//// 
 
Oniversity ol the State ol New York Bulletin 
 
 Entered as second-class matter August a, 1913, at the Post Office at Albany, N. Y., under the 
 
 act of August 34, 191a 
 
 Published fortnightly 
 
 No. 674 ALBANY, N. Y. November i, 1918 
 
 SYLLABUS FOR THE EXAMINATION AND CENSUS 
 OF MENTALLY RETARDED, SUBNORMAL, OR 
 ATYPICAL PUPILS 
 
 WITH AN OUTLINE OF SPECIAL CLASS ORGANIZATION 
 
 The Legislature of 1917 enacted a law (Education Law, article 
 20-B, section 578) providing for the education of children with 
 retarded mental development. The essential provisions of this law 
 are as follows: 
 
 1 The law applies to each school district in the State and to each 
 city in the State. 
 
 2 It requires the trustees or board of education of each school 
 district and the board of education of each city to take a census of 
 the number of children in attendance upon the public schools under 
 their supervision who are three years or more retarded in mental 
 development. This census must be taken in accordance with regu- 
 lations prescribed by the Commissioner of Education and approved 
 by the Board of Regents. 
 
 3 The board of education of each city and of each union free 
 school district in which there are ten or more children who are 
 retarded at least three years in mental development must organize 
 special classes for such children. Not more than fifteen of such 
 children may be in one class. Instruction must be provided which 
 is adapted to the mental attainments of these children. 
 
 4 A school district or city which has less than ten such children, 
 instead of organizing a special class, may provide for the instruction 
 of these children in any other city or district which has organized 
 special classes for such type of children. 
 
 It has been known for some time that there are large numbers of 
 children in the schools who are retarded or below grade. Many of 
 these are below grade for various reasons which may be overcome. 
 Such children should be given the opportunity and assisted to a 
 normal standard of work. There are also, of course, many other 
 children who have not the mental capacity to do the school work 
 of the average child. These children need special consideration also 
 and very often a special type of instruction. There are still other 
 
 G69r-Ja 19-3000 (7-1948) 
 
children who are not capable of mental development or of training 
 in the schools, whose presence is a menace to the well-being of the 
 school. 
 
 This law contemplates that all these children shall be located; 
 that special courses shall be provided for those who may be helped 
 in the public schools, and institutional care for those who are not 
 capable of mental development and who do not have proper home 
 environment. 
 
 The public, the school and the home must cooperate in this 
 important phase of school work. The whole plan must be admin- 
 istered with sympathy, with caution and with specific regard for 
 the rights of every child. The public school must be of service to 
 every child who is capable of being trained to become either wholly 
 or partially self-supporting and who has a home which is able to 
 give him proper care when not in school. When the school can no 
 longer be helpful to a child of this type and the home can not give 
 him the care necessary for the protection of society, the school must 
 then be an agency to bring to the proper authorities knowledge of 
 the necessity of providing for the care of such child, and to aid in 
 the location of the child in a proper environment. 
 
 The Legislature of 1918 made provision for organizing the schools 
 of the State so that this phase of work might be inaugurated. Two 
 specialists have been authorized for the Education Department and 
 the Department desires to give to the school authorities in the 
 various cities and villages of the State the benefit of the training 
 and experience of these specialists. It will require a long period 
 of careful, conscientious cooperation between the State and the local 
 school authorities to make this statute efifective and to accomplish 
 the great purpose which the Legislature had in mind in its enactment. 
 
 In connection with the estabhshment of special classes a series of 
 blanks have been provided by the State Department of Education, 
 and it is requested that they be used in all cases where the teacher 
 or other school of^cial has reason to believe the pupil is (a) back- 
 ward, seriously retarded or mentally deficient, (b) sufficiently 
 abnormal in conduct to interfere seriously with school work, or (c) 
 shows other serious nervous symptoms. It is not expected that each 
 city will immediately undertake to classify properly all the children 
 in the schools. The clearly marked cases or those giving the 
 greatest difficulty should be considered first. Following this, all the 
 retarded children should be examined, so that within a given time 
 
 '^ Of D. 
 "'^'1 ' 5 1919 
 

 every pupil needing special instruction and special treatment will 
 be taken care of. 
 
 These blanks are five in number as follows : ( i ) pedagogical 
 record, (2) personal history, (3) physical examination, (4) psycho- 
 metric test, (5) summary record. 
 
 The pedagogical record should be filled in by the teacher, in 
 cooperation, if necessary, with any other official. Properly filled 
 out, this blank will be very helpful in differentiating the various 
 general groups of retardation, classified by causes, as follows : 
 (i) late entrance, or lack of attendance, (2) physical infirmity, or 
 illness, (3) mental incapacity. The pedagogical record should be 
 the first blank used, and the findings deduced therefrom will deter- 
 mine the advisability of proceeding further and carrying out the 
 remaining four parts of the examination. This blank may be util- 
 ized also if it is desired to make a general school survey of the 
 mentality of pupils from the pedagogical standpoint. 
 
 The personal history blank should be filled in preferably by the 
 school nurse who, through her special training combined with the 
 fact that she is working in the field, seems particularly qualified to 
 obtain the valuable data concerning the home, family and personal 
 history. 
 
