The Family and its Members Part 15

--Sh.e.l.lEY.

"One man, at least, I know, Who might wear the crest of Bayard Or Sidney's plume of snow.

Behold him, The Cadmus of the blind, Giving the dumb lips language, The idiot clay a mind.

Wherever outraged Nature Asks word or action brave, Wherever struggles labor, Wherever groans a slave,-- Wherever rise the peoples, Wherever sinks a throne, The throbbing heart of Freedom finds An answer in his own.

Knight of a better era, Without reproach or fear!

Said I not well that Bayards And Sidneys still are here?"

--WHITTIER'S tribute to Dr. Howe.

=The Defective Children.=--Not those who die young, full of promise, to leave a memory of exquisite budding loveliness cut short by untimely frosts, but those who live on from infancy to childhood and from youth to physical maturity and even on to old age, yet never become responsible adults--these are the children we must consider.

The demand of the eugenists that such, if obviously defective, should be prevented from bringing forth after their kind is clearly the only social wisdom. The statistics of social pathology all point to mental defectiveness as the prolific cause of crime, immorality, vocational incompetency, illegitimacy, family failure, and marital tragedy. In a recent study of one hundred families in which feeble-mindedness was obvious, a study carried on by the Ma.s.sachusetts Society for the Prevention of Cruelty to Children, immorality was found in 58 per cent. of them; extreme filth and bad home conditions were found in 30 per cent.; and in 47 per cent. one or more members of these families were public charges. Where the mother is subnormal there is almost certain to be a line of feeble-minded progeny, and in this study, while there were only 7 per cent. of the fathers hopelessly deficient, in 25 per cent. the mothers were notably defective in mind.

Thirty-seven of these families showed illegitimate children--a far larger number than the average of normal population. Physical deficiencies also figured largely in these family records.

This particular study takes us into the region where Doctor Fernald, Doctor G.o.ddard and many others have prepared material for convincing the public mind that no one thing so increases social degeneracy and so adds to the sum of human misery as the unprotected freedom of defectives to procreate and pollute the family currents.[14] This is not a treatise on social pathology and elsewhere must be found the details of investigation and information that justify this statement.

What is here attempted is only a study of what should be the att.i.tude of fathers and mothers toward feeble-minded children if such should be their tragic problem.

=Custodial Care of the Defective.=--In the first place, the att.i.tude of mind of the parents, if they are themselves normal, is to be considered. What gives us feeble-minded children from feeble-minded parents is clear. The social prevention for carrying on known degeneracy cannot be too strongly stressed, and hence the first duty of normal parents is to consider the social danger of leaving a feeble-minded child, especially a feeble-minded girl, to any chance of parenthood. This leads to the question of removal from home of feeble-minded children to permanent custodial care in inst.i.tutions provided especially for their segregation, possible teaching and thrifty use of small work-power. Alexander Johnson, who has done so much in the United States to make all philanthropy wise and effective and particularly has helped to form public opinion concerning right methods of care and training of the feeble-minded, tells us that "one-half of the mentally defective can become one-third of a normal person," can be made happy and useful to the extent of considerable aid toward self-support if under constant supervision and given the trained care of special teachers.

There are few private homes in which any feeble-minded boy or girl can attain such a condition. The children who are "different," if having the sole devotion of father and mother, may be protected and made happy in the measure of their power for happiness. But if there are other children in the family neither they nor the afflicted one are comfortable. The measure of feeble-mindedness is usually the measure of unhappiness when the normal and abnormal are in close companions.h.i.+p. In most families it is not possible for either or both parents to give entire time, strength and devotion to one subnormal child. Where it is, there is no security that death will not prevent the permanency of that devoted care. Hence, it is generally safer and better for all concerned to place the feeble-minded in collective homes where their own kind are cared for exclusively and where segregated control can be complete and permanent through life. There is no horror of such places for those who have seen what flowers of happiness and what miracles of devotion may be found in "Training Schools for the Feeble-minded."

