A Demonstration Clinic
The Psychological Clinic Copyright, 1919, by Lightner Witmer, Editor. Vol. XIII, Nos. 1-3 December 15, 1919 :Author: the Staff of the Psychological Clinic,
University of Pennsylvania.
In April of each year the educators of Pennsylvania meet at the University to listen to lectures and addresses on subjects connected with education and to hold conferences and discussions on methods and plans for carrying on the work. This annual function is called “Schoolmen’s Week.” As part of the program this year a demonstration was given on Saturday morning, April 12th, at the Psychological Laboratory and Clinic. Similar demonstrations are given regularly on Saturday mornings and other days through the academic year as part of the required work in regular courses in psychology. The Psychological Clinic is open daily for examination when parents and teachers bring their children to obtain advice which they hope will assist them in solving difficult problems. The object of the demonstration here reported was to show the schoolmen of Pennsylvania what some of the methods of the Psychological Clinic are. The emphasis was laid on the use of psychological diagnosis in the practice of teaching. Professor E. B. Twitmyer, who is an expert on speech training and who has directed for many years the speech clinic, showed the principles and methods employed by him in curing two cases of speech defect. Dr Witmer showed four children who were not getting on well in school and who had been helped by means of clinical teaching carried on by volunteer student assistants attending the School of Education at the University of Pennsylvania. He also showed two cases, previously examined at the Psychological Clinic, who had failed to get on in school because of defects which had not been discovered in time to provide the kind of instruction fitted to their needs.
Record. Name J Age Nine years four months. Referred by Principal of school. Because of Mother’s refusal to permit him to remain in special class. School attended Public School, until March 1919. Is not now attending any school. Age entered Six years. School history Kindergarten, 1915. 2-1-17?1A. Not promoted in June. 9-3-17. Dropped and went to where he stayed five months, still in 1A. 12-17?1A. 2-1-18?1A. 9-18?1A. 1-19?IB. Principal states that this was an automatic promotion. 2-19. Orthogenic Backward Class. 3-19. Mother removed him from O. B. class and refused to let him return. Diagnosis Deferred for further study. Recommendation Clinic teaching to determine diagnosis. Terman Revision Basal age, 7 years. Mental age, 8 years 8 months. I. Q., .928. Physical condition Poor. Decidedly lacking in energy. Trouble with cervical glands. Frequent colds. Status at time of examination Reading?Could read nothing. Knew only A, B, C, and O. Arithmetic?Approximately second-grade proficiency. Number of hours instruction Five hours thirty-five minutes, distributed over thirteen periods. Present status Can read six pages of Book One of “The Young and Field Literary Readers.” Can spell and write all the words in those pages.
A DEMONSTRATION CLINIC. Report. J is nine years old, and, already so far as school work is concerned, he has proved a failure. He spent four terms in 1A, then a kindly principal promoted him to IB. She did not know his actual ability and was greatly surprised to learn a month later that he could not read a word. Furthermore, he was still talking an almost unintelligible baby-talk, and usually spoke in a low mumble. His speech defect made his retardation appear even greater than did his lack of school proficiency. The principal took the proper course with a case of the kind and transferred him to a special class. About three weeks later, J , who is an anaemic, nervous, frail-looking boy, decidedly deficient in energy, went home to mamma without any hat and also minus some other minor possessions. J ‘s mother rushed off to school to find the lost articles, and discovered in consequence that her boy was in a class with a group of boys, some of whom were twice his size, most of whom were of a lower grade than J , and some of whom were obviously feeble-minded. She felt that these were unfit associates for her child and so, when the principal refused to return him to the regular class, she removed him from school. The principal recommended a psychological examination, and J was brought to the Clinic. An examination with mechanical tests seemed rather inconclusive, and Doctor Witmer recommended further study and an attempt to teach. At the time of his examination J ‘s only literary equipment was a knowledge of the letters A, B, C and 0. Of course he could not read. The next week he began to come to the Clinic for teaching. Now, at the end of five and a half hours, devoted to the teaching of reading by the diagnostic method, J is reading. He has covered six pages of “The Young and Field Literary Readers,” Book One, and he knows every word included in those pages so as to be able to recognize it in an entirely different context. In arithmetic both his ability and his acquirement seem to be normal for the second grade. His speech is clearing up under instruction. A Terman test given a week ago gave him an intelligence quotient of .928, which means an intelligence normal for his age. Even his physical condition has improved as an accompaniment or result of the mental spurt. There is nothing to indicate that this could not have happened long since.
