Education of Children of Combined Defect
[Thanks to the courtesy of the Association of Education Committees we are able to print Mr. W. Popplestone’s Memorandum on the Education of Children of Combined Defect, which was forwarded by the Association to the Board of Education. In our January issue we pub- lished a letter on this subject from Mr. Popplestone, who is the Director of Education for Shipley, Yorkshire, and readers may recollect the article in the October number, 1926, by Dr Carleton Williams (Divisional Medical Officer for the L.C.C.).] Memorandum on the Education of Children of Combined Defect.
1. In offering suggestions for the effective provision of education for children who are suffering from Combined Defects, consideration must first be given to? (a) the types of cases to be dealt with; and (b) the numbers of children who, after medical examination and skilled testing, are certified as educable. 2. The Return which I submitted to the Association early last year from particulars furnished by 195 Local Education Authorities revealed the following types :?
(a) Children who are not Mentally Defective :? Boys. Girls. Total. 1. Blind and deaf … … … … … 3 5 8 2. Blind or partially blind and physically defective 11 11 22 3. Deaf or dumb and physically defective … … 4 2 6 4. Deaf or partially deaf and dumb or semi-mute 5 3 8 5. Blind and epileptic … … … … … 4 2 6 6. Deaf and epileptic … … … … … 1 0 1 7. Physically defective and epileptic … … 8 3 11 Total number of cases in the areas of 195 Authorities … … … … … 36 26 62
(b) Children who are Mentally Defective :? 1. Blind or partially blind and mentally defective 93 71 164 2. Deaf or partially deaf and mentally defective 109 82 191 3. Dumb or semi-mute and mentally defective … 12 8 20 4. Epileptic and mentally defective … … 357 296 653 5. Physically defective and mentally defective … 258 198 456 Total number of cases in the areas of 195 Authorities … … ??? ??? 829 655 1484
As these figures cover less than two-thirds of the country, it may be assumed that there are about 100 cases of the types (a) 1 to 7, and more than 2,200 of the types (b) 1 to 5 in England and Wales.
CHILDREN WHO ARE NOT MENTALLY DEFECTIVE:
3. All the cases of the types included in paragraphs 2 (a) 1 to 7 are described as of normal mentality, and are therefore educable. 4. Notwithstanding the variety of their defects, these children can all be accommodated in one institution, the small number of epileptics being separated from the non-epileptics.
5. As all the children of these classes in the country would thereby be collected in one school, the institution could conveniently be established in one of the Midland Counties.
CHILDREN WHO ARE MENTALLY DEFECTIVE :
G. The children who are mentally defective and are also suffering from one or more other defects demand more detailed consideration. They are much more numerous than the cases in which mentality is normal, and the extent of their defects is more difficult to diagnose, as requiring more careful and pro- longed testing. It is possible that very many of the children will need permanent care and supervision, and will fall to be dealt with by the Board of Control on or shortly after reaching the age of 1G. On the other hand, there are probably a fair number of the children who are not properly described as mentally defective?because of the difficulty of diagnosis?and whose mentality is but little retarded.
7. Of Mentally Defective Epileptics it is estimated that there are nearly 1,000 cases of children of school age in England and Wales. The Medical Officer of a County Borough Authority has expressed the view that epilepsy is almost invariably associated, in the mentally defective, with progressive mental deterioration, and that fits associated with sclerotic amentia are especially hope- less. This Medical Officer also suggests the desirability of making special provision for cases of post-encephalitic moral degeneration. Some of these are certainly amenable to skilled moral treatment in an institution, and the matter is engaging the attention of the Board of Education. In view, however, of the special difficulties which these cases present, and of the vary large number which would need to be dealt with, I do not propose to include them in the present suggestions.
8. Neither do I desire to suggest at present any provision for the education of mentally defective children who are also suffering from physical defects. It is estimated that there are nearly 700 of these crippled mentally defectives in the country. They are in a class apart, and constitute a problem quite different from that of the types described above, and much more complicated. In due course, the needs of these unfortunate children should be considered and pro- vided for as far as possible, but provision for the simpler types should first be undertaken.
9. The types of cases to which particular attention should be directed are those included in paragraph 2 (b) 1, 2 and 3 above, viz. : Blind or partially blind mentally defectives, deaf or partially deaf mentally defectives, and dumb or mental welfare. 101 semi-mute mentally defectives. Of these types there are probably 560 cases in the whole country, and judging- from the remarkable success of the late Mrs. J. Meiklejon at St. Leonards and of the London County Council at their Institu- tion at Penn, it is fair to assume that 300 of these children are educable. 10. It has been suggested that most children who are mentally defective and blind, or mentally defective and deaf, probably owe their condition to congenital syphilis, and that such cases will tend to degenerate still further as they grow older. Therefore, by the kindness of the Directors and Medical Officers of ten Authorities in whose areas a large number of these defectives have been found, I have arranged for a careful investigation to be made of the cases, and the result of the inquiry has proved that there is no foundation for the suggestion. Of 143 cases?58 blind mentally defectives and 85 deaf mentally defectives?only ten children have been found whose condition is attributable to congenital syphilis.
