Ruth
- Author:
Mildred Collins and Arthur Phillips
- Role:
Clinical Teacher,
- Affiliation:
University of Pennsylvania
Ruth’s first and last visits to the Psychological Clinic form an interesting study in contrasts, which may well serve to introduce our subject to the reader. A frail little body, clad in a remodeled black coat with which was worn a contrasting red beret; a thin pallid face peeping shyly from behind her father, her large brown eyes shielded by immense silver-rimmed spectacles?this was Ruth. Persuaded to leave the protection of her father, a closer view revealed the fact that her eyes were pitifully crossed, and that due to this defect, she was obliged to hold her head to one side, focusing her right eye on the object to which she was attending. The little mouth, too, was constantly held open, and her first spoken words or sounds bore the indubitable marks of the cleft palate for which she had undergone an operation at the age of three. Her thin arms were covered with a growth of abnormally long dark hair, and her fingers could be bent toward the wrist almost double, indicating lack of muscle tone. Standing or sitting, she suggested low vitality. She slouched rather than sat, and her head lay upon her arms resting on the table in front of her. Her father reported that she was unable to help herself in any way, could not dress herself, and that, after almost endless efforts at instruction on his part, she could not hold a pencil in her fingers so as to make even a faint mark on paper. Poor vision, defective speech, lack of motor control, low vitality tell the story ?f Ruth’s handicaps. Add to this, her lack of special adaptation due to her unwillingness to play with other children because they were all “too rough,” and the picture of this little lady is complete. Contrast with this shy, retreating, pathetic child, Ruth as she appeared in June?a little “jumping-Jack” of a girl, prettily clad in a short flowered dress, clutching in her right hand a bunch of roses, humming merrily the tune of the latest radio number, while waiting for her clinic hour to start. Her physical defects remain but the shy air has been replaced by one of self-possession. A spark of mischief, totally lacking at her first appearance, is constantly breaking forth from her eyes. Self-assertiveness, almost obstinacy, a will of her own, at any rate, is appearing, and when she is told to count the colored cubes she is replacing in the box, she replies with a blunt, “No, I won’t.” A little inquiry brings the information that Ruth is showing this newly acquired quality at home also. This is not the only change in Ruth, but we must wait for that until we record a bit of the history of this child.
Ruth was born May 12, 1922. She is the older of two girls. Betty Rose, three years, three months old, is reported to be normal in every way. Ruth was born prematurely at eight months. According to her father, the premature delivery was due to the fact that he was taken ill the night before the child was born and his wife had become much exercised over his condition. According to the grandmother, it was due to a Turkish bath. In a masterful way, grandmother tells the rest of the story. At birth the child weighed four pounds eight ounces. The condition of the mother was so serious that there was not time to think of the child who kept losing weight until she weighed only three pounds, four ounces. At the age of three, an operation for the cleft palate was performed. At six, Ruth had the measles. She talked at three years, walked at four, and was made clean at three?a history of retardation.
She started school in the first grade this fall. The teacher refused to keep her because her speech was unintelligible, and because she could not give Ruth the individual attention she required. The physician consulted by the family at this juncture recommended that she be brought to the Psychological Clinic for advice as to the best procedure to follow.
In the psychological examination, Ruth’s performance was distinctly inferior. Her work with the Witmer formboard and Witmer cylinders placed her in a group inferior to 100 per cent at the six year level. Her I.Q. of 53 is entitled to the same rating. The only ability she displayed during the course of her examination was her singing. She sang, “Hallelujah, I’m a Bum,” and “Sonny Boy.” She kept the tune well but for words substituted undistinguishable “Mns.” The diagnosis was feeblemindedness (status praesens). The recommendations were that her eyes and teeth be examined and that she return to the clinic for teaching when her eyes had become adjusted to her new glasses.
Ruth reported for Clinic teaching in January. This report covers, therefore, the work of a single semester. It was a problem to know where to begin with a child possessing so many defects. The work began with an attempt to teach her the Witmer Formboard. It was indeed a sorry sight to watch her at the task of putting the RUTH 89
eleven blocks back into their recesses?a four year old test?hampered as she was by her poor eyesight, and her inability to see the whole board at once. Often in attempting to focus her right eye on the formboard, she would lower her head until it was only an inch from the recess. Then she would run her fingers over the recesses assisting thus kinaesthetically her poor vision in obtaining an image of the recess and of the block to be selected from the pile to insert into the recess. By much encouragement after her repeated failures, Ruth succeeded in correctly locating each block. Through many training periods, she finally succeeded in improving her performance from total failure to 55 seconds.