Record. Name R . Age Seven years seven months. Referred by Mother’s Assistance Fund. Because of Speech defect. School attended Public School. Age entered Six years. School history Entered 9-10-17?1A. 2-1-18?1A 9-18?IB. 2-1-19?2A. General standing 7. Diagnosis Infantile stammer, simple and curable. Recommendation Attendance at speech class. Mental status Normal for age in performance tests. Memory span 4 digits, 4 repetitions for 5 digits. Physical condition…. Good. Nose and throat negative. Teacher suggests possible deafness. Member of teaching clinic Taught three hours. Educational status…. Used anagrams, picking out letters in this fashion? FRNk called Father. Called H, E and E, F. Knows no phonics. Could spell cat and rat. Teaching Has been taught f, s, e, h, b, m, c, k. Discriminated between dog, cat and ran as words. Learned to sound cat, rat, sat, etc. Dr Witmer states That is not deaf, but has poor discrimination for sounds due to faulty articulation. Thi3 leads to something resembling word deafness. Speech Work Can give all sounds by imitation. Drilled on mouth positions, ordinary words used in casual conversation and lists of words containing r and t. Has learned “Barber, Barber” and is given drill on difficult words found in that classic.
Report. R is seven and one-half years old, but he has not yet learned to talk so that anyone can understand him. He entered school when he was six and was promoted to the second grade in January. Although he is reported poor in reading, he is expected to reach a higher class in June.
R does well in manual tests. His memory is trainable, although he has a limited memory span. There is nothing to indicate that he has not an adequate mental equipment to do the work of the second grade, but he does have a very definite speech defect, so great that it is a most decided handicap in learning to read. The defect is an infantile stammer, that is, a prolongation of so-called “baby talk.”
R was placed in the speech class conducted by Dr Twitmyer. The teacher to whom he was assigned tried to use his reading to aid in speech instruction, and discovered that, with the exception of the words of his name, R did not know a single word. He was then given special instruction in regular first-grade work in addition to the speech training. In the few weeks he has been coming to the Clinic, he has learned to say a great many words correctly, has become more willing to try to talk and has made a start toward acquiring reading by learning half a dozen or more words and the sound names of the letters forming them. There is a chance for R , but only if given special instruction along the line that he needs, for he can never profit by school work as long as his speech defect remains so great.
Record. Name S . Age Thirteen years seven months. Referred by Children’s Dispensary, University Hospital. Because of Backwardness in school. School attended Public School. Age entered Not known. School history begins 11-8-15. School history 11- 8-15 Grade 2A 11-10-15 IB 1-31-16 IB 2-15-16 3- 7-17 1A 9-10-17 IB 2- 1-18 2A 2-28-18 Left school 3-11-18 2 A Teacher reports that she hopes S ‘s reading will improve enough so that he may be promoted at the end of the term.
Diagnosis Five years’ general retardation. Recommended Orthogenic teaching.
Physical condition Retarded about fi ve years. Nose and throat in need of care. Head girth 54 cm.
Educational status …. Could not read. Knew words like “is,” “be,” “the” and the like. Had no idea of phonics. If he had any idea of what was on a page he would try to read, making it up as he went along. The arithmetic was good second-grade work. Spelling was very bad. any combination of letters representing a word. Teaching Teaching continued for five periods of more than one hour each. Has been given much drill in phonetics, and required to be very careful in any reading attempted. Can now read simple stories in the second reader. . No instruction given in arithmetic, as that subject was so far in advance of his reading and spelling. Is required to do his spelling word from every angle of imagery, in which he seems deficient, so that he does not retain correct spellings. Prognosis Can be taught to read correctly and well. Number work probably not past abstractions. Spelling doubtful at present time. Note S likes to come to the Clinic very much. Does not like to go to school.
