Studies in Diagnostic Teaching Parker
- Author:
Samuel Lipshutz and Lorraine L. McNally, Clinic Teacher,
University of Pennsylvania
Parker is a victim of disordered control, a small victim and a pathetic victim. His disorder is so great that his distractibility is at the top of the scale, and his attention somewhere near the bottom. He can neither sit still, nor concentrate, nor do any one thing for even a short space of time?a much shorter space than the word concentration implies.
His mother insists his trouble is due to a fall. She adds the fact that about the time of the fall he had a touch of sleeping sickness. No final diagnosis has yet been made, but, on the basis of probabilities, the fall has most likely had less to do with his present state than the encephalitis. And we have corroborative evidence in the nature of his behavior to class him as a postencephalitic. Parker gives the impression of abnormality on first appearance. He is short for his age, and underweight. He is stocky, dark in complexion, and has dark hair. Throughout all his displays of interest, temper, apathy, and enthusiasm, his facial expression changes little, remaining almost fixed?a postencephalitic characteristic. He is exceedingly active. When his mother brought him to the clinic, she reported that he could not sit still for a minute, and that if he did, he feel asleep in his chair. In view of his unemotional appearance, his activity strikes the observer as being almost febrile, and the general impression of even a slight observation is always disquieting. Before proceeding upon a discussion of more specific details of his behavior and lack of progress, it might be well to dispose of the matter of preliminary information. Parker was born on September 13, 1915, and his age is, therefore, thirteen years and four months. He was brought to the clinic by his mother and an aunt, referred by the family physician, because of nervousness. His father, a steamfitter, died a few months ago, and the family is in poor circumstances. The father had been in good health before his death and the health of his wife was given as excellent. Parker was in the 6th Grade, with conduct reported as fair, and work as also fair. We have found both these statements are slight exaggera270 THE PSYCHOLOGICAL CLINIC tions. His work might better have been described as poor, and his conduct as atrocious.
He had no significant medical history, beyond the obvious encephalitis, having had the usual children’s diseases. He walked at fourteen months, talked at twelve, and was clean at two years, which performance is normal. The present health is described as poor. He has three sisters and one brother, all younger. Since the age of seven?the age of the fall and of the sleeping sickness ?he has been very stubborn; has had auditory hallucinations at night, and has not played well with other boys.
To complete this thumbnail physico-psychological sketch, he did the Witmer Cylinders first in 53 seconds, and, second, in 67 seconds. I may say here that this inferior second performance is a great characteristic of all Parker’s work. He has a visual memory span of 9, and an auditory memory span of 7. The results on the Dearborn Formboard corroborated these as did the Binet-Simon, which gave him an IQ of 77, or, with a chronological age of twelve years and eleven months, a mental age of an even ten years. Of this Binet result I will speak later.
We have now, some definite picture of Parker, both psychologically and physically. On the structure of these figures must be placed the individuating characteristics?those tilings which make Parker precisely what he is, and which prevent him from being considered as anything but a case of inferior control, coupled with emotional deficiency. A more or less detailed description of what he does, says, and is seems to be the only logical procedure. The first time I saw him he entered the room with a dim smile ?he always has a dim smile at the commencement of hostilities *?and sat down in the chair I indicated. In a moment he was up and rambling about the room. He wanted to operate a typewriter on a nearby desk, and was on the point of going off into a tantrum when I refused to let him do so. He noticed a bookcase, and he went to it and removed an armful of books, mostly primers. He put these on the table, and without noticing me in the least, began to turn pages quickly, looking at the pictures, but never changing his expression in the slightest. I took the books away and drew him into a conversation. In a few moments he indicated that he wanted to be an aviator; that an uncle was going to take him to China; that he liked school and his teacher, but didn’t feel like doing any work, and that he was going to quit school and get a job. He spoke steadily, in an undertone (which he never raised in all my knowledge of him). He contradicted himself shamelessly, and went blithely ahead, piling improbabilities upon improbabilities, and giving any answer to any question. I do not mean to indicate that he lied consciously?he did not. But he romanced; he saw himself in glamorous situations; and he was a great victim of wishful thinking. We spent the entire first hour in desultory conversation of a cross-examining sort: at the end of the hour I had a pretty fair notion of what to expect. The second was no disappointment. Parker was always ready to talk; always ready to look at pictures; always ready to jump around and take things apart? but never ready to do any work. When work was suggested, or when a question he did not like was put to him, he would sulk. This sulk was one of the most complete I have ever seen. His head would go down on his chest, he would start to cry, his face would turn red, and his mouth would quiver open.