11. The educable cases of these types are therefore sufficiently numerous to require the establishment of two institutions?one for blind or partially blind mentally defectives?about 130 children?and the other for deaf or partially deaf mentally defectives and dumb or semi-mute mentally defectives?about 90 cases. The first of these schools should be located in the North of England, and the other in one of the Midland Counties. The London County Council’s School at Penn, intended primarily for deaf mentally defectives, has accommodation for about 80 children.
INSTITUTIONS MOST URGENTLY NEEDED.
12. I have ventured to suggest the establishment of three institutions, namely :? 1. A school for 100 children who are suffering from more than one defect but are of normal intelligence, to be established in one of the Midland Counties. 2. A school for 130 blind or partially blind mentally defectives, to be located in one of the Northern Counties; and 3. A school for 90 deaf or partially deaf mentally defectives and dumb or semi-mute mentally defectives, to be established in the Midlands.
HOW THE INSTITUTIONS MAY BE ESTABLISHED :
13. Children suffering from combined defects are found in small numbers in the area of almost every Local Education Authority in the country, and are not sufficiently numerous in any one area, with the exception of London, to warrant the Authority in incurring the expenditure necessary for the establish- ment of suitable schools. To this circumstance is due the fact that the education of these children has been wholly neglected by provincial Authorities. 14. The following are alternative methods of dealing with the problem. The necessary provision might be made (a) by some voluntary body; (b) by the Local Education Authority of a large area or by a combination of Authorities, for the benefit of children in the Authorities’ own districts, and in the areas of other Authorities who would contribute towards the cost of maintenance of the institutions; (c) by the Board of Education, on the analogy of the institutions for specially difficult types of mentally defectives, which have been established and are maintained by the Board of Control.
15. The first of these methods has been tried with much enthusiasm, but it has not hitherto been possible for voluntary workers to benefit more than a very small number of the children who need provision. The pioneer school for Blind Mentally Defective Children, a voluntary institution established by the late Mrs. J. Meiklejon at St. Leonards-on-Sea in 1903, did magnificent work for 22 years. It was closed in December, 1925, owing to financial strain and the failing health of the founder, who was also responsible for two other institutions for mentally defective children. The school was certified by the Board of Education, and affiliated to the National Association for the Feeble- minded, but Education Authorities and other bodies interested in blind mentally defective children were either unaware of its existence or did not consider that a voluntary establishment was the most suitable for such children, as the Institution was never full. When it was closed, Mrs. Meiklejon experienced the utmost difficulty in placing the children, as they were unsuitable for any existing institution for the training of children of one defect. She considered that there was the direst need for special provision for the education of these unfortunate cases.
16. Mrs. A. E. Priestley, at the Kindergarten Preparatory Boarding School, The Mount, Whitby, receives a very small number of dumb or semi-mute children of retarded mentality; and a small institution?The Ellen Terry National Home for Blind Mentally Defective Children?with accommodation for 18 children, has been established at Reigate.
17. The Essex Voluntary Association, a Welfare Organization which is doing a useful work in the administrative County of Essex and the County Borough of East Ham in the training of adults and children who are either blind or mentally defective, also undertakes the training and supervision of children of combined defect in workhouses or in their own homes or boarded out with foster parents.
18. The second alternative?the provision by one Local Education Authority or a combination of Authorities of each of the three institutions now urgently required is a practical proposition. Three schools so established, for the types of children specified, would meet the present need so far as strictly educable children of these types are concerned, at a small cost. The Board of Education consider that provision would appear to be best made by one or more Authorities as suggested, and have expressed their willingness to consider any proposals that may be put forward by Authorities for the provision of suitable schools. Other Authorities from whose areas children were sent to the institutions would contribute towards the cost of maintenance of the schools. 19. In view of this expression of opinion by the Board, the third alterna- tive?the provision of institutions by the Board of Education?is not practicable at the present time.
20. Of these three methods I suggest the second for the special considera- tion of the Executive of the Association of Education Committees and of Authorities by whom the provision can most easily be made?the provision of each of the three institutions required, by the Local Education Authority for one large area or by a combination of Authorities.
21. The largest number of Children of Normal Intelligence who are suffering from Combined Defects are found in Birmingham, Gloucestershire, the West Riding, Hull, Bristol, Bury, Kent and Manchester. Blind Mentally Defective Children are most numerous in Salford, Oldham, the West Riding, Bristol, the Isle of Ely and Manchester.
Deaf Mentally Defectives are found in largest numbers in London, Derby- shire, Birmingham, Staffordshire, the West Riding, Salford and iNorthumberland. 22. If I might venture to ask the special attention of individual Authorities to the question of providing the necessary schools, I would request the con- sideration of the Birmingham Committee to the needs of the children of Normal Intelligence; the Manchester, Salford and Oldham Committees to the require- ments of the Blind Mentally Defectives, and the Derbyshire, Birmingham and Staffordshire Committees to the cases of Mentally Defectives who are Deaf or Dumb. In making provision for the education of these unfortunate children the Authorities would be doing a humane as well as an educational work, and their proposals would, I believe, receive the sympathetic consideration of the Board of Education.
23. It may be that other situations than those I have suggested may be found more convenient as the places in which the Institutions should be established, and that individual Authorities rather than Joint Committees of Authorities may best undertake the work. I merely offer the suggestions I have submitted as a basis for consideration. W. POPPLESTONE.
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