 The physical examination blank may also be filled in by the school 
 nurse under the direction of the physician or may be done entirely 
 by the latter. 
 
 The psychometric test records should be made by some person 
 qualified to do such psychological work. If no such person is avail- 
 able, the State Department of Education may be called upon to 
 furnish the examiner. 
 
 The summary record should be filled in by a qualified medical 
 exkminer, or by a psychiatrist of a qualified mental clinic, or by the 
 State Department of Education, after the data derived from the 
 four other records have been considered. A copy of this blank is 
 to be returned to the State Department of Education, Albany. It 
 will be noticed that the word diagnosis appears only on the summary 
 record. This has been done to safeguard the child and to make sure 
 that no one is pronounced mentally deficient or feeble-minded, 
 except after a medical diagnosis based on conclusive evidence. 
 
 It should not be lost sight of that the information gained by use 
 of these records is in the nature of a privileged communication, and 
 should therefore be obtained tactfully and with a consideration for 
 the feelings of the pupil and his family, and should furthermore be 
 regarded as essentially confMential. 
 
It is suggested that the various parts of each record be kept in a 
 folder or large envelop (9 x 12) which in turn should be kept in 
 a filing cabinet located in the superintendent's office or other suitable 
 place. These records may be filed alphabetically, by special classes, 
 or in any other manner more suitable to each local situation. A 
 cross reference card index by name of pupil would be of value. 
 
 It is intended that the records should be preserved and used year 
 by year in each case. In this manner a continuous history is 
 obtained which will be of decided value to local school authorities, 
 to the State Department of Education and to other agencies inter- 
 ested in the subnormal child. 
 
I Pedagogical Record Blank 
 
 [To be filled in by teacher] 
 
 THE UNIVERSITY OF THE STATE OF NEW YORK 
 
 THE STATE DEPARTMENT OF EDUCATION 
 
 PEDAGOGICAL RECORD — MENTALLY RETARDED OR 
 SUBNORMAL PUPILS 
 
 Date 
 
 City or village School 
 
 Name Date of birth 
 
 Address Mental age 
 
 Age at date yrs mos 
 
 Attendance regular or irregular 
 
 Grades skipped Repeated 
 
 Cause of irregular attendance 
 
 Ever truant Cause 
 
 Ever in court Cause 
 
 Note any extraordinary circumstances unfavorable to progress, 
 that is, ill health of child or of members of his family; foreign 
 language spoken in home; undue amount of, or unsuitable labor 
 outside of school; unfavorable home environment, etc. 
 
 What physical defects are noted on medical card 
 
 Underscore words that best describe the child : active, passive, 
 moody, depressed, happy, ambitious, indolent, affectionate, sensitive, 
 bold, cruel, destructive, insubordinate, peculiar, mischievous, ring- 
 leader, quarrelsome, deceitful, lies, steals, sex offender, sex abnorm- 
 ality, bad companions, 
 
 State any peculiarity, disease or defect in any other member of 
 the family. 
 
 Give your reasons for the mental retardation. 
 
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8 
 
 Suggestions for Pedagogical Inquiry or Survey 
 
 To determine the nature of mental retardation a full and accu- 
 rate pedagogical history is indispensable. Information should be 
 obtained on just as many items as possible and should be as 
 accurate as circumstances will permit. Most of this blank pre- 
 sumably can be filled out by the teacher without entailing any undue 
 time or labor, because the items called for are those ordinarily found 
 in the individual record book or in the records kept in the principal's 
 office. The item "mental age" can be filled in only as the result 
 of the psychological examination. It should be written as a fraction 
 in which the mental age is the numerator and the physical age is the 
 :denominator. These should both be expressed in years and months ; 
 example, -r^l which means that the child was 12 years and 3 months 
 old when the psychological test was made and his mentality was 
 equivalent to that of a child 6 years and 8 months of age. 
 
 The pedagogical history form is designed to present in condensed 
 form the principal facts of the child's school progress. When com- 
 plete, the first column will indicate in what grade or grades each 
 year of the child's life has been spent from entrance to date, and 
 his general standing in each grade. The second column, " place," 
 indicates in what school or schools the child has been from the age 
 of six to the present. . The name of the teacher of each grade is 
 called for because she is often able to furnish valuable data con- 
 cerning the child's early years that may not be in the possession of 
 the child's present teacher or of the principal. Inferentially this 
 form furnishes the basis for estimating years of retardation. 
 
 The pedagogical chart is designed to represent graphically the 
 child's success or lack of success in his work. This form permits 
 of a graph for each year if desirable, by paying careful attention tO' 
 the date in the first column. Begin the graph line in the first column 
 at the left in the date of record. By using dii?erent colored inks or 
 by the differing character of the line (solid, dashed, dot and dash) 
 several records at yearly intervals can be shown. This graph 
 becomes very expressive by drawing a straight line across the form 
 indicating the grade in which the child ought to be according to his 
 chronological age. For example, a child 13 years old may be doing 
 4A reading and 3B arithmetic, 4B spelling, 2B writing, etc. The 
 graph then appears as an irregular line in the lower part of the 
 form. Now draw a straight line through yA or 7B showing the 
 approximate work he should be doing at 13 years. A glance tells 
 
that he is approximately from three to four years retarded in his 
 pedagogical standing. 
 
