A Contrast in Efficiency
Clinical Reports
Robert was a well-built, fair-haired boy of twelve years of age. Calm, composed and self-sufficient, he seemed to hold himself somewhat aloof from those about him. He was an unusual boy in that he possessed that extraordinary combination of intelligence, a pleasing personality and physical attractiveness. His frank, winning smile captivated the class immediately. Not at all self-conscious, he complied readily with whatever the examiner asked him to do. Edward, his brother, was an entirely different proposition. He was short and physically undeveloped and looked more than a year and seven months younger than Robert. The most striking thing about his appearance was his unusually large head and “egg-shaped” face.
His hair was fair like Robert’s but unkempt and unruly. He wore very thick spectacles. He seemed to have plenty of pep and an excited interest in his surroundings. Unlike Robert, he was very self-conscious and nervously agitated. He was operated upon a year ago?a piece of the skull removed and a great amount of cerebrospinal fluid drawn off. He was found to have excessive fluid and a deeply imbedded cerebellar tumor. Since his operation, he has been improving gradually. He suffered from optic atrophy due to pressure on the optic nerve. His sight is now getting better, although he still has marked circumscription of vision.
Edward’s mother is suspicious of his mental condition. Not because he is up at dawn every morning to take his cold shower, but because he shows lack of judgment in many little things. He shows a pronounced inability to grasp many necessary details of life, but on the other hand, in some things, he is quick and bright. He is in the fifth grade in school and succeeds better in those subjects requiring a good retention for details such as spelling. Robert is making good in first year high school, having skipped a grade in grammar school. He is really accelerated two years above the normal boy of his age in school work.
Robert completed twelve tests while Edward was still working on the second. In addition to being very speedy, Robert showed superior imageability and initiative. His time in all the tests was quite above the average for his age. He showed excellent trainability as he decreased his time in each trial and thus improved upon a good initial trial. He took less than twenty-five seconds for the first trial in each of the Knox tests and reduced this to seven or eight seconds in the third trial. He was very much interested in the tests and eager to do his best. He showed remarkably fine concentration and distribution of attention throughout. In contrast to this performance, Edward solved the formboard in fifty seconds but took one minute, forty-two seconds for the second trial. He had to be taught the cylinders, but even after he was shown how to do it, he worked slowly. He took four minutes forty-nine seconds to work out the Healy A puzzle. His memory span was a little better than expected (auditory 6, visual 7), but even at that, it was only equal to that of a sixyear-old child, and Edward is eleven. The two brothers offer a fine comparison in efficiency. Robert solved his problems quickly and accurately, giving a maximum of output in a minimum of time. He was highly intelligent and above normal intellectually. His principal asset is an unusual power in reasoning and abstraction. He presents a positive picture of intellectual efficiency. Edward, on the other hand, displayed no efficiency at all. In fact, he was not even competent. He showed abnormally poor trainability, even allowing for the fact that he was half blind. There was no doubt that he lacked power of abstraction and judgment and that he disclosed a specific disability for mechanical things. Although he seemed to be laboring under a great emotional strain throughout the testing, he showed plenty of initiative. He was, however, a picture of intellectual incompetency. His performances were subnormal, but allowing for his great visual defect, he was diagnosed as having normal mentality. It has been only one year since his operation and although he has improved greatly in that time, a reliable prognosis cannot yet be given. There is a chance that Edward may grow up into normal manhood, but it is an exceedingly slim chance. It is probable that he will not develop much more either physically or mentally. He is apt to die of one of the infectious diseases to which hydrocephalics are very susceptible.
Helen Wilson Brown, B.S., Graduate Student, University of Pennsylvania.
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