Epilepsy. A Functional Mental Illness
- Type:
Book Reviews & Abstracts.
- Author:
Rows and W. E. Bond. H. K. Lewis
& Co., Ltd. 1926. 8s.
Epilepsy is a disease about which much is known, but little understood. Without some knowledge as to its causation, a rational therapy seems out of our grasp. The search for a cause has elicited few facts, but many theories. A study of the voluminous literature shows two principal groups of theorists. On the one hand stand those with generous imagin- ations, who have built up a philosophy of the disease on bold lines, physiological or, more often, psychological. On the other are those who see epilepsy as the outcome of some chemical change or structural abnormality, the presence of which they have been at great pain to demonstrate. Pre-eminently, epilepsy affords an admirable battle-ground for the physiogenic and the psychogenic schools. The battle-ground is, indeed, common to most mental and not a few physical disorders. The psychogenic school would, generally speaking, have us believe that the disorder represents the reaction to life of an individual hampered by a peculiar mental make up, and that the convul- sive and other attacks, are but incidents in that reaction. The physiogenic school, for the most part regarding the fits as the most important feature of the complaint, direct our attention to structural changes in the cornu ammonis, or the motor cortex, to endocrine imbalance, to vaso-motor instability, to metabolic disorders, to chemical alterations in the blood or cerebro- spinal fluid, or even to the large intestine, where those who are anxious to economize in thought or labour can find the cause for any disease under the sun.
There is one general criticism that can be levelled at most of, if not all, the theories that have been advanced. They claim too much. There is no theory that fits in with all the facts. Nor is it likely that such an one will be found. The very definition of epilepsy is a matter for debate. The causation is probably complex in each individual case ; still more complex in that great group of patients who are labelled as epileptic.
This general criticism applies to the admir- able essay entitled ” Epilepsy, A Functional Mental Illness,” by Drs. Rows and Bond, which has recently been published in book form. These authors have a novel and definite to put forward as to the cause of epilepsy* a . its relation to the other psychoses. The the may be briefly outlined as follows. Me ^ exploration will show in every case that^ cause of the first fit was an emotional one. i5 sequent fits are the result of the revival ot original emotion, whether by exoge1^ stimuli, memory associations, or the like. value of the aura, which is constant in a given case, and of pre- and post-epileptic m tal states, or of those mental conditions kn? as epileptic equivalents, is determined by emotional state and its associations. ^ activities of the lower cerebral centres and ^ the autonomic nervous system, form an integ j part of what is known as consciousness, a in modifying consciousness, emotion has a p found eft’ect upon the whole of the nenf?jje system. The actual convulsion may well j due to vasomotor stimuli reaching the cereD ^ vessels, and profound and repeated stimuli give rise to those anatomical changes in . central nervous system which may be found old standing cases of epilepsy. By autonofl’ stimulation also, emotion may give rise ^ endocrine imbalance. The hypothesis o* special mental makeup prior to the commen . ment of the fits is unnecessary. All the men ^ pictures found in the disease can be traced the original emotion and its ramifications ^ association in the mental life of the patient, ^ to the prejudicial effect of the social handic^P which he finds that he must submit to. j It is well-known that the mental states fou . in epilepsy may conform to those found almost any of the psychoses. Besides drea / states, fugues, automatism, there may be sta of mania, melancholia, confusion, stupor, etc’^ which are in no way distinguishable from th?.^ found in the true psychoses. lEpilepsy lS? fact, the great prototype of all the psychos^ Similar symptoms and mental states must the result of similar mechanisms, and in P pounding this theory of the origin of epilep the authors are, in fact, applying it to the P^. choses in general. From an serological P01 ^ of view, moreover, this means that epilepsy a hysteria are indistinguishable. ?