 The pedagogical chart is very helpful when interviewing parents 
 as to the correct placing of a child in a grade and more especially 
 in the special class, as it affords convincing proof of the child's 
 retardation. 
 
 In the column under " traits " are listed some of the most import- 
 ant functions of mentality. The measurement of the pupil's 
 intelligence is here amplified by an estimate of his " memory," 
 "attention," and "practical judgment" (common sense) and his 
 character by his " obedience," " self-control," " moral reactions," 
 and " companionability." " Economic efficiency," representing 
 combined functions of intelligence and character, means the pupil's 
 practical ability to perform useful work. Very young children or 
 those markedly defective possess very little, if any, economic effi- 
 ciency. As a rule, economic efficiency progressively increases with 
 age, and even defectives or subnormals by the age of 14 or 15 may 
 develop to a level of self-support or at least partial self-support. 
 The " traits " tabulated are not easy to evaluate. It is, however, 
 requested that a rating be given each one on the basis of 5, in which 
 I is lowest, 3 average and 5 highest, with the date on which the 
 rating is made. An additional column is provided for subsequent 
 ratings. 
 
 It is desirable that the years of retardation be very carefully 
 computed and that the method of computation be as nearly uniform 
 as possible throughout the State. It is important to note that 
 " being in a grade " is not an accurate criterion of a child's success 
 or nonsuccess in school. Age of entrance into school and into 
 the various grades is a fundamental basis for judgment. The fol- 
 lowing tables will furnish a basis for computation. Table i indi- 
 cates the standard age for beginning the work of each grade as 
 adopted by the superintendents of the State of New York. 
 
 Table 1 
 Standard ages for beginning the work o£ each grade 
 
 B 6 
 
 yrs. 
 
 but less than 
 
 7 yrs. 
 
 B 10 yrs. 
 
 but 
 
 [ess than 11 y 
 
 1 A 6^ 
 
 
 
 71/3 
 
 
 5 A W/2 
 
 
 115^ ' 
 
 B 7 
 
 
 
 8 
 
 
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 2 A 7J4 
 
 
 
 8J4 
 
 
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 B 8 
 
 
 
 9 
 
 
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 13 
 
 3 A %y2 
 
 
 
 9y2 
 
 
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 B 9 
 
 
 
 10 
 
 
 B 13 
 
 
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 4 A 91^ 
 
 
 
 105^ 
 
 
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10 
 
 Table 2 
 
 Dates of birth used in computing ages 
 
 Age, September 15, 1918 
 
 12-15-1912 to 6-14-1913= 5^/4 years 12-15-1906 to 6-14-1907=1 li/4 years 
 
 6-15-1912 to 12-14-1912= 6 " 6-15-1906 to 12-14-1906=12 
 
 12-15-1911 to 6-14-1912= 614 " 12-15-1905 to 6-14-1906=12^ " 
 
 6-15-1911 to 12-14-1911= 7 " 6-15-1905 to 12-14-1905=13 
 
 12-15-1910 to 6-14-1911= 7y2 " 12-15-1904 to 6-14-1905=13^ " 
 
 6-15-1910 to 12-14-1910= 8 " 6-15-1904 to 12-14-1904=14 
 
 12-15-1909 to 6-14-1910= SVi " 12-15-1903 to 6-14-1904=14i/4 " 
 
 6-15-1909 to 12-14-1909= 9 " 6-15-1903 to 12-14-1903=15 
 
 12-15-1908 to 6-14-1909= 91/ " 12-15-1902 to 6-14-1903=15^ " 
 
 6-15-1908 to 12-14-1908=10 " 6-15-1902 to 12-14-1902=16 
 
 12-15-1907 to 6-14-1908=10^ " 12-15-1901 to 6-14-1902=16i/4 " 
 
 6-15-1907 to 12-14-1907=11 " 6-15-1901 to 12-14-1901=17 
 
 Note: Age is figured to nearest birthday; for example, any child whose birth 
 date falls between June 15, 19 12 and December 14, 19 12 is considered six years 
 of^age, etc. 
 
 Table 2 furnishes data for computing the child's age at the begin- 
 ning of the current school year, September 15, 1918. Amount of 
 retardation is found by comparing the age of a given child, as ascer- 
 tained from table 2, with his proper grading as ascertained from 
 table I. For example, John Doe was born August 7, 1909, and he 
 entered second grade September 1918. Is he retarded and how 
 many years? By table 2, John Doe's birthday will fall in the eighth 
 line from top 6-1 5-1909 to 1 2-1 4-1 909 and his age is therefore 
 estimated as 9 years. By referring to table i, a child 9 years old 
 should be entering fourth grade in September and we estimate that 
 John Doe is pedagogically two years retarded, provided that he 
 entered the first grade when he was 6 years old and that his attend- 
 ance has been fairly regular since entrance. 
 
