A Clinical Examination Blank for Backward Children in the Public Schools.II
The Psychological Clinic Vol. 1. No. 8. , January 15, 1908. L> fS. :Author: J. D. Hellman, University of Pennsylvania.
In the last number of The Psychological Clinic I explained the purpose of the blank, the general arrangement of the items, and the method of grading employed, especially the method of grading mentality. To assist me in the further presentation of the items of this blank, I have reproduced an actual blank partially filled out, which will be found on the next page. At the top of the blank is the name of the child, in this case an assumed one. On the same line with this, is a space provided for the purpose, is the number 12. This number indicates the order of the blank in a series. The serial classification of the cards will be determined by convenience. In my investigation, the cards of the boys and girls were placed in separate series for each school.
The significance of the items which give the child’s residence and serve to locate him in a particular class and school and under a particular teacher in the year when the examination was made, needs no explanation. If these items are not sufficiently intelligible from an examination of the reproduced blank on the next page, a satisfactory explanation will be found in the preceding article.
Directly below the recorded data locating the child, are found the data which indicate why this child has attracted special attention.
Progress and conduct are followed by E, G, F, D, and vD, the initial letters for excellent, good, fair, deficient, and very deficient. Gradation of progress should be made from the standpoint of the rapidity with which the child passes through No. T% Name QkCtWyI) /VYuJf^O Grade Class ” 190 Address Grade School School uiass lav ?aaress rx Class 190 ^ Address b” 0 On JlOsh_V / 190 Teacher ^ ?}J (Xa.PAXK/J ,190 *Teacher THaAA (XdUX/VYlA/ Progress E G F D Ml) Date of birth <b j OO Age 1 Conduct E G F D Age on entering school G No. years In school / Attendance vR I vl A School history (Rel) (hxa/bsvO oA’^UclXaauV Most deficient in A Habits ^.QW. 54321 54 3 21 Father living dead Nornial vG G M/S1 ,D Deficient Bl^IHIM II Id Mother living dead Health. vG G P P vP Home Care vG G F V Step-father, Step-mother Nutrition F G M V St ” Culture vG G F P ^ Nationality F. Support R W M ft^vP ” Discipline vG G F P ^ ” M. Occupation- of provider (^KLhJ^hJ Birthplace Child works at /y)A Lives with - Anormality Asymmetry Home Lang. Trunk Older brothers living dead Arms ” sisters ‘ ” Legs Younger brothers ” 41 Hands sisters ” ” Feet Eye, R. ) Cranium Eye, L. ) Forehead Defects Face Disease Ears Ear, R. } Eyes Ear, L. ) Nose Defects Lips Disease . Palate Co-ordination 5 4 3r 2 1 Tonsils vB B^d Norm Shy vS Naso-ph’nx Am Resp P&fs Sull Sur Mth Breathg Sto In A1 NeVv vN Teeth L vR Refl Norm Imp vl Tongue Stu Wilf Firm Flex Voice Stammer (inf) 5 4 3 2 1 Speech Stutter 5 4 3 2 1 Diseases Filled in by |.l0^iuLYVVCVW Date .. .U-WYUU.1}”. y 1 fj P.’[ laboratory of Psychology, University of Pennsylvania.} The J. Lewis Crozer Fund. the grades. Many teachers feel inclined to call a child’s progress good because it does well in its grade, regardless of the fact that the work has been repeated one or more times. The grade and class of the previous year will enable the investigator to see how often or how much of the work was repeated. Progress should be marked with reference to the rapidity with which the child passes through the grades, without regard to liis attendance. If a retarded child’s progress be good at the time of the examination, then special effort should be made to find the cause of retardation in his past school life. A space is provided for a brief synopsis of the “school history.”
As a basis for rating conduct, I chose the agreement between the child’s actions and school regulations. In addition to interfering with a child’s progress, poor conduct may have a diagnostic value of its own. For example, deficient conduct may be a consequence of low mental capacity. When a child is unable to take part in school exercises, his conduct is invariably of such a nature as to conflict with the order of the school. Deficient conduct may be indicative of defective home discipline. When conduct is very deficient at school, delinquency is often associated with it. When conduct was reported deficient, I always inquired into the child’s moral history, and often obtained a story of thefts, gambling and sexual indecency. I recall at least two cases of horse stealing, quite a number of gambling and no less than six who had been guilty of sexual offences. I do not for an instant believe that the teachers knew of most of the cases, or that they reported all the cases which they did know. Care should be taken not to mark as deficient the conduct of a restless child, who may simply be unable to control his body on account of ill-health.
