Wt4 7^7 A Syllabus for The Clinical Examination of Children. EDMUND B. HUEY, Psychologist LINCOLN STATE SCHOOL AND COLONY. Lincoln, Illinois. School Print. _. . : ~ ----- TMP96-021758 INTRODUCTORY. America is now going seriously about the work of providing special classes and schools for defective children, special courts for juvenile delinquents, and, in general, special and suitable treat- ment for the exceptional child. To do this work effectively a systematic examination and record should be made of each case. Such record is necessary for the adequate treatmant of the rase itself. It furnishes, besides, most valuable data for the research psychologist and statistician. The forms here presented have been worked out in handling the cases here, and are for the most part now in use in this the state institution for the feeble-minded. In getting and recording this data at least four blanks will ordinarily be used. Photographs taken in front and in profile may well be attached to the physical examination blank, or may precede the whole clinical record if this is made in a single booklet form. With certain supplements to be added on the psychological side, the syllabus endeavors to provide for a complete account of the child, under the following rubrics: A. Home Record. I. Heredity. II. Growth and Retardation. III. Medical History. IV. Environment and Personal History. V. Capacities, Habits, and Character. B. Teacher's or Attendant's Record. I. Habits and Chacteristics. II. Capacities and Incapacities. III. Intelligence and Perception. IV. Learning, Interests, Imitation, and Memory. V. Morals. VI. Social Reactions. C. Physical Examination. I. Anthropometry and Description. II. Defects and Deformities. III. Medical Examination. D. Mental Examination. I. Intelligence and Retardation. A. HOME RECORD. (Information to be obtained from parents, family physician, and others who know the family well). General. Child's full name and present address. Name and address of parent or guardian. Date of birth of child, or, if unknown, apparent age. Birthplace of child, of father, of mother. Occupation of father and mother. Heredity. 1 2 3 4 5 6 7 8 9 10 11 12 13 bo c "> '_l o bo < Si bo < O 0) -a £ ££ -a a: c 1 6 _> £ j5 — > •i- o c — h- 73 n X (0 r small, thick, flat, pointed, fissured, enlarged papillae. Thyroid: Enlarged, atrophied, absent. Thorax: Breasts absent, atrophied, small, large, supernumerary; de- velopment of breasts in male; pigeon breast, funnel breast. Upper Limbs: Very long, very short, asymmetrical; malformation of right, left hand; fingers united, supernumerary, two- jointed, very long, very short. Little fingers imperfect. Left handed, ambidextrous. Lower Limbs: Club foot; toes united, supernumerary; knock- knee, bow-legs, legs or feet very long, very short, asymmetrical. Genitals: Incomplete descent of one or both testicles. Organs over-developed, undeveloped, atrophied. Hermaphrodism, true or false. Phimosis. Stenosis or reduplication of vaginal and uterine canals. Undeveloped uterus, ovaries, vagina. Clitoris enlarged or hooded. Skin: Pallid, sallow, leathery, prematurely wrinkled, birth-marks. Hair: Coarse; scanty on face, eye brows, chest, pubes. Hairy moles or tufts on body. Gray hair in patches. Bald spots. Eye brows meet. Abnormal distribution of hair. Nails: Thin and friable, pigmented, arched and thickened, long, short, furrowed lengthwise, crosswise. Nutrition: Anaemia. Obesity. Vaso-motor: Flushing, local heat or cold, excessive or local sweating, factitious urticaria. Bodily Characteristics: Gigantism, dwarfism. General balance relaxed. Asymmetrical posture or head balance. Scoliosis, lordosis. Feminine aspect. Mincing or shuffling gait. Medical Examination. 