II. Bobby
Arnold Ginsberg and Arthur Phillips, Clinic Teacher, University of Pennsylvania
Bobby, aged 7 years and 5 months, was brought to the clinic by his mother in October, 1928, because of retardation since an attack of encephalitis. He was referred to the clinic by his aunt who is a teacher. Bobby is the youngest of two children. His older sister, Ethel, is 16 years old and is doing good work in the first year of High School. A “nervous breakdown” prevented her from starting school at six years, accounting for her relatively low grade in High School. The health of both parents is reported to be good although an enlargement of the thyroid gland was observed in the mother.
Conditions at birth were normal, although the child did not receive nourishment from his mother’s milk. At two months he suffered from mal-nutrition. At three years he had a severe siege of encephalitis lethargica. After his recovery from the illness, it was necessary to teach Bobby to talk and walk all over again. He also had measles and whooping cough. A recent operation for tonsils is said to have improved his school work.
Bobby’s school history consists of three terms in 1A grade. His conduct is good. He has begun to show signs of improvement and according to reports from his teacher Bobby may be promoted this June. For some time after a seat was assigned him in the school room, he had difficulty in finding it.
Bobby received an I. Q. of 93 placing him in a 10% group superior to 20% and inferior to 70% at his age level with respect to I. Q. His Basal age was 5 years, and he passed three tests at the Six Year Level and two at both the Seven and Eight Year Levels. This score seemed to be a fair estimate of his ability at the time of the examination.
His performance on the Witmer Formboard was superior to 30% and inferior to 60% of 6 year old boys on a quantitative scale. His discrimination was fair and his co-ordination good. A slight tremor was observed in these performances.
Bobby failed both trials of the Cylinders although he demonstrated sufficient discrimination to complete the test had he not been overcome by fatigue.
His audito-vocal memory span forward is four, placing him in BOBBY 59 a group of 30% superior to 10% and inferior to 60% for 6 year ?lds. He is unable to give a reverse span which makes him inferior to 50% at the 6 year level. His knowledge of colors is good. According to Philadelphia School standards anthropometric measurements are exactly right except his head girth which is inferior to 75% of 5 year old boys (50.5 cms.).
Bobby is a very affectionate child of normal appearance. He is well-behaved and shows the result of excellent care and training in his home, without which the youngster would have been unable to make as much headway after having had encephalitis. Diagnosis was deferred until “an attempt to teach” should be made and he was recommended for clinic teaching.
In the first term of the current school year his clinic teacher taught him the large letters of the alphabet with much difficulty. He also learned some of the small letters and counting up to 30 after a fashion.
When Bobby returned to the clinic after a short illness for the second term of teaching, I was assigned to the case. I spent the first few lessons reviewing the work he had studied under his previous teacher; finding he had forgotten a great deal, I had to reteach him the large and small letters of the alphabet. Our progress along these lines was quite rapid and within a few weeks Bobby was able to recognize all the large and small letters of the alphabet. Through conversation with him I discovered his appetite for reading was voracious, but this can be compared to the trite saying “his eyes were bigger than his stomach.’’
I started Bobby in a primer, Under the Story Tree, teaching him to read by the analytic method, that is, learning words from the story content. His progress was amazing, within two lessons Bobby apparently could read two printed pages of the first story. But when in the next hour he began to review his previous reading work by starting with the second line in reading matter and pointing to the first, I had discovered that Bobby had not learned to read but he had memorized the entire two pages. He was unable to read words picked out of the regular reading order.
Since this method of reading had failed I turned to the oldfashioned phonetic method, teaching him the sounds of the letters separately and building up the words by integrating the sounds. It seemed very difficult for Bobby to memorize the sounds of the letters and the procedure was slow. He had particular difficulty with certain letters such as H, R, K, etc. After a few hours of drill Bobby had mastered the sounds well enough for us to start on the process of word integration from the sounds. I attempted to teach him to read short monosyllabic words phonetically. We began with the most simple members of the ‘’ at” family. I first wrote words on the board and had Bobby sound out each letter, then pronounce the word as a whole. This type of work seemed to bore Bobby and the amount of concentration of attention he gave to the Primer was even further reduced. Bobby seemed unable to comprehend the fact that in reading the members of the “at” family the syllable ‘’ at” was repeated in each word, such as cat, rat, sat, etc.; for him, each letter of each word presented a new problem.
