MEDICAL INSPECTION OF SCHOOLS 



This nerve fatigue may result in a child being unable for the time 

 being to keep up in its work in school. 



Forgetfulness, loss of interest in work and play, desire for solitude, 

 untidiness in dress or person, and like changes of character, are some- 

 times incidental to the period of puberty. 



IV. Mentally defective children in the public schools exhibit cer- 

 tain common characteristics. The essential evidence of mental defect 

 is that the child is persistently unable to profit by the ordinary methods 

 of instruction, as shown by lack of progress or failure of promotion through 

 lack of capacity. After one, two or three years in school, they are either 

 not able to read at all, or they have a very small and scanty vocabulary. 

 One of the most constant and striking peculiarities is the feebleness of the 

 power of voluntary attention. The child is unable to fix his attention 

 upon any exercise or subject for any length of time. The moment his 

 teacher's direction is withdrawn, his attention ceases. 



These children are easily fatigued by mental effort, and lose interest 

 quickly. They are not observant. They are often markedly back- 

 ward in number work. They are especially backward in any school 

 exercise requiring judgment and reasoning power. They may excel 

 in memory exercises. They usually associate and play with children 

 younger than themselves. They have weak will-power. They are 

 easily influenced and led by their associates. These children may be 

 dull and listless, or restless and excitable. They are often wilful and 

 disobedient, and liable to attacks of stubbornness and bad temper. The 

 typical "incorrigible" of the primary grades often is a mentally defective 

 child of the excitable type. They are often destructive. They may be 

 cruel to smaller children. They are often precocious sexually. They 

 may have untidy personal habits. Certain cases with only slight intel- 

 lectual defect show marked moral deficiency. 



The physical inferiority of these defective children is often plainly 

 shown by the general appearance. There is generally some evidence 

 of defect in the figure, face, attitudes or movements. They seldom 

 show the physical grace and charm of normal childhood. The teeth are 

 apt to be discolored and to decay early. 



It is a most delicate and painful task to tell a parent that his child 

 is mentally deficient. This duty should be performed with the greatest 

 tact, kindness and sympathy. It would be a great misfortune for the 

 school physician and teacher, as well as for the child, to designate a 

 pupil as feeble-minded who was only temporarily backward. 



Temporary backwardness in school work may be due to removable 

 causes, such as defective vision, impaired hearing, adenoid growths in 



194 



