FEEBLE-MINDEDNESS, a term descriptive of a condi tion of low intelligence. In England the term has been reserved for the highest group of mental defectives, those now called morons in the United States. In America the term covers the entire group of mental defectives. The following definition of feeble-mindedness was adopted by the American Association for the Study of Feeble-mindedness—the only authoritative body on this subject in the United States. Resolved: "I. That the term, feeble-minded, be used generically to include all degrees of mental defect due to arrested or imperfect mental development as result of which the person so affected is incapable of competing on equal terms with his normal fellows or manag ing himself or his affairs with ordinary prudence. 2. That the feeble-minded be divided into three classes, viz.: Idiots.—Those so deeply defective that their mental development never exceeds that of a normal child of about two years. Imbeciles.—Those whose mental development is above that of an idiot but does not exceed that of a normal child of about seven years. Morons.— Those whose mental development is above that of an imbecile but does not exceed that of a normal child of about twelve years.
"This grouping admits of the use of the older pathological terms, such as hydrocephalic, microcephalic, paralytic, etc., as adjectives indicating the respective complications." As will be seen, this classification accepts the term feeble mindedness as generic, referring to the entire group of mental defectives; and adopts a new term, moron (Gr. moros), for the highest group. The present view is that the moron is not neces sarily a person "incapable of competing on equal terms with his normal brothers or of managing his affairs with ordinary pru dence." The reason we have had so many morons in the past who did suffer from this incapacity was that they had been improperly trained or educated.
Care and Treatment of Feeble-minded.—It is commonly stated that primitive peoples and the ancients destroyed their mentally defective children. Not until late in the i6th century does human sympathy seem to have been aroused for this de fective class and then attention was centred on the cretin, a special form of mental defective due to non-functioning of the thyroid gland. At that time Felix Platten, of Basel, Switzerland, called attention to this group of unfortunates. In the early part of the 17th century, St. Vincent de Paul at the French asylum known as the Bicetre gave some special attention to idiot children; not, however, until the 19th century was any considerable effort made to care for these cases. In Germany a private school had been established by Dr. Saegert, in Berlin, in 1842. The first school in England was established in 1846 through the efforts of Dr. Parmalee and Dr. Reid, and soon after that came Carchester and Earlswood.
In 1792 a wild boy known later as the "savage of Aveyron" was found in the woods by some hunters. He was trained by Itard, who thought to demonstrate certain philosophical tenets. He was observed in his work by Seguin, who, impressed with the possi bilities of educating idiots, opened a private school in Paris in 1837 and devoted the rest of his life to this work. In 1848 he emigrated from France to the United States, and it was largely as a result of his work that institutions for the feeble-minded were started in the United States. In that year, two schools were started in Massachusetts: one, a private school at Barre; the other the beginning of a State institution, which was in con nection with the Perkins Institution for the Blind, and was also under the direction of Dr. Howe, who had previously found feeble-mindedness among his blind children in South Boston. The second State institution was established by New York State in 1851. The third was in Pennsylvania in 1852, now known as the Pennsylvania Training school at Elwyn. The fourth institu tion was established at Columbus, 0., in 1857, and the fifth in Connecticut in 1858. Kentucky and Illinois established institu tions in 1860 and 1865. Other States followed as their populations increased or their needs developed, until at present there is a State institution in all States except Nevada, Utah, Arizona and New Mexico. There is also an institution in the Territory of Hawaii. The early institutions were influenced largely by Seguin's example and enthusiasm ; and they were motivated largely by the impulse to educate or cure the idiot. It was found, however, that there were large groups which were practically incapable of any edu cation. Accordingly, in 1878, an institution was established in Newark, N.Y., for the custodial care of untrainable idiots. The custodial idea then prevailed for some time.
In 1923, the latest census available, there were in institutions in the United States 50,640 feeble-minded persons. This is ap proximately 5 per 10,000 of the population. About one-half of these are of imbecile grade, one-sixth idiots and one-third morons. It is generally agreed now by students of the problem that I% of the population need such care. This would be proportionately reduced if the public schools took care of the moron as suggested above. A new epoch began in 1896 ; at Faribault, Minn., was opened a psychological laboratory for the study of the feeble minded. Ten years later, in 1906, the Training school at Vineland, N.J., opened a psychological laboratory at that institution which has been in continuous operation. Similar work has been done in various other institutions for short periods. Psychological study has led to a clearer understanding of the abilities and disabilities of the feeble-minded of the various grades, with the result that their education and training has been established upon a sound scientific basis. Present day ideals for the feeble-minded are stated by saying : The idiot may be trained to make known his physical wants, and to eat a little less like an animal; the imbecile may be trained in the lower grades to a little self help, and in the higher grades to considerable useful work if under careful direction and supervision; the moron may be trained to be an efficient institu tion helper and even for self support outside the institution, pro vided his training is begun early enough and done thoroughly enough along right lines.
Types.—Previous to the adoption of the classification above given, much emphasis was laid upon types of mental defective ness. As already pointed out, work for the feeble-minded began with a consideration of the cretin, a condition endemic in Switzerland and northern Italy, where it is due to an hyper trophied thyroid gland showing as a goitre. In the United States the cretin, or cretinoid, as he should be called, is the result of the congenital absence of the thyroid gland. In either case, the condition is the result of lack of iodine in the food or drinking water. The cretin does not grow, either physically or mentally; he has marked physical characteristics easily recognized. If the condition is discovered early, thyroid extract may be administered, producing the same result as though the child had a normally func tioning thyroid gland. Another type of considerable importance is the so-called "mongoloid" or "mongolian," so named because of a fancied resemblance to the northern Asiatic races. This type is congenital, but not hereditary. It is believed to be due to the failure of the mother to nourish the child properly in utero. Mongoloids in general have the intelligence about equal to a four-year-old child; rarely they attain to that of an eight-year old. If understood and carefully treated, they are affectionate, interesting little children, but always little children. The hydro cephalic is the result of the disease hydrocephalus, producing the greatly enlarged head, and as a rule, mental deterioration, varying in all degrees of mentality, even up to normal. The microcephalic, or small head individual, is generally not higher than imbecile grade. The typical feeble-minded person is simply and solely a person whose mind has not developed. He is what the name implies, simply weak or simple minded. There are no peculiarities or typical features, except such as result naturally from the low degree of mentality. Much confusion results from considering extraneous circumstances as essential characteristics of feeble minded people. There are, it is true, some slight fundamental dif ferences according to what has been the cause of the condition.
first rule for the treatment of the feeble minded is to make them happy and to remember that, no matter what their chronological age, they are irresponsible children. It is useless to scold them for their mistakes, because they do not understand. Encouragement for all their good efforts and praise for all their successes is the rule. As to education and training, it must be concrete and definite, manual and industrial training rather than book work. They cannot handle abstractions, or understand general principles. It is useless to teach them rules of morality, for they cannot apply them. The high grades can be trained to do many useful things under direction. They can do many kinds of house work and farm work, simple repair work and even use simple machinery, to which they have been thor oughly trained. They do most of the manual work in and about the institutions where they live. This materially reduces the cost of their maintenance. As a rule, these children are happier in an institution than they are in their own homes, because in institu tions they are with children of their own mentality and conse quently are more comfortable than in their own homes where they are impressed with their inferiority. (H. H. Go.)