"We have two Parliamentary Acts dealing with the mentally defectives: -first, The Defective and Epileptic Act of 1899 which deals with all such children who are capable of education. Roughly speaking we take no children who test less than IV by Binet and keep none who reach XI by Binet; second, The Mental Deficiency Act of 1913 which deals with all mentally defectives below seven years, over sixteen years and all who are of too low grade to be educated in any school.

The anticipated procedure when the act was passed in 1899 was that all children would remain at school till sixteen and be passed on to the Mental Deficiency Committee at once, either for supervision, guardianship or institutional care. Unfortunately the wording of the 1899 Act was so loose, that certain children may leave school subject to the approval of a special subcommittee, but if they are allowed to leave before sixteen, the Mental Deficiency Committee accepts no responsibility for them unless arrested or in serious trouble. Now at the present time there is a frightful scarcity of labor and it seems a pity to keep in school sturdy boys and girls who are needed by their country and who could earn good money in their homes.

Moreover, it is a very difficult thing for anyone, doctor, teacher, or superintendent to say definitely whether these children will do well in the wide world or not, until they have been tried. Now, here comes our scheme: We have chosen a large number of good, reliable firms of all kinds in different parts of the city: carpenters, lunch positions, gardeners, wire workers for the boys and for the girls: laundry work, leather stitching, pinafore making, paper bags, etc. These are called approved firms and they are willing to treat any of our children just like other workers and with the same rates of pay. They will also permit a teacher to visit the child once a month in order to see his work and confer with the foreman as to the child's progress.

At the half-yearly examination I confer with the head teacher and we choose the most suitable children who may be considered as eligible for this trial; we select the most suitable firms and communicate with the manager. The parent is then seen and the offer is made to her: 'Under the Act we have the power to keep your child at school until sixteen years of age, but, as he being over fourteen years of age, seems to be suitable and fit to care for himself and do reasonably good work, we are willing to allow him to leave school on condition that he goes to work at a place we choose for him and that he remain in that place until he is sixteen. If he fails to do this or to give satisfaction to his employers, he must immediately return to school and stay until he is sixteen.'

The advantages of this method are many. Chiefly we have tested the child to see if, working under good conditions, he will be able to keep a situation and give satisfaction. The employers are as a rule pleased because they know that they will get the child's best work and that they can return him to school if he proves unsatisfactory, while the visiting teachers will see that the child is not imposed upon, and that he has suitable work.

Phild is ever allowed to go to work under fourteen years of age, and most

of them are fourteen and a half and fifteen years old. They are only the best and highest grade of children that we have. If a child cannot keep his situation and give satisfaction, he returns to school; it may be that he is tried again with another firm and again fails. All the children who are kept till sixteen (that is the least responsible and worst cases) are referred to the local authority under the Mental Deficiency Act. Moreover we are able to tell which of those on trial with firms are likely to continue working under slight supervision which must also be recommended to the local authority. Of course this scheme is quite new and is just a tentative way of bridging the gap." This experiment in Birmingham is suggestive to those who have the same problem to work out.

Let us consider what becomes of these children who leave school and who are not provided with such after-care. In a recent canvass of the situation in Boston, sixty-five of the special class graduates were located and their working history reviewed.

From September 1913 to September 1915 (2 years):

31 out of 65 had a working history of over 14 years and less than 2 years. 11 out of 65 had a working history of over 1 year and less than 11 years. 10 out of 65 had a working history of over 6 months and less than 1 year. 13 out of 65 had a working history of less than 6 months.

To be sure one of these with a working history of nearly two years, had had eighteen positions. One she had held for one day only and the longest time was three months. In her case, these two years covered the time from seventeen to nineteen years of age. The positions secured by this group of sixty-five required but little skill; the list includes bundle girls and boys in drygoods stores, delivery boys, office boys, nurse girls, peddlars, workers in brush making, shoe blacking and basket making establishments, carpet factories, rubber factories and laundries; while working in candy factories is a favorite employment. This gives a clue to the kind of positions that are open for the mentally defective, and with these in mind, the after-care officer should know of vacancies as they occur and attempt to fill them.

In Springfield, Massachusetts, the following information is valuable with reference to 135 pupils enrolled in public school special classes from May, 1898, to December, 1915 (17 years). There was a total enrollment during that time of

91 boys 44 girls 135

Of this number there were enrolled in the two special classes:

Enrolled in the grades of children promoted from the special class.

Deceased and removed from city.

Married......

11

22

1

Status unknown.

Total..

69

Data with reference to the 66 pupils not included in the above:

Enrolled in state institutions, Dec. 1, 1915.

Regularly employed

Irregularly employed
Unemployed

Total

16 or 24.2%

29 or 43.9%

10 or 15.2%

11 or 16.7%

.66 or 100 %

In a preliminary report published December, 1915, on children discharged from ungraded classes in New York City, Miss Farrell reports on 350 pupils who have been out of school from one to eight years. Of this number:

54 8% were employed for wages.

8 8% were employable but temporarily out of work at the time of the investigation. 24.6% were cared for at home and many of these at home had economic value.

In the three cities cited, all children in such classes have been certified as mentally defective by qualified psychologists and physicians.