 Many factors enter into the question of retardation, all of which 
 should be carefully weighed before rendering a final decision upon 
 a child's candidacy for special class. But the careful statement of 
 years of retardation furnishes a working basis for all who are called 
 upon to make a partial diagnosis of the child. 
 
 This blank may be used as the basis for the initial survey for the 
 establishment of special classes. It will be well to include in the 
 initial survey all children from first to eighth grades who are not 
 making satisfactory normal progress through the grades. 
 
II 
 
 2 Personal History Blank 
 
 [To be filled in by school nurse or physician] 
 THE UNIVERSITY OF THE STATE OF NEW YORK 
 
 THE STATE DEPARTMENT OF EDUCATION 
 
 Personal History Record — Mentally Retarded or Subnormal 
 
 Pupils 
 
 Date 
 
 City or village School 
 
 Name Sex Age . 
 
 Address Nationality. . 
 
 Parents [names] 
 
 [Give (i) Parents' (and if possible grandparents') names, nationality, age, occu- 
 pation, hai)its, treatment of children, attitude toward school, health and men- 
 tality. 
 
 2 Social status and general repute of family in community, the home, type of 
 dwelling, hygienic and economic conditions, language spoken in home. 
 
 3 Pupil's brothers and sisters, names and ages, in order (including stillbirths 
 and miscarriages) , occupations, school record, health and mentality. 
 
 4 Pupil's history. Developmental: gestation, birth; age of teething, walking 
 and talking. Illness; accidents; play; conduct; attitude toward school; habits. 
 
 For further suggestions and detail of record making, consult the Syllabus on 
 Retarded Pupils.] 
 
 Suggestions for Personal History Inquiry 
 
 Give as complete data as possible concerning the following: 
 parents' names, ages, consanguinity, birthplace, language spoken, 
 length of time in this country, education, occupation, income ; habits 
 (alcohol, drugs); criminal record; sex perversion; general health, 
 tuberculosis, syphilis or gonorrhea, epilepsy, nervous or mental dis- 
 ease. Describe mentality of father, mother; attitude toward the 
 school ; treatment of the child — abused, indulged etc. 
 
 Secure, if possible, the same data concerning grandparents. 
 
 Social status of family; general repute in community. Ever 
 receive public relief? Type and location of dwelling — tenement, 
 detached house etc. ; hygienic and economic conditions — crowded 
 dirty, untidy etc.; poverty, poor management etc. 
 
 Pupil's brothers and sisters, names and ages given in order 
 (including miscarriages and stillbirths, if possible to obtain this 
 information), occupations, school record, health, and notes on 
 mentality of each. If married, give married name and children. 
 If any are deceased, give cause of and age at death. 
 
 Pupil's own history. Give health of mother during gestation. 
 Full-term child? Instrumental or difficult labor? Blue baby? 
 Injury during labor? Convulsions then or later? Snuffles or other 
 sign of syphiHs? Skin disease? Age of teething ? Second teeth? 
 
12 
 
 Age and development of walking, talking. Malnutrition in infancy? 
 Development of puberty, early, late, accompanied by abnormalities ? 
 
 Illnesses: Rickets? Tuberculosis? Scrofula? Scurvy? Con- 
 vulsions? Enlarged glands? Meningitis? Infantile paralysis? 
 Epilepsy? Chorea or St Vitus dance? Scarlet fever? Measles? 
 Diphtheria ? Typhoid ? Whooping cough ? Any trouble with ears, 
 eyes, nose? Obstruction to breathing? Mouth-breather? Skin 
 disease? SyphiHs? 
 
 Accidents. Severe accidents, possibly contributing to or causing 
 retardation ? 
 
 Conduct. If any mental peculiarity is present, at what age did it 
 manifest itself ? Hides, breaks or destroys things ? Ill tempered or 
 good tempered? Emotionally unstable? Runs away from home? 
 Attitude toward animals ? Conduct in home and elsewhere ? Atti- 
 tude toward school? Any delinquencies? Court record? Habits? 
 Sleep? Development and control of bladder and rectum? Per- 
 sonal cleanliness? Any sexual abnormalities? Uses tobacco, alco- 
 hol, drugs, excessive tea, coflfee ? Other bad habits ? 
 
 Play. Kind of associates? With younger children? Attitude 
 toward playmates? Other abnormalities of play? Describe kind 
 of play? 
 
 Capacities. Does child help in any way around the home ? In 
 what way ? Work elsewhere ? What can the child do in a practical 
 way? 
 
13 
 3 Physical Examination Blank 
 
 [To be filled in by school physician assisted by iiitrse] 
 THE UNIVERSITY OF THE STATE OF NEW YORK 
 
 THE STATE DEPARTMENT OF EDUCATION 
 
 Physical Examination Record of Mentally Retarded or Sub- 
 normal Pupils 
 
 Date 
 
 City or village School . 
 
 Name 
 
 Age Nationality Height Weight 
 
 General appearance. Stigmata of degeneration. Deformities. 
 Anthropometric data, if indicated. 
 