The symbols vR, R, I, vl and A are used to record attendance. These symbols are the initial letters of very regular, regular, irregular, very irregular, and absent. The choice of the words used in connection with this item, as with all the other items, resulted from an attempt to employ words which Ave re already used by the school for the same purpose, or which would assist the investigator and teacher in making the rating. If the five point system of grading be strictly followed, a child who is present from 17 to 20 days in a month will be considered very regular; from 13 to 16 regular; 9 to 12 irregular; 5 to 8 very irregular, and 1 to 4 absent. As truancy is closely related to attendance, this fact should always be investigated in connection with it, and recorded on the back of the blank. On the face of the blank no space was allowed for truancy and a number of other important facts, because they are of relatively infrequent occurrence, and a note on the back of the blank involves very little time and effort.
The card of John Smith, reproduced on page 218, records his progress and conduct as very deficient; attendance, however, is regular. He entered school at six years of age, and at the time when this blank was filled out, June 4, 1907, which may be seen from the bottom of the card, he had been in school one year and was at that time seven years of age. His school history shows that the work of the year was done in the school in which he was found at the end of the year.
We therefore see that we have a record of deficient progress which is not explained by irregularity of attendance, nor by entering school late, and which is either associated with or caused by deficient conduct. When next we look at the grading of mentality, we find that he has been placed in the group of those having deficient mentality and that he is classed as a backward child.
The ratings of progress, conduct, attendance and mentality, which have been considered, are indicated by a check mark over the symbol of the reported grade of the respective quality. This is an easy symbol to make, and the saving of time is an important desideratum. If I dissented from the teacher’s judgment with respect to any item of the blank after having examined the child, I noted the fact by drawing a horizontal line through the symbol of the grade in which I placed him. Thus, if I had considered this boy a high grade imbecile, the blank, in addition to the check mark through Bkw, would have had a horizontal line through IH. The marks employed are immaterial, but it is important that they should be made as quickly as possible and should be easily distinguished in the subsequent collation of the data of the blanks.
We now see that we have to do with a backward child of normal age in the first school year, who has been regular in attendance throughout the year, but whose conduct is reported as very deficient. Is his backwardness the consequence of deficiency of conduct ? Is it the result of school conditions ? Has it followed upon the home environment? Or is it based upon structural defects, or inheritance ? Directly below the entry of the child’s mental grade is found a group of items relating to the child’s environment. His health is reported as fair, nutrition poor, support poor, home care poor, home culture very poor, and home discipline very poor. There can be very little doubt that the progress of a child in school, independent of any physiological backwardness, is the result of these various factors. Even physiological backwardness may be augmented, and probably caused, by the associated activity of a number of unfavorable environmental conditions. The extent to which these factors are associated with different degrees of mentality as revealed through school work, is one of the subjects of my investigation.
In employing this blank, the general health of the child is to be recorded as very good, good, fair, poor, or very poor. Th^ record is based upon such judgment as a teacher or parent would give. It is not a report such as a medical examiner would make. The object is to find to what extent the child’s health interfered with his attendance at school or with his performing daily tasks, even if he were in actual attendance. It does not propose to record the existence of actual disease. If the child is found to be suffering from some special disease, this is to be reported in the space provided at the bottom of the blank after the word diseases. Here also are to be recorded such children’s diseases as the child may have suffered from in the past. When facts worthy of special note are discovered in this connection, they are to be recorded on the back of the blank.