The process of teaching the Witmer Cylinders was much more tedious, but Ruth progressed until her performance showed good discrimination, and ability to correct her mistakes as soon as made. In the formboard work, her progress was retarded by poor motor control, wandering attention, inability to concentrate, combined with incessant motions of restless hands and body, under the strain of instruction. Owing to her being easily fatigued, the instruction could not be continued long without rest intervals. In these intervals, she was given the color blocks, and soon learned to match and name the colors.
One day when Ruth came into her clinic room, there was a large ‘’ C ” on the board. Always ready to ask questions, she asked what it was. She was told. “C” was then written on the board many times and in different colored chalks. Each time it appeared, she repeated the sound of the letter. This task was then replaced by another, to be returned to later to see if the recognition would carry over?and it did. The vital test came the next clinic day, at which time “C” was again placed on the board while time stood still to see if the carry-over had lasted the forty-eight hours. The smile on Ruth’s face when she shyly said ” C ” can only be compared to Archimedes’ “Eureka.” Ruth had definitely entered the new world of letters.
An illustrated book of the alphabet was now given her. She learned one by one all the letters she could correctly say. Owing to her defective speech, she was unable to say, B, G, J, P, Q, X, Z. Then she was instructed to pick out these letters and name them whenever she saw them. Her father proudly tells how she stopped outside the clinic one day before the whitewashed letters inscribed on the walk and picked out with evident satisfaction the letters she knew from
BEAT HARVARD
Slowly the letters were built into words through a process of drill and association of the word with the object. Cat, mat, liat, rat she learned to recognize and to spell. These were in turn combined into simple sentences as “I see a cat.” “I eat meat.” Not at a single glance could she recognize the sentence, but by spelling out the words, and naming them, auditory images were formed that proved helpful to retention. Auditory images helped out here as kinaesthetic images assisted in learning the formboards. At the same time and by the same method, Ruth was learning to recognize numbers. Association was also used at this point to assist recall. Number 9 was a balloon on the end of a stick; 4 was a man sitting on a chair; 8 was evolved from a cat, sans ears and tail.
Thus interest was held, and progress made. Script letters were introduced?not wholesale, but related to the words already learned. Here again the progress was encouraging. At the end of the semester, Ruth could read without help and hesitation such sentences as “I see a mat.” “I see a star.” “I see the moon.” “He hit me.” Her vocabulary now includes such words as cat, rat, mat, hat, hot, star, moon, sun, tree, eat, meal, I, it, in, see, doll, can, man, yes, the, run, on, sat, out. On the day, when Ruth was given the word “to,” according to our usual procedure, she was given a sentence of illustration? “I went to see my grandma.” Ever after, when “TO” was placed on the board the entire sentence was recalled. At another time, when she was being taught ‘’ Can,’’ A CAN of Soup’’ she became restless. She was told to run across the class room. When she told her mother what she had learned at the clinic that day, she said, “Can, a can of soup,” “Look, I run,” she added. In her next lesson she learned to recognize and spell’’ Run.’’ In teaching arithmetic, the problem became a more serious one. Numbers was her “no man’s land.” The concept of numbers was foreign to her. Her face was a variable territory, sometimes possessing one eye, two noses and two mouths; at other times possessing three eyes, one nose and two mouths. This astonishing information was elicited in response to such questions as, “Ruth, how many eyes have you ?’’ She had to learn precisely what one, two, three meant. She was made to pick up every kind of object. Blocks were used to advantage. A listener wTould have tired of hearing the instructor say, RUTH 91 Give me one white block. Give me one blue block. Give me one red block.
Finally, the idea of number penetrated Ruth’s understanding. Moons, stars appeared on the blackboard, first by ones, then by twos, then by three to the tune of Ruth’s counting. When the term closed, she was able to count from one to twenty, and could give the combinations of one with all the digits. Thus slowly, and by persistent repetition, a beginning was made in arithmetic, but it is only a beginning. When Ruth returns to the Clinic in the fall, this process of concentrated teaching must start anew.
From these five months’ training, it is evident that Ruth has a measure of trainability. Still lacking in motor control, and incapable of intelligent speech, she would be unable to make much progress even in a special class. Her best chance for further progress lies in the individual instruction provided by the department of Diagnostic Education.
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