TRAINING THE IDIOT AND IMBECILE*

BY GEORGE J. VEITH, M. D.,

LETCHWORTH VILLAGE, THIELLS, N. Y.

Perhaps the most vital problem to cope with at an institution for feebleminded children is, "What can be done with the low grade imbecile and the high grade idiot?" Is it possible that they may profit in any degree by special training so that finally they might perform some useful work?

Dr. Charles S. Little, superintendent of the State School for Feebleminded at Letchworth Village, called attention to the fact that many of these unfortunate children, a real mass of human wastage, were sitting in idleness. They appeared to be playing about with no purpose, making much work for their matrons and attendants, and creating all kinds of disturbances and noises. They were most untidy, always unclean and constantly acquiring undesirable sex habits. To change their habits and make them useful was a stimulating problem.

A group of 57 girls, various types of high grade idots and low grade imbeciles who could neither dress nor undress, was selected. The only qualification for membership in the class was that each girl must be able to walk to and from her classroom and have the use of one or both hands.

The group was sent out with a cart to clean up. It soon became evident that these children could pick up pieces of paper and small stones that were lying about the grounds. About two hours of their time were spent each morning in the accomplishment of this work. For a period of three months, they were trained to dress and undress. It was an exceedingly difficult task in the beginning, and although improvement was slow, it was gradual. At the close of three months of careful training and discipline, the results were amazing. They are summarized, as follows:

Two instructors and four high grade morons with capability for doing hand work, were appointed to work out this experiment.

The best type of instructor is one who has actually done dormitory work, thus getting in touch with the children's wants and desires, and learning how they live. It is only in this way that she realizes their need and is able to get down to their world. It is most essential that the work be in the hands of teachers whose interests are fixed upon what is to be achieved. They must possess patience to a marked degree. They must be willing to get down to the level of this type of child and to become an actual part of that child's world.

The efficient cooperation of the chief instructor, Miss Tillie Steffey, whose ready and complete response under great difficulties and discouragements has done much to make this plan effective, is greatly appreciated.

This low grade class which meets from 8 a. m. to 4:30 p. m. has grown from 57 to 139. It numbered 200 for a period of two months, but owing to lack of help, it was necessary to drop 61 of them. If the help problem were not somewhat of a handicap, so that more individual instruction could be given, an increased degree and amount of work would undoubtedly be possible. It is expected that eventually this class will form the nucleus of an industrial school.

This trial test, the object of which was to discover what could actually be done with the group selected, was made with children whose mental ages were classified as follows:

From 5 years to 5 years, 4 months....
From 5 years, 4 months to 5 years, 11 months.
From 6 years to 6 years, 11 months..

Total

Number

9

32

37

23

11

8

19

.. 139

Note that 101 of them are less than five years mentally. The 19 with the highest rating are apparently of lower grade than six years, and their mental deficiency is further complicated with psy

chosis, epilepsy and emotional instability. Following are their

Of these, 14 are Mongolians, and 5 have paralysis of one arm. One child is totally blind and 6 others have very poor vision. Nine of them have their mental deficiency complicated with a psychosis, and 13 are unable to talk.

The intelligence quotients of the group are interesting.

The mentality of an idiot girl is so simple that one seems to be baffled by the thought of teaching her. However, if we bear in mind that some difficulty is overcome when the teaching is related to real concrete life experiences, and attempts are made to give much training involving repeated urgings and automatic response, it is possible that important results may be obtained.

The first thing taught our children is unbuttoning the clothing. This involves the easiest and most practical movement the hands can make. A strip of muslin one yard long and two inches wide, with buttons sewed on one end and buttonholes worked in the other end, was used by the instructor to great advantage. It was found most practical to hold this in proper position, while the teacher placed her own hands over those of the child to help her push the button through the hole. Occasionally the child was

allowed to try without any assistance. The frequency with which this motor act was performed, secured greater precision, competency and independence. It required from one day to a week to attain to this, but at the end of that time 51 out of the 57 trained were able to unbutton their own clothing perfectly and with ease.

The child is now taught to keep stockings up. The garters are either taken off or left on the ankle. Getting a firm grip on each side of the stocking is helpful before a pulling upward is practiced. The garters are then pulled above the knees over the stockings. One day was given to the accomplishment of this task, which seemed to offer little difficulty after the unbuttoning was learned.

To teach this type of child to button her clothing required from one to three days but no new work was given for two weeks. The essential feature is repetition of the same movements, to repeat so constantly that the act becomes habitual.

Tying the shoe-lace is taught before lacing the shoe. A piece of board 14 inches by 2 inches, with a block of wood about two inches square nailed at one end to the longer board, is used to accomplish this. The two-inch block represents the ankle. The laces are tacked in place around the block end in such a position as will enable the child to start in exactly the same way as she would were she lacing her shoe. Tying the bow is most effectively taught when the teacher stands over the child, and step by step, places her hands in each new position necessary for tying. These first movements are usually very difficult, since the mind of the idiot or imbecile does not react or control the muscle movements to any extent.

Now, lacing the shoes becomes an easy matter. Shoes are clamped on the tables and the children instructed individually. They find it hard to know which lace to pick up after one has been laid down. Both strings are held until each has been used, then both of them dropped and the same process repeated until all eyelets have been laced. This repetition finally becomes mechanical. It took as long as four weeks with individual instruction each day to complete the instruction. After that length of time the help of the instructor was no longer needed.

At our institution, shoes, night-gowns, and dresses are labeled, and in order that these low grade children have sufficient power to select their own garments, it is necessary that they recognize their

names. Accordingly, the latter were printed or written on tapes corresponding to those sewed on the clothing. Each child was taken to the desk and shown her name. By habitually repeating the act she learned to recognize the first and last letters, or a combination of letters which attracted her attention. Later she was encouraged to select her tape from among several. Finally the same was done with all names of members of the class. Sometimes as many as six or eight tapes of one particular child would be arranged on the table with the others, and invariably the child selected all her own names. The instructor who had worked with long continued patience and perseverance, observed that these children were emotional and susceptible to praise, and thereupon highly commended the successful. After five months of such practice, 47 could select their own, out of any number of names placed before them. Intentionally this work was discontinued for eight months. Out of mere curiosity, we re-tested, the second situation being identically the same as the first. Only three were unable to repeat the experience.

Knowing that the children could recognize names, we felt certain that they would likewise have the ability to select individual letters of the alphabet. Our buildings are designated by letter, not named, and then, too, this would be useful in the laundry, where the sorting of hand towels and other linen, as they come from the mangle, is necessary.

Cards containing eight bright colored letters each about two inches high, were made, together with corresponding single letters. The latter, being arranged again, were sorted and placed on the corresponding letter of the cardboard. Great difficulty was experienced especially with the E and F, the C and G, and the M and W. This was due to the fact that a different phase of the first experience was presented. Consequently, the idiot and imbecile type did not know how to act because of her inability to recognize similarities. She had not been trained previously to solve exactly the same kind of a problem and therefore could not adapt herself to a new situation.

Passing the fingers over the letters so as to distinguish the differences in form, aided those children to whom this suggestion was presented, to sort much more easily than those who had not attempted to do it in this manner.