 Nutrition 
 
 Head Face 
 
 Vision Eyes 
 
 Hearing Ears 
 
 Speech Mouth ; tonsils. Nose ; adenoids 
 
 Teeth 
 Gastro-intestinal 
 
 Chest Heart Lungs 
 
 Genitalia Sexual 
 
 Skin Wasserman 
 
 Neurological (reflexes, etc.) 
 Remarks 
 
 Physical Examination 
 
 It is assumed that the subnormal child should have a particularly 
 thorough physical examination. On this account a special blank 
 giving more space for record, has been provided. 
 
 If the child is unusually small or large or shows other marked 
 deviation from the usual conformation it is then suggested that the 
 commoner anthropometric measures be taken ; for example, breadth, 
 length and circumference of head, and height sitting and standing. 
 Stigmata of degeneration or any deformities should be carefully 
 described. 
 
 On the blank are enumerated as mere headings the physical fields 
 of inquiry that are important in every special case. It is especially 
 necessary that an examination as complete as possible be made of 
 eyes, ears, mouth, nose, including tonsils and adenoids, and record 
 made thereof. If no examination is made in any of the fields of 
 inquiry, this fact should be stated on the blank. The reverse side 
 of the blank may be used or additional plain sheets be appended in 
 case the special physical examination requires more space. 
 
14 
 4 Psychometric Test Blank 
 
 THE UNIVERSITY OF THE STATE OF NEW YORK 
 
 THE STATE DEPARTMENT OF EDUCATION 
 
 PSYCHOMETRIC TEST BLANK 
 
 Date 
 
 City or village School 
 
 Name Age, yrs mos 
 
 Address Grade Mental age 
 
 Birthplace Color Date of birth 
 
 Nationality 
 
 Examiner Examination requested by 
 
 Reason of request 
 
 Year 3 
 
 I Points to parts of body (3 of 4) 
 
 Nose Eyes Mouth Hair 
 
 2 Names familiar objects (3 of 5) 
 
 Key Penny Closed knife Watch Pencil 
 
 3 Pictures (enumeration or better) 
 
 a Dutch home 
 h Canoe 
 c Post office 
 
 4 Repeats 6-y syllables (i of 3) 
 
 a " I have a little dog." 
 
 h "The dog runs after the cat." 
 
 c " In summer the sun is hot." 
 
 5 Give sex (note form of question) 
 
 6 Gives last name 
 
 Al. Repeats 3 digits (i of 3; order correct) 
 
 Year 4 
 
 1 Compare lines (3 of 3, or 5 of 6) i 2 3 
 
 2 Counts 4 pennies (no error) 
 
 3 Copies square (pencil, i of 3) i 2 3 
 
 4 Comprehension, first degree (2 of 3) "What must you do: 
 
 a " When you are sleepy ? 
 
 b "When you are cold? 
 
 c " When you are hungry ? " 
 
 5 Discrimination of forms (Kuhlmann, 7 of 10) 
 
 Errors 
 
 6 Repeats 4 digits (i of 3, order correct, read i a second) 
 
 4739 2854 7261 
 
 Al. Repeats 12-13 syllables, (i of 3 absolutely correct or 2 with 
 one error each) (a) " The boy's name is John. He is a very 
 good boy." (b) "When the train passes you will hear the 
 whistle blow." (c) "We are going to have a good time in 
 the country." 
 
15 
 
 Year 5 
 
 1 Comparison of weights (2 of 3) 3-15 15-3 3-15 
 
 2 Colors (no error) Red Yellow Blue Green 
 
 3 Esthetic comparison (no error) 123 
 
 4 Three commissions. Key Door Box 
 
 5 Definitions, use or better (4 of 6) 
 
 Chair Doll 
 
 Horse Pencil 
 
 Fork Table 
 
 6 Patience (2 of 3, i minute each) 123 
 Al. Age 
 
 Year 6 
 
 1 Right and left (3 of 3, or 5 of 6) R. hand L. ear R. eye 
 
 2 Mutilated pictures (3 of 4) 
 
 Eye Mouth Nose Arms 
 
 3 Counts 13 pennies (i of 2 trials, no error) i 2 
 
 4 Comprehension, second degree (2 of 3) " What is the thing 
 
 to do: 
 a " If it is raining when you start to school ? 
 b " If you find that your house is on fire? 
 c " If you are going some place and miss your car?" 
 
 5 Coins (3 of 4) Nickel Penny Quarter Dime 
 
 6 Repeats 16-18 syllables, (i of 3 correct or 2 with one error 
 
 each) 
 a " We are having a fine time. We found a little mouse in 
 
 the trap." 
 b " Walter had a fine time on his vacation. He went fishing 
 
 every day." 
 c " We will go out for a long walk. Please give me my 
 
 pretty straw hat." 
 Al. Morning or afternoon (note form of question) 
 
