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

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London County Council 1908

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

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61
In a paragraph on the prospects of children in special schools the Royal Commissioners
reported:—
"The result would thus appear to be that from 5 to 10 per cent. of the children are moved into the ordinary
schools and do well. Of the class below them, some 45 per cent. at most ' do manual work well and are of fair intelligence
as regards ordinary matters of life,' and they are considered capable of earning their own living altogether
or to a material extent. The third class, about 50 per cent. of the whole, are 10 per cent. of them ' fit only for
a custodial home,' and about 40 per cent. capable of doing a certain amount of work under supervision. These
figures, however, and the others which we have quoted above from various sources, should probably be subjected to
some reduction."
The only real difference between this estimate and ours, is that about 10 to 15 per cent. figure
in our estimate as able to earn their own living, which the Commissioners assign to the lower grade
of only able to partially support themselves, is possibly due to the form in which the questions were put.
Special Class of Children who do not improve.— The children who are pupils of
special schools for the mentally defective are defined by section 1 (a) of the Elementary Education
(Defective and Epileptic Children) Act, 1899, as being those who, not being imbecile, and not being
merely dull and backward, are defective, that is to say, children who by reason of mental or physical
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.
It is very difficult to say how far a child who is not imbecile, is yet incapable of receiving benefit.
The following are notes of certain children formerly in the Leo-street Special school:—
1.—When examined in October, 1903, this boy's articulation was very defective. June, 1904, he was unintelligible,
had no idea of calculation and had made practically no improvement. June, 1905, he was doing nothing,
was in the lowest grade, constantly smiling. June, 1906, his mechanical work was not better than the three R.'s.
March, 1907, he could not count beyond four, hopeless intellectually. January, 1908, he could count up to 10. He is
now 12 years of age and his speech is unintelligible to strangers.
2.—This girl was examined in January, 1903. She could not articulate plainly, was said to be quick at housework,
but educationally "nil." Said she had two fingers, three heads, but one nose. In September, 1904, she could
not step in line. Was of the poorest mental stuff in the centre, was malodorous. June, 1905, very unintelligent.
June, 1906,, a very low type of intellect not making any improvement in any subject. Was absent at each subsequent
visit of the doctor. Reported as making practically no advance.
3.—This girl was examined in September, 1904. She was a tiny, undergrown little girl who knew nothing. In
June, 1905, she was aged 10, had only two teeth in the top jaw, her mental capacity was nil; has had operation for
tubercular bone. Now over 12 years of age; has to be frequently sent home owing to verminous condition.
4.—This boy was examined in June, 1904, when 8½. Very weak-minded, no power of calculation. June, 1906,
power of grasping any point so limited that he will not be equal to an infant within 3 or 4 years. Manual work
bad. January, 1908, no advance mentally; now aged 12.
5.—This boy was examined in January, 1905. A defective-looking boy. Said his age was 12; it was only 9.
Could not write figure 3. June, 1906, knew a few monosyllables in book. March, 1907, articulation very poor,
improvement slight. January, 1908; now 12 years old and his mental capacity shows no advance.
In April, 1908, these cases were submitted to the Special Schools Sub-Committee as, although
they could not be certified as incapable of being educated, yet they had made practically no advance
in knowledge for many months. The Council ultimately decided in June to exclude these children,
as they were apparently incapable, by reason of their defect, of receiving benefit from the instruction
given in the school; and further that particulars of the cases should be sent to the Local Government
Board and to the Board of Education for their observations. The Local Government Board replied
that they had no jurisdiction in regard to children not chargeable to the Poor Rates. The first of the
cases was subsequently readmitted on the request of his parents, but later, after careful consideration,
excluded on a medical certificate as ineducable. As he is not a pauper he will now run the streets
uncontrolled.
Moral Defectives and Permanent Custodial Treatment.—The necessity for com-
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pulsory powers of detention in custodial schools till 16, and later for the rest of life, of certain moral defectives
is a most pressing matter. For instance just as we find incases of pure word-blindness a defect of a
particular region of the brain, sometimes as a hereditary failing which may occur in children normal in
other respects, or combined with any amount of other defect, from mere dulness to low grade mental defect,
imbecility, or idiocy, so cases are found of morally defective children, who vary in mental capacity from
some cases which are exceedingly clever in other respects, to children who are so bad as to be classed
as imbecile. Very commonly through such individuals being on what might be considered as a lower
scale of mental development than normal the emotions are much more developed relatively than the
intellectual qualities which give restraint, so that they are exceedingly plausible in speech, and have a
peculiarly attractive gift of adapting themselves, smiles or tears being available with equal ease
according to their environment. There are great differences in the way the defect is manifested. It is
almost impossible yet to classify them, but a provisional arrangement might be made into (a) Passive
(b) Active.
(a) Passive cases (only passive trouble in school conduct).
i. Children who have irregular but recurrent outbursts showing moral defect in slight
degrees amounting to uncontrollable bad temper; often with a complete heedlessness of all
correction or advice, and very often a tendency to roam or wander away. These cases are
probably of an epileptic nature and require detention and are to be regarded as cases of disease.
ii. Children who seem merely not to be amenable to discipline. This is a large class and
I think a very large proportion would be taught habits of obedience by regular and inflexible
corporal punishment. Most of them are subjects for industrial training later on, but they often
present other defects, e.g., wordblindness.