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The

Psychological

Clinic

Copyright, 1919, by Lightner Witmer, Editor.

Vol.

XIII,

Nos. 1-3

December 15, 1919

A DEMONSTRATION By

the

Staff

of

the

University

of

CLINIC

Psychological

Clinic,

Pennsylvania.

In April of each year University to listen to

the educators of Pennsylvania meet at lectures and addresses on subjects connected with education and to hold conferences and discussions on methods and plans for carrying on the work. This annual function is called "Schoolmen's Week." As part of the program this year a demonstration was given on Saturday morning, April 12th, at the Psychological Laboratory and Clinic. Similar demonstrations are given regularly on Saturday mornings and other days through the academic year as part of the required work in regular courses in psychology. The Psychological Clinic is open daily for examination when parents and teachers bring their children to obtain advice which they hope will assist them in solving difficult problems. The object of the demonstration here reported was to show the schoolmen of Pennsylvania what some of the methods of the Psychological Clinic are. The emphasis was laid on the use of psychological diagnosis in the practice of teaching. Professor E. B. Twitmyer, who the

is an expert on speech training and who has directed for many years the speech clinic, showed the principles and methods employed by him in curing two cases of speech defect. Dr. Witmer showed four children who were not getting on well in school and who had been helped by means of clinical teaching carried on by volunteer student assistants attending the School of Education at the University of Pennsylvania. He also showed two cases, previously examined at the Psychological Clinic, who had failed to get on in school because of defects which had not been discovered in time to provide the kind of instruction fitted to their needs.

%

THE PSYCHOLOGICAL CLINIC.

Record. Name

J Nine years four months. Principal of school. Mother's refusal to permit him to remain in special class. Public School, until March 1919. Is not now attend-

Age Referred by Because of School attended

ing

Kindergarten, 1915. 2-1-17?1A. Not promoted in June. 9-3-17. Dropped and went to where he stayed five months, still in 1A.

Diagnosis Recommendation Terman Revision

Physical

condition

Status at time of ination

12-17?1A. 2-1-18?1A. 9-18?1A. 1-19?IB. Principal states that this was an automatic promotion. 2-19. Orthogenic Backward Class. 3-19. Mother removed him from O. B. class and refused to let him return. Deferred for further study. Clinic teaching to determine diagnosis. Basal age, 7 years. Mental age, 8 years 8 months. I. Q., .928. Poor. Decidedly lacking in energy. Trouble with cervical glands. Frequent colds.

exam-

Reading?Could read nothing. and

Number of hours instruction Present status

any school.

Six years.

Age entered School history

Knew only A, B, C,

O.

Arithmetic?Approximately second-grade proficiency. Five hours thirty-five minutes, distributed over thirteen periods. Can read six pages of Book One of "The Young and Field Literary Readers." Can spell and write all the words in those pages.

A DEMONSTRATION CLINIC.

Report. is nine years

so far as school work is failure. He spent four terms in 1A, then a kindly principal promoted him to IB. She did not know his actual ability and was greatly surprised to learn a month later that he could not read a word. Furthermore, he was still talking an almost unintelligible baby-talk, and usually spoke in a low mumble.

J

old, and, already

concerned, he has proved

a

His

speech defect made his retardation appear even greater than did his lack of school proficiency. The principal took the proper course with a case of the kind and transferred him to a special class. About three weeks later, J frail-looking boy, decidedly deficient

,

who is

an

anaemic,

nervous,

in energy, went home to mamma without any hat and also minus some other minor possessions. J 's mother rushed off to school to find the lost articles, and discovered in consequence that her boy was in a class with a group of boys, some of whom were twice his size, most of whom were of a lower than J , and some of whom were obviously feeble-minded. She felt that these were unfit associates for her child and so, when the principal refused to return him to the regular class, she removed

grade

him from

school. The principal recommended a psychological An examination and J was brought to the Clinic. with mechanical tests seemed rather inconclusive, and Doctor Witmer recommended further study and an attempt to teach. At the time of his examination J 's only literary equipment was a knowledge of the letters A, B, C and 0. Of course he could not

examination,

The next week he began to come to the Clinic for teaching. Now, at the end of five and a half hours, devoted to the teaching of reading by the diagnostic method, J He has is reading. covered six pages of "The Young and Field Literary Readers," Book One, and he knows every word included in those pages so as to be able to recognize it in an entirely different context. In arithmetic both his ability and his acquirement seem to be normal for the second grade. His speech is clearing up under instruction. A Terman test given a week ago gave him an intelligence quotient of .928, which means an intelligence normal for his age. Even his physical condition has improved as an accompaniment or result of the mental spurt. There is nothing to indicate that this could not have happened long since.

read.

