School Maladjustments of Some Mentally Superior Patients in a Psychiatric Clinic
- Author:
Schott, Ph.D.
Psychologist, Division of Neuropsychiatry, Henry Ford Hospital,
Detroit
In recent years since the development of standardized intelligence tests has given educators a means of classifying their students according to mental ability the individual of superior mentality has become the object of considerable interest and special study. One of the earliest results of the studies in this field was the discovery that the ordinary school routine, being adjusted to the needs of the average pupil, fails to meet the needs of the superior pupil in the best way. Some of the resulting maladjustments of students with superior intelligence have been defined and analyzed. A recent article by Leta Hollingworth1 has called attention to certain forms in which these maladjustments are likely to appear and explains them on the basis of a combination of intellectual superiority and immaturity in other phases of development. Various correctional programs have been advocated, but efforts in this direction have left in the school population many gifted pupils who are sufficiently maladjusted to cause them to be referred to a psychiatric clinic for individual guidance.
For this study we took in alphabetical order from our test files in the Division of Neuropsychiatry of the Henry Ford Hospital the records of 400 patients who had been examined at various times during the last five years. Three criteria were set in choosing these records. We included only those which showed that the patients were above age six, that they had had a complete examination * This study, which was reported to the Psychological Sub-Section of the Michigan Education Association, October 30, 1931, has been made possible through the cooperation of Dr Thos. J. Heldt, Physician-in-Charge, Division of Neuropsychiatry, Henry Ford Hospital, Detroit, and the writer is indebted to him and to Jack H. Schott for assistance in revising the manuscript. i Hollingworth, L. S., The Child of Very Superior Intelligence as a Special Problem of Social Adjustment. Ment. Hyg., 1931, 15, 3-16. with the Stanford-Binet Test and that they were listed as “in school” at the time of their study by the clinic.
Of the 400 patients thus selected 241 are boys and 159 are girls; that is, of the group approximately 60 per cent are boys and 40 per cent are girls. The I.Q.s of this group show a moderately normal distribution ranging from 33 to 149 with a median I.Q. of 96. The number of mentally superior patients with I.Q.s of 110 and higher is approximately equal to the proportion reported by Terman2 and others for the school population as a whole. In our group we find 77 patients, or 19.25 per cent of the entire number, with I.Q.’s of 110 and above. Of these, 46 are boys and 31 are girls, the ratio between the sexes remaining almost exactly the same as in the larger group (60 to 40). They ranged in age from 6 to 25 years, the median being 11 years, and in school placement from the first grade to the senior year in college, with the median at the sixth grade.
Although of school age and of the same general range of intelligence these patients are not strictly comparable to the school population as a whole because selective factors are operating in bringing them to our attention. An analysis of the sources from which they were referred shows that only 20 per cent of the 77 mentally superior patients are referred by social agencies and schools; 12 per cent are referred by other departments of the hospital; over two thirds, approximately 68 per cent, are referred to our division as private patients by their families, by the patients themselves or by their private physicians. This indicates that on the average the group is superior in economic status to a group with similar intelligence in the general school population.
In this group of 77 mentally superior patients we find 48 cases (62 per cent of the 77) with school maladjustments prominent among the complaints made about their behavior. In a group of 176 mentally average patients (with I.Q.s from 90 to 110 as determined in our clinic) the number with school maladjustments is estimated to be about 40 per cent.
Since we found that our mentally superior patients became involved in school difficulties about one and one half times as often as our mentally average patients we were interested in discovering what types of school maladjustments are characteristic of these superior individuals.
In a recent report on behavior problems studied in the Institute 2 Terman, L. M., The Measurement of Intelligence. Houghton Mifflin Co. 1916, p. 78.
of Juvenile Research in Chicago, John Levy 3 lias stated that, regardless of economic status, personality problems generally increase while social problems decrease as intelligence rises. For purposes of comparison with Dr Levy’s findings we grouped the school maladjustments of our mentally superior patients in categories similar to his classification of behavior problems as follows: (a) Personality and emotional problems include all deviations in which the pupil has difficulty in getting along with himself or other people. His difficulty in getting along with himself is expressed in brooding, excessive worry over school status, morbid fears of nervous breakdown, etc. Difficulty in getting along with others is expressed in temper tantrums, negativism, sullenness, stubborn “streaks,” ” smart alecky” hehavior, etc. (b) Problems of delinquency constitute social problems and include resistance to organized authority as seen in truancy, lying and deceit, stealing and destruction of property, (c) Sex offenses are placed in a separate category. (d) Academic problems include failure in school work or marked decline in scholarship and special disabilities. (e) Physiological problems are those related to the individual’s own body, such as tics, habit spasms, hysterical and epileptiform seizures, encephalitis, chorea, etc. In patients showing more than one type of maladjustment, each type is tabulated separately; hence the total number of maladjustments exceeds the total number of maladjusted patients. For example academic failures as well as physiological disorders are often directly traceable to emotional conflicts. In our group of 48 mentally superior patients with school maladjustments we find personality and emotional difficulties predominating. They are three times as frequent as academic difficulties, five times as frequent as physiological disorders, and ten times as frequent as delinquency. We had only two cases in which sex problems were known to be factors in school maladjustment.
