London's Pulse: Medical Officer of Health reports 1848-1972

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London County Council 1904

[Report of the Medical Officer of Health for London County Council]

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Boarded-out Children.—The number of boarded-out children on March 31st, 1905, was as follows:—

BlindDeaf.
Boys2337
Girls1819
Total4156

and of these 97 children, 30 are extra-Metropolitan.
Mentally Defective.—These children are provided for under the Elementary Education
(Defective and Epileptic) Act 1899. There are 79 centres, of these 75 are ordinary special schools
for day scholars and four classes for older boys. There is also one Residential school. The
mentally defective children are defined as those who not being imbecile are yet, by reason of
mental (or physical) defect unfit to properly benefit in the elementary school.
The Education Acts make no provision for the small class now termed "moral imbeciles."
The feeble-minded may be classified as those whose feeble-mindedness is physiological and
those in whose case it is pathological. No study of feeble-mindedness is possible except by
continuous reference to the normal, and thus these physiological cases are classed as cases of natural
variation, and in some respects may be quite normal. In others they are perhaps hopeless. In the
second Report to the late School Board this class was illustrated by the cases of "word deaf"
and "word blind" children, which we had observed, and it is possible that a similar class exists in
the "moral imbeciles."
Feeble-mindedness expresses to some extent failure to reach a certain level in the general
summation of mental qualities. If by any means we could make a numerical estimate of the
mental capacity of each individual, and set it out for a large body of persons who were healthy in
all other respects, the distribution of mental qualities would probably be represented by the ordinary
"curve of error," the continuous line in the diagram. A few cases at one end would represent
geniuses, a few at the other end would be idiots, and one class would gradually pass through the
merely clever, through the great mass of mediocrity to the dull and then feeble-minded, but each
succeeding class would gradually merge into the other without any sharp break. If now a similar
number of persons were taken, but quite unselected, so that those damaged by disease were also
included, it would not materially alter the facts, but merely increase the numbers lying on the
negative side of the normal, and increase the numbers presenting considerable defect more than it
decreased the numbers with mental powers above the average judged by our previous standard
(see diagram XI., page 42).
Such a curve furnishes us with a good diagrammatic representation of the varying capacities
of different individuals. If now an area equal to one-hundredth the whole is cut off one end, this
represents the estimate of the Committee on Feeble-minded Children as to the class to be provided
for by special education. But there is still a considerable mass of children who from various causes
are below the normal, and who, even if they pass through school attaining Standard II. or III.
before they leave, receive no such benefit as they would if educated with special regard to their
hindrances. These, so far as the imperfect means at command allow, may be estimated as
amounting with the feeble-minded to 10 per cent. of all, and this represents the class presently to
be referred to who require education by intermediate schools.
Similar classes on the other side might be taken as worthy of education beyond the ordinary
elementary school, and a smaller class as worthy of secondary training in the highest degree.
The effects of loss, partial or wholly, of single senses is known, but when defects are combined
the difficulties of education are very greatly increased.
The most typical class of combined defects are the victims of inherited disease who are often
mentally dull, suffer with eye troubles (interstitial keratitis) during the second half of school life
and in some cases also become too deaf to understand speech. There are also many deaf or
partially deaf cases presenting mental defect, blind cases with deafness or mental defect, but other
cases are merely nervous or debilitated, and it may be said that we have very little knowledge of
the mental condition and possibilities of most of the children with combined defects.
The importance of a thorough study of these cases, more especially those presenting physiological
variations, is not yet realised. They throw much light on the educational processes of