Such, in very brief outline, is the thesis a vanced, and a good deal of evidence, s ^ clinical, some rather speculative, is brou? forward to support it. It is, however, we sU&j gest, untrue to say that similar symptoms ^ mental states must be the result of sim1* mechanisms. In dementi:a P ? distinguish” clinical picture may include mental states able from those of epilepsy, o n’a> all of such as confusion, stupor, o ernotion, which are demonstrably due,_ n g -n the but to the activities of sPir jn about 50 brain. Again, epileptic fits oc grades of per cent, of all cases of the ffross defect primary aments, where there shortage ot brain development and ac ‘ n -m those cells, and are also relatively c whether whose brains are damaged in i ^ actual by inflammation, hemorr ag , n emotional trauma. Is it likely that thereif these cause in such cases?, or, alt eptic, are all patients are not to be called P -^ren who the backward and feeble-nun e? oUt? The suffer from fits, to be similar Y. . ernotion is revival by association of the orl? o? ^ts, and in said to be the determining caus the aura this connection stress is lai an emotional which in every case is said to ^ recent ex- and not a physical basis. u v the closest amination of 300 cases of ?p P_nu’;ective aura questioning could only elicit a in 40 per cent, of the patients.^ ^ bloc, to To attempt to apply this tie are sure, the great mass of epileptics w > ^ t^at in be a mistake; but it is Prob^l!^ortant factor many cases emotion is an i P *a^y is this which has been overlooked. J^ice men, and so in the epilepsies of the eX~s(~, material on it is significant that most o roun(j among which this book is based wa sant erno- these patients. If, however, u p authors tions really played so large a par bave been Would have us believe, there s epileptics an enormous number of PoS ‘ ent that the whereas there is general fgr<embling true number of cases, clinically directly ?ut ? epilepsv, whose disease arose Qne cannot War service, is not very large. ^ sGil that resist the conclusion that it is book, counts most of all. On pp- ” , history of we find an account of the emo 1 m and the an epileptic, set out in some ‘lajnt was conclusion is reached that hi Averse influ- obviously the result of various ,-er years, ences and circumstances in ns innate and it is unnecessary to assum circum- tendencies. But the influences ^ been stances detailed do not appear than must any more extraordinary or a?ye seemS much occur to thousands of us, and i ten^ency to more reasonable to assume tna the epileptic type of reaction is present in varying degree among the population, and that the reaction will be readily evoked in some by minimal stimuli, be they emotional, toxic, or metabolic.
We unhesitatingly commend this book to all who are interested in epilepsy. It is not a com- prehensive account of the disease, but an essay on its causation. Though rather loosely put together, it is interesting to read, and contains much that is fresh and thought provoking. If the authors claim too much for their theory, they are not the first who have regarded one of the many factors in the causation of this baffling disease as its primary and universal cause.
J. Tylor Fox. The Psychology of the Thinker. By I. B. Saxbv, D.Sc. Lecturer in Education, University College, Cardiff. University of London Press : 1926 : 7/6.
The aim of this book is to give an account of the psychology of thinking, in the light of our present-day knowledge of the nature and functions of the unconscious. To Dr Saxby, thought is a tool developed in the service of man’s desires; working along certain lines, it develops and uses the concept as a means to satisfaction; working along other lines, it shows itself in phantasy-thinking, which at first leading away from reality, may finally return to it in the form of art and literature. In order to pacify the mind of the reader from unacknowledged, and often unwarranted associations, aroused by the words conscious and unconscious, Dr Saxby makes use of Semon’s terms, engram for the trace left on the organism by an experience, and ecphory for the active functioning of the engrams. The free use of these unfamiliar terms will cer- tainly, as the writer conjectures, to some extent repel the beginner, yet, once the initial difficulty has been overcome, it will conduce to a clearer appreciation of the author’s meaning”.
The first five chapters of the book are devoted to a consideration of the function of thought, the next four to a discussion of the thought-process, the last seven to an account of the acquisition of knowledge. The whole exposition is commendably ciear and is ac- companied by a wealth of illustration drawn from a wide range of reading- and experience. It has been said that the mentally defective child resembles a machine in which the wheels move so slowly that it is possible to analyse the parts and to distinguish their connections and inter-lockings. But even in such circum- stances, he sees most who has most knowledge of the general nature of the working of machines; he who has a plan ready in his mind knows for what to look, and on which parts first to concentrate attention. In the same way he will understand best the slow working of the defective mind, who knows best the intricacies of the thought process, as it normally occurs; he will best be able to help such a mind to accumulate and systematise knowledge, who has realised exactly the methods by means of which such accumulation and systematisation are brought about in the mind of ordinary intelligence. Hence an analysis such as that presented by Dr Saxby as her central thesis must be of great value to those who are seeking to teach and guide the feeble-minded.