These findings are in general agreement with Levy’s conclusions mentioned above. That is, in our mentally superior patients, personality problems have increased markedly over social problems. Levy suggests that personality problems are a more mature expression of maladjustment than resistance to organized authority in the form of delinquency and other social problems. Another possible explanation of the difference noted above is that the more intelligent individual realizes the folly of overt resistance to the 3 Levy, J., A Quantitative Study of the Relationship between Intelligence and Economic Status as Factors in the Etiology of Children’s Behavior Problems. Am. J. Orthopsychiat., 1930-31, 1, 152-162. demands of society and he stops short of delinquency in seeking emotional outlets. In other words he knows much more accurately than the less intelligent individual how far he can go without involving himself in serious trouble with constituted authority. For this reason he is likely to be a more baffling school problem than the delinquent because he seldom commits an offense serious enough to warrant extreme measures of correction (such as expulsion or the filing of a delinquency complaint) but he keeps up a series of minor resistances that are exasperating to the teacher and demoralizing to the class. His behavior is often inconsistent and often his offenses are interspersed with periods of good behavior. In attempting to eliminate such problems of mentally superior pupils, the school has two useful programs: first, that of testing general intelligence, special abilities and achievement so that the superiorities as well as the deficiencies of the individual may be recognized and evaluated; and second, that of special education for the guidance of certain groups. Undoubtedly recognition and special attention have effected adjustments in many cases of mentally superior pupils who otherwise might have reached a psychiatric clinic eventually. Our study contains two extreme cases in which the school’s attempt at adjustment aggravated the problem instead of alleviating it. One was a patient with an I.Q. of 136, who, after failing in the fifth grade of a suburban school, was placed in a special class for subnormal children, his superiority entirely unrecognized. In contrast to this we note the case of a seventeen year old boy who had reached the tenth grade when he was brought to our clinic after truanting successively from public school, a private school, and a military academy. To us he explained that when he was in the sixth grade he was told that his score on a “mental test” placed him “in the genius group” and therefore he was expected both by his teachers and his parents to achieve as a genius should, and nothing less was acceptable. The patient complained that he was subjected to constant pressure and surveillance and he was so antagonized by the efforts to force him to achieve perfection that he revolted and truanted constantly. These are exceptional cases and here the school maladjustment constitutes the major problem, which is comparatively simple.
A more typical case of general personality maladjustment is that of an adolescent girl whose superior intelligence (I.Q. 123) was in large part responsible for her impatience with the more formal and superficial demands of society. Her earlier gestures of defiance so frightened her mother that the relationship between them became strained. While both felt the situation keenly, neither would make advances to restore the bond of affection and confidence which previously existed. The patient’s attitude of defiance gradually carried over from the home to the school where she became a severe problem by reason of her refusal to comply with the simple routine requirements of the school system although she was always able to pass examinations successfully. She developed an exalted opinion of herself and at times was argumentative and outspoken to the extent of openly insulting her teachers in class. Frequently she became sullen and stubborn in her reactions to everyone. By the time she was brought to the clinic her mental reactions were becoming definitely morbid. After the parents and school authorities were contacted and the patient made several visits to the psychiatric clinic, sufficient adjustment was brought about to enable her to carry her high school work to completion.
The individual aspect of most personality problems suggests that in many cases of mentally superior individuals presenting school problems the school maladjustment is only one manifestation of a general personality disorder which is more likely to have its roots in the home situation than in the school. However, it is very difficult to demarcate the responsibilities of home and school in the etiology of such cases. Apropos of this question it is interesting to note that 33 per cent of our mentally superior maladjusted group are “only” children and 21 per cent are first born with younger siblings, a total of 54 per cent whose ordinal position may predispose them to development of personality disorders in the home, even before the individual reaches school age. This preponderance of first born and “only” children is less significant for our group than for an unselected cross section of the school population because in the economically superior classes from which most of our patients are drawn, families probably are generally smaller than the average for the city.
These considerations may have some bearing on the question of why the school’s efforts in the direction of individual analysis and special education, over a number of years, have failed to eliminate problems of maladjustment in mentally superior pupils. The explanation may lie, at least partially, in the school’s inability to control the home situations. To educators this view is more consoling than encouraging. It implies that the cause of such maladjustment is not primarily in the school, but is probably where the school can hardly reach it. In such cases educators may appeal to the psychiatric clinic, which offers a neutral ground for the resolution of family conflicts and the reshaping of parental attitudes.
Summary
The study of these 400 neuropsychiatric patients who were drawn from the school population shows a moderately normal distribution of intelligence quotients with approximately 20 per cent of the entire number rating as superior (I.Q. of 110 and up). Of these mentally superior patients 62 per cent have school maladjustments prominent among the complaints made about their behavior. The type of school maladjustment which predominates among them is personality and emotional difficulties. These are three times as frequent as academic difficulties; five times as frequent as physiological disorders; and ten times as frequent as delinquency. Sex offenses as factors in school maladjustment are negligible in this mentally superior group. The roots of the problems which predominate in this group often are to be found in the home situations where the school can not reach them. Hence it becomes necessary to appeal to some neutral agency such as the psychiatric clinic for help in resolving family conflicts and for direct constructive work in parent education.
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