The affectional side of the nature of a mental defective may be of unusual strength and may find special objects of love among those still more handicapped than itself. Those visiting intimately in such School-homes may see a higher-grade imbecile caring for a lower-grade with patience and devotion; they may see the compet.i.tive element in training, reduced in levels for the accommodation of the slender stock of mentality, producing on that lower level the same good results that normal children gain from trying to imitate and to excel.

Small attainments are sources of pride in a cla.s.s of defectives which if exhibited among the normal would give bitter experience of contrast. By making the standard of behavior and of attainment suited to their little power, the delight of conquest over difficulties need not be denied to the feeble-minded.

Hence, again, it is far from wise and often far from most loving to keep the child who can never grow up in the company of those who follow the usual path from infancy to maturity. This means, of course, if this idea of the more general use of special homes for the subnormal is to be carried out, a large increase in provision of such homes. Such large increase is often opposed by short-sighted economy.

The expense of establis.h.i.+ng and maintaining such homes in adequate number and of scientific and humane provisions is counted over and taxpayers made alarmed at the sum total. What is lacking usually in the count is the sum total of the enormous sums society now pays out for the unregulated and socially dangerous neglect of this cla.s.s of unfortunates. Doctor G.o.ddard's "Kallikak Family" and many other accurate showings of what it costs to leave uncared for one feeble-minded girl in unbefriended freedom should convince any sane person that the most wasteful extravagance any community can commit is such neglect of what Mr. Johnson has called "the divine fragments" of humanity.

To make provision for the insane is seen to be a social necessity and the family more than any other social inst.i.tution profits by the hospitals and asylums for the treatment and care of such. The relief of having an insane relative taken away from the home, after months and perhaps years of anxiety, fear, and suffering on the part of every other member, cannot be too strongly pictured. The effort now making to secure early treatment for the first symptoms of mental derangement and to give even "border-line" cases and exceptionally "cranky" and nervous people special treatment in mental hygiene marks the beginning, we must believe, of effective preventive work in this line.

The feeble-minded, however, have a claim of perpetual childhood upon the parental sympathy, and that, together with common ignorance concerning their condition or numbers and the social dangers inherent in their neglect, give us the alarming discrepancy in numbers between the feeble-minded in suitable segregated care and those left to find their way or lose it in the usual walks of life. Since Doctor Seguin wrote his _Treatise on Idiocy_ in 1846 the verdict of science and of philanthropy has been acc.u.mulating as to the need for the full and complete protection of all who cannot manage successfully, even in the simplest details, their own lives and the lives of those with whom they are most closely related. Yet to-day, it is claimed by many observers, we have only about fifteen per cent, of those requiring special protection on this account adequately cared for by society.

The family must be relieved of personal care of its insane, its lower-grade feeble-minded, and its moral idiots. It must be so relieved for the sake of the normal members of the family. It must be so relieved still more for the sake of lessening vice, crime, degenerative tendencies, and actual waste of public money in public court procedure and in other public inst.i.tutional provisions.

To induce the state of mind in parents which will help on the better and more adequate social care of these afflicted members of society, the sense of shame and the keen suffering from social stigma in such cases must be mitigated. It must be seen that although it may be the fault of one or both parents that such a child has come into the world, it is an added and deeper fault, even in many cases a social crime, to leave that child in ordinary relations of life. It is true that what Dr. Caleb W. Saleeby well calls "racial poisons" are often the cause of the damaged germ plasm that starts the handicapped human being along his devious course. Alcohol, syphilis, and other elements of degenerative action may have doomed the child and in such cases the father's or mother's sin or carelessness is the cause of the child's tragical condition. In such cases the dullest conscience must feel remorse. It is, however, not always the fault of the immediate parents. It may be a far more remote inheritance that has started the degenerative psychosis that results in either insanity, feeble-mindedness, dipsomania, or "general debility of character."

