The Education and Care of the Mentally Defective Child in Renfrewshire
- Author:
Mrs. Fern,
Convener of Health and Special Schools Committee, Renfrewshire Education Authority.
The primary duties laid upon Education Authorities by the Education of Defective Children (Scotland) Act, 1906, and the Mental Deficiency and Lunacy (Scotland) Act of 1913, are ascertainment of mental defect in the school population of their area, the provision of educational facilities for such cases as are considered educable in Special Schools, and the notification of those considered uneducable to the appropriate authority, i.e., Parish Councils and the General Board of Control for Scotland.
It will thus be seen that, apart from purely educational provision, the res- ponsibility laid upon Education Authorities under the Acts is most important, as their primary investigations form the foundation on which the whole structure of the problem of the care of the defective child is built.
The Education Authority is essentially a clearing house for all manner of cases of mental defect. Their obligation, however, with regard to severe mental deficiency is extremely limited.
The matter of ascertainment is all important, and, in Renfrewshire, for the past few yea’rs, we have been concentrating upon scientific, and, as far as possible, complete ascertainment of mental defect in the area.
Unfortunately, the work was somewhat hampered in the early years by the prejudice existing on the part of the general public against provision of special school accommodation for mental defectives. Some objected on the ground’of expense, others on grounds of stigmatisation, and questions such as ” What is the use?”, or ” Does the result justify the expense?”, were often asked.
Undoubtedly there was some ground for such questions at that time, as many of the children admitted were cases for whom institutional treatment was the only solution. It is satisfactory to note, however, that now, generally speaking, only the high grade type is dealt with in the Special Schools, and, consequently, considerable educational progress is made.
The crux of the whole matter lies in the selection of proper cases. If proper cases are selected, then those schools not only justify themselves, but become an absolute necessity.
During the past two years in Renfrewshire, the Education Authority has made provision for the establishment of backward classes in every large school in the area. Extra teachers have been appointed for this purpose; one is a psychologist, who has made a special study of the backward child. She devotes one hour each day in selected schools to the ascertainment of suitable cases for the backward classes. The rest of her time is taken up in preparing reports on special cases, e.g., temperamental, vocational, delinquent, mentally defective, etc., for the information of the medical staff and teachers.
With the organised establishment of backward classes, the great majority of admissions to special schools should now be from Infant and Junior Divisions only. Of course, it is inevitable and incidental to a moving- population such as ours, that an occasional ease of mental defect escapes observation, and icmains in an ordinary school till twelve or thirteen years of age.
Under the Authority’s Scheme, when a teacher expresses the opinion that a case is unable to profit from education in the ordinary school, special repoits are made by the Head Teacher and the psychologist as to the child’s intelligence and scholastic attainments. If these indicate subnormal intelligence, they are considered together with other evidence of subnormality by the Medical Officer, before certification.
The report of the psychologist is of exceptional value, and we hope that, in the near future, it will be found that the Medical Officer’s field of investigation into mental defect will be more or less limited to the backward class. We have two large Special Schools in Renfrewshire?one in Paisley for the upper area of the Countv, with a roll of 21G, and one in Greenock, for the lower area, with a roll of 80 Owing to the lack of sufficient Special School accommoda^ tion in the latter area,” there are about 150 additional cases of mental defect being taught in ordinary schools. The Authority also provide for the education of about 30 children resident in the Epileptic Colony of the Orphan Homes of Scotland, Bridge-of-Weir.
These schools are equipped on up-to-date lines and staffed by highly Qualified, specially trained teachers. The work is carried out in ideal school buildings, which are amply provided with rooms for special treatment ^ ort iopa? ic, dental, etc. Use is made of the latest educational methods in teaching the three Rs, and a teacher is engaged each forenoon in dealing with speech detects, in addition to the ordinary general training provided, the girls receive a thorough grounding in domestic science, and the boys are taught handwork, cobb ing, an gardening. Every effort is made to ascertain the special aptitude of each child in order that special training may be given with a view to helping the pupil to become wholly or partially self-supporting in later life. The Aurist, Oculist, and Dentist, visit these schools regularly, and the general health of the children is supervised by the Authority’s Medical Officers, who visit once or twice weekly.
