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Report of the Medical Officer (Education).
137
Deterioration led to demands for further inquiry, culminating in the Royal Commission on the Care
and Control of the Feeble-minded. Feeble-minded being a generic term used by American writers for
the whole class of mentally defective persons in contradistinction to the English use of the term as
given below. This Commission adopted a triple classification of the mentally defective into idiots,
imbeciles and feeble-minded, the definitions being—
An idiot is one so deeply defective in mind from birth or from an early age that he is unable
to guard himself against common physical dangers.
An imbecile is one who by reason of mental defect existing from birth or from an early age is
incapable of earning his own living, but is capable of guarding himself against common physical dangers.
A feeble-minded person is one who is capable of earning a living under favourable circumstances,
but is incapable, by reason of mental defect existing from birth or from an early age, of competing on
equal terms with his normal fellows or of managing himself or his affairs with ordinary prudence.
These definitions appear to have received general acceptation, but a certain amount of confusion
arises if they are regarded as in all respects identical and conterminous with those implied by the Act
of 1899, in which the essential test is educability in certain schools or classes. The lower limit of this
basis is rather more circumscribed, power of self-protection alone, even in proportion to the age, being
scarcely sufficient qualification for admission to a special school, while the other tests laid down in the
formal definition apply essentially to adults and not children.
Yet, from the returns of the after-care committees, it would seem that the children in the special
schools have not departed widely from the postulates of the Royal Commission, for if some have been
able to manage their affairs with ordinary prudence, few have been able to compete on equal terms
with their fellows from the ordinary schools.
The distinction is of importance, as those who declare that mental defect is lifelong and incurable
only use the later definition which excludes those who have materially benefited by their education.
They have, however, to admit that they cannot diagnose the slighter case with certainty at an early age.
The Act of 1899 would appear from the fact of requiring benefit from education to suggest the
possibility of recovery or improvement, and although it excludes the backward it provides for those
who suffer from retarded mental development, whether due to adverse factors, physiological or pathological.
The special schools must necessarily contain a certain number of doubtful cases, some bordering
on ineducability, others on backwardness ; but these are revised at regular intervals.
The progress of the special schools in London from the medical aspect is recorded in my previous
reports to the education authority, in which special problems and the difficulties arising therefrom
have been discussed—
1903.—Over-age children in Standard I. Imbeciles and epileptics.
1904.—Word-blindness. The special treatment of backward children.
1905.—The distribution of mental qualities. Physiological variation in mental qualities.
Intermediate schools.
1906.—Physical defects as a cause of backwardness. Classification of backward children.
The associations of mental deficiency.
1907.—Development of articulatory capacity. Backwardness associated with physical
defect.
r 1908.—A census of 5,000 children in the special schools to determine the number likely
to do better in an intermediate school and the probable results of special school education on
their subsequent wage-earning capacity. Moral defectives and permanent custodial treatment.
Word-deafness.
1909.—The teaching of writing. The conduct of admission examinations. The use of
observation classes. The use of the Binet tests of intelligence. The actual attainments of
mentally defective children.
1910.—Combined mental and physical defects.
A special enquiry by examination of the children in certain special schools was carried out in Tests
the autumn, and the children were reported on both from a medical and educational point of view, and of mental
enquiries made to determine— ability
(a) The number of children in these schools at present fit to be transferred to ordinary
schools.
(b) The number of children who would probably be fit for transfer before reaching the age
of 13 years.
(c) The number of children who are mentally defective within the meaning of the Elementary
Education (Defective and Epileptic Children) Act, 1899, i.e., "not being imbecile, and not
being merely dull or backward, are defective, that is to say, by reason of mental defect, are incapable
of receiving proper benefit from the instruction in the ordinary public elementary schools,
but are not incapable, by reason of such defect, of receiving benefit from instruction in such
special classes or schools as are in this Act mentioned."
(d) The number of children who—
(i.) Are imbecile,
(ii.) Are ineducable,
(iii.) Have reached mental limit and cannot be expected to improve further by
attendance at the schools.
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