To illustrate his behavior in these sulks, only one sample need be given. I asked him why lie did not do better work in school. At once his head dropped to his chest?he was through. I repeated the question?he started to cry. I said: “Parker, don’t you want to answer me?” and the sobs grew greater. He said something about not liking this place. He would answer no question, respond to no persuasion, but remained in his position. I did then what I was to find worked later in similar situations. I took a Witmer Cylinder Test and started to put the cylinders in the holes, without paying any attention to him. Purposely I put them in wrong. I seemed to be struggling with the difficulty of doing the board. Finally, after I had two-thirds of the cylinders in the wrong holes, I said, expansively, ‘’ There!’and put the board on the table in triumph. It was more than the boy could stand. He snatched the board away from me and re-arranged the cylinders. After that he remained amenable to reason.
We passed about two weeks in coming to know each other before I dared suggest any work to him. And when I did he had the greatest morning of his career. I took out a book he had always shown interest in?it must always be remembered that his greatest joy in life is to turn pages meaninglessly and endlessly ?and asked him to read a paragraph on the habits of the ants. He had seemed interested in the illustrations, and so I had chosen that particular section of the book. He refused, flatly. I asked him if he knew why he had come to the clinic. He said no. I told him he had come to study?to learn, and that I was going to help him. Again I asked him to read. He sulked?refusing to answer. I felt that if I worked the cylinder trick again, we might go on thus endlessly, and so I said, sternly, “Parker, you are going to read!” He said, “You’re not my boss. This is a free country.” The fact that it was a free country was always his battle-cry. He started to leave the room. I pushed him down into his chair again. He struggled. His face flooded with red, and lie snarled. I sat back, wondering how long it would take him to decide to leave. He got up, and waited to see if I would chase him. As I did not he walked out. He left the building, and I pursued him, with the help of one of the clinical assistants. We caught him about a block distant. He picked up a rock and threatened to throw it, but did not. Once we were certain he knew the way home, we let him go, realizing that the morning was over.
And at the next hour he was back, with the same faint smile, precisely as if nothing at all had happened. This, I think, is characteristic of his abnormality. No normal boy would have returned. If he had returned, he would have returned with an apology, or with a sheepish look. But Parker was quite placidly happy, as ever.
It was then, hesitantly, that I started to give him the proficiency tests. I found?to my everlasting surprise?that he had sixth grade proficiency in almost all subjects?and certainly in arithmetic and spelling. But, as he said, in school he did not feel like working. And that was that?perhaps a disorder in motivation as well as a disorder in control. It was when I began to ask him what work he would like to do that he really started to accomplish something in his hours at the clinic. He indicated a preference for arithmetic, and said that his school work was in decimals. We worked in decimals. His concentration was not great, but it seemed, surprisingly, to grow as the days passed. He learned arithmetic easily, acquired new processes without trouble, and was very good at the basic operations?the fundamentals. These results led me to doubt a little his extreme deficiency as indicated by the Binet-Simon, and made me interpret them in the light of his usual unwillingness to perform. It is my belief?unfortunately there was never the opportunity to demonstrate it?that he would score from five to ten points higher if he took the test with an examiner he had grown to know and trust.
After a few weeks of the arithmetic he had had enough. I tried him again on reading. He refused to read aloud. I believe I have enough evidence, in respect to this matter of reading aloud, to say that he must have been made ridiculous in reading before a class to such an extent that he has developed a phobia on the subject. Since he refused to read for me under any circumstances, I made him promise to practice at home, before a mirror, if only for five minutes during the day. He promised, but he was an easy promiser, and never attempted to carry out his word.
It was obvious that teaching would do him no good. Leaving school and going to work would do him less good. Distractible, uninterested in the matter in hand, over-active, full of repressions and minor phobias, he was as unsuitcd to the workaday world as to the world of school. That he will get a job is inconceivable; that he could hold one if he got it is even more improbable. Left to himself at the clinic he would run around halls, take anything apart he could lay his hands on, ring bells to make noise, waylay students and aimlessly ask them for tickets to the football games. After the hour in the clinic, he would never return to the school for the rest of the day. He has a chip on his shoulder against the whole world, and he has no apparatus for accomplishing something by fighting the world. He refuses to be made to do anything; he refuses to do anything; he refuses to be made to talk about his defects. All of this is in -the line of the recognized postencephalitic characteristics; that he will ever recover or progress very far is highly improbable. The best thing for him, it would seem, would be to be taken from the city, and farmed out somewhere, far enough away from machinery not to hurt himself, and given enough work to make him grow stronger physically. Provided he would stay on the farm, and provided he would do the work, and provided he would not find some ingenious way of hurting himself, good might be accomplished. But it needs more than two hours a week of clinic teaching. Were his family in better circumstances a full-time tutor might be hired, and results might be obtained. But that is out of the question. As a matter of fact, his mother looks forward to his financial aid, not yet having reconciled herself to the fact that he will always be more of a liability than an asset. That his future can in any way be made brighter, is I think, doubtful. Parker is a human won’t, full of aggravations against the world, determined that no one will boss him, physically inadequate to the struggle for existence on his own, and temperamentally unable to control his actions.
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