Deficient
I
OUR boy was three when a nerve specialist said to me abruptly, ‘The child is deficient.’
I knew that diseased parents frequently condemn their offspring to mental and physical deformities, but I had not until that moment imagined that ‘people of our sort’ might have deficient children. Of course we refused at first to accept such a diagnosis, and consulted successively, with less and less hope, many diverse specialists. Even now (and the boy is twelve) I can scarcely credit it. I have never been able to say the word ‘feebleminded ’ at all — but I have had to learn a great deal about feeble-mindedness.
Perhaps the fact that has seemed to me most singular is that the deficiency which cannot be accounted for by heredity or disease is not an extraordinary phenomenon. On the contrary it occurs so often that every child born runs the risk of being afflicted. The general state of health of the parents, their worldly status, their attitude toward the expected baby, the existence of other normal children, the care given the mother, weigh not at all. As one physician put it, ‘You buy two watches made by the same firm for the same price: one keeps perfect time, the other can never be regulated. No one knows why.’
Such children in the state institutions alone are counted by the hundreds. The correlated astounding facts are that, despite the prevalence of feeble-mindedness, physicians do not know why it happens and so cannot prevent it. And they do not know how to cure it.
There are types of deficients easily classified, — that is, the idiot, the moron, the cretin, and so on, — some recognizably incapable of any development whatever, others whose progress and limit of attainment may be accurately forecast. But there are many like our boy who fall into no category. The plight of the classified is heartbreaking enough, but at least there one is not groping in the dark — searching for a clue, tortured by the fear of just missing it. For, one hears, a deficient child has been cured — glandular secretions, adenoid growths, or cerebral pressure were found to be responsible for the trouble. Sometimes even he simply ‘seemed to outgrow it and now is perfectly well.’
The parents of a child that exists only as a living organism have but one problem to consider — its physical care. The parents of an essentially vicious or totally irresponsible child can have no choice about its disposition. But the questions which parents in our situation must decide are complicated indeed. A few apparently answer them as it was once suggested that we might: ‘Put him in an institution and forget that you ever had him.’
It can easily be done — all but the forgetting. Most physicians say, however, ‘We don’t know what the future may bring forth. Hope — and give him every opportunity.’
Our boy is personally attractive. I have always been thankful that he is. Many subnormal children are, for one reason or another, unpleasant to look at. He is extremely affectionate. He adores music, appreciates color, has a neat sense of humor, is a keen observer. His faults are serious lack of concentration, of ambition, of that selfcontrol which emanates from the normal, innate conception of what is or is not ‘ done.’
Such a backward child is pathetically a real child of nature, with the frankness, the unconsciousness, the innocence, and the flashes of insight which inspire the beautiful Irish fancy that they are dear to the fairies. But such qualities certainly make adjustment to civilized daily life most difficult.
If someone says in company, ‘One of my children was bom blind (or deaf, or lame),’ the greatest sympathy and interest are displayed. ‘How are you teaching him?’ ‘Is he happy?’ ‘There are compensations, after all!’ But if one says, ‘My child was born deficient — he is twelve years old but only seven mentally,’ a curious restraint paralyzes all tongues. This attitude, the result of very general ignorance, must be endured unless one adopts the protective policy of silence, of ‘forgetting that you ever had him.’ Yet how unreasonable it is that to the sorrow of having borne a helplessly handicapped child should be added the burden of undeserved humiliation!
It seems to me that this is almost the hardest obstacle to surmount when trying to shape a life for the deficient. No allowances are made for him, no one wants to help him — he is an outcast. And that is why the unclassifiable, the border-line, cases are really the most tragic.
II
There is the paramount problem of education. A tutor at home is not the desirable solution. All human beings must have companionship, and one of the things the backward child often has to learn is how to get on with other people. He does not coöperate easily; he may be stubborn and selfish because he lacks the social sense. But he cannot attend the schools designed for his normal brothers and sisters. There are some ‘special’ classes in the public schools (but very few), there are private special schools, and the public institutions. The financial capacity of the family must be considered here. How much should the normal members sacrifice to give the subnormal one his chance, when the hope of real benefit is at best very doubtful? Yet, again, if anything is to be accomplished it must be in the early, plastic years. And instruction short of the very best obtainable may mean irretrievable opportunity lost.