 Year 7 
 
 1 Fingers. R. L. Both 
 
 2 Pictures (description or better) 
 
 a Dutch home 
 b Canoe 
 c Post office 
 
 3 Gives differences (2 of 3) 
 
 Fly Stone Wood 
 
 Butterfly Egg Glass 
 
 4 Copies diamond (pen, 2 of 3) i 2 3 
 
 5 Ties bow knot. Time Method 
 
 6 Repeats 5 digits (i of 3, order correct) 
 
 31759 42835 98176 
 
 Al. Days of week. Mon. Tues. Wed. Thurs. Fri. Sat. Sun. 
 Al. Repeats 3 digits backwards, (i of 3) 283 427 958 
 
i6 
 
 Year 8 
 
 1 Counts 20-0 (40 seconds, i error allowed) Time errors 
 
 2 Comprehension, third degree (2 of 3) What is the thing for 
 
 you to do: 
 a Broken something 
 b Danger of being tardy 
 c Playmate hits you 
 
 3 Gives similarities 
 
 Wood Apple Iron Ship 
 
 Coal Peach Silver Auto 
 
 4 Vocabulary, 20 words Score Total vocab. 
 
 5 Ball and field (inferior or better) 
 
 6 Definitions, superior to use 
 
 Balloon Football 
 
 Tiger Soldier 
 
 Al. Six coins. .05 .01 .25 .10 i.oo .50 
 
 Al. Dictation. Time Score 
 
 Year 9 
 
 1 Date, a Day of week b Month c Day of month d Year 
 
 2 Weights 123 
 
 3 Repeats backwards 6-5-2-8 4-9-3-7 8-6-2-9 
 
 4 Sentences 
 
 a Boy, river, ball 
 b Work, money, men 
 c Desert, rivers, lakes 
 
 5 Makes change: 10-4 15-12 25-4 
 
 6 Rhymes : Day Mill Spring 
 Al. Names months 
 
 Jan. Feb. Mar. Apr. May June July Aug. Sept. Oct. Nov. Dec- 
 Al. Stamps 
 
 Year 10 
 
 1 Vocabulary, 30 words. Score Total vocab. 
 
 2 Absurdities, a b 
 
 c d e 
 
 3 Comprehension, fourth degree 
 
 a 
 b 
 c 
 
 4 60 words (score by half minutes) 
 
 I. 2 3 4 5 6 
 
 5 Designs 
 
 6 Reading and report. Memories Time Mistakes 
 Al. Repeats 3-7-4-8-5-9 5-2-1-7-4-6 
 
 Al. Repeats 20-22 syllables, a be 
 
 Al. Healy A. Form board. Time. 123 Method 
 
12 
 
 
 Score 
 
 Total vocab. 
 
 
 Time 
 
 
 Time 
 
 
 Time 
 
 d 
 
 
 e 
 
 
 6-9-4-8-2 
 
 5-2-9-6-1 
 
 17 
 
 Year 
 
 1 Vocabulary, 40 words. 
 
 2 Dissected sentences 
 
 a 
 b 
 c 
 
 3 Fables a 
 
 b 
 c 
 
 4 Repeats backwards 3-1-8-2-9 
 
 5 Pictures, interpretation (3 of 4) 
 
 a 
 b 
 c 
 d 
 
 6 Similarities 
 
 a Snake, cow, sparrow 
 
 b Book, teacher, newspaper 
 
 c Wool, cotton, leather 
 
 d Knife-blade, penny, piece of wire 
 
 e Rose, potato, tree 
 
 7 Abstract words: pity, revenge, charity, envy, justice 
 
 8 Ball and field (superior plan) 
 
 Vocabulary (the score is the number of correct definitions 
 multiplied by 2) 
 
 gown 
 
 tap 
 
 scorch 
 
 puddle 
 
 envelop 
 
 rule 
 
 7 health 
 
 8 eyelash 
 
 9 copper 
 
 10 curse 
 
 11 pork 
 
 12 outward 
 
 13 southern 
 
 14 lecture 
 
 15 dungeon 
 
 16 skill 
 
 17 ramble 
 
 18 civil 
 
 19 insure 
 
 20 nerve 
 
 21 juggler 
 
 22 regard 
 
 23 stave 
 
 24 brunette 
 
 25 hysterics 
 
 26 Mars 
 
 27 mosaic 
 
 28 bewail 
 
 29 priceless 
 
 30 disproportionate 
 
 Additional tests and notes on examination 
 
 Psychometric Blank 
 
 The psychometric testing should be done only by a qualified 
 examiner. 
 
 At the beginning of the four-page blank, space is provided for 
 the child's personal data, the date on which the examination is made, 
 the exact age of the child at that time, with the date of birth, and 
 the mental age score. 
 
18 
 
 Then follows an adaptation of the Stanford revision of the Binet- 
 Simon intelligence scale for the years 3 to 12 inclusive. The tests 
 are so arranged that the first four of each group, with the exception 
 of year 12, may be given as an abbreviated scale, where time-saving 
 is essential, each test having an evaluation of 3 months. In year 12 
 the first six may be thus used, with an evaluation of four months 
 each. Insert sheets may be used, care being taken that they are 
 properly secured to the blank, for recording the pupil's reproduction 
 of the square (4, 3), diamond (7, 4), the designs (10, 5), the ball 
 and field (8, 5; 12, 8) and the free association (60 words) (10, 4), 
 and also for notes on the examination and any other performance 
 tests that may be applied. 
 
