acts and language of the parents in presence of the children? By the presence of lodgers or others admitted to the home?

77. Are the children known as "young street walkers"? Have the parents been aware of such practice or have they deliberately encouraged it?

78. Are the children of bad moral reputation in the neighborhood? In the school? Is there evidence of unnatural relations between parents and children? Between the children?

79. Is there reliable record of physical examination of any of the children showing venereal disease or evidence of immoral relations?

(g) Inducement of chronic dependence

80. Are the parents now or have they been frequently in receipt of charitable aid either public or private for which their neglect is responsible?

81. Have the parents or children ever been inmates of public institutions?* Under what circumstances?

82. Is there record of dependency in the case of grandparents, uncles, aunts?

83. What is the testimony of public relief-giving agencies regarding family? 84. What is the attitude of parents and children toward relief?