THE PSYCHOLOGICAL CLINIC.

4

Record. Name Referred by Because of School attended Age entered School history

Diagnosis Recommendation Mental status

Physical

R Seven years seven months. Mother's Assistance Fund. Speech defect. Public School. Six years. Entered 9-10-17?1A. 2-1-18?1A 9-18?IB. 2-1-19?2A. General standing 7. Infantile stammer, simple and curable. Attendance at speech class. Normal for age in performance tests. Memory span 4 digits, 4 repetitions for 5 digits. Good. Nose and throat negative. Teacher suggests possible deafness. .

Age

condition....

Member of teaching clinic Educational status....

Teaching Dr. Witmer states

Speech Work

Taught three hours. Used anagrams, picking

out letters in this fashion? FRNk called Father. Called H, E and E, F. Knows no phonics. Could spell cat and rat. Has been taught f, s, e, h, b, m, c, k. Discriminated Learned to between dog, cat and ran as words. sound cat, rat, sat, etc. That is not deaf, but has poor discrimination for sounds due to faulty articulation. Thi3 leads to something resembling word deafness. Can give all sounds by imitation. Drilled on mouth positions, ordinary words used in casual conversation and lists of words containing r and t. Has learned "Barber, Barber" and is given drill on difficult

words found in that classic.

A DEMONSTRATION CLINIC.

5

Report. is seven and one-half years old, but he has not yet learned He entered school that anyone can understand him. when he was six and was promoted to the second grade in January. Although he is reported poor in reading, he is expected to reach a higher class in June. R

to talk

so

R

does well in manual tests. His memory is trainable, he has a limited memory span. There is nothing to indialthough he cate that has not an adequate mental equipment to do the work of the second so

grade,

great that it is

defect is

"baby

an

but he does have

a very definite speech defect, handicap in learning to read. The stammer, that is, a prolongation of so-called

a most

infantile

decided

talk."

R was placed in the speech class conducted by Dr. Twitmyer. The teacher to whom he was assigned tried to use his reading to aid in speech instruction, and discovered that, with the exception of the words of his name, R did not know a single word. He was then given special instruction in regular first-grade work in addition to the speech training. In the few weeks he has been coming to the Clinic, he has learned to say a great many words correctly, has become more willing to try to talk and has made a start toward

acquiring reading by learning half a dozen or more words and the sound names of the letters forming them. There is a chance for R but only if given special instruction along the line that he needs, for he can never profit by school work as long as his speech ,

defect remains

so

great.

6

THE PSYCHOLOGICAL CLINIC. Record.

Name

S Thirteen years seven months. Children's Dispensary, University Hospital. Backwardness in school. Public School. Not known. School history begins 11-8-15. 11- 8-15 Grade 2A IB 11-10-15 IB 1-31-16 2-15-16 3- 7-17 1A IB 9-10-17 2- 1-18 2A 2-28-18 Left school 2A 3-11-18 Teacher reports that she hopes S 's reading will improve enough so that he may be promoted at the end of the term. Five years' general retardation. .

Age Referred by Because of School attended Age entered School history

Diagnosis Recommended Physical condition Educational status

Teaching

Prognosis Note

Orthogenic teaching.

....

Retarded about fi ve years. Nose and throat in need of care. Head girth 54 cm. Could not read. Knew words like "is," "be," "the" and the like. Had no idea of phonics. If he had any idea of what was on a page he would try to read, making it up as he went along. The arithmetic was good second-grade work. Spelling was very bad. any combination of letters representing a word. Teaching continued for five periods of more than one hour each. Has been given much drill in phonetics, and required to be very careful in any reading attempted. Can now read simple stories in the second reader. No instruction given in arithmetic, as that subject was so far in advance of his reading and spelling. Is required to do his spelling word from every angle of imagery, in which he seems deficient, so that he does not retain correct spellings. Can be taught to read correctly and well. Number work probably not past abstractions. Spelling doubtful at present time. S likes to come to the Clinic very much. Does not like to go to school.

A DEMONSTRATION CLINIC.