From this point of view it is, perhaps, not wholly a disadvantage that the engram theory adopted by Dr Saxby, compels her to take up a distinctly deterministic view of the course of mental life. Intelligence, she considers, ” con- sists in a tendency to inhibit acts of proved uselessness, combined with the power of find- ing new paths for the energy which has been set free.” Both these factors Dr Saxby accepts as inborn, which is, indeed, the orthodox attitude in present day psychology. The teacher can help the pupil by providing the needed stimuli so that numerous and useful engrams may be formed ; she can also teach method, by breaking up problems into simpler units, but she cannot add to the intelligence with which the child has been endowed at birth. For many people, I admit that this view probably still requires to be emphasised; but it should not be regarded as a proved and ultimate truth. We need not yet on the basis of results accumulated through intelligence tests, give up the view that spirit may call to spirit, and that the success of many a teacher depends not on perfection of method, but on that giving of herself, which is spiritual con- tact, spiritual inspiration.
Margaret Drummond. London County Council’s Annual Repor*’ Vols. II., III., & IV. P. S. King & Sons. Ltd. 1/0, 2/6, 1/0: 1926.
These three volumes, which include the Re ports for the year 1925 of the School MedlC^ Officer, the Education Officer and the ? ? ? /)! Hospitals’ Committee, all contain matters interest to mental welfare workers. The Mental Hospitals’ Committee Report ^ a general survey of the development in L.C.C. Mental Hospitals and Institution?’ Following- up their experiment at Horton Me tal Hospital and the Maudsley Hospital, t Council have agreed to the employment ox part-time woman occupation officer at all tn Mental Hospitals.
The Report shows that the Council is P1”^ pared to continue its support of Occupat’ ^ Centres and make a more extensive use Guardianship.
In the School Medical Officer’s Repor^ figures are given (p. 147, Vol. III.) shoW’n? the number of mentally-defective child1” (other than imbeciles) suffering from a secon defect :? ^ Boys. Girls- ^ Mentally defective and epileptic 53 30 ^ >> ff ,, blind … 3 ^ rll ,, deaf … 26 28 ? ,, ,, physically ? defective 85 63 *
Interesting details are given of Dr Shru sail’s special enquiry concerning Mongols IP’ 147). The Report states : ” Mongolism occur in families of any social class, thoug in data collected from the public elements- schools the proportion met with in the mio” classes is likely to be underestimated. Ait taking out the percentage of distribution of t ^ social class and occupation of the parents 272 Mongols, and comparing it with a sim1’^ percentage as revealed by the data of t Registrar-General, it will be noted that the are relatively more examples whose Pare? “r belong to the middle or distributing class, mixed occupations, which include service in t Army, Navy or Mercantile Marine, Police, the like, and fewer belonging to the artisan ^ unskilled labour classes, and poverty is dently not a factor in the causation.” (p. 1* j Dr Nairn Dobbie has been associated ^vl an investigation into vocational guiaarl carried out by the National Institute of Inou has1 Ps^hol?g”y- Dr Elizabeth M. McVail conrTf*3111^6^ Prev’ous history and physical clas 1 10n ^ children (girls) in backward ?frep6^ ^er conclusions show that illness and back attendance are mainly responsible for 0ver<5^air<^ness” P^eac^s f?r special medical f0r ^ and care for backward children, and drenSm- v classes. ” The proportion of chil- am0n 1 Physical defects is much higher than Comb^St normal children. In the two classes lg Dlne^’ ^ Per cent, had defective vision, cent Cen.t- defective hearing, and 4.3 per and ?r?:anic heart disease, while lung-trouble avera^0nera^ c^ebility were also much above the that fu incic3ence. It is of interest to note lono- effects of illness and disease persist ?f inafter .^le disease has been cured. Habits special tent’on acquired owing to defect of the theme i Senses remain when the defects are selves corrected.” (p. 160, Vol. III.) the TGre are 13>?00 children in attendance at ?ne_L?”c’0n Special Schools, of whom about ti?n ft are mentahy defective. The Educa- difficult-P?r- points out that the administrative accom lGS n.