Child Guidance, the Clinic and the School
- Author:
KIMBER, M.R.C.S., L.R.C.P., D.P.M.
j.1 his paper outlines the need for the development pr0ri8ht deling or the right spirit, but before titi Ceeding with its subject, I would explain its P’ac*ng ^e “Clinic” before the
the 1 ” ^as ^een done deliberately to indicate sin 2r?u.nd from which the problem is approached, do e .^is is my only justification for entering the as .?f education. Apart from this, I write but a scribe without authority.
He If experience is based on the work of the Qi . 0rdshire Psychiatric and Child Guidance agn ‘ which began in a small way nearly ten years Pre anc* to which not far short of 500 children of J wSCh?01 or school age were referred last year. jn as dissatisfied with the task of acting merely Ca a first aid capacity relegated to picking up has es, anc* t^s’ I trust healthy, dissatisfaction SlJ encouraged me to put forward here some hafesti?ns not only as to where things appear to as t6 ?one wrong but also, with less certainty, j0 how they might be put right.
aCc trust, therefore, that the proposals will be tk: epted, considered and judged in the light of nis explanation.
^?nie Problems needing Consideration thex/ecent stuc*y undertaken by a committee of ^vith en s Group on Public Welfare associated py/1. the National Council of Social Service, and con under the title of ” Our Towns throws Slderable light on our immediate problems. More and more “, the Report states, ” it is j_?’’ne in upon us that the educational services get ?ld of the child too late. An onslaught must be made on poverty by means of family allowances and minimum wages, and the children with unsatisfactory homes must be helped by letting them live day by day in a different environment; they must have nursery schools from the age of two years. We cannot afford not to have the nursery school; it is the only agency capable of cutting the slum mind off at the root, and building the whole child while yet there is time.” ” The five-year-old enters school already suffering from all the complaints which the school doctors and nurses will spend their time in combating during his school life. The under- fives have been found lousier than any other group; evacuation showed that children under five were already set in bad habits of every kind.” (1) The Importance of Right Feeling If the aim of education is to ensure “right living it must be recognized that ” right living ” comprises more than learning. The child must be educated as regards its body towards ” positive health ” (hygiene), as regards its mind into right thinking (intellect), and as regards the spirit into right feeling. The development of right feeling or the right spirit is certainly not the least important but probably receives the least attention. The technique of its development is certainly the least well understood.
I shall approach the question from the point of view of the problem which the child presents to the community in its school life, in the hope that? looked at from this point of view?the main outline of the problem may be clearly apprehended. The small child is, then, an individual endowed with certain intellectual capacities, and the school system sets out to deal with these in a more or less adequate way. Certain abnormalities of intellec- tual endowment call for modified handling, if full benefit is to be secured for the child, but more important, far more important in the early years, is the emotional make-up of the child.
All human relationships are profoundly affected by feeling. The child’s relationship to other individuals, to mother, father and the family, and the development of a good relationship with school friends and teachers and later with workmates, colleagues and society at large, is in great part influenced by his capacity for right feeling. Not unfittingly, right feeling has been referred to as the Divine Spark, since it is through this talent that generous impulses and our higher aspirations develop, while without it the merely intellectually educated acquire but a selfish ” safety first” attitude to life’s challenge. We must realize that only through the development of right feeling can a child learn to ” love ” his brother whom he hath seen and, if we are sincere in our protestations, we shall ensure that he is given real opportunities for taking this first step, for only after this will it be possible to give an appropriate answer to the further question, ” How can he love God whom he hath not seen ? “
Both the gifted and the dull child will respond to similar lines of treatment in developing right feeling, whereas a definitely modified curriculum will be needed for the latter, if we are to ensure his acquiring the habits of right thinking.
Development of Right Feeling
It is not my intention here to survey the physical health of the schoolchild nor the home conditions and other factors embraced in the term ” environ- ment though a full educational scheme cannot neglect these important factors.
It is essential, however, to consider these and also the school ” atmosphere ” and environment, in so far as they affect the emotional development of the child, since the development of right feeling is of at least as great, if not of greater, importance than that of intellectual ability. Complaints have been made recently that, judging by the conduct of the young in too many instances, the schools have instructed but have failed to turn out useful citizens, in spite of the fact that in many cases the intellectual capacity of the individual was normal or even superior. This is expressed tersely in the saying that the schools are occupied with the teaching of ” learning rather than living “.