=Heredity.=--Prof. E.G. Conklin says, "Heredity may be defined as the appearance in offspring of characters whose differential causes are found in germ cells." Doctor Galton says "the two parents between them contribute on an average one-half of each inherited faculty, or each parent one-quarter. The grandparents contribute between them one-quarter, or each one-sixteenth." The responsibility for a poor specimen of humanity, therefore, is not solely the parents'; they may share it with a considerable group. Many a defective obviously owes his condition to some remote ancestor, "to the third or fourth generation," as the old Scripture said; and many a charming trait, for which the immediate parents would like to take credit, is really a gift from some great-grandparent.

This fact should make it easier for parents of defectives to bear the burden and easier to make it seem less a shameful confession of individual responsibility and more a sad confirmation of the fact that we are all members one of another and no one lives to himself alone.

=Difficulties in Care of Morons.=--The case is clear as to treatment, so all enlightened social workers and social students agree, in respect to the obviously defective or insane. The difficulty is to care protectively and yet justly for the higher-grade defective or what is now called the "moron." Doubtless we should all see it best to begin at the lower levels of defectiveness and abnormality for pressure upon society to socially protect in segregated inst.i.tutions all the afflicted. The point at which compulsory methods should be used might be placed at a widely differing level by many most acquainted with the need for some form of social control of and for this cla.s.s. Parents in particular would resent any snap judgment and should do so as to the mental condition of children not obviously imbecile. It is certain that the high-grade moron makes much trouble and gives social tragedies without number, but it is still more certain that no social machinery has yet been devised ingenious enough to really cla.s.sify such persons and place them where they can do no more harm. As Dr. Lightner Witmer well says in his warning against careless diagnosis, "In training clinical examiners I advise them not to diagnose a child as feeble-minded unless they feel sure they have sufficient facts to convince a jury of twelve intelligent men that the diagnosis of feeble-mindedness is the only logical conclusion to be drawn from the facts." It is undoubtedly true that many high-grade imbeciles or morons would be adjudged not feeble-minded by most juries. It is also undoubtedly true that many youths who are "peculiar" or "backward" or unusually susceptible to influence from others or especially lacking in power of self-control are in social danger and need some form of social protection more effectual than is required in the case of the normal child and youth. Higher grades of abnormality and those less understood must be approached, however, both in matters of examination and of care, from different angles of observation from those used in discovery and treatment of the obviously imbecile.

In this connection mention must be made of the efforts to give supervision of special sort and under official direction to those able to earn their own living or partially so, at least, and who yet need special protection and care. _The Proceedings and Addresses of the Forty-fifth and Forty-sixth Sessions of the American a.s.sociation for the Study of the Feeble-minded_ contain specially valuable articles on "Extra-inst.i.tutional Care" and on education of the higher-grade defectives. Two articles published in _Mental Hygiene_ of April, 1921, on the vocational elements in such extra-inst.i.tutional care are most enlightening as to possibilities in this difficult field. The first of these, ent.i.tled "Experiments to Determine Possibilities of Subnormal Girls in Factory Work," by Elizabeth B. Bigelow, shows that certain kinds of routine work may be followed successfully by girls who are mentally under the normal. The second article, "Vocational Probation for Subnormal Youth," by Doctor Arnold Gesell, of Yale University, shows how the courts may use probation power and agency in the interest of self-support and a helpful industrial relations.h.i.+p. The new Children's Code recently recommended to the Connecticut Legislature by a special Commission advocates giving Juvenile Courts power at discretion to establish the status of "Vocational Probation,"

under the supervision of officers of the Court, in place of commitment to an inst.i.tution, provided helpfully supervised employment may be found for the boy or girl in which they may become self-supporting.