^erent in providing special school ably moc*ation for children who are inevit- ‘ation Ca/tere(^ among the general school popu- Londo h ^6en ncreasec by the fall in the Va^ ^-rate. A summary is given of ti?n jsri^Us activities of the schools, and atten- educat rawn to the development of physical rTlentali?nj ^ames and swimming in schools for ment fe^ct^ve children. ” The develop- triarked SwImming ir> these schools is very childre ‘ -ant^ more than one quarter of the W?rthvn T tbe sch??’s can now swim. It is sions record that on three recent occa- VaHantmentally”defective children have made Were c atternPts at life-saving, two of which successfC(]eSS^u’” third attempt, while un- divino- fiU 1 ^as exceptionally creditable, a lad to regc times into deep water in his efforts n?t hav! u b?y whom h was found later could the ol ^ ^Cen saved as he was entangled in ia,n of a barge.” (p. 18, Vol. IV.) a
Profn NoRmality and Deficiency. By Luelbn’r,Sidne-v L- Pressey, Ph.D., and Allen JL’PTressey, Ph.D. pp. xii, 356. George This Unwin, Ltd. : 1926 : 10/6. esPecial]eXue^ent .text book will be welcomed, }vorl<ers^ social workers, mental after-care ‘nS” the ^ose who are employed in help- c octors at Nervous and Mental Out- patient Clinics. Tt will, however, appeal also to a much wider public: teachers, heads of departments, and, in fact, all those who find it an advantage to understand the every-day practical psychology of their employees and pupils will find much to interest and instruct them in this very readable and stimulating- piece of work.
Here is a book that can be safely recom- mended to those who ask for a good all-round introduction to the study of mental ill-health and deficiency; there is a great need at the present time for such a book. It is non- controversial and is generally in accordance with the work of the best teachers of the day. The most valuable point about it, however, is that it leads the student on to listen and to observe for himself and to reflect the facts obtained sanely and intelligently; it does not so much set out to teach as to show how the worker must learn for himself. The one fault is that there is a good deal of repetition, which seems rather unnecessary even in an elemen- tary book such as this; the reason is quite obviously that the writers are anxious to drive certain big principles home, but in another edition it would be well to do some judicious pruning.
Part I. deals with the methods of cise- study, and is the most valuable part of the work. The student is gradually led by stages to the recording of a case, and there is excel- lent advice as to the accurate recording of it, so that it shall not only be useful at the time of taking but for all time. There are most frank and practical pieces of advice as to the manner, of interviewing the patient and his immediate family, and of obtaining from them the family history and other particulars with- out offending or hurting them in any way. This matter is approached from a fresh and sympathetic angle and, so far, I have not seen anything in that way better done.
Part II. deals with the various types of Mental Disease and Disability, and very rightly starts with the picture of the normal or aver- age individual and his family. The writers are careful to point out how this standard differs in the different walks of life, a fact that is often lost sight of, even by experienced social workers. Next follows what the writers call the ” Borderland Cases,” using the word in a different, and one may say, in an infinitely more correct sense than we in England gene- rally use it to-day. Under this heading- are grouped the ” emotionally mal-adjusted,” the ” emotionally unstable,” and the ” peculiar people.” Test cases are given which illustrate these types beautifully and which do more to instruct than many chapters and many hours of lectures. The remainder of this part is taken up with the description of the functional and organic psychoses and feeble-minded condi- tions. When the writers get on to purely medical ground they do not appear to be quite so sure of themselves, but, since this is not really the principal part of the book, it is not, perhaps, a very serious fault.
Part III. deals with many big problems, such as that of the adolescent, the delinquent, the non-educable, the adjustments of school life and many other subjects. There is a good chapter on mental hygiene in which there are some very suggestive remarks about the cause and the prevention of mental abnormality.
