Clinic Reports XXIV
Leah, five years old, is an interesting combination of Cretin and Mongolian. She was brought to the Clinic because she is still unable to talk. The child’s history reveals general physical retardation. She cut her first tooth at thirty months, and walked at thirty-six months. At two, “Something was wrong with her spine,” her mother said, and “she got tired sitting.”
Leah is now only slightly below normal size. When she came into the Clinic, her health, motor control, and coordination seemed good. She has the flat nose, round head, red cheeks, slanting eyes and fissured tongue of the Mongolian. Her hands are well-shaped, and her skin is soft and moist, although her muscles are rather flabby. Cretin characteristics are her ready smile and protruding tongue.
The mixed type, also, is evident in her behavior. Her sister says “She gets tired playing, but when she is tired, she keeps on going with something else. She likes to keep busy.” During the examination, however, her behavior was more that of the Cretin. She showed great fatiguability?often stopping, resting her cheek on her hand, and looking around the room with a vacant smile. She ran to her sister several times, but always returned obediently to the examiner.
The formboard test indicated insufficient attention, both distributive and analytic. At the end of five minutes one block was correctly placed, apparently by accident, while the others were laid over the wrong recesses. Apparently she made no attempt to compare the shapes of the blocks and recesses. The second trial, after instruction, was also a failure. Most of the blocks were placed over the wrong recesses, when Leah began to remove them.
Dr Witmer then gave her the three-block board. Her distributive attention was just adequate for satisfactory performance. Her persistent attention was better. She worked very slowly, showing no improvement in method after several trials.
Leah seemed to enjoy the colored cubes. She understood the order “Give me a block,” but could not recognize color names, and because of her low degree of sensitivity, she could not match colors.
The intelligence level of this child is well below four years. Her failure to learn the formboard, and the lack of imageability shown by her failure to match shapes, indicate that, in spite of her docility, her attention is so poor that she is non-educable.
Nothing in the family history points toward a hereditary cause. Leah is the youngest of ten children, all the others reported normal. The parents are foreign-born. The child’s history of retardation shows that her defect is congenital.
The diagnosis is low grade imbecile, of mixed Mongoloid-Cretin type. This child will probably never be able to talk in sentences, or to care for herself. The treatment recommended is institutional care. Although Leah is so lowgrade, her rather attractive appearance and manner may secure her admission to a training school. Frances Q. Holsopple, A.B., Scholar in Psychology. (262)
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