1. Neuro-muscular System: (a) Reflexes: Knee jerk. Achilles. Pupillary. Conjunctival. Plantar. Ankle clonus. Cremasteric. Abdominal. Arm. Jaw. Palatal. Pharyngeal. Defecation. Micturition. (Examine others where indicated.) (h) Electrical responses. (c) Cranial nerves: II. Visual field. Optic discs. III. IV. VI. Strabismus. Ocular movements. Nystagmus. Ptosis. Diplopia. V. (motor, sensory.) VII (paralysis, tics.) IX, X, XI, XII. (d) Vertebral column: (deviations, etc.) (c) Sensation: Vision R. L. Hearing R. L. Smell R. I,. Taste. Pressure. Temperature. Pain. Muscular. Stereoagnosis. Anaesthesias, hyperesthesias, paresthesias, especially asymmetrical or local variations. Headache. Vertigo. (f) Motor: Tonicity. Strength. Co-ordination or ataxia. Tremors (coarse, fine, unilateral, intentional, spastic, ataxic, intermittent, jerky, uudulatorv.) Paralysis. Contractures. Tics. Spasms (general, unilateral, local, tonic, clonic, purposive.) (g) Other nerve signs. (h) Speech: Stammering, stuttering, lisping, defective articula- tion, semi -mutism, mutism, (i) Writing: (j) Mimic and gesture: (k) Gait. 2. Ej'e, ear, nose, and throat: 3. Skin, mucous membrane, trophic disorders: 4. Circulation: Heart. Pulse. Temperature. Blood pressure. Veins. Arteries. Blood. Vasomotor. 5. Respiration: Rate. Character. Chest inspection. 6. Alimentation: Stomach. Intestines and abdomen. Breath. Tongue. Appetite. Digestion. 7. Liver, spleen and pancreas. 8. Other glands (tonsils, adenoid vegetations, cervical, sub- maxillary, axillary, inguinal, thyroid.) 9. Genito-urinary system: Reproductive activities and mis- fit uctionings. 10. Laboratory examination of sputum, blood, urine, etc. 11. Habits: (Sleep, drugs, beverages, tobacco, uucleauliness.) 12. Infections, vermin, vaccination. D. MENTAL EX A MI N ATION . Intelugknce axd Retardation. The Binet Scat,!:. Mental examination of Age Examined by Grade Passed tests of expected at this age. Accord- ing to these tests, child's intelligence is approximately at the level of years of age, indicating a retardation of years. Syllabus used Conditions. Mentality of one and two years. 1. Eye follows light 2. Block is grasped and handled, when placed in hand. 9 3. Suspended spool is grasped when seen. 4. Candy is chosen instead of block. 5. Paper is removed from candy before eating, child having seen the wrapping. 6. Child obeys simple commands, and imitates simple movements. Mentality of three years. 1. Touches nose, eyes, mouth, and pictures of these, as directed. 2. Repeats easy sentences of six syllables, with no error. 3. Repeats two numerals. 4. Enumerates familiar objects in pictures. 5. Gives family name. Mentality of four years. 6. Knows own sex. 7. Names key, penny, knife. 8. Repeats three numerals in order, when heard once. 9. Tells which is longer of lines differing by a centimeter. Mentality of five years. 10. Discriminates weights of 3 and 12 grams, 6 and 15 grams. 11. Draws, after copy, a square that can be recognized as such. 12. Rearranges a rectangular card that has been cut diagonally into two triangles. 13. Counts four pennies. Mentality of six years. 14. Shows right hand, left ear. 15. Repeats easy sentences of 16 syllables. 16. Distinguishes pretty from distinctly ugly or deformed faces, in pictures. 17. Defines, in terms of use, the words fork, table, chair, horse, mama, three satisfactorily. 18. Performs three commissions given simultaneously. 19. Knows own age. 20. Knows whether it is forenoon or afternoon. Mentality of seven years. 21. Notes omission of eyes, nose, mouth, or arms, from as many portraits. 22. States number of fingers on right hand, left hand, both hands, without counting. 23. Copies written phrase, with pen, so that it can be read. 24. Draws diamond shape, from copy, so that it can be recognized. 25. Repeats five numerals in order, when pronounced once at half second intervals. 26. Describes pictures shown in No. 4. 27. Counts thirteen pennies. 28. Names penny, nickel, dime, and silver dollar. Mentality of eight years. 29. Reproduces correctly two facts, after once reading seven lines about a fire. 10 30. Counts values of six stamps, three ones and three twos, in less than fifteen seconds. 31. Names red, green, blue, yellow. 32. Counts from 20 to in twenty seconds with not more than one error. 33. Copies easy dictation, so that it can be read. 34. States difference between paper and cloth, butterfly and fly, wood and glass, in two minutes, two satisfactorily. Mentality of nine years. 35. Names the day and date, allowing error of three days either way on day of month. 36. Names days of week in order, in ten seconds. 37. Gives correct change from a quarter paid for an article costing four cents. 38. Defines in terms superior to statements of use, in No. 17. 39. Reproduces six facts from seven lines read once, in No. 29. 