Each chapter is in turn summarised, and mental exercises are given upon the subject of the text. A list of books and pamphlets directly bearing upon each chapter is also listed, so that those who wish to amplify the subject may know exactly where to go for their informa- tion, instead of laboriously wading through enormous tomes and never finding what they want. The literature advised is practically all English and American and the selection is particularly good.
Finally there is an annotated bibliography and a good index.
ISABEL EMSLIE HUTTON.
Pubt.ic Social Services. Published by The National Council of Social Service. 4th ed. 1926. 2/-.
This useful little handbook has been in con- siderable demand in its earlier editions, and we welcome a fourth edition (revised and en- larged). It is a handy summary of all the various public social services, the chapters dealing with Public Health, Education, the Poor Law, Industry and Employment, and the Administration of Justice, being especially useful to the general reader.
The Health of the School Child. Ann” Report of the Chief Medical Officer of t Board of Education for the Year 1925. H-^ ? Stationery Office. 1926. 1/6.
There are many parts of this Report deali?f> with the general health of school children vhlC one would like to quote. Especially interestifl& is the chapter on ” The health of the yoUJ/j child on admission to school.” (pp. 23-3 ?/ There still remains in Sir George Newman opinion great cause for anxiety about the pre school years. Sir George Newman refers the valuable Report (for the Medical Reseat Council), of Professor Noel Paton and ProfeS sor Leonard Findlay on ” Poverty, nutritt?() and growth ; Studies of child life in Scotland- And his comments are as follows : ” Their c?0^ elusion is that ‘ heredity and the inherit^ growth impulse play no small part in determ”1 ing the growth of the child, and that in spite 0 environmental factors, which may appea prejudicial, the slum child tends to develop ?j the lines of its parents … Of the environments characters studied, maternal efficiency seerT, more closely associated with variations in tn condition of the child than our measures 0 poverty, underfeeding or overcrowding … ^ studies suggest that maternal efficiency is n.? directly and immediately associated with s’zC of family, cubic capacity of the house Per person (i.e., with overcrowding), and ^vlt’ maternal health.’ It will be seen that this n^v and elaborate investigation tends to supp0 neither the extreme Economist nor the extrefl16 Eugenist. It brings us back to the mother””” her health, her capacity to nurture, the siz^ of her family and house, her Intelligence an devotion to the care of her children. I thin both biology and human experience will supp?r, that conclusion. It is not this or that dietaO or clothing, or environment, which is the pfe. dominant influence. The predominant influen<^ are more likely to be the nature of the ch’ as the offspring of its parents and the nurtur provided for it by an intelligent and an efficien mother.” (p. 31.)
Every worker among subnormal people 1,1 their own homes will heartily endorse this c?n elusion, and it is a truth that should be borjj in mind in all discussions regarding 1 marriage of defectives, and the care of defec ives within the community.
Sir George Newman’s report on the mental subnormal child, shows that ^iel^ nts for some improvement in the arrang e(jucat-lon. ascertainment, supervision ana Educa- Ihere are now, according” to t e children tion Authorities’ returns, these certified as mentally defeetrve- aooroxi- ” 32,975 mentally defective c i ^ speCial lately one-half are accommo these schools. The total in day schools at present is for 15,1^3 schools; and for 1,880 children in rf schools, 1^,470 are attending public elerne . ? s and 860 are in other 4 educational ins tion In 3,872 are not in any school or m control 1925 there were notified to eh:iJren 1,509 authorities 842 feeble-minded chd ‘ imbeciles, and 218 idiots.” (P- - WPre 30,821
The figures for last Yea soecial school mentally defective children, with sp accommodation for 16,569 chi re ^ The Local Authorities’ aSC^rtafnI^iie school represents 6.7 per thousand o . . /^y Population, while the Board s e many considered too low), con in Sir George Newman summarises Qrjc Q? conclusions so far reached throug wrote the school medical service. Last.year^he wr ^ at some length in defence of th financial mentally defective children, despi e . ayS : outlay.5 In this year-s report he^aptly.say ^ The mentally defective ar J?nrp costly educate and care for ; but they ar5 ^ need to neglect.” He again e^rly training and care. . early is proving the large part ta . of the training, conduct, habit, and P ? uman mind, child in the development of th body and fuller regard must now be pai , ^e capacity, nurture and_ ‘ behavio nt t^e mfant and young child if we wou P motor subsequent formation of faulty se= ‘ baCk- and mental actions, leading to d re wardness and mental defect. Moral .ssues also concerned.” (p. 81.)
