News and Notes
special Three Months’ Training Course for Teachers of Mentally Defective and of Dull and Backward Children.
In view of the greatly increasing number of Local Education Authorities who are now opening or exploring the possibility of opening, new pec - cnpr’rii Classes for Dull and Backward Children, the C.A.M.W. is organising a Special Three Months’ Course for teachers newly taking up this branch of ^ork; such teachers it is generally agreed that there is need for a ongei pei training than that provided by the ordinary Short Courses organiscc . r? Association for the Board of Education, and it is hoped that this new venture will, therefore, meet a real need.
The Course will be held in London during the summer term, from May 7th to July 25th. Its Headquarters will be at 63, Eccleston Square kindly lent to the purpose by Miss Violet Dale, where lectures and classes wi e e c an ? Common Room for the use of students will be provided. Students wi c: - quired to make their own arrangements for board and lodging, but u in tion as to hostels and boarding houses will be given them if desired. The scope and nature of the Course is described in a Memorandum to Local Education Authorities at the same time as the preliminary prospectu , from which we quote as follows :?
” In this Course the needs of teachers of Classes foi the Dull am Backward and of Special Difficulty Classes will be specia y c< ~VPrv Besides lectures on psychology and the medical aspects of ie pr y opportunity will be given to them of observing the necessary ac ap a ion o ordinary methods of individual teaching to the special needs o le su - normal child. Practical questions such as the following will be dealt with . the general curriculum and time-tables will be discussec anc t eir Pl^c ica working demonstrated; the correlation of manual and hree woi v wi be closely examined; the role of physical education and organised games in the development of the unstable and anti-social child will be carefully studied; the best methods of grading the children by intelligence, psycho- logical and other tests will be demonstrated. Throughout the Course the teachers will be given opportunities of themselves teaching groups of difficult children, of learning various forms of manual work, and of taking part in classes for eurhythmies and other physical exercises.”
During part of the Course the students’ school practice will be superintended by Miss Sarah Luce, H.M.I., who has been kindly lent to the Association by the Board of Education, and who has had special experience in connection with the training of teachers of mentally defective children.
The Course has been fully approved by the Board, who are prepared to offer certain facilities to Local Education Authorities desiring to send teachers. Appli- cations are also invited from the teaching staff of Institutions certified by the Board of Control and from private teachers desiring to qualify for the work. The last date for receiving applications is February 28th, 1925. Copies of the Preliminary Syllabus, Memorandum and Application Form may be obtained from Miss Evelyn Fox, 24, Buckingham Palace Road, S.W.I. SScorfc Ootirses during 1925.
In addition to this longer Course, the Association is holding during the year two of the usual Short Courses which it organises for the Board of Education?the first at Sheffield, from April 18th to May 9th, the second in London from July 2nd to 23rd. Particulars of these may be obtained on application.
The G.A.fsLW.’s Course in Menial Diseases, for Social Workers, Maudsley Hospital. This Course, announced in our July issue, was held, by permission of the London County Council Mental Hospitals Committee, from October 27th to November 1st, 1924, at the Maudsley Hospital, Denmark Hill, under the direc- tion of Dr Edward Mapother, Medical Superintendent.
Lectures were given by Dr Mapother on Mental Disorders, by Dr Shrub- sail (Assistant Medical Officer, L.C.C. Public Health Department) on Mental Deficiency, and by Miss Evelyn Fox and Miss Bashford (Almoner at the Mauds- ley) on Social Work in connection with Psychiatric Clinics. Three most inter- esting demonstrations were given, one at the Maudsley itself, and two at Claybury Mental Hospital, by Dr Petrie (Deputy Medical Superintendent), and in addition the students were taken through the wards of the Maudsley in order that they might gain some idea of the various modern methods of treatment carried on there.
The Course was an unqualified success; all the students spoke enthusiasti- cally of the help it had been to them, and “The Lancet,” in its issue of 20th December, bore testimony to its significance from the wider aspect, in the course of an article on The Present Needs of Psychiatry, from which we quote as follows :?