7

Report. A thirteen-year-old boy bent over a table trying to read a selection in the first reader. His brows were drawn together and his mouth puckered as he struggled with the complexities of s-l-o-w and h-a-v-e. The next time he found these words, he spelled them out again and so it happened a third time?first-grade reading was no joke to S .

At arithmetic S did much better for he had acquired most of the combinations during his school career, but spelling?S couldn't He saw no reason for that letter was one spell. supposing preferable to another in any

was not good in school. given instance. S S is graded in 2A. He has repeated at different times all of the classes below that grade and one or two above in an effort to get a running start. His school life has been strenuous but not valuable to him, and S is now "going on" fourteen. It is time he was doing better. S thinks so himself and is eager to quit

school and go to work. He has lost all interest in things academic. The Psychological Clinic was asked to try S No out. well. reason was found for his inability to read. work He plans He does tests well, and the mental equipment which he uses in his In social life seems to be fully adequate for his environment. the lacked he it was found that very attempting to teach S

foundations of reading.

Drill in the use of phonics, insistence upon in accuracy reading and definite care in the study of his words for 's work so much that spelling and language have improved S there seems no doubt that he could have been taught to read and spell properly years ago. Now that he is almost ready to leave about the best that can be expected is that he may learn to read well enough to read the daily paper. The years of instruction S has received have not given him as yet the most necessary tools to be used either in the acquirement of knowledge or as means to the end that he may be self-supporting.

school,

8

THE PSYCHOLOGICAL CLINIC. Record.

Name

Age Referred by Because of School attended Age entered School history

A Fifteen years six months. Children's Dispensary, University Hospital. Backwardness in school. Public School. Not known. School history dates from 11-8-15. 11- 8-15 Grade 4A 3B 11-10-15 3B 1-31-16 2- 1-16

1

Diagnosis

Recommendation Terman Revision

Physical condition

Desires

2B 3-29-17 3A 9-10-17 3B 2- 1-18 3- 1-18 Left?suspended for truancy. 11- 4-18 3B 4A. Successful in work of 4A. 2- 1-19 Retardation; on the anatomical scale, four years; pedagogical scale, five years; mental age score, six years. Apparently quantitatively feebleminded. Considering family history and mechanical tests, will probably be above the line of social competency. That he be taken from school and put to work. Basal age, 7 years. Mental age, 9 years 2 months. I. Q., .659. Retarded four years. Referred to the Nose and Throat Dispensary. Often at Children's Dispensary for colds and minor ailments. To go to work. Interested in automobile repair shop.

A DEMONSTRATION CLINIC.

9

Report. "bags" school. He is fifteen years old and ready to work, but the law requires him to stay in school and study the reading and arithmetic that goes with the fourth grade. When A was ten he was in the fourth grade too. He has been in other grades since then but never one higher than the fourth. Now at fifteen he is running neck and neck with the attendance officer, in bad with the school because he will not attend and get his lessons, A

go to

in bad at home because he will not go to school and cannot go to work and thus ease the ever-increasing pressure on the family income;

and, lastly, in bad with the community because he has no lawful employment and is thus open to mischief with every bad boy of the neighborhood. A social worker interested in the family brought A to the Psychological Clinic because he is doing so poorly in school. He did He He uses his hands very well. solve a new problem readily, planning the solution with skill. He has good ability at following directions and gives evidence of clear thinking in every test he attacks. On one point alone he is

not prove to be feebleminded. can

limited, his responses to questions indicate his lack of acquaintance with his own tongue. He can read, but he cannot tell about what he has read. He fails to give definitions and bits of information usually picked up in school. He has not acquired either arithmetic or reading in a poor.

His

involving

ability

their

to use words is

use

way to make them adequate tools of use to him in later life. A is too big a boy to associate with the ten-year-old children who are in the fourth grade; he is too old a boy to enjoy attempting the same lessons he did five years ago. The fact that he rebels against the regimen suggests a not undesirable self-respect. The Clinic cannot

help.

There is

no way to

release A

from

his school obligation, so he is completing his education in the accumulation of such material as the street affords and in the acquirement of habits of idleness which will

handicap

him all his life.

10

THE PSYCHOLOGICAL CLINIC. Record.

Name

E Fifteen years. Philadelphia Committee for the Protection of Girls and

Age Referred

Women.

Because of School attended Age entered School history

Diagnosis Recommendation Terman Revision

Educational status....

