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91
The Ministry of Health appointed a Committee of Enquiry on Venereal Disease,
and an application was received from the Committee asking for information as to the
relationship between mental deficiency and venereal disease. Arrangements were
made for Dr. F. C. Shrubsall, the medical officer in charge of the branch dealing with
the administration of the Mental Deficiency Act in London, to give evidence.
Mental deficiency
in
relation to
venereal
disease.
During the year considerable attention has been paid to the certification of
children for special (M.D.) schools and to the criteria for exclusion of children as
ineducable with a view to their being dealt with under the Mental Deficiency Act,
1913. The following statement bas been prepared by Dr. F. C. Shrubsall.
Criteria for
the certification
of
children for
special (M.D.)
schools.
Children come to notice because of either all round inefficiency, delinquency or
failure to profit in ordinary schools. Those who have to be excluded as ineducable
in special schools come within the former category.
The estimation of the mentality of an individual depends on many factors;
due credit has to be given to all kinds of ability, and the lower the apparent grade,
the more definitely the emphasis falls on simpler activities. In dealing with low
grade children great weight is always assigned to any attainments of a practical or
normal character, though full credit is allowed for any knowledge of reading, writing,
or counting. No child would be excluded from school solely because of inability
to acquire the fundamentals of the R's, or because of a failure in any one type of
activity. Decisions as to educability rest on a wider basis than formal tests alone.
The Board of Education point out that children excluded from special schools,
save in some very rare circumstances, will be either idiot or imbecile. The idiot is
so far defective as to be unable to protect himself against ordinary physical dangers,
while the imbecile can protect himself thus far, but cannot be taught to manage,
himself or his affairs. The points noted, therefore, in the main, concern the adaptation
of the individual to his environment. A few children show such all-round intellectual
defect coupled with such instability of temperament and lack of physical or
emotional control as to be obviously unsuitable even for a trial in a special school,
since their presence could only prove detrimental to the interest of others, without
appreciable benefit to themselves. Such children are, at once, definitely certified
as idiots or imbeciles, as the case may be, and proposed for notification to the local
authority under the Mental Deficiency Act. Children on the border line are given
a trial in special schools, and this trial is continued as long as there are evidences of
material improvement. A considerable number of these children prove amenable to
educational influences; a few, after a trial, fail from emotional or intellectual reasons.
Some can acquire a little knowledge, but prove so irresponsible and inefficient in
practical matters as to be incapable of managing themselves, while others, though of a
stable emotional type, prove eventually unable to acquire the simplest rudiments
both of a literary and a manual education. All children in the special schools are
reviewed by the medical officers at regular intervals, and if a suspicion of failure is
aroused, a special report is made before any administrative action is proposed.
There are types of congenitally feeble-minded persons whose physical characteristics
are such that the medical officer is able at an early age to make a definite prognosis
of incapacity. The children in some of these types appear to lay observers to
be bright and engaging. Their imitative capacity is such that they may even appear
to the casual spectator more intelligent than a normal child of the same age. As an
example, the type which goes by the name of Mongolian imbecile may be cited.
Characterised by definite bodily stigmata, they are recognised almost from birth
if brought under medical observation,but frequently their brightness is so marked that
it is impossible to resist the claim that they should be given a trial in a special class.
For the purpose of certification, the results of mental tests are considered in the full
light of the physical condition of the subject and the whole observable and recorded
behaviour as interpreted in the light of clinical experience. It is recognised that,
whereas certain subjects merely represent the lowest grades of inherited mentality
found in a normal scale, in others, the result is due to actual damage to the nervous
10161 G 2