” The Course was attended by over 50 workers from all parts of the country representing extremely varied branches of social activity. Natur- ally, in large part they were those whose work is intimately connected with mental disorder and deficiency, and these included in addition many of the county secretaries of the Central Association for Mental Welfare, repre- sentatives of the Board of Control, and various lay officials in charge of Institutions and other arrangements. But perhaps even more significant as indicating the growing recognition of the impoitance of these problems was the presence of many whose work is less specially associated witn them. Among such were persons representing county councils, Poor Law Guardians the Charity Organisation Society, the almoners of several ot the main London hospitals. Probably there is no one whose work brings him closely into contact with mental disorders who requires convincing as to the necessity for drastic reconstruction, but whether this Commission ” will be fruitful will certainly in large part depend on the existence of an instructed public, not one ready to rest content with mere depreciation of those struggling to do their best under difficult conditions, but rather one aware of the real defects and requirements. Every attempt was made to stress these points in the recent course, and apart from its strictly prac- tical value to those attending, a useful function of such a Course is t ic creation of numerous foci of accurate information.
It was not possible on this occasion to arrange a course longer than one week, but the organisers of it fully realise that at least two weeks is really needed and hope that future courses may attain this length.
A New Guardianship Scheme.
In spite of the Board of Control’s continual exhortations! on the need for the more extended use of the provision of the Mental Deficiency Act which en- ables defectives to be placed under Guardianship, so far only one organisation in the country?the Brighton Guardianship Society?has systematically undei- taken the work. The pioneer activities of this society under the leadership of its energetic Secretary, Miss Grace Woodhead, have shown the possibility of finding in selected areas a considerable number of suitable people willing to act as Guardians, and have paved the way for further developments. The C.A.M.W. has for long been anxious to follow the lead thus given, but financial considerations have hitherto made it impossible for any definite proposals to be put forward. Now, however, through the generosity of various friends, the Association finds itself in a position to institute a scheme, and has appointed a worker for an experimental period of six months to carry it out under the direction of a specially formed Guardianship Committee.
An area within easy reach of London has been selected in which to begin the work and preparations are being made for an intensive survey of the possi- bilities the district affords. When these have been fully explored and a list of suitable people who have consented to act as Guardians or to take defectives for a trial period on leave of absence from Institutions has been compiled and cases will be placed for Local Authorities at a small capitation fee payable to the Association to cover expenses of administration and supervision.
It is not proposed to make any hard and fast rule as to the type of cases accepted, but at first preference will be given to those who have already received some training in an Institution or who are at any rate known to be capable of responding to training. Special attention will be given in every case to the question of employment and occupation, and as a general rule no child will be placed, unless adequate facilities for training can be guaranteed. Defectives will be visited at least once a month, and if necessary more often, by the Guardi- anship Officer responsible to the Association.
i.e., Royal Commission on Lunacy and Mental Disorder.
T Vide Ninth Annual Report, p. 47, and Tenth Annual Report, pp. 49-51. Also paper by Miss Ruby Darwin read at C.A.M.W. Conference, 1922. If this experiment justifies itself, it is hoped that the experience gained will be of general value, and that it will encourage local Associations for Mental Welfare to initiate similar schemes in other areas.
Is Mental Deficiency Increasing?
For his exceptionally interesting and valuable Presidential Address to the Anthropological Section of the British Association at Toronto last summer, Dr. Shrubsall?Senior Medical Officer, Public Health Department, London County Council?took as his subject ” Health and Physique through the Centuries ” in order to estimate the validity of the view so prevalent in this country amongst certain sections of people that we are, as a race, degenerating physically and mentally.