His reasoned discussion on th^Pj,^?^ tjie special school is enlightening. special country as a whole,” he says, %SrPm0re school can never, at best, be a so u i “han a part of the problem (p- for indicates that room should be found pntally the dull and backward, but for | e juni0r deficient child who is not asocial in u^ j Elementary Schools, if the modern tendency for a more individualistic education and smaller classes is encouraged and developed. Supervision and After-care (Circular 1341) are considered at some length, and special reference is made to the valuable work done by the Kent, Cambridgeshire and Somerset Associations for Mental Welfare, (p. 88.) The after-history of boys (unselected as far as practicable) who were in attendance at Special Schools in different areas has been examined. ” A summary of these records of after-care shows that out of 211 boys, approximately 134 are capable of engaging in regular work, often of a skilled character, 47 are in reasonably regular work, while 30 are not employable under ordinary conditions, and require care and control, whether at home or at an institution. The general impression left on one’s mind after perusing these records is, first, the large number of boys who, on leaving the Day Special School, obtain reasonably regular work; secondly, the small proportion of them who cause special trouble or get into the hands of the police; thirdly, the fact that those in irregular odd jobs will become a charge on the community, unless they belong to good homes … But, whatever may be their subsequent employment, their educational backwardness and instability of character, demonstrate the need for a good home, or, failing this, the kind of sympathetic supervision so admirably provided by such voluntary societies as the Central Association for Mental Welfare, and many of the 4 After-Care ‘ Committees throughout the country.” (p. 90-91.) The Sheffield Outbreak of Encephalitis Lethargic a. 1924. Medical Research Council. H.M. Stationery Office. 1926. 1/9. This Report is welcome, as the outcome of a close study of this baffling disease, the cause and cure of which is still unknown. All over the country, there are now neurologists devoted to its investigation, but, as it was first des- cribed by Von Economo, in Vienna, as recently as 1917, it is still early to expect an adequate understanding of it.
This Report consists of an Epidemiological Report, by Professor F. E. Wynne, M.B., a Pathological Report, by Professor J. S. C. Douglas, D.M., a Clinical Report, by Professor A. J. Hall, M.D., F.R.C.P., and A. GurneyYates, M.D., M.R.C.P., and an Appendix. Etiology : Summary of Recent Researches, by J. R. Perdrau, M.B., B.S. The researches here set forth show negative rather than positive results, and no startling new theories are advanced. Professor Wynne investigated the question of infectivity. He says (p. 12), ” While several cases are on record where the disease assailed simultane- ously a number of persons living in institutions, the evidence of infectivity among members of a normal community is generally very slight. Thus, in the Glasgow epidemic, Dr Chalmers found only two instances in which more than one case occurred in the same household.
” In the Sheffield outbreak, I have been able to find evidence of contact, more or less inti- mate, in six instances, involving 13 patients, or just over 4 per cent, of the total number of cases ascertained.’’ After setting forth the de- tails of these cases, he adds (p. 15), ” It will be seen that any attempt to deduce the possible limits of an incubation period from these cases, is little better than guesswork, owing to the difficulty of obtaining exact dates of contact and the uncertainty that obtains in most cases as to the date of onset … If the disease were ‘ infectious ‘ in any but a negligible degree, one would expect, with confidence, to find evidence of its spread in the elementary schools. In the Sheffield outbreak, however, while 82 children of school age were affected, there were only 45 instances of more than one case occurring in the same school. These were distributed among 20 schools, out of the 136 in the city area. In only one case were there as many as 4 cases in one school. In 3 schools there were 3 cases in each, and in the other 16 there were 2 cases in each. In 3 schools only were there instances of 2 cases occurring in the same class. As it is certain that many of these children must have continued to attend school after symptoms had developed, it would seem that it is only with difficulty, if at all, that the disease is communicated from one individual to another.”