Poor health may not only cause prolonged or repeated absences, and so indirectly retard the child: it often interferes with vigorous mental action, and is a predisposing cause of fatigue. When fatigue, is readily produced, sustained attention, which is so essential for mental acquisition, becomes practically impossible. Many physical ailments are a continual source of irritation to the nervous system, not only because they produce a condition of malaise, but because they withdraw attention from the lesson to the source of excitation. The connection between good health and the attainment of the objects of school instruction is so close that school systems are awakening to the need -of physical directors and medical inspectors to look after the physical welfare of the children. Mental, and often moral, deterioration may result from prolonged ill-health. The nutrition of the child is also to be recorded on the basis of general observation, rather than a physician’s examination. The five classes, in one of which the child’s nutrition may be recorded, are indicated by the letters F, G, M, P, and St, which’ stand for the words fat, good, medium, poor, and starved, respectively. Faulty nutrition retards the child’s progress, whether it is due to disease or to improper and insufficient diet. If no positive knowledge of the diet can be obtained, the rating of nutrition may be based upon certain signs to be observed in the child. After the item habits, in the blank, I usually recorded such facts as I could obtain concerning the child’s diet. Thus, John Smith’s nutrition is recorded as poor, and after the word habits occurs the formula, “1. Coffee -f- bread & cake; 2. Beer, 3. Tea.” This means that the child’s usual breakfast is coffee, bread and cake; that he drinks beer at dinner and tea at supper. In this case it would appear that the poor nutrition was probably due to insufficient and improper diet. This condition is one which I have found in a very large number of the backward children whom I have examined.
The child’s color may be employed to assist in determining his nutritional status, for paleness is an effect of either an insufficient supply or an impoverished state of the blood, due to a lack of oxygen or the proper kind and amount of food materials; but lack of color must not be mistaken for a light complexion as shown by the color of the eyes and hair, nor must a dark complexion be interpreted as an absence of paleness. Paleness may be due to a blood disease called anseinia, and when this is the case, the skin will remain permanently pale without change of color. The color of the lips, and changes of color in the finger nails when subjected to pressure, may also be observed. If this change of color upon pressure is not very decided, it may be taken as a sign of poor nutrition. If the return of color upon removal of the pressure is slow in appearing, it indicates vaso-motor disturbance.
Other important signs of poor nutrition are emaciation, and deficient weight in comparison with height. Disproportion among the several members of the body may indicate defective nutrition at some period previous to the time of examination. Signs of defective nutrition during the early period of rapid development previous to the second year, may be observed in teeth, ears and in other developmental defects. These, however, are not to be taken into account in this connection, excepting in a general way. They will be entered under anormalities and asymmetries of the bodily members.
If the financial support of the child in the home is poor, it is likely that poor nutrition is the result of insufficient diet. Tf the support is ample, poor nutrition is more likely to be due to physiological conditions, and to be associated with ill-health. The support which the child receives at home is entered as rich, wellto-do>, medium, poor, or very poor. The financial condition of the family not only militates against the child’s health and nutrition, and so causes retardation: it becomes a direct cause of retardation owing to the fact that many children are kept from school to assist in eking out a livelihood for the family. Many children in Camden leave school about the middle of May to engage in some kind of occupation. This is especially true of the Italian children, who leave school about a month and a half before the close of the term to obtain employment as berry-pickers. Moreover, in my investigation there appeared to be some families so afflicted with ill-health and poverty that they would have to depend upon charity for their subsistence if they sent their children regularly to school. Poverty becomes a direct cause of retardation when it is so extreme as to prevent the family from supplying proper and sufficient food, clothing and housing. The nurture of thousands of children in our large cities is the direct cause of adult inefficiency.
Home care, home culture, and home discipline are usually directly correlated with the financial status of the family, though there are many exceptions to this rule. Home care is rated as very good, good, fair, poor, or very poor. The cleanliness of the child’s person and clothing is the best indication of home care. The vitiated air in which many of our teachers and children are immersed day after day, has its origin not only in the poisonous products of the breath, but also in the children’s clothing, which is often soaked with filth. It would surprise any investigator “to learn how many parents adopt the convenient custom of “sewing up” their children for the winter. As the cold weather increases, the number of garments increases, and as the weather moderates the garments diminish. During this entire period the clothing worn next the skin is unchanged, and may be neither washed nor aired for months. This filthy condition not only militates against the child’s well-being, but interferes with his progress in school, because these children are repulsive to most teachers.
Insufficient clothing makes it difficult for many children to maintain health and keep in daily attendance. I was informed by the principal of one of the Camden schools that there had been a marked improvement in attendance upon supplying the poorest children with the cast-off clothing of those in more fortunate circumstances. The overcrowding of a family into one or two rooms, the result of insufficient financial support, is also a frequent factor in reducing home care and home discipline to a minimum.
