Jack Q: A Clinic Study
Madella Rigby Recorder, Psychological Clinic, University of Pennsylvania
It was in March, 1927 that Mrs. Q. first brought her son to the Psychological Clinic for examination. Jack was eight then and in the IB Grade at school. He had entered school at six and one-half years old, and his record has been poor work and good conduct. His teacher complains that he is inattentive but she hastens to add that he causes no disturbance. He likes to go to school but seems immune to education in the classroom. Exposure to it the second year brought on chorea. In short, Jack’s trouble is that he does not seem to retain anything he has been taught, and consequently, he does very poorly in reviews and is not promoted. He is fast growing too large for First Grade. Something must be done. The question raised by his teacher is whether individual instruction will do more for Jack than the classroom method has done.
The study of Jack’s case has been an interesting one among our Clinic records. He has been examined three times with an interval of one year between the first and second, and the second and third appointments. Different examiners did the testing at each of these sessions. He has been a case for diagnostic teaching under two different student teachers,?the first time was just after his first examination in 1927, and he is at present being taught two hours a week in our Clinic. This study is a synthesis of the records. Jack’s family background and home environment seem to be very good. His father is in the employ of the Pennsylvania Railroad, and, if we can judge from Jack’s appearance, the family must be in comfortable circumstances. Mrs. Q. is an intelligent woman, energetic, and eager to follow our recommendations. She earnestly desires to do all she can for this, her youngest son. Jack is one of four siblings. The oldest is a boy of twenty-one who is a draftsman. The next child is a girl of nineteen who is a typist. The third child died at seven months of age of diphtheria, leaving a wide difference between the ages of Jack and his brother and sister. He is a child living in a world of grown people and this seems to have had its effect on him in making him very sober and quiet.
In his manner he seems to be quite a little man, in behaviour a conformist, a child who is seen and not heard,?even his school teacher has attested this. Jack comes and goes through the Clinic neatly dressed, a clean little fellow wearing his glasses as we recommended. He is well built though not large, his frame is well knit, and he walks with a normal gait. His straight brown hair is brushed back from his freckled face and he has a well shaped mouth and chin, but his teeth are somewhat uneven. He has a most engaging way of closing his lips with an air of finality that is emphasized in the way he draws in the corners of his mouth about which dimples play and seem to mock his seriousness. He gives you the impression that he is one of those with a capacity for long, deep thoughts, but when he speaks his replies are often irrelavant and disappointing?to such a degree as to suggest that he has not been thinking at all but has been in a sort of daze?miles away. This day-dreaming is very hard to credit in the face of his seriousness and perfect conformity of behaviour. He does not protest but submits manfully to teacher or examiner though he sometimes looks scared to death and is on the verge of tears when he is pressed for an answer. The more he is urged the surer he seems to be of his failure, resulting in him withdrawing into his shell and refusing to say anything at all. Sometimes he seems evasive and introduces his own topics instead of attending to the matter of the teaching. He is a charming conversationalist and doubtless feels that he should provide his share of the entertainment. He helps the teacher by injecting little comments on the weather, his watch, or a new pair of shoes he is wearing. A delightful little codger, indeed! But from the educator’s point of view he is an enigma. One teacher reports, “Sometimes when I tell something to Jack (he listening very attentively apparently all the while) and I ask him to repeat immediately after me, what I have said, he isn’t able to give me one word of what I have just told him. Once I had him repeat a sentence three or four times. He said it perfectly three times, and on the fourth repetition got stuck in the middle and could not finish it.”