The schools tap practically the whole Renfrewshire Area. _ A travelling teacher, with special school training, was employed experimentally tor a few months last year in giving instruction to mental defectives who, through transport and other difficulties, were not attending special schools. The experience gained was valuable. The result of the experiment is that these children are now classified and the position in the outlying districts is known. The children showed their adaptability to special school methods, and the superiority of these methods was fully demonstrated. Arrangements are now being made for the conveyance ?f these children to a special school centre.
Cases are transported from outlying areas to special schools by motor ambulance and specially chartered tram cars. The Authority has four motor ambulance vans and three trams are engaged morning and afternoon. Arrangements are being made for a few cases to travel by train. For each ambulance and tram car there is a special guide, whose duty is to take the children to and from school and to attend to the comfort and wants of the children in school, including serving of meals. Children get cocoa or milk at 10.30 a.m. and a hot dinner at 12.30. Extras are supplied when necessary. Except in cases of necessity, an inclusive weekly charge of 1/3 is made for meals.
Transport problems are not acute in Renfrewshire. The area is a compact one, and it is possible, without much loss of time, to reach any part by train, tramcar, or motor. There is, therefore, no difficult rural problem. The total number of ascertained cases in Renfrewshire on 7th April, 1926, was 518, made up as follows :?
In Special Schools … … … … 262 On lists, awaiting admission 33 In ordinary schools … … … … 151 Uneducables … … 72 518
In cases of doubt as to whether or not children are of too low grade for a special school, it has been the practice to send all such children, for a brief period, at least, to the Special School in the Area. Here they are kept under observation, their confidence gained, and a Local Care Visitor introduced to pupil and parent. Besides making doubly sure that the diagnosis of uneducability is correct, this procedure has the effect of ensuring that no case escapes the knowledge of the Local Care Committees, and that no child so certified misses the safeguarding which is his right under the Act.
We are fortunate in Renfrewshire in having our Physical Defectives and our Mental Defectives taught under the same roof, and in having a working agreement between the teachers, under which cases are sent from one to the other for observation.
Thus, in a doubtful case of mental defect, where definite diagnosis is further obscured by periods of absenteeism, due to physical disability, and where remedial measures are advisable before definite opinion is given, the child is at once sent to the Physical Division, where his defects are attended to, his general health improved, his education carried on in pleasant open-air surroundings, and the relation of his backwardness to physical fitness assessed.
These safeguards all make for scientific ascertainment, and the proximity of the two schools also makes decertification a practical proposition. If a case progresses well, decertification is invited by trying that case in a physical class for observation. In this manner also the Special School can be utilised as a Psychiatric Clinic for observation in difficult and problem cases of delinquency. Although gradually disappearing, difficulties are still met with, e.g., securing the notification of cases by teachers to Medical Officers, and obtaining the consent of parents to their children being sent to Special Schools. So far, no case has arisen where extreme measures have had to be taken. A friendly talk by the Doctor or Headmistress with the parents, usually had the desired effect. This is fortunate, as probably forceful measures by our Authority at this juncture would undo much of the progress already made and destroy the confidence existing. A visit to the Special School has often the desired effect of overcoming parents’ scruples and prejudices.
Children in our special schools are under continual medical supervision, and notes are kept on special case sheets, of physical condition, mental condition, conduct, progress, and attainments, until finally reported on under the Act, at 15J years, prior to being passed out to the Local Care Committees at 16 years. In Renfrewshire, it is the practice to recommend in all cases ” Supervision by Local Care Committee,” except those for Institutions and Guardianship.
LOCAL CARE COMMITTEES.