19 
 5 Summary Record Blank 
 
 THE UNIVERSITY OF THE STATE OF NEW YORK 
 
 THE STATE DEPARTMENT OF EDUCATION 
 
 SUMMARY RECORD — MENTALLY RETARDED OR 
 SUBNORMAL PUPILS 
 
 Date 
 
 City or village School 
 
 Name Sex Age 
 
 Address Nationality 
 
 Parents [names] 
 
 1 Family history 
 
 2 Environment 
 
 3 Personal history 
 
 4 Pedagogical history 
 
 5 Social history and reactions 
 
 6 Moral reactions 
 
 7 Economic efficiency 
 
 8 Practical knowledge and general information 
 
 9 Pedagogical examination by 
 
 10 Psychometric tests by 
 
 11 Physical examination by , 
 
 12 Psychiatric examination by 
 
 Diagnosis by 
 
 Confirmed by 
 
 Disposition of case 
 
 Summary Record 
 
 This very important record is intended to summarize in the 
 briefest possible manner the findings in the various fields of inquiry. 
 It is only after the consideration of each of these fields that a 
 diagnosis is made ; indeed in many instances it is the only safe way 
 in which an opinion as to the mentality of the child can be formed. 
 
 The blank is to be filled out only after the data on the pedagogical 
 record, personal history, physical examination and psychometric test 
 blanks have been obtained. Practically, the official making the 
 psychometric tests will no doubt in cooperation with the school 
 physician be qualified to pass judgment upon each field of inquiry. 
 The diagnosis should be made by the school physician or if possible 
 by a qualified psychiatrist. The scope and the main points to be 
 determined in each of these fields is as follows : 
 
 1 Family history. Is there sufficient evidence of feeble-minded- 
 ness, insanity, degeneracy or other factors to warrant the assump- 
 tion that the child is defective on a hereditary basis? 
 
 2 Environment. Is the home or other environment so unfavor- 
 able as to promote mental- and physical retardation and inferiority ? 
 
20; 
 
 Consider repute of family, social status, quality of home, economic 
 condition. 
 
 3 Personal history. Does early history indicate " primary " (con- 
 genital or hereditary) mental defect? Are there other known causes 
 which may have produced the defect? Was this cause, or causes, 
 engrafted upon an apparent normality? ("secondary" defect). 
 
 4 Pedagogical history. Does this indicate that retardation is due 
 to inherent or organic defect, or to other causes, irregular attend- 
 ance, late entry, etc. 
 
 5 Social history and reactions. This refers to the child's relation 
 to his associates and his environment. The following topics bring 
 out more clearly just what is considered under this heading: 
 Obedient? Quarrelsome? Ill tempered? Teased? Easily influenced? 
 Conduct in general? Amusements? Interests? Recreations? Asso- 
 ciates ? 
 
 6 Moral reactions. This field covers individual or innate traits 
 of the moral or ethical sphere. Has the pupil moral sense? Does 
 he lie, steal ? Is he egotistical, vain, selfish ? Has he sexual vices ? 
 Does he know difference between right and wrong? Court record? 
 
 7 Economic efficiency. Practical ability to perform any kind of 
 useful work. Consider pupil's record, if he has ever worked for 
 wages ? 
 
 8 Practical knowledge and general information. Every-day 
 matters of common knowledge and common sense, such as may be 
 acquired independent of schooling. Contrasted with scholastic 
 acquirements and intellectual ability. 
 
 9 Pedagogical examination. Does this show sufficient retardation 
 to warrant at least a tentative diagnosis of f eeble-mindedness ? 
 (Three or more years of retardation, with full schooling.) 
 
 10 Psychometric tests. Does the mental age level as determined 
 by these tests indicate mental deficiency ? Give the mental_ age. _ 
 
 11 Physical examination. Does the physical examination give 
 supporting evidence of a diagnosis of mental deficiency? Briefly 
 indicate main points. 
 
 - 12 Psychiatric examination. Are there any evidences of a 
 psychopathy? A qualified psychiatrist should evaluate this as well 
 as the eleven preceding fields and arrive at a diagnosis. 
 
 The information desired under each of the above headings may 
 be expressed by a plus or minus, in which the minus sign means 
 defect or subnormality. For example, the minus sign opposite 
 " Family history " indicates that the family clearly shows evidence 
 of mental deficiency or other factors producing subnormal offspring; 
 opposite " Pedagogical history " it indicates that the pupil's school 
 record furnishes convincing evidence of defect. The plus or minus 
 sign, especially the latter, should not stand alone without some brief 
 explanation as outlined above. 
 
 As stated above, the diagnosis should be made by a psychiatrist 
 of a qualified mental clinic, but in addition it is subject to review 
 and confirmation by the State Department of Education. 
 
21 
 
 There is space on the blank (using reverse side, if necessary) to 
 record the disposition of the special case, whether special class, 
 excluded, sent to institution, etc., and also for the subsequent history. 
 
 A copy of each summary record is to be sent to the Physical and 
 Mental Diagnostician, State Department of Education, Albany, 
 N. Y. 
 