By home culture is meant the degree of mental development and refinement attained by the family. If the child has an intellectual, moral, and emotional environment of high grade, his school progress is favored by it. The conception of culture is not very definite, nor is it easy to estimate the different grades of home culture. I asked the teachers to base their judgments on the kind of literature read in the home, on the parents’ occupation, and the-content and modes of conversation. In the determination of the culture level, as well as of other facts about the home, the child himself very often serves as a satisfactory index. The relation of home culture to school progress is not to be settled off-hand without a careful inquiry. Children from the homes of very ignorant parents often stand high in their school work, but intellectual standing is not the whole of culture. Where the moral element is prominent, the members of a family live a life of duty and self-restraint and effort, whether at home or in school. This, of course, means application and discipline that develop habits of work and attention so necessary for school progress. Lack of moral training in the sense of absence of proper home discipline is a frequent cause of lack of industry, application, and concentration of attention. I consider the item of home discipline one of the most important determining factors of school progress. A well disciplined child will always be amenable to the directions of his teacher and the regulations of the school. On the other hand, a child may manifest good moral conduct, may give no trouble in school, and yet may lack the essentials of discipline. In explanation of the deficient progress of John Smith, I consider the rating bf home discipline, very poor, as significant. In his case, it also resulted in deficient conduct.
We now know something of this boy’s environment. lie is the offspring of parents who are living in poverty (his father is a pressor, a tailor’s assistant), unable to supply his body with sufficient food, though not requiring him to work as yet, unintelligent enough to furnish him with beer, tea and coffee, unwilling or unable to accord him satisfactory care of body and clothing, low in the scale of culture, and incapable of supplying the mental and moral discipline, the lack of which is probably evidenced in his retarded progress and deficient conduct. In the lower left-hand corner of the blank are a number of items of great interest in determining the general physical aptitude of the boy, as well as certain traits of character which stand in close correlation to the manifestation of intelligence. Does the boy show good motorial co-ordination? The check mark stands over the number 3, which gives his co-ordination a rating of medium. We learn little from this that throws light on the association of motor with intellectual deficiency, but from a large number of cases we may see whether boys deficient in intelligence more often manifest good co-ordination, poor co-ordination, or medium.
It is impossible to give in this place an extended discussion of the factor- of co-ordination. A few words in regard to it will have to suffice. Co-ordination may be defined as the ability to accomplish by means of muscular contractions and with the least possible expenditure of energy, a definite purpose or assigned task. It means more than the simultaneous or successive synergy of two or more muscles or groups of muscles. It requires a delicate adjustment of the muscular innervation necessary to move a member of the body at a given rate through a given distance. There is reason to believe that control of this muscular innervation is dependent upon the will, and that volitional activity is closely associated with mentality.
Several criteria may be employed to pass judgment upon the degree of co-ordination. One is the accuracy with which the task is accomplished. Thus, if a child be asked to move his arm a given distance in a given direction, his co-ordination may be regarded as good if his movement corresponds very exactly to the one required. Judgment of the degree of co-ordination may also be based upon the facility displayed in the accomplishment of an assigned task. In my investigation I employed the following method to rate co-ordination: I threw a number of pegs, about two inches long and one-eighth of an inch in diameter, upon the table and asked the child to pick them up as rapidly as possible, using for the purpose but one hand and holding the pegs in the same hand while he continued to pick them up.
Below the word co-ordination are five groups of symbols and words descriptive of mental and emotional character. Their appearance on the blank was to some extent in the nature of an after-thought. It was not my purpose to determine whether the child was shy or bold, amiable or sullen, stolid or nervous, reflective or impulsive, stubborn or vacillating in will; but it became apparent that shy children are often misjudged. They are apt to be under-rated in intelligence and bold children over-rated. Shy and timid children will not do so well in their recitations as the bold and forward. Some children approximating the condition of moral imbecility are extremely forward and bold, and give the appearance of great intelligence, and are therefore apt to be rated high. Teachers are apt to underestimate the capacities of a sullen or surly child, and give too favorable a rating to an amiable one. The child whose thought is characterized by reflection is oftentimes under-rated in comparison with the impulsive child. Moreover, many of these characters have a diagnostic value. Shyness is often associated with deafness, for the semi-deaf child often knows that something is required of him, the exact nature of which he is unable to comprehend. Sullenness is associated with adenoids, as is also stolidity. Nervousness and impulsiveness and vacillating will are symptomatic of impoverished nervous systems. It is also true that these characters exercise a facilitating or retarding effect upon school progress and general mental development. The shy child is not likely to get so much out of the school work as the bold child. The amiable child receives more attention from its teacher than the sullen or surly child. The child who is alert in mentality is more apt to profit by the school environment than one who is stolid or nervous. The child whose will is firm, will do better work than one whose vacillating will produces want of application, or one in whom wilfulness or stubbornness awakens antagonism and negativism.