A very interesting investigation was made into the social conditions of those suffering from the disease, from which it was deduced that encephalitis is not a disease associated with poverty and its accompanying conditions. The evidence of the Sheffield figures confirm previous investigations, showing the greater susceptibility to infection in males (the most susceptible age for males being 15-30 years), and greater liability to death in females. This Report, together with Dr Tredgold s Paper at the C.A.M.W. Conference, and Df’ Borthwick’s Report on the Encephalitis Unit) Metropolitan Asylums Board Norther0 Hospital, Winchmore Hill, give in convenient form some of the most recent pronouncement5 on Encephalitis lethargica.
Report of the Committee on Education anp Industry (England & Wales). First part- H.M. Stationery Office. 1926. 1/6. Second Report of Progress. Vocational Guidance Experiment. National Institute of Industrial Psychology.
The terms of reference to the Committee otl Education and Industry, the first part of vhoSe report is just published, were :? ” To inquire into and advise upon the public system of education in England an Wales in relation to the requirements 0 trade and industry, with particular refer’ ence to the adequacy of the arrangement5 for enabling young persons to enter int0 and retain suitable employment.”
This first Report deals with the second part o* the reference, and gives a useful historic^1 summary of the development of organise*3 arrangements for placing persons in empl0^’ ment since the Labour Exchanges were fifS. set up, in 1909, and the Education (Choice 0 Employment) Act was passed in 1910. I*1 Unemployment Insurance Act, 1923, created a new position. By this Act a Local Educati011 Authority was not permitted to exercise Choice of Employment powers unless it also undertoo duties in connection with unemployment bene11 for persons between 16 and 18. The positi^ at present as regards juveniles is that * County Councils (and 26 Boroughs and * Urban districts who are immediately resp0lsible, but exercise the powers of the Count; Council), and 56 County Boroughs have unde1” taken the duties as Education Authorities. The Committee approve in general ^ present system. Two of their major recon* mendations are :
(1) That the Ministry of Labour shoul assume entire responsibility centrally in regar to Juvenile Employment, whether the work- done locally by the Education Authority or jv the Ministry of Labour by means of JuveO1 Advisory Committees.
(2) That Working Certificates should be required in all cases of employment belo ^ age of entry into Employment ? ‘
as to bridge the gap between 14 and >? . A passage in the Report, which J^j^don interest, refers to the work ? Mentally Association for the Care of tllie f- Defective and the After Care Associ ^ Blind, Deaf, and Crippled Children, in S to Juvenile Employment. Ihe Lon o T7moi0y- Council decided to leave Choice o P rnent to the Ministry of Labour, , Ministry continued the arrangemen s these Associations exercised powers o of the Council. The Report describes the work on behalf of defectives between 14 and , adds:?(p. 32.) , , ,
” We would, therefore, recomment a^ in all areas where no definite P . taken in the matter, the Local Education Authority or the Ministry ?f La tjon consider whether, probably by co- p . with Voluntary Associations, so? .. . , factory system might not be es a m The precise form that any sue i > might take would depend partly o circumstances and on the exis en suitable local Associations for detect children and juveniles.” This is a very important ^commendation, and it is a tribute to the efficiency o 1 ‘ niethods of investigation and fo ow? which have been adopted by the Associations.
Ihe grant from the Ministry of if the London Association amounts to ? ? all those areas where there are Loca ? t-ions for Mental Welfare were to organi definite system of After-care for p.reat defective children, there would be a S improvement in the statistics of employm for such children.
The figures given above indicate that t Ministry of Labour is responsible for a section of the country, and we look or\ a speedy development of the system o s, ln aid of Juvenile employment, suci a proved so successful in London.