Conduct we recognize is the resultant of three ultimate mental factors?cognition, affection or feeling attitude, and conation. Cognition includes the intellectual attributes of mind (including apprehension and judgment), affection the emo- tional attitude (including probably interest), while conation covers the processes of volition and activity conditioned by the other two. The question is: Does our educational system concern itself equally with the affective aspects ol the child’s development as with the cognitive 1 Honesty will, I think, compel us to answer “no ” and yet ” modern psychology regards feeling as the dynamic factor determining behaviour (2) This factor of affect or feeling which is s? important, is a very evasive entity, partly perhaps because it functions to a great extent at unconscioLlS levels. It is interesting to remember that it vvafS not separately recognized till the time of Kanj’ cognition and conation alone holding the fieW” Though we pay lip-service to it to-day and acadern1’ cally its position is established, in the practical field of education it is far from receiving the attention it deserves, and while arrays of intelligence tests exist there is no comparable system determining the affective capacity or developmen of the individual. Not only is this so, but in sonie quarters so much importance is attached to the Intelligence Quotient that the lack of means t0 estimate the affective capacity or to determine an emotional quotient is barely recognized, so that a real danger exists of the Intelligence Quotient being regarded as the equivalent of mental capacity. This is really a disastrous state of affairs, since right knowing is of little value without righ feeling?in fact a high degree of intelligence associated with ill-developed or perverted feeling’ attitude almost ensures its possessor becoming a social problem in some way or other as is shown by the appearance in the courts and clinics 0 individuals in childhood or adolescence with Intelligence Quotients well above the average- The Teacher and the Parent
The school rightly is primarily concerned with the child’s intellectual and cultural development’ while the growth of right feeling must have its foundations laid in the home, but a proper partner’ ship is essential for the adequate progress of the child.
” The aim of the school “, writes Mr. W. B. Little, ” should be to get the fullest co-operation between the school and the parents in all matters affecting the welfare of the children. It has been found that the best method of dealing with apathetic or prejudiced parents is to interview them privately, and to have a quiet talk about the needs of the children. If the parents will not come to the school, then it is worth going to visit them. At heart, in spite of their prejudices, the great majority of people desire happiness for their children.’’’’ (3)
It seems possible that many teachers would regard the problem of home visiting, in addition to the calls now made on them, a further burden that they should not be asked to bear. It is in fact a tasK where not only tact but a somewhat specialize^ technique is required, which in most cases is only acquired by an individual after a course of training and some practical work under supervision- i Moreover, when difficulties have arisen, as they f often will, between the school and the parents- I the descent of the headmaster on the home Wi* ‘ probably help little, whereas an intermediary hj ; the form of a trained social worker might accomplish much.
In some instances, a move in this direction has ready been made by the appointment of School tendance Officers as ” School Welfare and a ^?dance Officers but something more than change in name is required, and the duty of osecuting in cases of non-attendance cannot in ^ork106 associated satisfactory welfare be f6 teachers would not be absolved?could not in’ tk are to occuPy the position they should trial!- estimation parents and pupils?from king close and understanding relations with w rents, but much difficult and time-consuming tra COuld be done for them by adequately as ‘ned social workers, who would also be of great ^tance in the formation and successful running parent Teacher Associations.
he psychological justification for the employ- f0rnt. the methods I have indicated as a basis Vj}, ^development of right feeling is undisputed. par “fight feeling” engendered between child, VVeifnt and teacher, the foundations have been ri and truly laid for the fuller development of the linking and of healthy living, for hygiene of irM^H-Son’ ? sch??i (society) and of the home, imn n? all the domestic virtues (a field of great but ?rtance which I must mention in this connection b . ?n which I cannot enlarge). From such t081 nnings may be more surely built up that desire ofn[V-e ^hieh is the foundation of the teachings ^hristian citizenship.
