Diagnostic Teaching. A Case of Deficient Energy
- Author:
Ide, Ph.D.,
University of Pennsylvania.
The Psychological Laboratory at the University of Pennsylvania maintains a Speech Clinic and Class for instruction under the direction of Dr Edwin B. Twitmyer. Children who suffer from any sort of speech difficulty are brought to this clinic for diagnosis, and if the case is a normal, healthy individual who promises to be co-operative, arrangements are made for teaching half an hour one day per week. At that time instruction is given to the parents so they will be able to continue, in part at least, the drill in the home.
John was brought to this clinic by his kindergarten teacher. At that time he was said to be four years old getting along well with children of his own years. Except for his infantile speech his teacher had no complaint to make of him. His father had had trouble with his speech in childhood and had suffered four operations on his tongue but had recovered from his speech defect. John, also, had had some sort of operation on his tongue at two years but had not begun to speak correctly. He had had whooping cough, measles and two attacks of pneumonia during his short life and was reported to have had concussion of the brain in infancy, but no details of this were available.
The prognosis made at the Speech Clinic was so hopeful that John was regularly enrolled in the speech class. He came once or twice and then did not show up again. An inquiry at the home brought out the fact that several members of the family had been ill but at that time were fully recovered. The mother promised to return the boy to the class but failed to do so, and after a second inquiry by letter, which elicited no response, the case was dropped. Four years later John and his parents appeared again at the Psychological Clinic. This time they were seeking not the Speech Clinic but the clinic which deals with children having other sorts of defects than those of speech. They were in trouble and were looking for .help and moral support.
John had been in school during the entire four years first in the kindergarten and then in the first grade. In that time he had failed to be regularly passed from the 1A class to the IB class, but owing to his size the principal of the school had decided to pass him on anyway. He had proved totally unfitted to do the work of the IB class, whereupon the principal had consulted the parents by letter, and after permission had been received the child had been sent to the Orthogenic Class for Backward Children. Most of the members of this class were boys from two to six years older than John, and they immediately began to make life miserable for the boy. One night be had appeared at home without his cap which some older lad had snatched from him. John’s mother called at the school, observed the schoolmates of the boy, and immediately refused to permit him to remain in the class. She demanded his return to the regular grade which the principal refused.
John was a fairly nice looking blond child, tall for his age and very thin. He was pale and rather listless looking with vacant eyes fixed on the opposite wall. He was never observed to smile. He spoke very little. His mother was a large, strident woman, positive but none too exact in her statements; his sister was of the same type but as yet well under the control of and over-shadowed by her mother; while the father, a large, rather pompous individual, was the only one of the trio really concerned about the boy. Surrounded by his family John appeared rather insignificant, a smaller and paler copy of his mother in appearance but without her striking personality.
With performance tests John did very well, in fact as well or better than many children of his age. He did not plan well and was afraid to try out his ideas, but he made good time neverthelsse. He had a memory span of five digits, adequate for a child of his years. In school work there was almost no efficiency. He could write his name and one or two simple words but did not know how to make one of the letters when asked for it by name. His mother reported that he could draw well, but on trial his effort was not better than any six-year old would make. He could not read and knew only two letters when asked for them from a group. He was taught the first four letters but at the close of the period did not give more than two correctly.
Dr Lightner Witmer, Director of the Laboratory, who had charge of the examination, did not return a diagnosis on the examination as given. It was obvious that the child did not have first grade efficiency, and to test the matter and determine whether the difficulty lay with the boy or with the school arrangements were made to teach the child at the clinic four hours per week, the mother to supplement this teaching by drill at home.
Because the boy appeared so frail he was taken to the dispensaries at the University Hospital where two physicians gave as their opinion that he was suffering from mal-nutrition and some glandular difficulty. The mother was told to give him cold baths, plenty of good nourishing food, out-of-door play and a tonic. For a short time the cold baths were given, but the mother reported that the boy struggled a great deal in the tub and it made her too nervous to force him to take the bath. Nothing more was heard about the matter, and no further co-operation was secured in attending to the physical welfare of the child.