The choice of words with which to describe mental and emotional character is not an easy one. The words that have been selected for this purpose were chosen after careful consideration. It is possible that different words may recommend themselves to others as being more suitable. The words selected were picked out primarily because they were thought to give an adequate description of a mental character, that is, for the purpose of providing an exact psychological designation, but also to furnish terms familiar to the everyday judgment of the teacher. The terms describe the following five traits of character:?
Social reaction:?boldness or shyness.
(2) Feeling and its expression:?amiability, responsiveness, sullenness or surliness. (3) General mental and physical activity:?stolidity, inertness, alertness, or nervousness. (4) Intellectual character:?reflectivity or impulsiveness. (5) Will or volitional character:?stubbornness, wilfulness, firmness, flexibility, or vacillation.
I give below various words tliat may be employed to describe each of the five groups used in connection with each of these five traits of character. The one which is employed upon the blank stands at the top in each case, printed in italics. Social reaction:
very bold bold normal shy very shy insolent courageous indifferent reserved afraid impudent forward unconcerned coy cowardly impertinent pert timid saucy bashful diffident Expression of feeling:
amiable responsive passive sullen surly sweet impressionable indifferent sulky rude genial sympathetic apathetic cross gruff gentle phlegmatic peevish morose General activity:
stolid inert alert nervous very nervous apathetic inactive active eager excitable impassive sluggish bright restless wooden Intellectual character:
very reflective reflective Normal impulsive very impulsive meditative thoughtful indifferent thoughtless rash cautious Will:
stubborn wilful firm flexible vacillating intractable determined normal submissive wavering obstinate headstrong yielding unstable obdurate refractory pliant unyielding It will be seen from the above that the child’s social reactions are distinguished as presenting opposite characters of boldness and shyness. Children who present neither character in marked degree are called normal. Perhaps it would have been better to describe them as indifferent. Children with an excess of either character are described as very bold, or as very shy. Feeling, or more accurately the expression of feeling in the child’s reaction to the teacher and other persons of his environment, is characterized as amiable, responsive, passive, sullen, or surly. for which the symbols Am, Pesp, Pass, Sull, and Sur are employed in the blank. The amiable child is characterized by a sweetness of disposition which is bound to make friends. Thus, amiability wins a teacher’s regard and leads to efficient effort on her part, but amiability in some cases leads to an excess of feeling which is detrimental to the best intellectual work. The child who is classed as amiable possesses a character which is therefore of. doubtful value for school progress. On the other hand, the child who is characterized as responsive is easy to work with, sympathetic, and is the most favorably situated child so far as feeling is concerned. The sullen child scowls and pouts, showing ill temper in facial expression but remaining silent. The surly child is more active in the expression of his ill humor, using voice and bodily action to demonstrate its presence. These children are difficult to treat in large classes. Their feelings, unless they are won over by a skilful and good-tempered teacher, are a serious bar to mental progress. The child who is indifferent in the expression of a state of feeling, and in his reaction to the (teacher, is characterized on the blank as passive. Passivity may give free play to intellectual effort, and the passive child may furnish a more favorable soil for the teacher’s efforts than the excessively amiable child, but feeling is a great stimulus to effort and it is probable that in most cases passivity is a relatively unfavorable soil.
A child’s activity, whether of mind or body, may be such that we may characterize him as alert. When present in excess it becomes nervousness. At the opposite extreme is stolidity. For an intermediate grade between the stolid and the alert child, the blank employs the term inert, or inactive? The five grades are therefore stolid, inert, alert, nervous, and very nervous, represented respectively by the symbols Sto, In, Al, jSTerv, and vNWith respect to intellectual activity, all children may be divided into three classes,?the sensory or reflective, the motor or impulsive, and those who are neither. The latter group the blank designates as normal, though probably the term indifferent or mixed is to be preferred. The impulsive type is distinguished by the rapidity with which it responds to a question or other mental stimulus. This type of child does not stop to think. As soon as an appeal is made to it, there is an immediate response, which is frequently ridiculous on account of immature thought. The reflective type is characterized by relatively slow but intelligent responses. The blank subdivides the reflective and impulsive groups into two sub-groups, in which each quality appears in either a moderate or excessive degree. The blank, therefore, disA CLINICAL EXAMINATION BLANK. 229 tinguislies children as very reflective, reflective, normal, impulsive, and very impulsive. The symbols for these words are vR, Refl, Norm, Imp, and vl.