. e within the educational system there is ?reat ” *iciVe Her, child be ? vwmiuucs iu uc a. prooiem cannot properly 0*ded as other than a medical (psychiatric) js jL0nsibiIity. The question of how far the conduct ernJl6 result of emotional, intellectual nhvci^ai ?r ?xaxa vxiv vuuvuixunai OJ’ilClll LI1CIC IS hav -ScoPe ^or the educational psychologist?as I e lndicated below?and an extensive field exists chilHC meciical (psychiatric) aid is not needed, the l Q who continues to be a problem cannot properly reearri^^ ? ?< …. xjv/ v? xUl U1V ‘wUllUUVL en^e result of emotional, intellectual, physical or rear?-nrnenta’ factors is a very complex one (not’nn?’ some cases at least, extensive medical 0n’y psychiatric) investigation if a correct ^osis is to be made.
a n, j.Child Guidance Clinic must therefore remain the Ca* responsibility, although it is true that at ther^r?Sent time many children who are referred inst e’ they had been correctly handled in the first WoJ^e with the help of an educational psychologist, d never have required clinic treatment.
The Nursery Years
paJ~APerience has shown that in too many instances, a(T nt.s in the home unaided are not capable of 8uid child in the first five years that care, sck a^ce and training which is so vital for its future in h career- Children too often become ” set Scu habits General provision of Nursery latit? h *S- indicated and it is to be hoped that dev i 6 given to individual authorities to ?bs ?P them on their own lives, subject to the beferVance certain standards of efficiency, ?re any degree of uniformity is demanded.
The Sub-Normal Group
For the intellectually sub-normal children who are, however, above the feeble-minded group in ability, special classes in the ordinary schools are desirable. These ” dull ” children constitute approx- imately 10 per cent, of the whole. Teachers with special training are required for their education, and a special type of curriculum is needed in which concrete materials are employed as far as is practic- able. Individual attention should be available as required, and therefore the numbers in special classes must be small. The children in these classes should, however, participate quite freely in the normal school recreative and social activities.
Special Day Schools for the educable mentally defective (feeble-minded) children are desirable. These constitute only about 2 per cent, of the school population. By attendance at schools rather than boarding at residential special schools, the influence of the home, which is so important for the feeble-minded child, is secured. Modern transport facilities should enable a day special school suitably located, to provide for the needs of a wide area. The mother of the feeble-minded child is probably right when she refuses to let him go to a residential school, for in spite of arguments to the effect that this will provide suitable education? which it may, from the intellectual standpoint?the child will miss the chances of full emotional develop- ment, the inculcation of right feeling, which a good home life should give.
The much larger and more important problem of the education of the dull and backward child urgently requires further consideration, for delay in recognizing and treating such disabilities often causes the child to experience considerable emotional distress. Frequently the disability of such children is recognized by their teachers, and often in a large class attempts are made to give them some special help, but among children of their own age group they get left behind in class in spite of all such efforts. This is almost inevitable, since it has been shown that for the most part these children haye great difficulty in grasping abstract ideas and relationships and their verbal ability is usually very restricted. If attempts are persisted in to teach them on normal lines with the standard equipment, these children will become more and more deeply dis- couraged. Failure will be heaped on failure and dull hopelessness, evasion or active aggressiveness will characterize their conduct, according to individual make-up and experience.
Far too often it is not till this stage is reached that the child is referred to the Child Guidance Clinic when a psychological test shows that his Intelligence Quotient is such that he has the mental capacity of a child several years younger, e.g. a mental age of 1years in a child of 10 years. His actual scholastic attainment level may be even lower than this. By this time not only has the defect itself to be dealt with by remedial coaching in individual sessions in order to make up some of the lost time, but often emotional disturbance is so marked that a prolonged period of treatment on psychological lines is required in the clinic by play therapy, group play or individual psychotherapy.
Without unfairness it may be said that such an advanced state of affairs should not be allowed to develop. There are two measures which might be taken and which would, I think, prevent it. First, arrangements for such children to be examined in the schools and at an early age by an educational psychologist. Second, the wider establishment of Special Classes, to which I have already referred, where the dull children (10 per cent.) can receive education suitable to their needs.
The Educational Psychologist
The services of an educational psychologist should be available in the schools. The appointment should probably be on a sessional or part time basis in order that the individual may not become narrowly specialized purely on school problems. Short of arrangements for a systematic estimate of the intelligence of every child entering school, his (or her) duties would be to assess the intelligence of any child who was not making satisfactory progress, to indicate the reasons and the remedy. Where there appeared to be a purely educational problem, this would be explained to the teacher concerned and suggestions for handling the case given. In some cases, this might mean the temporary transfer of a child to a special class.