Physical Desires

condition

Bad conduct in school and truancy. Public School. Not known. Not complete. Had reached fifth grade. Normal mentality. Retarded and backward. That she be taught a trade. Recreational opportunities. Basal age, 8 years. Mental age, 10 years 6 months. I. Q., .674. Reading, fourth grade. Can reproduce (10-year level). Arithmetic, third grade. Good. To be transferred to another school, but refuses to stay in school and improve her conduct so that she can be transferred. No occupational preferences.

A DEMONSTRATION CLINIC.

11

Report. E fifteen years old, has entered the dream world where plumed knights rescue lovely ladies before breakfast and marry and live happily ever after, in one volume. Each romance, at ten farther and farther away from the cents each, has placed E realm of reality, until now the pages of arithmetic and reading in the fifth grade automatically become lovely stages upon which dream people in flowing garments hold impossible conversations and perform marvelous deeds. Lessons were sadly out of place with E ,

,

and to avoid their continued torture the stage was often set and peopled in places outside the schoolroom. Since truancy is not to be desired, and teachers found it impossible to deal with the problem of E certi, the knot was cut by issuing to the child a domestic which permits her to sit in her slovenly home and dream away the hours undisturbed. Her E is not feebleminded, although very backward. performance tests show good ability with the hands and a fair amount

ficate,

of

planfulness. Her memory span is short and is not compensated easy trainability. With the manual dexterity which she shows, E ought easily to be able to learn some of the simpler operations involved in mill work. She may be able to keep herself above the line of social competency if no great stress is placed upon her judgment and ability to plan ahead. The romantic aspect which brought her into conflict with the schools is probably an adolescent phenomenon, which is not serious in itself, but if not rightly directed may result in serious non-conformity to the standards demanded by her

by

own

social group.

THE PSYCHOLOGICAL CLINIC.

12

Record. Name

S

Age

Ten years seven months.

Referred by Because of School attended Age entered School history

School

Recommendation

Speech

status

nurse

of last year.

Speech defect.

Diagnosis

Mental status Physical condition..

.

..

Public School. Six years. One term 1A. One term IB. Two terms 2A. One term 2B. One term 3A. One term 3B. Promoted on encouragement to 4A, but will not be promoted this term to 4B. She is not doing onefifth of the work now. Her written papers average less than twenty. Infantile stammer somewhat complicated by throat condition. Nose and throat examination; attendance in speech class. Infantile; one and one-half years retarded. Sore throat Much improved since tonsilectomy. avoided and child has improved in flesh. When Can give any sound desired by imitation. required, talks very nicely. Apparently no active co-operation in the home, so that training is progressing very slowly. Child can recite "Owl and Pussycat" and "My Shadow."

A DEMONSTRATION CLINIC.

13

Report. has been petted all her The youngest of a family of four, S life. She is now ten years old, a "big girl," but she still retains many of her baby habits including that of " baby talk." In this she has been her family and the young women of her acquaintance because it sounded so "cute." With the speech defect, S has

encouraged by

also continued to lean strongly upon the parental oak, and in its absence upon the teacher or anyone else handy, for S has never learned to stand alone in the

simplest matter. Speech Clinic because a school nurse had She early showed ability to say recommended it to the parents. anything that she desired in good English, while at the Clinic, but apparently it has been hard for the family to remember that S is almost eleven, and they still permit her to talk in the old way at home. S goes to school but is not to be promoted to the 4B class in June, for her work is worth not more than twenty on a scale of one hundred. 's amiability which Part of this trouble has been S has made it possible for S to get promoted more on the basis of her tears than on her ability to read and do her sums. S must be taught to speak correctly. She will never read accurately until she speaks well enough for the teacher to understand her. She must also learn to do things for herself, both at home and at school. will never make Unless these two points are won, S a normal, healthy woman. S

came

to the

14

THE PSYCHOLOGICAL CLINIC. Record.

Name

Age Referred by Because of School attended Age entered School history

Diagnosis Recommendation

Terman Revision

Physical condition

Educational status

....