Most doctors advise sending the child away to school. They believe that he either receives too much attention or is ignored at home, that he may disturb family harmony, deprive the other children of a natural home atmosphere, be unhappy himself, a conscious misfit. At school he will be under the direction of instructors trained to cope with his needs, on duty for short intervals and so not hurried or impatient. He will be among his peers, some of whom he is bound to excel. He will not be reminded that he is ‘different’ by restrictions peculiar to himself. And his family at home are unhampered.
The private special school is very expensive. Wealthy parents, willing to pay more than generously for expert instruction, make a sliding scale possible, but still, for people of moderate means, with the education of other children and the probability of providing lifelong care for the deficient to consider, the fee may be almost prohibitive. The alternative public institution is probably far better equipped from an all-round educational standpoint, but it has (at least in our state) very disagreeable features. The child becomes really a state ward. The parents may visit him only on set occasions. He has but one short vacation at home a year, in midsummer. He may or may not be ‘paroled’ when of adult age.
In order that he might have special medical treatment, we sent our boy at three and a half to a private sanitarium for children; but removed him after six months when we were convinced that the treatment was accomplishing nothing and that in every other way he was being neglected. The woman physician at its head was constantly away, attending conferences or lecturing. The nurses were unintelligent. Our baby could not express himself, but it was only too apparent that he was unhappy. Thereafter, until he was eight, I taught him at home with sporadic assistance. Then we finally decided to send him away to a private school.
It is, I am sure, one of the best in the country, conducted by a physician of experience and high ideals. But it has the faults which we have come to believe are inseparable from any attempt at mass education of the subnormal, whether under public or private control. If the head of such a school is a big person, clients will flock to him. With outside demands upon his time for consultations, and so on, and the administration of a large plant, obviously he must depend upon others to carry out his ideas. However well conceived and planned these may be, the patience, enthusiasm, and personality of the teacher count for everything. To find willing, capable assistants for such exacting work is a very difficult task. For the director to check their success by keeping in intimate touch himself with fifty children or more is a practical impossibility. Yet it is absolutely essential that the deficient be studied, controlled, understood by someone he trusts, who wants him to develop and is always there to help him. That vital interest cannot logically be very strong in a casual, no matter how conscientious, instructor.
Then the whole routine of life as it must be arranged for so large a specialized group is unnatural — not really fitting the child to adjust himself to the world outside. He is not called upon to face unexpected situations, he need never make personal decisions. He becomes ‘institutionalized.’ At the same time, he is exclusively surrounded by other subnormal children, his peers but not his exemplars. He is imitative, and, as he knows no better, is prone to acquire the undesirable qualities he sees in others. And because he is admittedly queer, it is only too easy for him to form, unreproved, bad habits which he could overcome.
Perhaps some of these faults could be done away with in a very small private school, but if it were a really good one it could not avoid growing. Every sort of pressure would be brought to bear to permit the admittance of additional pupil—because there are so many children of this sort whose parents do not know what to do with them!
III
Now, after three years of boarding school, we have our boy at home again. He was always very homesick — he had reached the point of asking, with tears, why he must go away, while his brother could stay at home. He did not seem to be progressing enough to justify his (and our) unhappiness. We foresaw the difficulties when we decided to make the experiment, but we felt that we could never be satisfied until we had given him his chance, here in the environment evidently most congenial.
Our immediate household has easily made the slight readjustments. His brother leads the distinctly separate life of any older child, yet his very presence stimulates the admiring younger boy. The children who run in and out become to his subconscious mind patterns for behavior — even their naughty reactions are normal ones! Since we have made no secret of his ‘illness,’ their attitude toward him is an incurious one, and, as a rule, chivalrous. Like all properly brought up children, our boy realizes that if he is good he will be rewarded; if he is not, he will have to be disciplined. He falls into line because everyone else he is associated with does. Thus, to my mind, in dealing with this type of the subnormal, the important thing is not to search for a square hole to fit the square peg, but to ease it into the round hole at hand by smoothing off its corners. It may never fit, but perhaps it won’t fall out!
In making plans for the family as a whole, when we finally decided to have our boy permanently with us, we determined that it would be wise to relieve any strain by a definite separation from him each year. So we send him to a special camp for two months in the summer. This temporary change of authorities is also good for him, and he is freer and enjoys a larger variety of activities than we could provide at the average seashore resort.
