The Relation of Physical to Mental Defect in School Children
- Author:
Walter S. Cornell, M.D.,
University of Pennsylvania.
The age of our race between six and fifteen years is a distinctive one, from the fact that the problem of diet, so important in infancy, decreases with the corresponding increase in bodily activity. So, also, the prevalence and effect of contagious diseases suffer a reduction. For these reasons the mortality rate decreases progressively, and the probability of survival becomes steadily brighter.
The age of development, however, is one in which the subsequent physical and mental welfare is largely predetermined. Though the child’s life be fairly safe, his fortune still lies largely in the hands of his parents, his environment, his teacher, and his physician. First must be met the burdens of heredity, producing thousands of sickly, deformed, and neurotic children. A perpetually (or rather, life-long) acting force is here to be combated and reckoned with. Second to heredity is a poor city environment, with its lack of fresh air and its improper diet of canned foods. Exposed to these influences, healthy infants succumb and join the ranks of those already suffering from rickets, anfflmia, and adenoid nasal obstruction. Finally, the ignorance of parents causes indifference to the damage already done, and adds premature decay of the teeth to the existing list of evident ‘ physical imperfections.
Are these injuries to the health of the child also harmful to his mind ? Will he ultimately pass through their pale of influence more or less scarred, but possessing the same knowledge and mental faculty that make for power, as his more vigorous neighbor ?
Backward and subnormal children approach so nearly the ? ordinary child that the connection between physical defect and brain defect is often not demonstrable at all in individual cases.
In these the acting influences are of minor degree, being principally poor eyesight, deafness, and poor nutrition (adenoid growths are included in the latter two). We may either assume that the rule of a sound mind in a sound body is a natural law, and so reason by analogy that it operates in these cases, or by a study of a large series of cases draw positive original conclusions from this very class itself. The latter is well worth proving, if it be possible to do so.
In the special classes for backward children conducted by our large cities, the reports show that almost every backward child exhibits physical defect of some sort. In these classes the proportion of defective children is given by one authority as 95 per cent of the whole number.
That the physically defective among ordinary school-children show subnormal mentality is the converse of this proposition and should be capable of demonstration.
In the following investigation I have endeavored to clearly establish this relationship. The children studied were those of three Philadelphia public schools, whom I had previously physically examined in prosecution of the official work of medical school inspection.
The first step was the recording, in each school, of the name, physical record, and scholarship of each child. The last mentioned datum was obtained by using the previous term-marks iii three of the school studies, from which an average mark was easily calculated.
The average term-mark of the whole school was first obtained by the simple process of adding the term-marks of all the children together, and dividing by the number of children. For example, in the Claghorn School this was 73.1. The record-cards of the children were then divided into two collections: one of the healthy or normal children, the other of the general group showing some noteworthy physical defect. The average term-mark (the scholarship index) was then calculated for each group separately, and the two compared, first with each other, and then with the term-mark of all the children previously calculated.
The results showed that in each school, and in each individual branch of study in each school, the healthy or normal children stood higher in their classes than the average children, and the physical defectives, taken as a class, stood lower than the average children.
Allison School?219 Children, Both Sexes, G to 12 Years Old. Average Normal child : 75 Average child 74 General defectives 72^ Adenoids and enlarged tonsils 72 Deaf 67.2 Ninth Street Primary School?84 Children, Both Sexes, G to 10 Years Old. Language Arithmetic Spelling Average 64 cases normal children 72.9 75.5 75.4 74.6 84 cases average children 70.5 74 72.8 72.4 21 cases general defectives G3.3 70 64.8 6G 8 cases adenoids GO G6.7 65 63.9 No cases deaf.
Claghorn School?252 Children, Both Sexes, 12 to 15 Years Old. GeographyLanguage Arithmetic and Average History 179 cases normal children 74.4 72 76.6 74.3 252 cases average children 72.7 70 76.5 73.1 73 cases general defectives 71.4 65.1 76.2 70.8 An investigation on slightly different lines was made possible by the existence in the Claghorn School of four classes of the same grammar grade, which had been so made up at the beginning of the year that the brighter children constituted two classes, and the duller children the other two classes. The latter were smaller, so as to afford more opportunity for individual instruction. A comparison of the physical condition of the children is instructive: Class 1 Class 15 Class 9 Class 11 Bright Children Dull Children Chil^-en Number of children 50 39 32 29 Normal 36 32 20 13 Defective 14 ? 12 16 Percentage of normal children 72% 82% 62.5% 44.8% In June, 190G, the school medical inspection corps of Philadelphia was directed by its chief, Dr Thomas J. Beatty, to make a comparative study of those bright children exempted from their annual examinations, and those children whose lower scholastic standard necessitated their examination for promotion. The proportion of physical defects recorded in the two groups was made the basis of comparison. I am indebted to Dr Beatty for per2U THE PSYCHOLOGICAL CLINIC. mission to publish the figures which I submitted to him at that time. It will be observed that, on averaging the five schools, the brighter children showed the lower percentage of physical defect.
Exempt Children Non-Exempt Children Normal Defective Normal Defective Ninth Street Primary School 5G 28 39 38 Ilutledge School 87 35 75 34 Allison School 128 65 81 49 Camac School 183 71 103 75 Claghorn School 193 61 127 66 647 260 425 262 Percentage defective . 28.8 per cent. 38.1 per cent.
An effort was made to determine the exact degree of influence of defects of the nose and throat. The harmful results of these have been recognized in recent years. In the Claghorn School the four classes of bright and dull children were examined again. Their eyesight proved to be about the same (averaging 5-~y ~). Enlarged tonsils, adenoids, deafness, and nasal catarrh occurred much more frequently, however, among the two classes of duller children. In many the adenoid expression was written only too plainly on their faces. The following table shows the findings:
Class 1 Class 15 Class 9 Class 11 Bright Children Dull Children cwitlre^i Number of children 50 39 32 29 Nose and throat conditions: Number defective 6 4 9 9 With single or combined defects, viz: Tonsils 3 4 3 3 Adenoids 2 1 5 6 Deaf 2 .. 5 1 Catarrh .. 2 3 Percentage of children with nose and throat defects 12% 10.2% 28.1% 31% The conclusions to be drawn from the foregoing facts are very evident. The educational result in our public schools suffers a discount of about G per cent in the case of the physically defective children, as well as a waste of the time rightfully belonging to the normal children. The drain on the teacher’s energies is more than proportionately increased by the presence of such children, because of their associated nervousness or stupidity. Note.?This article is from a chapter of a book in course of preparation, entitled “Medical Inspection of School Children.”
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