Report.
A thirteen-year-old boy bent over a table trying to read a selection in the first reader. His brows were drawn together and his mouth puckered as he struggled with the complexities of s-l-o-w and h-a-v-e. The next time he found these words, he spelled them out again and so it happened a third time?first-grade reading was no joke to S . At arithmetic S did much better for he had acquired most of the combinations during his school career, but spelling?S couldn’t spell. He saw no reason for supposing that one letter was preferable to another in any given instance. S was not good in school. S is graded in 2A. He has repeated at different times all of the classes below that grade and one or two above in an effort to get a running start. His school life has been strenuous but not valuable to him, and S is now “going on” fourteen. It is time he was doing better. S thinks so himself and is eager to quit school and go to work. He has lost all interest in things academic. The Psychological Clinic was asked to try S out. No reason was found for his inability to read. He plans work well. He does tests well, and the mental equipment which he uses in his social life seems to be fully adequate for his environment. In attempting to teach S it was found that he lacked the very foundations of reading. Drill in the use of phonics, insistence upon accuracy in reading and definite care in the study of his words for spelling and language have improved S ‘s work so much that there seems no doubt that he could have been taught to read and spell properly years ago. Now that he is almost ready to leave school, about the best that can be expected is that he may learn to read well enough to read the daily paper. The years of instruction S has received have not given him as yet the most necessary tools to be used either in the acquirement of knowledge or as means to the end that he may be self-supporting.
Record. Name A Age Fifteen years six months. Referred by Children’s Dispensary, University Hospital. Because of Backwardness in school. School attended Public School. Age entered Not known. School history dates from 11-8-15. School history 11- 8-15 Grade 4A 11-10-15 3B 1-31-16 3B 2- 1-16 3-29-17 2B 9-10-17 3A 2- 1-18 3B 1 3- 1-18 Left?suspended for truancy. 11- 4-18 3B 2- 1-19 4A. Successful in work of 4A. Diagnosis Retardation; on the anatomical scale, four years; pedagogical scale, five years; mental age score, six years. Apparently quantitatively feebleminded. Considering family history and mechanical tests, will probably be above the line of social competency. Recommendation That he be taken from school and put to work. Terman Revision Basal age, 7 years. Mental age, 9 years 2 months. I. Q., .659. Physical condition Retarded four years. Referred to the Nose and Throat Dispensary. Often at Children’s Dispensary for colds and minor ailments. Desires To go to work. Interested in automobile repair shop.
Report.
A “bags” school. He is fifteen years old and ready to go to work, but the law requires him to stay in school and study the reading and arithmetic that goes with the fourth grade. When A was ten he was in the fourth grade too. He has been in other grades since then but never one higher than the fourth. Now at fifteen he is running neck and neck with the attendance officer, in bad with the school because he will not attend and get his lessons, in bad at home because he will not go to school and cannot go to work and thus ease the ever-increasing pressure on the family income; and, lastly, in bad with the community because he has no lawful employment and is thus open to mischief with every bad boy of the neighborhood.
A social worker interested in the family brought A to the Psychological Clinic because he is doing so poorly in school. He did not prove to be feebleminded. He uses his hands very well. He can solve a new problem readily, planning the solution with skill. He has good ability at following directions and gives evidence of clear thinking in every test he attacks. On one point alone he is poor. His ability to use words is limited, his responses to questions involving their use indicate his lack of acquaintance with his own tongue. He can read, but he cannot tell about what he has read. He fails to give definitions and bits of information usually picked up in school. He has not acquired either arithmetic or reading in a way to make them adequate tools of use to him in later life. A is too big a boy to associate with the ten-year-old children who are in the fourth grade; he is too old a boy to enjoy attempting the same lessons he did five years ago. The fact that he rebels against the regimen suggests a not undesirable self-respect. The Clinic cannot help. There is no way to release A from his school obligation, so he is completing his education in the accumulation of such material as the street affords and in the acquirement of habits of idleness which will handicap him all his life.