A competent teacher was given the task of bringing John up to par so that in the remainder of the year?some three months?and the summer school John might be prepared for second grade work in the fall. The mental examination had been good enough to warrant the assumption that the difficulty lay largely with the conditions under which the boy had been placed in school and not with some innate mental deficiency.
John liked his teacher and did well with her. The first period he learned fourteen letters. He had all the combinations in addition up to twelve already and had begun the multiplication tables. He was able to tell the story about the “Three Bears,” putting in many details, but speaking so softly and in such a monotonous tone as to remove from it all the dramatic element. His speech was very poor, the “th” and “t” being missing and final endings and many other sounds absent or slurred.
For more than two months John continued under the care of the same teacher. During that time he learned to read twenty-three pages of a Mother Goose primer, to spell thirty words from this same primer, to give all the number combinations up to twelve, and to count by 2’s, 3’s, 5’s and 10’s to 100. He wrote freely and legibly the words he could spell and was able to set down his small sums in arithmetic. In speech work, he seemed to have improved remarkably, the “t,” “th,” “ch” and “sh” being clearly given. He still spoke in a monotone and in a low voice. He seemed to be lacking in “pep,” never springing up and walking around as does the normal child, and in no way appearing interested or excited about anything. He did his work when it was placed before him, never asked questions and was apparently willing to sit down and accept what the world happened to give him.
At this time his teacher left, and another one had to be provided. On examination before the new teacher came in it was noted that the boy was an adept at watching for cues, and that he did not go ahead on his small tasks without having to be encouraged at every turn and that he followed directions only when given one at a time. A strenuous effort on his part would produce for a moment responses to two directions, but under the pressure of school work he could not maintain attention or retain orders long enough to carry them out. In fact this was so prominent a symptom that alone it would have been sufficient to have rendered him unfit to compete in a class of normal children. Any task which required longer than a few seconds for its completion was not completed alone, even though the process was perfectly familiar. In other words, the boy had not come to rely upon himself at all, but his teacher had furnished for him all the support he had needed.
A month’s vacation during June gave John an opportunity to get well rested up for the summer’s work, when he was given one hour per day formal instruction with some outside drill from his mother, as had been done before. lie appeared a little bit better physically than he had been at the end of May. He had grown taller, but he still looked pale and coughed croupily. His mother said he was not sleeping well, often waking with a loud scream and complaining of terrible dreams. During the day he was very nervous.
John was able to read sixteen pages of his primer when he came back. He missed a word or two on the last few pages, but he got along very well. He had forgotten some of the letters when he attempted to write them, and his good pronunciation had entirely disappeared. His speech was as slovenly as it had been when he first began work. He responded correctly to one command, but his movements were so slow that several seconds elapsed before there was any apparent attempt to respond. He had forgotten how to count by 3’s, 5’s and 10’s although he could still do so by 2’s, and he had to begin over again with his multiplication tables. He had lost all of the words he had learned to spell.
By the end of the summer he had read forty-six pages in the primer. He had completed the 2’s in the multiplication table and some of the 3’s. He had learned to write the numbers up to 1000, and he could add and subtract simple numbers involving carrying by 10’s. He had about thirty words upon which he was certain in spelling, and he wrote legibly.
There had been regular drill on speech work during the summer, but at the close of the session John was still unable to use his initial consonants properly. He would do so under compulsion only, and then only when he had been reminded just before he started to speak. If he made a mistake, he would not try to correct it himself but would wait for directions from his teacher. So far the gain was so slight as to be negligible.