The paper ranged over a wide field, its data being drawn from sources as far apart historically as the records on mummy cases during the Roman occupation of Egypt, ‘’ The Vision of Piers Ploughman,” and the surveys of the male population of military age made by the Ministry of National Service in 1918, together with the findings of the School Medical Service since the intro- duction of compulsory medical inspection. In this historical setting it examines such questions as the effects of wars, disease and famine on national physique; the effects of the industrial system with its concomitants of adverse conditions of work, unhygienic housing and bad feeding; the expectation of life at different periods of history; infant mortality, and the relative fertility of different social groups. With all these space forbids us to deal here, but at the end of the paper Dr Shrubsall comes to the question which forms the title of this para- graph, and we have obtained his permission to quote in full his exceedingly interesting summary of the position in London :?
” There seems to be a general impression that the number of defective individuals, particularly of those suffering from mental defect, is greatly increasing. There is little evidence on this point of a comparable nature, but it may be definitely said that in London no such increase has taken place during the last fifteen years. The stocks from which defective individuals come are certainly often prolific, but the infant mortality is high. Indeed, so far as those individuals who are themselves mentally defective are con- cerned, the figures from institutions indicate death rates from ten to twenty times as great as those of the normal population. The figures regarding the defectives who have been kept under supervision in their own homes indicate rates far above the normal, though perhaps less than those in the institutions to which the worst cases naturally drift. Contrary also to popular belief mentally defective individuals do not mate in nearly as high a proportion as the normal. Out of some 360 defective girls who, while remaining outside an institution, have been under supervision during the past ten years and who are of reproductive age, only 18 have married, and only 17 have had illegitimate children, a figure which, if regrettably above zero, is not one to cause alarm. Of their children a large proportion appear up to the present to be of normal capacity. There is some reason for thinking that there is a great inter-marriage between defective stocks, and that the actual number of such stocks is in reality quite limited. ” The London school service has collected information as to the size of the families, one member of which has come to notice on account of mental deficiency. The figure will naturally appear higher than one derived from the census returns, since no knowledge exists concerning childless families in which all the children had died. The figures are corrected to show only completed families which have been taken as those where the mother, at the time of the enquiry, had died or had attained the age of 45, and, for purposes of comparison, similar figuies are given foi the fami- lies of children who had obtained scholarships.
No. of No. of rrniln Pregnancies No. of Surviving P’ of Mother. Deaths. Children. Imbeciles and Idiots … ??? ??? G-? L7 4”3 Children at Schools for the Mentally Defective 5.3 .9 4.4 Scholarship holders.
” As the differential death rate continues to act there is reason to think that the defective stock are less effectively fertile by the time the reproduc- tive age is reached. If it be remembered that the factors act still more severely against those themselves actually defective, the^ reason w y t le defective has not over-run the country is evident. Experience in any c l - dren’s hospital or infant welfare centre reveals the handicap against t .e children of the mentally inferior parent.”
No doubt Dr Shrubsall’s conclusions on this question as well as his equally re-assuring ones on the wider issues raised by his paper, will^seem to many of our readers to err on the side of unwarrantable optimism. But it should be remembered that, as Medical Officer in charge of the division in deficiency of an area as large and densely populated as is that administered by the London County Council, where, moreover, the whole of the medical work in connection with both the Education Acts and the Mental Deficiency Act is in the hands of the same department, he has had the opportunity of collecting an unusually large number of cases. His opinion is based on a body of statistical data which is likely to be more comprehensive and reliable than that available in t le majority of other areas, and is not lightly to be set aside. Nevertheless, we fee sure that he will welcome well-informed criticism in opposition to the views he has put forward and we invite correspondence upon them in these columns. The Mentally Defective School Child.
Whilst the Board of Control is emphasising the importance of the thorough ascertainment of persons subject to be dealt with under the Mentai Deficiency Act, the Board of Education is manifesting equal concern about the ascertain- ment of mentally defective children and to this subject its Chief Medical Officer in his Report for 1923*, recently issued, devotes special attention. There are two factors, he says at the outset, which make it impossible to ” give with any scientific accuracy the total number of defective children eithei in the country as a whole or even in single areas, (a) the failure in some areas to make any attempt at complete classification, and (b) the necessarily varying criteria adopted in areas where genuine efforts have been made to cover the groun . Neither of these factors will, in his opinion, ever be entirely inoperative, but never- theless there is room for ” far greater accuracy that at present exists, and alrea y the Board have made some progress in this direction.”