In cases where the cause was not clear or the problem was one in which possibly emotional and physical factors were involved, the child would be referred directly to the Child Guidance Clinic. While purely educational problems, including a number of special reading disabilities, could be dealt with adequately by these means in the school and there is no need to call in the aid of the specialized services of the Child Guidance Clinic, it should be recognized that the Clinic is essentially a medical service of a highly specialized kind and it can no more form a subsidiary part of the educational service or the school medical service than, for example, can the services providing for the treatment of tuberculosis or orthopaedic conditions. There should, however, be no hesitation in referring children early for treatment for thereby the time required is shortened and a successful result is much more probable.
The Value of Play
The part that play occupies in the development of young children is emphasized by Dr Susan Isaacs in regard to Nursery School education. She also emphasizes the value of play in helping them to solve three of their greatest difficulties. Play is a factor in overcoming much of the feeling of insecurity responsible for both fears and temper tantrums; it enables the child to compensate for feelings of being unloved and not wanted and with increasing dexterity to lose the fear of its own destructive impulses which are often very disturbing. Finally’ f through play, the child achieves a feeling of create6 power and ability to control its environment. All these considerations are of practical imp?r’ tance also in devising a curriculum suitable for the dull child. . - |
While in various directions the value of specia educational methods for the less talented children followed by careful placement in suitable occupy* tions on leaving school had been fully proved 111 pre-war years, it was the Army Medical ServlC? under enlightened psychological guidance whic” seized the opportunity the war offered of deffl0!1’ strating on a large scale how great a return 1 community service the dullard can give if he 1 properly instructed, considerately handled and give. an adequate idea as to his value as an individual and of his responsibilities in consequence of position. Much can be learnt from this very successful experiment. . ?
For the dull children a much more practice, scheme of work is required. Such a scheme sh?11’ not be developed in isolation, thus ostracizing u1, pupils who should take a share in the general sch??, I activities as far as possible. An education^ I psychologist would be of considerable help 1 j dealing with and advising on a number of individua_ special problems which are bound to arise 1 connection with such a scheme.
Too often under present conditions many childre continue in the schools till finally a long-suffer^ teacher’s patience is exhausted or some overt of rebellion on the part of a pupil who, owing his handicaps, has been continually frustrated, f?rC^ authority to take some more definite action. ? then is the child referred to the Child Guida?c Clinic or possibly the Juvenile Court. By this tifl1^ a reputation for consistent misconduct and matted tion is established, and the child so often fee* without friends and without hope. A well-esta17’ lished emotional disturbance, hard to eradicate’ has been grafted on to what was at one time possu^ j a fairly simple educational disability. Many hour must be spent in treating such a child at the Cliu1 if a successful result is to be achieved, whereas ha the services of an educational psychologist bee made use of in the school at the beginning, ^ , might all have been avoided.
Vocational Guidance
From the point of view of the medical psychology who sees not only children, but adolescents, iu , Clinic, there is one further aspect of education tn j seems important, the ” placement of leavers This, I am aware, has not been di regarded. Mr. W. Thompson, Director of Educate for Sunderland, writes: ” This is one of the most important factors that educationists must face in their consideration of a future system and not least in its bearings on delinquency
And again: ” Too long have we been placing ‘ square pegs into round holes ‘ and endeavouring to round them off. The effect has been a lack of interest on the part of the ‘ pegs ‘, wasted or misguided energies?or rather leaving surplus energies for less worthy objects?and eventually a drift into ‘ blind alley ‘ occupations, and squandered abilities(4).
pere again the trained psychologist can help, ostered by the National Institute of Industrial sychology over a period of years, vocational tests “ave been developed by psychologists, and while ^uch of what has been done is not yet published and is not generally available, even with our present nowledge something can be done?if not to fit child for the most appropriate job, at least to avise against gross misfits.
” is reported of the late Sir Truby King that he ??k to his child welfare work because ” too late ” was written all over his duties in a mental hospital. I must claim indulgence on similar grounds, and should like to emphasize the point that the psycholo- gist?be he medical, educational or industrial?can help the educationist by advice, by suggestions and sometimes by criticism. What I have here set out is an attempt to help on these lines, and I make no greater claim than that.
References
Our Towns, p. 104. Oxford University Press.
(2) An Introduction to Psychological Medicine. Gordon Harris and Rees. Oxford Medical Publications. (3) Co-operation: Children?Teachers?Parents. W. B. Little. Health Education Journal, January, 1943. (4) Some Aspects of Juvenile Delinquency. A paper presented to the North-East Federation of Educa- tion Committees. W. Thompson.
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