=The Colony Plan.=--The Report of Dr. Anne T. Bingham, Psychiatrist of the New York Probation and Protective a.s.sociation, based upon 839 mental examinations of girls and women coming under notice because of breaking the laws or because manifestly in moral danger, is an important study. Doctor Bingham highly recommends the "Colony Plan"

for the care of the higher-grade feeble-minded. In this plan small groups of those who show mental deficiency or any special need of social care are established under necessary supervision and control in colonies, near their own homes if possible, and given suitable work in the profit of which their families may share if dest.i.tute. The natural homes of such girls and women are often lacking both in helpful discipline or moral protection and to leave them in full charge of the parents is often the worst possible neglect. This Colony Plan is described in an article by Charles Bernstein, ent.i.tled "Colony and Extra-inst.i.tutional Care for the Feeble-minded," published in _Mental Hygiene_ for January, 1920. The needed supervision, protection and care for higher-grade morons is difficult to secure unless some form of official control is initiated. That official control is often only available for those who have already suffered some serious consequence of their abnormal condition. What we need to work out is a better and more effective means for helping the family to do what is needed for the mentally handicapped child.

=Mental Hygiene.=--No adequate treatment of this vital movement can be given here, but the family need for social provisions along this line must be urged. Few families can afford the money, few parents have the wisdom, to secure the right sort of special treatment for minds not so diseased as to be legal subjects for insane hospital care or for inst.i.tutions for the feeble-minded, which yet make the family life miserable and the family success difficult. There is growing a conception of the need, especially in our complex modern life, that so often unsettles or overburdens the mind, to have all manner of free clinics and economical methods of care for those who can not well care fully for themselves. This movement will go on until the mental invalid of every sort will find as ready social sympathy and as adequate social aid as does the physically weak, ill, or crippled.

Such a serviceable little pamphlet as that of Mr. Brady's on "Mental Hygiene in Childhood" gives useful suggestions. Meanwhile, the family interest is keen and must become more active and commanding in ridding society of the inducing causes of diseased germ plasm. The whole "social-hygiene" movement, so-called, is in the direction of cutting off the supply of the defective and making every family less likely to have children who never grow up.

The call during the War, and a call heeded by many who had been ignorant of all the facts taught them in training camps, was "Keep Fit to Fight," The call of peace, and may it be heeded as the facts of inheritance are better known by all, is, Keep Fit for Parenthood. The sins of youth, so often sins of ignorance, carelessness, and unbridled pa.s.sion, which doom childhood to blindness, to congenital deficiency of all kinds, to permanent twist of mental powers, or to lack of ability to meet life's demands--these sins of youth will be less in evidence when education is fitted to life's full responsibilities of choice instead of being side-tracked in narrow lines of scholarly acquirement alone.

Meanwhile, for the parents whose children number one or more of the handicapped there is the comfort of securing for such all that science and special arts of teaching and inst.i.tutional provision can give to make the life of those who can never grow up at least comfortable and free from exploitation by evil influences. That some of the n.o.blest and best of men and women are giving their lives in wise and loving ministration to these least among the children of men is proof of the overmastering power of human sympathy. Meanwhile, again, we are finding out that the more discriminating observation of children and their more truly scientific rating will take many children from the lists of the "backward" and the "difficult" and even the supposed feeble-minded into the ranks of the educable toward full normality.

=Special Rooms in Public Schools.=--The special rooms in the schools and the special schools in the school system and the school nurses and school doctors and the visiting teacher, with her power of making connection between the home and the school and playground, all show that we are coming to a point where every child will have a better chance for having his mental and moral as well as his physical diagnosis correctly made. And such a diagnosis we have already learned often shows that no congenital doom marks the child labelled "different," but rather some curable bad condition in his life that needs only wisdom and economic power to correct. The "Observation Cards" to which allusion has been made as helping toward discovery of the specially gifted may also, if used with discriminating judgment, show that many whom we thought lagged behind their mates from native disability can be made to keep up with the procession if they are rightly fed, have enough sleep, get a chance at fresh air, and are not made the victims of industrial exploitation.

The new gospel of environmental change in the interest of better physical, mental, and vocational opportunities for all, includes not only the better care of all incompetent for self-control, self-support, and self-direction, it also is coming to include a far more searching investigation of the causes of degeneracy and backwardness, and many children are thereby lifted from the hopeless cla.s.ses to the group of those requiring only special care and teaching to be able to be cla.s.sed as normal.