In December, 1923, there was issued to Education Authorities a levised schedule for recording returns of the number of defective children ascertained by them, and at the time of compiling this Report 209 Authorities, including London, had used this schedule. On the basis of the actual numbers so obtained plus an estimate of the numbers in the 108 areas for which information was not yet * The Health of the School Child. H.M. Stationery Office. 1924. 2/-. forthcoming-, an estimate of the number of defective children in the whole country has been worked out. According- to this computation the total number of feeble- minded children is 29,278, of whom 14,670 are in Special Schools, 11,170 in Elementary Schools, 665 in other Institutions, and 2,773 attending no school at all.
Taking, however, the London returns (viz., 12.47 feeble-minded per 1,000 of the school population) as generally reliable, Sir George Newman considers that the number quoted above ” almost certainly minimises the facts,” and for present ( purposes of administration he has worked out a revised estimate based on figures half-way between the average of the 208 areas who filled up the new schedule and those of London.* The total number of feeble-minded children then works out at 44,553 or 8.6 per 1,000 of the school population.! This figure he does not put forward as being a scientifically accurate estimate applying rigidly to every area, but he claims that in every case it can be taken as a ” practical starting- point of enquiry,” and if in any area the figures obtained vary appreciably from it, ” there are at least good grounds for careful scrutiny of the local arrangements for the discovery of defects.”
Turning to the question of Special School accommodation, the Report states that on March 31st, 1923, there was provision for 16,392 children (in Day Schools, 14,676, and in Residential Schools, 1,716) a state of affairs which, in the light of the statistics presented above, is deemed to be gravely unsatisfactory.* In a section of the Report, headed ” Special Co-ordinated Researches/’ it is announced that the Medical Department of the Board have decided to set up a Representative Committee to review the whole problem of the mentally defective child in its medical and administrative aspects. Amongst the points to be studied by this Committee in detail are ” the ascertainment and classification of M.D. (feeble-minded) children and their relation to ‘ dull and backward ‘ and imbecile children respectively; the present educational provision as found in Special Schools; the working of the arrangements between the various official bodies concerned in the care of the feeble-minded (e.g., Board of Education, Board of Control, Local Education Authority, Local Control Authority, Central Association for Mental Welfare) ; the evidence afforded by after-care records over long periods and the relation of these to the earlier action taken ; and the special enquiries which might suitably be made to elucidate problems arising out of the education, occupation and ‘social environment of the feeble-minded children.”
In addition to officers of the Board of Education the following members are stated in the Report to have been appointed to serve on the Committee :?Dr. Cyril Burt (Psychologist, London County Council), Miss Evelyn Fox (Central Association for Mental Welfare), Mrs. Pinsent (Board of Control), Dr F. C. Shrubsall (Assistant Medical Officer, London County Council), Dr A. F. Tred- gold (Physician, Royal Bethlem Hospital), and Dr F. D. Turner (Royal Eastern Counties Institution),
A list of ihese returns given in an Addendum (p. 70) shows the London figures
exceeded in only two areas (Blackpool and Plymouth) and only closely approached in three, viz., Burnley, Manchester and Stoke-on-Trent.
f In an Addendum to this Section of the Report the average cost per child in these Schools is given as follows :?Special Day Schools, ?25 ; Residential Schools owned by Local Education Authorities, _?71 ; Voluntary Residential Schools, ^64.
J The first meeting of this Committee was held on 29th July, 1924. A further member was recently added to it, viz., Miss Hilda Redfern, Head Teacher, Monyhull Colony Resi- dential School.
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