He is very apprehensive. The presence of anyone besides his teacher in the room is very upsetting to him. Signs of the chorea are still noticeable in the twitch of his eyebrows and forehead. It is quite amazing that in spite of the timidity excited by the teaching periods, Jack can look as fresh after the lessons or after the long siege of an examination as he did before. He does not show fatigue. His discharge rate is very slow, his responses are often long in coming but this seems to be due to stage-fright, for it is more apparent at the beginning of the testing than at the end. The results of the three examinations in the Clinic in the last three years are remarkable principally for their uniformity. On the Stanford Revision of the Binet-Simon test, Jack, at the Chronological Age of 8-0 had an Intelligence Quotient of 85, a Basal Age of 5, a Mental Age of 6-10 with the Upper Limit 10. One year later, with a Chronological Age of 9-1, he had an Intelligence Quotient of 83. At that time his Basal Age was 6, his Mental Age 7-6, with the Upper Limit 10. The following year, with a Chronological Age of 10-0 Jack had an Intelligence Quotient of 73, with a Basal Age of 6, a Mental Age of 7-4 and the Upper Limit 10. On the Memory Span test for digits, Jack’s score in 1927 was Visual 5, Auditory 5, Reverse 2. In 1928 his score was, Visual 6, Auditory 6, Reverse 4, occasionally only 3, but he was credited with 4. In 1929 he gave a Visual Span of 6, and Auditory Span of 6 and a Reverse of 3 occasionally. In a like manner his trial time on performance tests shows little variation. In 1927 on the Witmer Formboard, his scores were (1) 48”, (2) 45”. It was noted that he showed good analytic descrimination but had difficulty with the two triangles. His concentration was good. In 1928 his scores were (1) 32”, (2) 54”. It was remarked that his method was trial and error, his motor discharge was slow, he used but one hand, he showed good concentration of attention. In 1929 his scores were (1) 37”, (2) 39”. He used but one hand and seemed to confuse the forms, especially the triangles. On the Witmer Cylinder test he showed greater improvement in the three years. In 1927 (1) Failure in five minutes (2) 106”. In 1928 (1) 235”, (2) Failure in five minutes. In 1929 (1) 277”, (2) 74”. His method in all these examinations was trial and error. The nature of his errors in 1927 strongly suggested some visual defect. He was therefore sent to the Graduate Hospital for examination. The condition was hyperopia, glasses were prescribed and he has been wearing them ever since. His third examination again showed errors that suggested eye defect so he was sent again to the Hospital to have his glasses readjusted. This has been done and Jack’s progress with lessons since he has been wearing his new glasses seems to have improved. The uniformity of the results in the course of three years seems to point to the fact that Jack has reached his limit of development in many respects. The validity of the test results as a measure of school competency is further borne out in the success or, to be exact, the lack of it, which we have experienced in teaching this case in our Clinic.
When Jack first reported for diagnostic teaching after one and one-half years in the public school it was discovered that he had been subjected to the word method of teaching reading. This had not been very helpful to him. He did not know the alphabet. T, he called The. B, he called By, and Y was Yes. He did know M, 0, J, A, and H; and he was able to write digits from 1 to 10 on the board. The first session of Clinic Teaching that Jack enjoyed in 1927 was spent in trying to write and recognize the letters of the alphabet. He came only four times when he developed chorea and was taken from school altogether. In the one lesson that he had wearing his newly acquired glasses, he showed definite improvement. Jack’s success with the letters in the course of four lessons was uncertain. He came again for Clinic Teaching in the spring of 1929. At this second term he seemed to have found himself in spelling. He had more confidence in his ability to spell than in his ability to do arithmetic. With gratitude Mrs. Q. writes to us, “He was talking to me about his work in school a few days ago and looked up at me and said, ‘Well Mother, it was the University that started me’.” This confidence, aside from the question of whether or not there is occasion for it in his present success, is a great step forward for Jack. After long drill he has learned to read now from the Third Grade Reader. He is still very slow but he is at last able to recognize words that he can spell and words that he learned in the 1st and 2nd Grades. He cannot, however, read to himself for meaning. When this is tried the result is nil even though he is able to read the passage aloud and tell its meaning in his own words. In the course of the teaching Jack has come to recognize this fact and to make use of it in helping himself. His memory seems to be greatly aided also by the use of kinaesthetic imagery. He does all his lessons whether spelling or arithmetic, in a stage whisper before he writes the answer.
The exceedingly slow discharge, both motor and mental, is an outstanding characteristic of the case. Jack’s work on performance tests and Binet in the examinations shows a low degree of trainability, which is borne out in the very slow learning process. In spite of the infinite repetition of stimuli in the kinaesthetic, auditory, and visual fields, the certain progress has been very slow and very small. His defective vision has been corrected by glasses, his vacations have been spent in improving his physical condition so that very little trace of chorea is left. It would seem that this little fellow at the age of ten has about reached his maximum capacity and the conclusions must be that the boy is of poor material. The attractive appearance of the child and his conformity of behaviour make it possible for him to come and go before your eyes daily without raising at once a suspicion of the elemental incapacity. His apparent freshness and immunity from fatigue are just so because he undergoes no strain during the teaching process. His alleged concentration is but detachment from the world about him and his rate of discharge augurs he will never catch up to the mad pace of this living. The chorea is another proof of his weakness. His sobriety that is interpreted by adults in terms of thoughtfulness is merely inertia.
