The Superficial Idiot? A Type
- Author:
Eleanor Larrabee Lattimore, Ph.D.
In Charge Social Service Department, Psychological Clinic, University of Pennsylvania.
In a psychological examination a diagnosis may be arrived at in several different ways. Sometimes a tedious array of tests and several examinations, together with data culled from the home and the school, are necessary to determine the mental status of a child. At other times a single characteristic may serve as a key to the entire mental situation. The two cases cited here illustrate the recognition of a definite type through the presentation of a single symptom. Alexander was just three years old when he was brought to the Psychological Clinic of the University of Pennsylvania because of his peculiar behavior and inability to speak. While the mother was giving the usual data in regard to his birth, babyhood, etc., Alexander passed through an adjoining room. The examiner had not seen him but heard him utter a peculiar cry which at once recalled to her memory Lucius, another three year old who had been examined a year and a half before. She jotted down Lucius’s name with the words “superficial idiot” and continued the interview. Later on a comparison of the two cases brought out the following facts in regard to Alexander and Lucius:
Alexander Was unable to talk; did not understand commands. Hearing appeared to be defective. Gait unsteady and staggering; refused to walk if he could be carried. Whimpered constantly, excepting when being carried. Would sometimes wake up crying in the night. Lucius Tried to say a few words and understood simple commands. Hearing appeared to be normal in the right ear but defective in the left. Gait unsteady and staggering; liked to be carried. Whined and moaned a great deal, crying lustily at times and fretting if forced to be quiet. Loved to rock, and to have his mother sing to him; was soothed by singing, and at times attempted to join in by humming a few notes. Cried a good deal at night. When put to bed in his crib he would change during the night from his crib to a bed, or he would place the pillows from the bed on the floor, and sleep on them there. Alexander Frequently put his hand to hia right ear or to the back of his head and cried as though in pain; banged his head against the wall or floor. If laid on his back he immediately rolled over toward the left side. Internal strabismus of right eye. Enuresis night and day; unable to make his wants known or care for himself at the toilet; could not dress himself. Explored objects with his lips in simian fashion and put everything into his mouth, no matter how filthy it might be; seemed to be unable to retain objects in his mouth and let them drop out; did not drool to any great extent; chewed the corner of his coat. Was pale and badly nourished; his head hung to one side as though it were very heavy. Could not feed himself, ate only bread and milk or bread and tea; would drink a small cupful of sugared milk. Bowels were irregular. Did not play; could not grasp toys. Birth and babyhood were normal. As a baby he was always troublesome, was slow in holding up his head; cut his first tooth at eight months and walked at nineteen months, though unsteadily. He had no convulsions, accidents or falls; had whooping cough and measles. The family history was reported as negative, excepting that the mother’s cousin was said to be a deaf mute and a cousin of the father .did not talk until his sixth year. Lucius Frequently bit the back of his hand, as though in pain, hit his ear or banged his head with sufficient force to produce a bruise and consequent hemorrhage. Eyes co-ordinated well; followed a lighted match readily. Enuresis night and day; unable to make his wants known or care for himself at toilet; could not dress himself.
Put almost all objects in his mouth; usually had a bit of twig or a broken match stick in his mouth and never swallowed it; did not drool. A husky looking little fellow, holding his head well up and sitting erect. Could feed himself but could not use a knife, fork or spoon. Was notional about his food, smelling it before tasting; had no regular meals; ate bread if sugared, or graham or vanilla wafers; would drink sugared milk, but only from a white enamelled cup.
Bowels were irregular. Did not play but knew enough to ring the door bell when he wished to enter the house. Delighted in banging doors; liked to pull the dishes off the dinner table, and to smash glass. Birth and babyhood were normal. His mother fell on the porch at the seventh month of pregnancy, but no bad results were noticed. He walked at thirteen months; tried to say “mom’ and “pop.” He had convulsions from the eighth month to second year; had whooping cough at nine months. The family history was negative. The diagnosis of superficial idiocy in the case of each of these boys was reached through their utter failure to respond to tests which are eagerly attacked by normal children. The simplest tests were too difficult. The Witmer formboard, which can be done easily by a normal child of four, aroused no interest in either of these children. Alexander seized the blocks and put them in his mouth. When confronted with the Seguin circles, consisting of three discs of equal size to be placed in similar recesses in a board, Alexander made some effort to place them in their recesses. Lucius’s attention was very fleeting. He heeded no commands excepting to pick up a bean bag and place it on a chair. This he did twice but was persistent in his refusal to do it a third time. He would not even imitate the examiner’s action in placing blocks in a pile and knocking them down.
Both children were difficult to handle and almost impossible in an ordinary home. In both cases the mothers were worn out with care so the children were placed in a temporary home to relieve the situation. Lucius improved to some extent in his habits of eating, although a more stubborn child could not well be imagined. He could not safely be left alone unless securely tied in his bed or chair. After six months Lucius returned to his home where he is the most difficult member of a family group of six children all under eleven years and one of them a cripple.
The mother is anxious to place him in an institution as soon as possible but he is still under age and so obstreperous that it will be difficult to place him in any state institution.
Alexander was cared for for four months in the temporary home under the same conditions in which Lucius improved, but no progress could be made toward his improvement. He gradually lost weight and became less active until death resulted from marasmus and meningitis.
Lucius is still under the observation of the Clinic but no change in his general condition is anticipated, excepting that he will become more difficult to control and more anti-social.
Disclaimer
The historical material in this project falls into one of three categories for clearances and permissions:
Material currently under copyright, made available with a Creative Commons license chosen by the publisher.
Material that is in the public domain
Material identified by the Welcome Trust as an Orphan Work, made available with a Creative Commons Attribution-NonCommercial 4.0 International License.
While we are in the process of adding metadata to the articles, please check the article at its original source for specific copyrights.