=Training the Nervous System.=--Professor James said, "The great thing in education is to make the nervous system the ally, not the enemy.

For this we must make automatic and habitual as many useful actions as we can and carefully guard against growing into ways which are likely to be disadvantageous." His advice for self-discipline is to "seize every first possible opportunity to act on any resolution made, and on every emotional prompting in the direction of habits one aspires to gain." Professor Thompson, in his book on _Brain and Personality_, says, "We can make our own brains, so far as special functions or apt.i.tudes are concerned, if only we have wills strong enough to take the trouble." These and many other admonitions in the direction of more effective mental training show the trend of modern education. How many a will has been weakened by bad methods of family influence! How many nervous systems made the enemy of education rather than its ally by bad family conditions!

The Parent-Teacher a.s.sociations are doing valiant service in bringing to the home the best thought of the school and in bringing to the school the best feeling of the home. It is not too much to hope that when the jointure between real education and pure affection is made more complete we may lessen the toll of incompetent personality and raise the social standard of human powers. In this connection one vital thought must not be over-looked, namely, the social advance we may reasonably expect from the new power of women to select the fathers of their children. Doctor Sumner said, "During the ages of the man-family men could not make up their minds what they wanted woman to become." If that be so, it is still more true that now, as the age of the man-and-woman-family begins, women are undertaking to make up their own minds as to what they want to be and to do and are attaining a freedom of s.e.x-selection such as they have not had before in the civilization we call our own. Doctor Todd says truly, in his _Theories of Social Progress_, that "from now onward the centre of selection is s.h.i.+fted from without to within, from pa.s.sive adaptation to active self-determination;" and he adds, "To rationalize s.e.xual selection and make it serve progress will be to revise the 'mores' and inject into them new principles." While women had no real power to select their mates in marriage; while their economic helplessness led them almost universally to marry as a means of support even when no real affection softened and sanctified the process; while they had no power over laws or customs, or knowledge of actual life outside the household, and hence had to take wholly on trust the character and protestations of the man they married; while women were in this subject condition they could not contribute to family life either a high standard of choice of parental quality or a forceful demand for previous purity and right living in the husband. Hence, women have up to a recent time been more sinned against than sinning if they pa.s.sed on defective germ plasm or doomed their children to suffering lives.

=Responsibility of Women in Marriage.=--Now the case is different. No woman of usual physical strength or natural ability or average vocational efficiency is necessarily tempted to make "marriage a trade." If she has any strength of character she can make her own way and find many good things in life for herself. She can, therefore, exact such a standard of character and attainment from any man who seeks her in marriage as he may well demand of her and can pa.s.s by as incompetent to family demand all who do not measure up to the requirements.

This may mean (in some circles of society, it is already coming to mean) what Wallace indicated when he said, "Woman is to be the great selective agent of the future." This cannot be, however, unless women hold themselves to the best standards that men in the past have exacted of their s.e.x and so holding themselves (where the race needs that they should stand) hold men also where the race needs that men should find their place. The defrauded children of every generation call with pathos of unique appeal upon men and women that the "racial poisons" shall be abolished, and evil inheritance be checked, and that every potential father and every potential mother shall hold sacred the torch of life to pa.s.s it on the brighter for their handling.

Meanwhile, such agencies as "The Committee on Provision for the Feeble-minded," with its central office in Philadelphia, and the "National Committee for Mental Hygiene," with its headquarters in New York City and its important quarterly publication, together with local a.s.sociations of similar type, are at work, as is well stated by one national body, "to disseminate knowledge concerning the extent and menace of feeble-mindedness and to suggest and initiate methods for its control and ultimate eradication from the American people." On such social effort afflicted parents of a defective child may depend for aid and direction.