Record. Name E Age Fifteen years. Referred Philadelphia Committee for the Protection of Girls and Women. Because of Bad conduct in school and truancy. School attended Public School. Age entered Not known. School history Not complete. Had reached fifth grade. Diagnosis Normal mentality. Retarded and backward. Recommendation That she be taught a trade. Recreational opportunities. Terman Revision Basal age, 8 years. Mental age, 10 years 6 months. I. Q., .674. Educational status…. Reading, fourth grade. Can reproduce (10-year level). Arithmetic, third grade. Physical condition Good. Desires To be transferred to another school, but refuses to stay in school and improve her conduct so that she can be transferred. No occupational preferences.
Report. E , fifteen years old, has entered the dream world where plumed knights rescue lovely ladies before breakfast and marry and live happily ever after, in one volume. Each romance, at ten cents each, has placed E farther and farther away from the realm of reality, until now the pages of arithmetic and reading in the fifth grade automatically become lovely stages upon which dream people in flowing garments hold impossible conversations and perform marvelous deeds. Lessons were sadly out of place with E , and to avoid their continued torture the stage was often set and peopled in places outside the schoolroom. Since truancy is not to be desired, and teachers found it impossible to deal with the problem of E , the knot was cut by issuing to the child a domestic certificate, which permits her to sit in her slovenly home and dream away the hours undisturbed.
E is not feebleminded, although very backward. Her performance tests show good ability with the hands and a fair amount of planfulness. Her memory span is short and is not compensated by easy trainability. With the manual dexterity which she shows, E ought easily to be able to learn some of the simpler operations involved in mill work. She may be able to keep herself above the line of social competency if no great stress is placed upon her judgment and ability to plan ahead. The romantic aspect which brought her into conflict with the schools is probably an adolescent phenomenon, which is not serious in itself, but if not rightly directed may result in serious non-conformity to the standards demanded by her own social group.
Record. Name S . Age Ten years seven months. Referred by School nurse of last year. Because of Speech defect. School attended Public School. Age entered Six years. School history One term 1A. One term IB. Two terms 2A. One term 2B. One term 3A. One term 3B. Promoted on encouragement to 4A, but will not be promoted this term to 4B. She is not doing onefifth of the work now. Her written papers average less than twenty. Diagnosis Infantile stammer somewhat complicated by throat condition. Recommendation Nose and throat examination; attendance in speech class. Mental status Infantile; one and one-half years retarded. Physical condition.. .. Much improved since tonsilectomy. Sore throat avoided and child has improved in flesh. Speech status Can give any sound desired by imitation. When required, talks very nicely. Apparently no active co-operation in the home, so that training is progressing very slowly. Child can recite “Owl and Pussycat” and “My Shadow.”
Report. The youngest of a family of four, S has been petted all her life. She is now ten years old, a “big girl,” but she still retains many of her baby habits including that of ” baby talk.” In this she has been encouraged by her family and the young women of her acquaintance because it sounded so “cute.” With the speech defect, S has also continued to lean strongly upon the parental oak, and in its absence upon the teacher or anyone else handy, for S has never learned to stand alone in the simplest matter.
S came to the Speech Clinic because a school nurse had recommended it to the parents. She early showed ability to say anything that she desired in good English, while at the Clinic, but apparently it has been hard for the family to remember that S is almost eleven, and they still permit her to talk in the old way at home. S goes to school but is not to be promoted to the 4B class in June, for her work is worth not more than twenty on a scale of one hundred. Part of this trouble has been S ‘s amiability which has made it possible for S to get promoted more on the basis of her tears than on her ability to read and do her sums. S must be taught to speak correctly. She will never read accurately until she speaks well enough for the teacher to understand her. She must also learn to do things for herself, both at home and at school. Unless these two points are won, S will never make a normal, healthy woman.
