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

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London County Council 1923

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

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106
There were 14 failures, 8 had a mental age of 6 or less, one had a mental age of 7,
4 had a mental age of 8 and one of 9 years. It had been noted that these elder
children were peculiar, unstable, and making but little progress. Trials were made
of 8 imbeciles at an occupation centre, of whom five failed completely, one was a
partial success and two succeeded. These two latter had beeu independently noted
as being rather above the average. One special case is of particular interest, a boy
of 14 years who, with verbal tests could not reach the 3 year old level, promptly
carried out this test. On further examination he was found to have so much practical
ability as to suggest that his defect was largely an auditory aphasia. Thus it
appears that the test standardises about 6 years of age, is readily and easily applicable,
and is independent of verbal ability.
The Animal Family Test.—The materials consisted of 24 cards forming 8
families of 3 members each. The families picked were those of the rabbit, horse,
zebra, dog, elephant, donkey, cat and bear. The cards were arranged in a standardised
order of 4 rows with 6 in each, the arrangement of the cards being such that
no two members of the same family appeared together in the series. The child is
told that there are eight families of animals, each with " Mum, Dad, and Baby," is
requested to collect them as quickly as possible and told to put them aside. Three
trials were given. The results with normal infants were:—
4-year olds. 5-year olds.
1st trial, 1 success, 6 failures. 1st trial, 5 successes, 10 failures.
2nd „ 2 successes, 5 „ 2nd „ 9 „ 6 „
3rd „ 2 „ 5 „ 3rd „ 12 „ 3 ,,
A six year old boy, who had been previously noted as a suspected mentally
defective, and a 7 year old boy, who had been actually recommended for the
Statutory M.D. examination, both failed hopelessly. It would seem that as
80 per cent, of the 5 year olds succeeded with 3 trials, it would be a fair test for
that age.
With a number of mentally defective children, the results of children with a
mental age of 5 years in the first, second, and third trials were respectively as
follows:—1 success, 2 failures; 2 successes, 1 failure; 3 successes, no failure. Of
children with a mental age of 6 years, there were no successes and 6 failures in the first
trial; 2 successes and 4 failures in the second trial, and 2 successes and
4 failures in the third trial. It may be added that 3 of these children had a very
low intelligence quotient. Children with a mental age of 7 years were all successful
in the first trial; and of children with a mental age of 8 years and upwards there were
6 successes and 3 failures in the first trial, 8 successes and 1 failure in the second, and
all were successful in the third. With the mentally defective children the results
are not quite so consistent, but on the whole they conform to those obtained by
normal children. Although it may be considered a fair test for a child with a mental
age of 5 to 6 years, and may be of use in special cases, it is too cumbersome for any
general routine work.
Encephalitis During the past five years there have been many cases of epidemic encephalitis,
lethargica. in connection with which two types of after-effects have been evident. One group
of children has exhibited progressive physical weakness, paralysis, and lack of
muscular control, often ending in death. Others have shown very definite conduct
changes, the duration of which it is impossible to forecast at present. In some
instances they have been noted over a period as long as five years. Part of this
conduct change and lack of control is specifically due to the effects of the inflammation
of the brain, but, on the top of these, further conduct changes of a functional
character are implanted as a result of the difficulties the patients find in attuning
themselves to the minor irritations of their environment. Some of the children
have recovered sufficiently to remain in an ordinary school; others have had to be
boarded out so as to relieve them and their parents from mutual irritation; a
certain number have been placed in industrial schools; some in special schools,