Every conceivable aid to the learning process has been used in teaching Jack, and repetition has been the keynote. Nothing, however, seems to be able to surmount the obstacle of the slow, very slow motor response and the low degree of comprehension. In arithmetic Jack knows his Two, Three and Four Tables in sequence, but isolated problems from these tables are subject to error. In paper work he is very slow to start and rarely completes a problem without some word of encouragement from the teacher. He knoivs the process of addition, but his incomplete mastery of the fundamentals keeps him from arriving at a successful solution of the relatively involved problems. Jack’s progress seems to be anything but uniform. To find the cause of this condition is our next concern. A summary of the early history of the case shows that he had a normal birth. He walked at sixteen months, talked before he was two years and was trained in habits of cleanness at the age of two. From these records we judge that he was not a precocious baby, but neither was he seriously retarded. Following his medical history in sketchy detail we find that he had measles when he was one year old. When he was three he fell from a ” kiddy-kar” and was unconscious for half an hour. At five years of age he had whooping cough and a light case of scarlet fever. Pneumonia?a severe case?attacked him when he was six. He had chicken pox the next year and an acute case of chorea. He has been circumcised and his tonsils and adenoids were removed when he was six. The array of diseases is formidable to be sure. It must be confessed that the pneumonia is the one of which we are most suspicious. The attendant fever of a case of measles alone has been known to lead to sequeilae similar to those of encephalitis. Jack, however, doesn’t show the physical nor the dispositional symptoms of this disease. The only suggestion of the encephalitis that we find in this case, besides the dulled mentality, is the owlish way in which his eyes stare out from behind his glasses, slightly suggesting the facies of Parkinsonism. For lack of more positive evidence then, we can only bear these facts in mind and accept Jack meanwhile as a healthy boy.
The next problem is that of disposal of the case. He has been promoted now to the Third Grade in school with the help of the teaching he has received in the Clinic. The teacher’s question of the best procedure for Jack,?individual instruction or classroom method?has been answered by combining the two. The Clinic has undertaken the individual coaching that is necessary to keep him abreast of his class. The most that can be done for him in the long run is to teach him to read, write, and figure. He must be kept up to his grade in school for a few years. It seems fairly well established that Jack will have to earn his living with his hands, and that at unskilled labor, his trainability and rate of motor discharge are too low to raise him to the level of a skilled workman. He is apparently not as good as the rest of his family.
It is the unhappy truth that Jack, in being kept up to the formal education of the school system is just another victim of the mistaken truth upon which our democracy is founded.
Since the apprentice system of education has been discarded and the democratic form of government has had its vogue the field of education has not become adjusted to the changing times. Kevolutions of social custom have been enacted, but education has been remarkably tenacious to its old standards. Ever since the beginning of our own nation, years and generations have been spent in trying to fit everyone with the academic type of education. The idea is all wrong. Citizens obsessed with the desire to take advantage of the opportunity offered in our public schools, are beginning to learn to their sorrow that academic training is not like a salve to be applied externally with wondrous results. It is only recently that educators have begun the gigantic enterprise of fitting each one with the sort of education he can best profit by. To date it seems that they have achieved this much: They have begun to appreciate the fact that academic training (i.e., in the formal classical studies) is wasted on certain types of minds. When a child fails to learn by the methods arranged for large scale teaching, he is brought to a psychologist and examined individually. Those cases where the retardation is due to specific defect?like the deaf, the blind, the lame or the incorrigible?have been provided for with considerable competency by the public school systems throughout the country. Even the undernourished and the physical weaklings are attended to. But the great mass of children of middle-class families who are undoubtedly normal (in the sense of being able to maintain themselves without supervision in society) and yet who do not possess the mentality to become academicians, who have no fondness for learning, must by the laws of our fair democracy stay in school to waste time, harrass the college-bred teacher, and grow in habits of idleness, wherein they are unhappy and disorderly themselves, a burden to their families and a reproach to the state. Only too few of them are as passive and conformed as young Jack. Too many of them with youthful vigor, chafe at the restraint that keeps them in school. They grow daily in hatred of authority and disrespect of learning. The great problem of training these children to care for themselves physically, and guiding them gently to a better use of their leisure time has on the whole been fairly well done so far by the schools. The task of fitting them consciously for some occupation for which they possess the mental requirements and the physique has scarcely even been started. Too much thought and energy have been expended on the inferior and the superior memhers of society in proportion to that given to the overwhelmingly large group of normal, lower-middle class people. The uncomplaining middle class struggle under school training in academic subjects, wasting much of its youth from six to sixteen, when all its members need to read?now that we have the talkies?is the newspaper and the scandal sheet, and all the figuring required is the week’s wages and the butcher’s bill. For a long time now it has been well nigh impossible for him to receive adequate medical attention. The best physicians and surgeons attend the poor in free clinics, have the rich as patients in their private hospitals. It seems that in the schools too he is being cheated. For after he spends ten years in school he must then begin (by learning a trade) to fit himself for economic competition.
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