Record. Name P Age Twelve years ten months. Referred by Juvenile Aid Society. Because of Fact that younger sister of seven can neither walk or talk. School attended Public School. Age entered Seven years. Two years missed because of illness. School history Entered in 1911 Three terms 1A One term IB One term 2A 6-22-14 entered 2B One term 2B Promoted to 3A and then transferred to Orthogenic Backward Class. Diagnosis Normal mentality. Specific defects in vision and audition. Recommendation Medical attention, especially eye and ear examinations. Also dental treatment and subsequent to these treatments restoration to a regular grade. Terman Revision Ten years four months. I. Q., .81. Physical condition Teacher reports boy nearly blind. Does not think him deaf. Examiner found him lacking in audition in one ear and dull of hearing in the other. The sight in one eye is entirely gone and very much reduced in the other. Body filthy and has “habits of an animal,” so teacher reports. Educational status …. Teacher reports that he learns absolutely nothing. He is so often truant that she feels unable to give him a rating. No co-operation at home.
Report. Because P ‘s sister never walked or talked, the family was referred to a well-known social agency in the city. A social worker inquired at the school P was supposed to attend, asking for his school record. His teacher reported him the most disgusting child in school, of filthy habits, given to answering questions with “queer expressions.” The social worker then brought P to the Psychological Clinic to find out what was the matter with him. The examiner was confronted by a 12-year-old boy, tall, pastycomplexioned, not at all prepossessing in appearance, who slid sullenly into a chair and waited with mouth open for what was to happen. He co-operated well with the tests, however, and showed at once his ability with mechanical material. His only defect was a marked lack of distribution of attention. His memory was good, he had an adequate memory span and good trainability. His general information, as indicated by the Binet tests, was not that of a boy of his years, for his school work had not kept pace with his advancing age, and the abstractions required in the twelve-year tests were beyond him. The total result showed a retardation on the Binet scale of two years.
While P was being examined, he constantly questioned the examiner with “Sir,” “H’m?” and “What?” The examiner inquired whether he heard well, and was met with an indignant denial of deafness. However, P finally acknowledged that the drum of one ear was missing and that he could not hear at all on that side. Further testing showed that he had reduced hearing on the other side. There was such a marked lack of distribution of attention in some of his work that a rough test was made of his vision with the result that one eye was shown to be completely blind and the other greatly reduced in acuity.
This normal boy had been shifted from regular class to special class and back again, partly because he had never been taught ordinary habits of cleanliness in the home, and partly because of nonsense replies given in the classroom. His present teacher knows that he is nearly blind but has not discovered the deafness. With no help from the parents, the school has not been able to keep P in regular attendance, and, while he has been in school, he has been unable to profit by the instruction offered him because of sensory defects so great as to require special methods of instruction.
Record. Name R Age Nine years two months. Referred by Social Service Department, Howard Hospital (1916). School nurse. Because of Backwardness in school. School attended Public School. Age entered Five years. School history Not complete. Two terms in 1A in regular grade. Now in special class doing first-grade work in reading and second-grade work in arithmetic. Diagnosis (1916) Deferred. Recommendation Transference to a special class. Medical care. Reexamination. Diagnosis Normal mentality. Terman Revision Basal age, 5. Mental age, seven years four months. I. Q., .72.
Report. R?-? lives in one of the tiny houses in a back street of one of the poorest districts in Philadelphia. With a brother and a sister, normal, alert Italian children, R at nine years of age sees the life of the street flow past her without taking part in it. R ‘s father is ambitious for her and the others and insists upon cleanliness and good behavior rather more strictly than do his neighbors. The mother is not “quite right in the head,” which fact isolates the family from others in the community for the neighbors are afraid of her.
R has not done well in school. Two years ago she was brought to the Psychological Clinic because of her lack of ability to do school work and also because her personal habits were not equal to those of the rest of her class. Since she was primarily a case for medical care, R was recommended to a special class, the medical care she was then receiving to be continued. For two years R has been receiving instruction in the special class. Her physical condition is much improved, but the school situation is the same as it was. R is still reading in the first grade and doing number work but a little more advanced. She has not yet learned to use English with any facility. Mental examination shows that she has good ability with manual tests, but her memory span is short and her trainability not great. She has no ability in the use of words. What can be done for R ? She is not a fit subject for an institution. She can learn to do simple work effectively and ought at the present time to be receiving instruction so that she will be prepared for occupational competency when she leaves school in six years. The time to make her an efficient unit of her group is now. These years in school ought to be valuable to her. She has a right to expect that they will be.
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