Ihe Report welcomes in a tentative psychological tests as aids to determ ? suitable employment, and refers to tie wo the National Institute of Industrial Vs^/)(f” and the occupations ol: the pupils aitei eav & The Institute has just issued its second Report of Progress on the work it is carrying- out through a grant from the Carnegie United Kingdom Trust. The Report is careful to emphasise that the work is still in an experi- mental stage, but to be able to point even to the present results is encouraging.
The technique of vocational guidance by psychological tests is beings worked out with scientific accuracy, and the follow-up of the children who were examined and advised are here shown :?
” Number of children who have been followed up successfully 161 Number of children in work of the same or similar kind as that recommended … … 103 (64%) Number of children in work of a different kind … … 58 (36%) Of the former group the majority are in their first post, only four have had more than two posts, and there are no cases in which dissatis- faction with the work has been definitely expressed (though this does not imply that none exists).
On the other hand, among those doing work of a different kind, 18 children (31 per cent.) have definitely expressed dissatisfaction either with the work or the prospects, and there are 10 children who have changed their work from three to eight times in less than a year. These results are generally in agreement with those obtained in a former enquiry, and may be con- sidered to be distinctly promising. They conccrn, however, only the children examined by the Institute. The corresponding rate of change among children who were not examined has yet to be inquired into.”
Report of the Consultative Committee of the Board of Education on the Educa- tion of the Adolescent. H.M. Stationery Office. .1926. 2/- paper, 3/- cloth covers. This Report is the outcome of deliberations by the Committee since May, 1924. They were asked by the Board to report upon the organization, objective and curriculum of courses of study suitable for children who still remain in full-time attendance at schools other than Secondary Schools, up to the a?”e of 15, and further, to consider the relationship of such curriculum to a good general education school. In regard to the latter part of this reference, the reference to the Committee on Choice of Employment and Industry (reviewed in this issue of the Magazine) would seem to cover some of the same ground and the Second Part of that Committee’s Report (when it appears) should be compared with the present findings. The Report deals exclusively with the problem of children aged 11?the age at which the Committee unanimously agree that all types of Education should be divided into primary and post-primary. The whole question of the adequate education of the child over 11 to the end of its school career (at whatever age that may be) is of burning interest, but as the Report avowedly deals with normal children, it does not specially concern mental welfare workers. There is, however, the recommendation, with some dissentients, that legislation should at once be introduced to raise the minimum school leaving age to 15 from the year 1932. Lord Eustace Percy’s immediate pronouncement, at the same time as the issue of the Report, that the Government does not propose to introduce legislation, but will leave the matter to the permissive powers granted to Local Authorities by the 1918 Education Act, removes this question from practical politics, unless further opinion should be greatly roused in its favour.
Such raising of the age would improve to a considerable extent the position of the feeble- minded child in the Elementary School, who at present leaves at 14.
Though no specific recommendation is made, it is evident that the Committee intend that all children over 11 unable to profit by the varied types of education proposed for the later years of school life, should remain in the junior school or be otherwise provided for.
If those recommendations of the Committee, which stress the need for an adequate number of teachers with the ” craftsman’s outlook and the craftsman’s interest ” (p. 232), and the development of practical work were carried out, there would be a valuable and direct effect on the training of all teachers, including those dealing with dull and backward and mentally defective children.
The Committee devote a chapter to the administrative difficulties caused by the division of powers among Educational Authorities. Their recommendation is as follows :? ” Finally, we recommend that con- sideration should be given to the question whether it may not be a desirable objective of educational development that provincial authorities for education should be insti- tuted, in which the authorities for Elementary Education only and the Authorities for Higher Education shall both be ultimatelv merged. Chapter X, p. 192.) “
Little Mothers and Big Sisters. By Hilda Halliday, M.R.C.S., L.R.C.P., D.P.H., Assis- tant Medical Officer, Maternity and Child Welfare Centres, Greenwich. Oxford University Press. 1926. 1/3.
The Publishers have sent us this little book, which is written as an Elementary Health Reader for the senior girls in schools. It is attractively printed and illustrated, and should provide a helpful stimulus to the readers for whom it is intended. Professor Kenwood, in his preface, says that, ” the author has set herself the task of suitably dealing with import- ant matters which bear upon the formation of the healthy mind as well as the healthy body.”
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