There are two Local Care Committees for Mental Welfare in Renfrewshire, these Committees have been in existence for five and six years respectively. The total number on the rolls of the Committees is 362. Practically all were Pupils in the mental side of the Special Schools. A considerable number completed e course provided; the remainder, on account of their low standard of attainment, Were found to be uneducable. There are 99 Visitors for the two Committees, and each person on the rolls is visited periodically and reported on. Every effort is made to enable Visitors to become acquainted with the pupils while they are attending- the Special Schools. This saves much explanation when an ex-pupil is visited. The Cards used by the Visitors are prepared by the Scottish Association for Mental Welfare. The Committees assist, as far as possible, all the cases reported. The assistance may take one or other of the following- forms :? (1) Arranging, when desired by parents or guardians, for the admission of low-grade and difficult cases into suitable institutions. (2) Securing suitable situations for former pupils who are fit for work. (3) Providing garden plots for boys, and arranging for assistance and super- vision when the boys are working on the plots. Potatoes, cabbages, and turnips are grown, and sold to the Special School. Last year twelve boys were provided with plots. (4) Providing Employment Centre for Former and Unemployed Pupils. One Centre is in operation, and is at present attended by ten boys and five girls, for two days per week, from 10 a.m. to 3 p.m. In addition, two girls get work sent to their homes, as they are unable to attend. The ages of the pupils range from 16 to 32 years. They are taught rug-making, toy-making, paper-flower making, wood-carving, leather-work, sewing, knitting, dressmaking, and embroidery. The work is taken home and in every case the worker is paid on the completion of the article. The goods are sold at the Special Schools throughout the year, or at an Annual Sale. A Visitor pays for the dinners supplied to the pupils at the Centre. The boys invariably return immediately to the Centre when unemployed. (5) Setting up Occupation Centres. These Centres are for boys and girls who are unfit or unsuited for Special Schools. Two are at present in existence. The total number of boys and girls on the rolls is 46. Their ages are from seven to fourteen. The pupils meet two hours per day on five days per week. They are taught personal hygiene, discipline, sociability, and generally made less ” difficult.” An attempt is also made to teach them to write their own names and to understand numbers, but most attention is given to handwork. The youngest and very low-grade, are instructed in bead-threading, card- lacing, woollen ball making, and working with plasticine. The older and slightly less low-grade, are taught to knit and sew, to make rugs, and paper-flowers, and to do simple house-work. In addition, dancing, singing, games, and drill, form part of the instruction given. During the forenoon, milk or cocoa and biscuits are supplied, for which a small charge is made. The Education Authority have generously given the use of their motor vans for conveying a number of the children to and from the Centres. Some of the pupils travel by tram car a distance of between three and four miles. Usually a friend or neighbour escorts the pupil to the car, here he is met by a guide and conveyed to the Centre. These Centres afford a great relief to the harassed, overworked mothers, and there has been a marked improvement, at least physically, in the pupils.
In addition to the assistance above referred to, the Committees have been able to render valuable help when mental cases have been unfortunate enough to get into trouble and brought before Police Courts. Particulars have been submitted regarding the mental condition of those charged, and the information given has been the means of the accused being sent to suitable mental institutions instead of to prison.
The Committees are somewhat handicapped in their work through lack of funds. The main part of the expenditure is the salaries of the Instructresses. The income is derived principally from grants from the Scottish Association for Mental Welfare, Education Authority, Parish Council, and Board of Control; also from donations, Sales of Work, and Whist Drives, organised by the teachers of Special Schools and members of the Committees. A larger income would enable the Committee to extend the scope of their work so as to provide more suitable premises and further training in handicraft and domestic subjects for the pupils.
Another feature which has recently been introduced by the Committees is the reading of suitable Papers, delivered at Mental Welfare Conferences, to the local members of Committees. This has been the means of giving much important information to the members, and has raised many useful and valuable discussions.
It is interesting to note the steps taken by the Paisley Parish Council for dealing with mental defectives. Two years ago the Council purchased an estate of about 56 acres, with a modern mansion house attached. This place is at present used as a Colony for mental defective boys and youths, mainly of the moral defective type. At present the accommodation is for 25, but when alterations are completed, it is hoped to provide for 40 inmates. They are instructed in gardening, and general farm work, including poultry keeping. Lessons are also given in rug-making and boot repairing. All have, from the physical standpoint, improved markedly, and there has been a decided change for the better in their conduct. Some of the younger boys are being taught in the evening by a specially trained teacher, who is also an experienced psychologist. A qualified nurse acts as Matron of the Colony.
In Renfrewshire, every effort is being made to get in touch with all mental defectives in the area, and the result is (1), close and effective supervision; (2), cordial co-operation between public bodies and Local Care Committees; (3), an awakening of public interest in the welfare of the mentally defective; (4), sym- pathetic consideration in Courts; and (5), complete records of all cases which have passed through the Special Schools.
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