The results of the follow-up work that has already been done and the fact that so large a proportion of the children are employed for wages, leads one to feel that the work done by the special class does carry over into their after life. Dr. Wallace of the Massachusetts School for the Feeble-Minded at Wrentham writes: "We have especially observed these children and believe they are more advanced according to their mental condition, manifest much better habits and their social relations in the institution are much better than the reaction of children admitted without the special training." At the Massachusetts School for the FeebleMinded at Waverly, Dr. Fernald is making a careful after-care study of all the patients who have been discharged from the school for the past twentyfive years. He says: "Wherever it is possible our field workers have visited these patients and the fullest inquiry has been made as to the kind of life they have lived since leaving the institution. The inquiry was planned primarily to furnish a basis of evolution as to the practical results given at the school. The inquiry also sought information as to the social, economic and moral life of the feeble-minded individual in the community.'

The results of this and similar studies will enlighten us as to the training best suited to prepare the child for adult life in the community. Besides the special class and after-care officer, there should be a definite plan of awakening community interest in the problem of the feeble-minded. Springfield, Massachusetts, has such a plan and in order to supplement the work of the psychological laboratory and the special classes, the Committee for the Study of the Feeble-Minded was formed in December, 1912. I quote from a recent report of Miss Cheney, the chairman of the committee, and a special class teacher of Springfield. The membership and purpose of this conference are outlined as follows:

Active members. Those actively engaged in individual efforts to educate and protect the feeble-minded.

Associate members. Representatives of various educational, religious, philanthropic, medical and civic organizations, who may confer with the active members at all times and in semi-annual conference.

Purpose. 1. To discover and record cases of mental defect in the community.

2. To persuade parents or guardians to place improvable cases in public school special classes or in private schools for atypical children or in state institutions for the feeble-minded, for education.

3. To interest employers in protected mentally defective persons who may have acquired the ability to perform skilled or unskilled labor.

4. To endeavor to remove from the community all unprotected feeble-minded persons to the permanent custodial care of state institutions.

5. To hold meetings at the call of the Chairman.

6. To keep a confidential card catalog with records of each case.

7. To record such facts in connection with mental defect as may shed light on the general problem, and to cultivate an interest in determining the causes of mental defect and the means of prevention.

8. To help mold public opinion to the need of providing opportunities for the education of the feeble-minded to the limit of capacity, and to the dangers of unprotected feeble-minded persons in the community.

During the three years of its existence, this committee has recorded 296 cases of definite or suspected mental defect. It has been actively engaged in arousing public opinion as to the need of further local and state provision for the feeble-minded and in securing support for legislative action, to provide a third institution to the located in western Massachusetts.

The committee maintains that the care of the feeble-minded need not fall wholly upon the community or the state, that the burden may be shared by the coöperation of both, with the purpose of providing not only education and protection for the feeble-minded, but of preventing the increase of mental defect and its attendant social evils.

Such a committee should also help to secure a law authorizing the permanent control and custody of the defective delinquent. These cases should be eliminated from our prisons and correctional institutions and cared for by themselves. The committee might also coöperate in establishing in the vicinity of their city, farm groups which would serve as training schools. Through visits to such schools the parents might overcome their prejudice to institutional life and later, if necessary, consider permanent custodial care for their children. Such a group could provide supervision and also be a clearing house for those who develop the need of institutional Several states have already in the farm colonies connected with their institutions such a combination of training school and permanent home. There the boys, many of them able to do the whole or part of a man's work under direction, are utilized to develop absolutely worthless land into valuable soil ready for cultivation. If the farm colony can be used to such good advantage by the institutions, it would seem possible to secure good results from a similar colony under the direction of school authorities and a committee similar to the one at Springfield.

care.

As the problem is recognized and public opinion created, it becomes evident that these individual community efforts should be systematized and have supervision. As so well stated by Dr. Fernald at the National

Clemen of Charities and Correction, Baltimore, 1915. "Many feeble« ipl, pura eventually become permanent public charges. Many run the pic. the courts, the penal institutions, the almshouses, ** ***** vatten, tre lying-in hospitals, and often many private societies spron rhape eventually to turn up in the institutions for the At any given time, it is a matter of chance as to what private organization or institution is being perplexed by * gekna they present. They are shifted from one organization or *** No Knother as soon as possible. At present there is no bureau g for who the knowledge and the authority to advise and compel proper a w pokection for this numerous and dangerous class." With a sprejeby ones of the feeble-minded, community interest, the help and sunt vten f existing records, and the cooperation of all existing agencies, ** date with och supervision would be dealing with the problem of Sammamindedness in a broad and constructive way. The bureau would

4

position to make a comprehensive study of the whole situation and mare biggestions which, carried out, would affect future generations. With the development of state supervision would come a greater demand for the cooperation and help of much societies as the National Commidtee on Mental Hygiene and the National Committee on Provision for The Peeble Winded.

In order to "fill the gap" or better in the words of Dr. MacMurchy, to "bold a bridge" between the special class and the institution, I have suggested fret that the public school insure diagnosis and treatment at an curly age, wt as a clearing house for cases needing permanent segregation, and attempt to train the others for appropriate employment; second: that the pupile upon leaving school be still further provided for in workrooms or in farm groups; third: that the guidance begun by the teacher be continued by after care and supervision; fourth: that there be a definite plan for awakening community interest in the problem; fifth: that state-wide supervision is necessary;) and finally: that the National Associations for the Peeble Minded formulate a program both educative and constructive, so that the nation as a whole may realize the "menace of the feebleminded"

With definite knowledge and mutual coöperation much can be done to bridge the gap between the school and the institution.

ADA M. FITTS, Supervisor of Special Classes, Boston, Mass.