 Suggestions in Organizing Special Classes 
 
 1 The number of children in each class is limited by recent 
 legislation to fifteen. 
 
 2 Secure a teacher who has had special training, or secure one 
 who will make special preparation at her earliest opportunity. Offer 
 an additional salary in order to get the best teacher possible. ' 
 
 3 Choose a sunny, cheery, well- ventilated room. Do not equip 
 it with immovable desks. The combination desk-chairs with adjust- 
 able desks are preferable as these can be pushed to the wall leaving 
 space for physical exercises, industrial work, etc. As a temporary 
 plan until funds can be obtained, use ordinary " kitchen " chairs. 
 Adjust these to proper height by sawing off legs of some of the 
 chairs and tables. Ideal equipment will furnish opportunity for the 
 pupils to cook and serve themselves a hot lunch, to learn the rudi- 
 ments of homekeeping, of cleanliness, etc. Plan for such ideal 
 equipment and furnish it as fast as conditions will permit. 
 
 4 Arrange the daily program so that only two-fifths of the day 
 shall be given to the academic subjects, and limit these to sense- 
 training, nature study, simple practical number work presented con- 
 cretely, language and easy reading including stories, dramatization 
 and elementary letter writing, simple drawing and painting with 
 colored crayons and paints. Spend three-fifths of the day in hand- 
 work, recreation and supervised play out of doors, gymnastics — 
 corrective, setting-up exercises, rhythm work and folk dancing — 
 rote singing, woodwork, industrial training and sewing, home- 
 keeping, training in habits of cleanliness by caring for their personal 
 appearance and the room. 
 
 5 Furnish adequate materials for handwork, for industrial train- 
 ing, for homekeeping, etc. Allow the teacher to assist in the selec- 
 tion of materials as she may know how to use certain materials and 
 not others. A trained teacher will know just what is needed. 
 Remember that the mind and the body are both benefited by 
 industrial training and handwork. 
 
 6 Remember that the State Department of Education is more 
 than willing to assist by suggestion and advice, by visitation and 
 personal help, or by furnishing data on equipment, materials etc. 
 
 We append a list of several books which will be found very sug- 
 gestive and helpful : 
 
 Anderson, Meta L. Education of Defectives in the Public 
 Schools. World Book Co., Yonkers on Hudson, N. Y. (paper) 75c. 
 
 Fitts, Ada M., & others. The Boston Way. Rumford Press, 
 Concord, N. H. $1. 
 
 Survey Committee of the Cleveland Foundation. Schools and 
 Classes for Exceptional Children. Cleveland, Ohio. 25c. 
 
22 
 
 Witmer, Lightner & others. The Special Class for Backward 
 Children. Psychological Clinic Press, Philadelphia. $1.50. 
 
 Ungraded. A monthly periodical published by The Ungraded 
 Teachers Association of New York City, 500 Park av. $1.50 per 
 annum. 
 
 If these books are not found in your local library they may be 
 borrowed, free of expense, from the State Library. Address Refer- 
 ence Section, State Library, Albany, N. Y. A more complete 
 bibliography covering the scientific and educational phases of mental 
 defect is also available. 
 
 In constructing our blanks and formulating our data upon the 
 examination and record-keeping in cases of mental retardation, 
 many authorities and publications have been consulted. We have 
 freely availed ourselves of helpful suggestions obtained from the 
 inspection of record blanks in use in this and other states. Owing 
 to the difficulty in determining the originality of some of the material 
 used, we can only express our indebtedness in blanket form to all 
 those who have preceded us in this work. We wish, however, 
 specifically to acknowledge the contribution made to mental diag- 
 nosis by Dr W. E. Fernald (Mental Hygiene, i (1917) : 211; 
 American Journal Insanity, 70: 253; Journal Psycho- Asthenics, 18: 
 73) by his " Ten Fields of Inquiry." We have added two more 
 fields : " Environment " and " Psychiatric Examination," not that 
 they really present anything new but chiefly because they are needed 
 on account of local conditions. We wish also to acknowledge help- 
 ful suggestions from the work of the Child Study Laboratory, 
 Rochester, N. Y. 
 
 As far as we know, the table for the Pedagogical history is new. 
 This seems to us valuable, as it gives at a glance the school history 
 and record of the pupil — information that is primarily indis- 
 pensable — in its chronological order, the natural sequence in which 
 the history-taker thinks and operates. 
 
 The general methods of psychiatric historj^-making, field-work 
 investigation and the use of the " fields of inquiry," as applied to 
 mentally backward and subnormal children in the schools is also, we 
 believe, an innovation. 
 
 Properly understood and used, we believe we have introduced a 
 procedure of great value not only in correctly diagnosing the 
 varieties of mental retardation but also in suggesting lines of treat- 
 ment both educational and medical. 
 
 W. B. Cornell M.D. 
 
 Physical and Mental Diagnostician 
 
 Eleanor A. Gray 
 
 Supervisor of Special Classes 
 Approved 
 
 Thos. E. Finegan 
 
 Acting Commissioner of Education 
 
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LIBRARY OF CONGRESS 
 
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