After a few hours were spent with the anagram card work, I felt that Bobby had advanced enough in the reading principle to be able to tackle a primer and read the words from the printed page as he saw them, instead of memorizing them or interpreting the pictures on the page as he was prone to do previously when I had attempted to teach him by the analytic reading method. I started him on the Elson Primer and to my astonishment Bobby was able to read after a fashion. The great interest Bobby showed in reading was more gratifying than the result itself. We continued in this book, reading each hour as much as possible until fatigue forced us to abandon the work for the day.
I now had Bobby keep a copy book in which I wrote the new words in each lesson and had Bobby learn them by writing each word five times and reading them aloud. Thus he was able to get both the visual, auditory and kinaesthetic images of each new word. The practical success of the plan has not been proven as Bobby knew very few of the words in the following session although his mother claimed he knew them the previous day.
In short, his reading now has progressed to the point where it is a cross between memorization of sentence ideas and real reading. The perfection of his ability to read, to my mind, depends on the ultimate solution of the following problems.
I believe Bobby’s most serious problem is that of his mental fatigue. From my observation of him at play and from his mother’s more inclusive observations Bobby seems to have tireless energy for play. At play, he is alert and vivacious and reacts normally in that field of endeavor. This fact I believe brings up the question of whether or not we will be able to reroute some of the energy used in play along channels of educational pursuits.
BOBBY 61
Directly related to this problem of fatigue is that of Bobby’s attention. It is said that the attention span of a normal person is very short. Therefore, the period of constant concentration is limited, but fortunately we are able through persistence of attention to remedy this condition. In Bobby’s case fatigue first takes its toll of his ability to bring back his attention as soon as his ability to concentrate fails him. The attention problem has also another phase in this case. Extreme distractability seems also to be the result of fatigue so much so that if Bobby is writing something on the blackboard he is distracted by the chalk he is using and the eraser.
A problem that is slight but I believe worth considering is that of motivation. Bobby is a very undependable child as far as trainability is concerned. Some days he is literally hungry for school work, other days his trainability is reduced to the irreducible minimum and practically nothing is accomplished. This condition may be interpreted as due in a small part to negativism, that is I believe that the boy either willfully decides that he will give no concentrated attention to his work or some days he is unable to give any concentrated attention due to prevous fatigue. Hence I think his extreme variation in trainability may be partly due to motivation and partly due to previous fatigue. The problems I have discussed such as fatigue, attention and motivation together with a slight tremor of the hands as demonstrated in the performance tests and his excessive affection for any one who seems to please him for the moment are behavior sequehe of encephalitis. We naturally ask what can be done for the disorders resulting from epidemic encephalitis. This is chiefly within the province of medical science to investigate so that an answer may not be possible. The disease is so new, the actual germ, if epidemic encephalitis is a germ disease, has not been isolated and therefore very little has been accomplished. Meanwhile supplementing medical treatment, Dr Hallowell in her study of Epidemic Encephalitis reported in Vol. XYI, Nos. 5-6, of the Psychological Clinic, recommends, “the usual measures of hygiene,? rest, good food, regular living habits and non-exciting environmental conditions.” The fact that Bobby found it most difficult to see that the syllable “at” was repeated in all the words of the “at” family and other similar conditions leads me to believe that his secondary or memorial area for vision is poor. He seemed to forget the sounds of the letters when they reappeared immediately in the very next word and each word having two letters that were always similar aided him in no way to pronounce it. Each word seemed to present an entirely new problem. The fact that Bobby’s secondary area for verbal visual imagery is poor leads me to believe that with a greater amount of stimulation of his memorial areas for verbal kinaesthesia, that is, encouraging lip movements in reading and audition will help Bobby to make up his deficiency sufficiently for him to make greater progress in reading.
Due to the fact that little work in Arithmetic is attempted in the 1A grade, I also spent a relatively small part of the hour with the subject. Bobby is able to read, write, recognize and count numbers from one to one hundred. We also worked with simple problems in addition and subtraction such as 2 plus 2 and 3 minus 1, etc. I believe his progress in arithmetic, although his proficiency now is just about that of the first grade, will also depend on the ultimate solution of our problems of fatigue and attention. The prognosis of this case, to my mind, is wholly dependent on our ability to treat the behavior sequelae of encephalitis with the aid of medical science. If this is not possible, I venture the opinion that Bobby’s condition if not naturally outgrown will become worse, for as his age increases these deficiencies will become more and more apparent.
Disclaimer
The historical material in this project falls into one of three categories for clearances and permissions:
Material currently under copyright, made available with a Creative Commons license chosen by the publisher.
Material that is in the public domain
Material identified by the Welcome Trust as an Orphan Work, made available with a Creative Commons Attribution-NonCommercial 4.0 International License.
While we are in the process of adding metadata to the articles, please check the article at its original source for specific copyrights.