P Twelve years ten months. Juvenile Aid Society. Fact that younger sister of seven can neither walk or talk. Public School. Seven years. Two years missed because of illness. Entered in 1911 Three terms 1A One term IB One term 2A 6-22-14 entered 2B One term 2B Promoted to 3A and then transferred to Orthogenic Backward Class. Normal mentality. Specific defects in vision and audition. Medical attention, especially eye and ear examinations. Also dental treatment and subsequent to these treatments restoration to a regular grade. Ten years four months. I. Q., .81. Does not think Teacher reports boy nearly blind. him deaf. Examiner found him lacking in audition in one ear and dull of hearing in the other. The sight in one eye is entirely gone and very much reduced in the other. Body filthy and has "habits of an animal," so teacher reports. Teacher reports that he learns absolutely nothing. He is so often truant that she feels unable to give him a rating. No co-operation at home.

15

A DEMONSTRATION CLINIC.

Report. 's sister never walked or talked, the family was Because P referred to a well-known social agency in the city. A social worker was supposed to attend, asking for his inquired at the school P school record. His teacher reported him the most disgusting child in school, of filthy habits, given to answering questions with "queer

expressions." The chological Clinic to The examiner

social worker then find out what

was

brought

P

to the

Psy-

the matter with him.

confronted

by a 12-year-old boy, tall, pastyprepossessing in appearance, who slid sullenly into a chair and waited with mouth open for what was to happen. He co-operated well with the tests, however, and showed at once his ability with mechanical material. His only defect was a marked lack of distribution of attention. His memory was good, he had an adequate memory span and good trainability. His general information, as indicated by the Binet tests, was not that of a boy of his years, for his school work had not kept pace with his advancing age, and the abstractions required in the twelve-year tests were beyond him. The total result showed a retardation on the Binet complexioned,

was

not at all

scale of two years. While P was being examined, he constantly questioned the examiner with "Sir," "H'm?" and "What?" The examiner inquired whether he heard well, and was met with an indignant denial of deafness. However, P finally acknowledged that the drum of one ear was missing and that he could not hear at all on that side. Further testing showed that he had reduced hearing on the other side. There was such a marked lack of distribution of attention in some of his work that a rough test was made of his vision with the result that one eye was shown to be completely blind and the other greatly reduced in acuity. This normal boy had been shifted from regular class to special class and back again, partly because he had never been taught ordinary habits of cleanliness in the home, and partly because of

replies given in the classroom. His present teacher knows that he is nearly blind but has not discovered the deafness. With no help from the parents, the school has not been able to keep P

nonsense

in

regular attendance, and, while he has been in school, he has been profit by the instruction offered him because of sensory defects so great as to require special methods of instruction.

unable to

16

THE PSYCHOLOGICAL CLINIC. Record.

Name

Age Referred by Because of School attended Age entered School history

Diagnosis (1916) Recommendation

Diagnosis Terman Revision

R Nine years two months. Social Service Department, Howard Hospital (1916). School nurse. Backwardness in school. Public School. Five years. Not complete. Two terms in 1A in regular grade. Now in special class doing first-grade work in reading and second-grade work in arithmetic. Deferred. Transference to a special class. Medical care. Reexamination. Normal mentality. Basal age, 5. Mental age, seven years four months. I. Q., .72.

A DEMONSTRATION CLINIC.

17

Report. R?-? lives in one of the tiny houses in a back street of one of the poorest districts in Philadelphia. With a brother and a sister, at nine years of age sees the normal, alert Italian children, R life of the street flow past her without taking part in it. R 's father is ambitious for her and the others and insists upon cleanliness and

good behavior rather more strictly than do his neighbors. The mother is not "quite right in the head," which fact isolates the family from others in the community for the neighbors are afraid of her. R

Two years ago she was Clinic because of her lack of ability to do school work and also because her personal habits were not equal to those of the rest of her class. Since she was primarily a case for medical care, R was recommended to a special class, the medical care she was then receiving to be continued. For two years R has been receiving instruction in the special class. Her physical condition is much improved, but the school situation is the same as it was. R is still reading in the first grade and doing number work but a little more advanced. She has not yet learned to use English with any facility. Mental examination shows that she

brought

has not done well in school.

to the

Psychological

has

good ability with manual tests, but her memory span is short and her trainability not great. She has no ability in the use of words. What can be done for R ? She is not a fit subject for an institution. She can learn to do simple work effectively and ought at the present time to be receiving instruction so that she will be prepared for occupational competency when she leaves school in six years. The time to make her an efficient unit of her group is These years in school ought to be valuable to her. She has a to expect that they will be.

now.

right

A Demonstration Clinic.

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