The question of having him taught has for the moment been solved by entering him as a day pupil in a very small special private school in a near-by town, one of the few schools which will consider day pupils at all. Its head is a quite unusual young woman; I can only hope for the sake of the children that she will be able to keep the enrollment down. Her personal talent for teaching, her intimate knowledge of each of the dozen boys and girls, are accomplishing a great deal.
But our boy is not being trained here in handicraft, in any occupation that he can use as he grows older. So I have investigated other avenues. Near enough for daily commuting is the state’s great school for the handicapped, a model for the rest of the country: practically self-maintaining with its farms, dairy, and many shops; where a boy, if he cannot learn to read, may become an expert cobbler, where a girl who could not manage a typewriter weaves lovely scarfs on a loom. The ideal combination for our child — to live at home and go to a school like that! But we cannot enter him except as a resident, subject to the drastic restrictions of visitors at stated times, of one twoweek vacation a year, ‘ because,’as the superintendent explained to me, ‘we cannot run the risk of the contagious diseases that might be brought in by a day pupil.’ I offered a list of such diseases successfully weathered, — including all but the most rare! — but to no avail.
We have thought too of arranging for manual instruction at home. It is difficult to decide without a trial what trade might attract our boy, and the necessary apparatus and the services of an instructor for one individual are costly.
There are other problems. Public prejudice, as I said before, has to be braved. The child must be really a sharer in our family life if he is to benefit from it. He cannot always be rushed off upstairs when callers arrive. His social training is even more important than his brother’s. If he is to have a place in the world at all, he must behave outwardly as the rest of us do. He cannot afford to become excited and lose his head when the unexpected happens. Therefore, also, he must be taken out of the quiet home routine sometimes — shopping, to the movies, traveling. All of this basic training means patient effort and determination on the parents’ part, and it is made harder by the embarrassment frequently suffered because he is ‘different.’ A blind child stumbling in the street arouses universal compassion; an ‘innocent,’ too often, covert amusement.
On the other hand, I do not advocate for one moment the freedom from watchful guardianship of any subnormal person of any age. His cross is that he can never be independent. But granting that, like our boy, some are temperamentally fitted to be members of a household, have certain abilities which, developed, will give them occupation and perhaps at least partially support them, should their families feel forced by economic necessity or social pressure to put them into institutions?
The Governor of our state, in his recent address to the Legislature, said: ‘In so far as it can be done, retarded and slightly defective individuals should be trained in special classes in the public schools. It should be borne in mind that only a small percentage [of such children] require segregation in the institutions. . . . Children who are receiving such training can live at home. By living at home, the children enjoy more normal lives than is possible at any institution, however excellent. Furthermore, families are saved the pang of separation.’
In the same address, the Governor quotes what the Children’s Bureau in Washington has said of the child-welfare activities in this state: ‘Most significant in this development have been the increasing differentiation and classification of those requiring care . . . and the use of the family home instead of the institution as a means of providing for dependent and neglected and certain classes of delinquent children.’ The Governor adds that the state maintains no orphanages.
A Juvenile Court judge expressed the opinion that separation of the delinquent child from his home, ‘even a very bad home,’ should be the last resort.
Welfare organizations now utilize foster homes for orphan babies whenever possible in preference to institutions, because experience has shown that the babies thrive better, even if less scientifically cared for.
The old saying has it, I think, that ‘we live by admiration, hope, and love.’ No technical terms quite explain what it is that we feel, that seems to wrap us safely about and sustain us among our own people, — those who are nearest, those unquestionably dearest, to us, — but there is something, definite, almost tangible. If perfectly normal, responsible grown-ups, with absorbing interests and far-flung contacts, need and long for this sure support, how much more essential must it be for the happiness and development of the groping, dependent child, usually inarticulate, often conscious of his shortcomings, but unable wholly to overcome them? ‘Admiration, hope, and love’!
The parents who find themselves, as we did nine years ago, suddenly face to face with tragedy, inescapable, can only try to alleviate it with such courage as they can muster and such knowledge as they may gain. But one hopes that public sympathy and coöperation will aid them more in the future than in the past to adjust, to a life they cannot avoid living, these pathetic little outsiders.