For the classification of the will the blank distinguishes the stubborn, wilful, firm, flexible, and vacillating, using for the purpose the symbols Stu, Wilf, Firm, Flex, and Vac. These terms are self-explanatory. There may be some confusion, however, of stubbornness with sullenness and surliness. It is true that a defect of will is often associated with a defect of feeling, but I have examined many cases that did not show any ill humor, who yet simply refused to obey all commands.
One other character is of sufficiently general significance to be treated in connection with the items that form the subject of this second article. The most superficial examination of a child will bring from him some utterance. In voice and speech, the examiner or teacher may quickly infer the presence of physical or mental defects. On the physical side the utterance of a single word in answer to a question may awaken the suspicion of naso-pliaryngeal obstruction. The treatment of purely physical defects belongs to my next article. In this place, I wish to consider defects of articulation, which are also active factors in causing retardation. Children with defective speech receive low grades in reading, and their intelligence is usually underestimated by the teacher, who attributes much of the speech defect to a lack of knowledge. These defects hinder progress in still another way. Such children are frequently ridiculed by their schoolmates on account of their impediments of speech. In this way they learn to dislike school, lose interest in their work, and become absentees. But more important than this is the effect of defective modes of articulation and phrasing upon written lano-uage. Some children with an infantile stammer write school compositions which mirror with great fidelity their habits of oral speech.
Defects of articulation are frequently associated with defective hearing, for a child who is unable to hear words distinctly will be unable to reproduce them properly. Observation has also shown that defects of articulation cause defective hearing of language. Children that appear to be deaf to words, improve when their defects of articulation are cured.
The words stammer, and stutter, are loosely employed by English writers to designate nearly every defect of speech. A definite meaning should be attached to each. In this blank the word stammer is employed to cover any defect of articulation, as, for example, the inability to produce certain sounds, Gr the substitution of one sound for another like th for s in lisping. A stammer may indicate defective organs of articulation, like a cleft palate, displaced teeth, or a partial paralysis of the tongue. A stammer, however, may simply be the persistence of an infantile speech habit, “baby talk.” This retardation in speech may be due to an undeveloped mind, or may be the result of adenoids or other obstruction in the resonance cavity, which may or may not have been removed. If the stammer is an infantile stammer, a check mark is made over the symbol inf. The degree of the stammer is indicated by a check mark over one of the five numbers appearing to the right of the word stammer. A stutter is characterized by a series of spasmodic hesitations and the frequent repetition of some of the spoken elements. This defect may be acquired by imitation. It may be the result of nervousness, or it may be due to an inability to co-ordinato the movements of breathing with those which control the articulation. Stuttering does not seem to have the same causal relationship to intellectual retardation as does stammering. The blank provides, as with other items, five grades for an estimation of the degree of stuttering.
From the record card on page 218, a blank partially filled in, we ascertain the following facts about the boy John Smith, which cause him to stand out as a distinct personality. Tie is seven years of age, has been one year at school, where he attended regularly, but where his conduct and progress were both very deficient. He is classified as a backward case, subnormal in intelligence. His co-ordination is only medium. He is bold in his association with his teachers, passive or indifferent in feeling towards them. He shows signs of nervousness. Ho is neither reflective nor impulsive, and is vacillating in will. We-have also learned that while his health is fair, his nutrition is poor, and that he is trying to do his school work on a breakfast of coffee, bread and cake; that he also drinks beer and tea. This insufficient and improper diet, which probably is responsible in largo measure for his nervousness, his vacillating will, and his deficient conduct and progress in school, is itself the result of the poverty of his parents, which enables them to give him but poor support, in a home that is characterized as of very inferior culture, providing very deficient mental and moral discipline, and inadequate care of his person and clothing. [To be concluded.]
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