In Whittier's tribute to Samuel Gridley Howe, the pioneer in this social care of defectives, one false hope is pictured, namely, that "the idiot clay" could "be given a mind." That hope could not be realized. The gates of destiny close at birth for many of the children of men. What we can do and are now beginning to try earnestly to accomplish is to prevent so many idiots from burdening the currents of life, to wipe out the social disgrace of leaving neglected wanderers on the highways of human effort who are unable to find the path of safety and of success, and to make a protected place of guidance and possible training for all the weak-minded and abnormal. We can, now we increasingly understand, do more than this; we can help with ever more ingenious and devoted care to give the merely slow and backward a better chance at life's opportunities and help to make these least able to adjust themselves easily to the common ways of the world more amenable to life's discipline and happier in life's restrictions.

=The Call for Preventive Work.=--The new call for social service for the children that never grow up is along new lines of preventive work as truly as in demand for more tender care of all who cannot be helped radically toward self-control and self-direction. The family, once overwhelmed by tragedies of abnormality, can now be aided as never before in lessening or in bearing the burden of such troubles. For the less seriously handicapped yet specially in need of social consideration--the blind, the deaf, the crippled, those of cardiac weakness, and the children born tired who might become rested and strong--the family has helps in education, medical treatment and work opportunities suited to the particular need, such as no previous era could furnish. Agencies for finding employment for the handicapped now show ingenuity of the highest sort in fitting the work to special needs, and the way in which the blind are taught to rise above their misfortune in happy use of the faculties and powers they actually possess is marvelous. The deaf have as yet been able to triumph over their misfortune in less degree, but the art of reading from the lips and other educational devices used in their behalf make their condition so superior to that of the deaf-mutes of old that it is cause for grat.i.tude to every parent of a deaf child. The crippled children now are seen not to be different from other children in their educational rights and as needing only more consideration of physical requirements to be fitted for useful work.

The significance of the removal of educational provisions for the blind, the deaf, the crippled, and the invalid children from the provisions of Boards of Charity and their a.s.signment to departments of state and local Boards of Education, is great. It shows that we are becoming as capable in the community-at-large of understanding the radical difference between those who are defective in mind and those who are merely handicapped by loss of some special sense or some physical power as loving and wise parents have been when either defective or handicapped children have called upon them for special care. The children that find it harder than most of their age and station to grow up to full enjoyment and use of life's opportunities, because of some weight of affliction, are, we now know, ent.i.tled to all the training that the normal child receives and whatever else of special education their condition requires. The children that can never grow up to mental maturity, even with all that educational ingenuity can offer, are the permanent members of Society's Infant Cla.s.s.

QUESTIONS ON THE CHILDREN THAT NEVER GROW UP

1. What is the modern social program in respect to the care and training of the feeble-minded?

2. What should fathers and mothers of the feeble-minded do to help realize that program?

3. How far should social control compel the segregation or sterilization, or both, of those obviously unfit to become parents?

4. What can be done by mental hygiene to lessen the numbers of the insane, the "queer," the weak-willed, and the slow-minded?

5. The consensus of experts seems to indicate that the first need is to segregate in suitable inst.i.tutions under permanent custodial care all the markedly inferior who cannot be self-supporting and who lack power of self-protection against the grossest forms of exploitation; the second need is to introduce new methods of supervisory control and humane protection and training in the care of those who are not normal but who, under favorable conditions of vocational guidance and direction and with a new home environment suited to their peculiar needs, may become wage-earners and fairly useful members of society. In the town for which you seek better conditions, which of these efforts is most needed at the present time? Is it to meet the needs for inst.i.tutional care or for supervision adequate and well applied for those left either in their own homes or placed in colony-care?

FOOTNOTES:

[14] See "Mental Diseases in Twelve States," as reported in 1919 by Horatio M. Pollock, Ph.D., Statistician New York State Hospital Commission, and Edith M. Forbush, Statistician of National Committee for Mental Hygiene, published in _Mental Hygiene_ of April, 1921.

CHAPTER XI

PRODIGAL SONS AND DAUGHTERS