What sort of a diagnosis can be made in the case of this boy? He looks normal enough except for an inert expression. His parents are normal. His sister is entering high school at fifteen. She is a strong and husky looking girl, well conformed and bright enough for her age. John does not seem well. He is thin, and he lacks that something we call energy. He never seems to have strength to give to his tasks. His mother reports that he has plenty of energy at home, but the sort of energy she is talking about is not the kind which lies behind initiative. John has a temper and occasionally has stubborn fits. He often kicks and yells when he is required to do something he does not like to do because this sort of objection has been found successful in avoiding those things he has found undesirable. His behavior at these times is not a display of energy in the sense of being supplied with that mysterious asset which makes for initiative. John makes no effort to do school work for himself. He has no interest in it, but neither does he show interest in anything else. His attitude toward the world is a negative one. His teachers are attempting to stoke a furnace in which there is no fire. He accepts, but he as readily rejects. The material he is taught does not stick. There seems to be nothing in the boy to appeal to, nothing to reach. He is not in revolt, at least as far as his teaching in the clinic was concerned. His mother reported that he refused to work for her during the summer, but he showed no tendency of that kind to his teacher.
The determination of this boy’s status is a difficult one. On the Binet scale he is easily normal, as his mental age very closely approximates his real age. lie has acquired some school work, and there is every indication that further pushing would result in his acquiring more school work. His relations with other children are reported normal, and he must have some competency with his fellows as he does fairly well at catching and throwing a ball. Many of his activities are curtailed by over-anxious parents. He has not been permitted to learn to swim because of their fear of his drowning, and it seems possible that the dominant personalities of the people at nome may over-shadow the one weakling and limit to some extent his natural abilities. It is impossible, however, to account for all of his defects on this score. Probably it is unwise at this time to call the boy-feeble-minded, but the prognosis on the basis of what he has shown intellectually is certainly not that of a normal child. The boy cannot be expected to make normal progress in school. He has not done so so far. The attempt to place him in the second grade this fall has failed, as he did not complete during the spring and summer enough work to make it possible to certifv him for a grade higher than IB, and it seems doubtful whether his proficiency after a month’s vacation will be even IB. There is another reason why John should be graded lower than IB in his proficiency. A child who is proficient in IB work is proficient to do that work in a group. Now John is barely proficient by himself under the constant eye of his teacher. Will he be able to do his tasks when they are assigned and he is left to do his work alone? He has never shown that he is able to do work alone at all. His wavering attention and general lack of interest will prevent him from doing anything by himself, even if he has the energy to try. He has never learned to work alone. He does not do so at home. His mother assists him in the mornings to dress, and takes care of him as if he were several years younger. He is not permitted to do things alone.
John’s speech defect is also a decided handicap in his school work. Until the teacher becomes accustomed to hearing him speak, it is difficult to understand all that he says, and his low tone in speaking is not satisfactory for the school room. He can do better, but it takes all of one teacher’s time to make him do better. He will not be able to get that teacher’s time in the school room. A speech defect is also an added disadvantage in that it is difficult for a child who is not very bright to learn to read properly, for the teacher, hurried as she is, has to take too much for granted. Words are mispronounced and misunderstood because she does not understand what is said but hopes they are right. Mostly they are wrong, and the child never does get his work straightened out.
There is no use suggesting that John should take his place in a public school. He ought not to be placed among children much older than he is as he would be in a special class. He cannot compete with his own age and class. The only thing that can be done is to place him in a school where children are handicapped as he is, or to provide a tutor for him. The former scheme has its advantages, as it will bring out the best initial efforts the boy has, and will not emphasize the differences between himself and his mates. It will also remove him from a home environment which cannot but be a handicap to a child as poorly equipped physically as this boy is, and who is not able mentally to do more than object to the edict of creatures so much stronger than is he. He is either over-indulged or over-dominated. The tutor will teach him, but will not give him the best opportunity to develop himself.
Such children as John have no place in the public school. The chance of their further successful development is not great. They lack the physical stamina which is necessary for those who have to fight to maintain themselves in this world. If they survive the pitfalls of disease, they possess so little initiative that they must rely upon somebody else to stand between them and the stresses of life. Whether this boy is placed in an institution for the feebleminded or not, or whether he is adjudged feeble-minded or not, makes very little difference in the prognosis of the case, for the present indications are that as he has been a failure in his child’s world in the past, just so may he be expected to prove a failure in the adult world of the future. He can perform, but he cannot produce. He can take, but he cannot give.
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