40. Arranges, in order of weight, boxes of same size and appear- ance weighing 6, 9, 12, 15, and 18 grams, in three minutes. Two out of three trials. Mentality of ten years. 41. Names the months in order, allowing one omission or in- version, in fifteen seconds. 42. Names a penny, nickel, dime, quarter, half, dollar, two, five, and ten dollar bills, in forty seconds. 43. Uses three given words in not more than two sentences. 44. Tells what one should do if misses train, if unintentionally struck by playmate, or if breaks an object belonging to others. Two satisfactorily. 45. Tells what would do if late for school, or before undertaking an important affair, aud why we should judge by acts rather than by words. (Two other questions may be asked.) Mentality of eleven years. 46. Detects incongruities in three out of five statements, in about two minutes. Uses three given words in one sentence. Names at least sixty words in three minutes. Defines charity, justice, goodness, two satisfactorily. Rearranges shuffled words of eight- word sentences, two out of three, w T ith one minute for each. Mentality of twelve years. 51. Repeats seven numerals in order, when heard once. 52. Names three words that rhyme with obey, in one minute. 53. Repeats, with no error, sentence of twenty-six syllables. 54. Infers a fact from given circumstances which indicate the fact. Mentality of thirteen years. 55. Images and draws result of cutting triangle from side of twice folded paper. 11 56. Images and draws new form produced by joining transposed pieces of diagonally divided visiting card. 57. Distinguishes between abstract terms of similar sound or meaning. The above scale is probably the best means yet devised for de- termining the fact and measuring the amount of mental retarda- tion. Revisions and additions will doubtless be needed. These tests represent the given ages only when the tests are applied ac- cording to the directions given by Binet and Simon in L/Anne Psychologique for 1908. I shall print a syllabus to guide in giv- ing these tests in an early, probably the June number of the Journal of Educational Psychology. A full account of them has been given by Dr. H. H. Goddard in The Training School for January, 1910. The circumstances of printing this syllabus have made it impossible to give full directions here. After each number, a plus sign means passed, minus means failed, exclamation point means absurd response, A means atten- tion wanting, T means timidity, R means resistance, I means ignorance, fraction means partial credit (rarely used). In making the count the child is credited with the level at which he passes all the tests, or all but one. To this is added one year for each five tests passed at higher levels. We record also the total number of tests passed, with the number that should be passed at the child's age. Half years may be used, for instance the child's age may be 10 1-2 and his mental level 8 1-2. The tests for one and two years, numbered separately, are ar- ranged in order of difficulty, and represent successive stages of mentality from the first month to two years. In the Binet scheme retarded children who cannot pass beyond the tests for two years are classed as idiots. -Above this but below the eight year level they are imbeciles. Children passing the tests for eight years or higher are classed as feeble-minded. The terms "backward" (or "retarded") and "unstable" may be used for the two main transi- tion classes between feeble-mindedness and normality. The intelligence is of course not the whole mind, and retarda- tion is not the whole of abnormality. A complete mental exami- nation, in the schema which I am working out here, will involve tests and observations upon sensory discrimination; perception- conception; ideation-imagination; orientation in space and time; association; learning and memory; feelings, interests, instincts; temperament and attitude; movement, imitation, suggestion, and automatism; intelligence and reason; play; attention, effort, will; mental span and synthesis; mal-adaptations and emotivity; ideals and values; self and social reactions. We are yet far from having standard tests and norms for all these functions. But intelligence is a function of all of them, and its measurement is our most repre- sentative single means of gauging mind. 12 L'ERfiSX 0F CONGRESS 029 898 067 8