Mental retardation

“ In light of this clinical definition of mental retardation, I cannot agree that the undeniable fact that mentally retarded persons have "diverse capacities and life experiences," ante, at 338, is of significance to the Eighth Amendment proportionality analysis we must conduct in this case. "Every individual who has mental retardation"-irrespective of his or her precise capacities or experiences-has "a substantial disability in cognitive ability and adaptive behavior." ”

“ Should a child's mental age show a retardation of three years as compared with his chronological age, and should there be no evident explanation of this, such as ill-health, neglect of school attendance, etc., he is reckoned as deficient mentally. ”

“ We shall first take up the question of utilizing information about school retardation in estimating the frequency of mental deficiency among groups of delinquents. It is 191perfectly clear that retardation in school position is not always an indication of mental retardation. A child may be behind the position in school reached by the children of his age merely because he has not attended school so long as his companions. ”

“ Thus it furnishes a convenient means for determining with considerable accuracy the degree of mental retardation of any particular child. Experience has shown, though, that its fixed standard, by which children are pronounced "mentally defective" if they fall three years behind the norm for their age, is not always an infallible guide. ”

“ But this augmentation in the amount of retardation, which is the first fact to strike the attention, ought not to conceal from us that there is real progress in the mental condition and in the studies; in fact, we may remark that if a defective child, in passing from the age of eight to eleven, has an augmentation of retardation of one year with respect to his companions, this proves that in the same time he has progressed two years with respect to himself. It is like an omnibus which goes more and more slowly, yet advances all the same. ”

“ Some heads of [16] schools, not all, have taken the trouble to satisfy our demands, and have fixed to almost a year the mental retardation of the child as compared with normal children of the same age. The following table summarises these replies, and shows that the majority of cases present a retardation of three years:
Mentally defective children with a retardation of—
According to a convention, of which we shall speak more fully later, we regard as defective in intelligence a child who shows a retardation of three years, when he himself is nine years of age or more. ”

“ A mere slowing of thought processes accompanied by subjective feeling of effort is the limit reached in true depression, while it is merely the beginning of the intellectual disorder in stupor, for one meets with retardation symptoms only in the partial stupors. The slowing in these cases seems to represent an early stage of the intellectual disturbance which reaches its acme in the mental vacuity and complete incompetence of the deep stupor, just as slow movements in the partial stupors seem to represent a diluted inactivity reaction. ”

“ It is also legitimate to use years of retardation as a short way of expressing rough borderlines when they happen thus to afford an easy method of empirically describing equivalent borderlines for a particular scale. ”

“ Over half of the pupils fail to progress through the grades at the expected speed. What are the causes of retardation? To what extent is it an expression of congenital mental deficiency? How many mentally deficient children are in our schools? ”

“ In the course of an ordinary depression a flight of ideas may also replace the usual retardation—"depression with flight of ideas." The delusions are interspersed with cheerful thoughts and the patients show certain activities and an interest in their surroundings, although still depressed and hopeless. When they begin to talk they complain of an inability to control their thoughts. There is an inhibition of speech but not of thought. They may be quite prolific in writing, and may show a characteristic flight of ideas. This condition often merges into genuine excitement. ”

“ Now, if the child is in the fifth grade or lower, or entered such a grade at the time he was of this age, one should investigate the question of feeble-mindedness. Unless more than one year of the retardation is explained by the person's absence from school since he was six years of age, he should always be turned over to an expert for examination. This retardation of two years in school attainment below the standard of seven in the first grade may indicate feeble-mindedness if the child has been attending school constantly, although the chances are perhaps 6 to 1 that it does not. ”

“ The borderline for the mature is the first difficulty which a court examiner will encounter when he attempts to obtain assistance from an objective system of measurement. Very little experience will convince one that it is not enough to describe the deficient ability of an adult in terms of years of retardation. It is widely agreed that at some age during adolescence practically all the mental processes are available that will be found in the mature. ”

“ Since the designation of the limits must be very rough until we have much further information from tests upon unselected groups, we have adopted the common method of description in terms of years of retardation, since it seems to afford for the 1908 scale the simplest expression of the borderline until the tests have been much improved. It happens that the empirical results for 5 years of age and over lend themselves to designating the lowest percentages in terms of years of retardation with only a single shift at 9 years of age. ”

“ How much retardation in school relative to the life-ages would still remain, cannot be determined on account of the uncertainty of the tests for older ages and the factor of volition. For the mentally deficient pupils still remaining behind the regular pupils it is necessary to provide 208other special classes. In these classes or schools the feeble-minded children would remain for their entire school course. ”

“ From the first class of cases we get the impression of complete mental development, accompanied by a kind of cowardice in regard to their own feelings; but among the second class of cases you may find patients showing a more serious retardation of development. The mechanism of repression seems here to be much more an automatic one. ”

“ The neglect of training, for instance, in periods of development may have resulted in the retardation which yields the symptoms of a feeble-minded brain, or the wrong training may have created vicious habits, firmly established in the mind-brain system and gravely disturbing the equilibrium. ”

“ The patient's insomnia and his headache, his feeling of tiredness and his disgust with himself, his capricious manias and his absurd phobias, his obsessions and his fixed ideas all may yield to the "appeal to the subconscious," and as a neurasthenic easily believes in the existence of various organic diseases in his body, Christian Science can perform here even "miracles." In the case of retardation, the psychical influence will have to be in the first place one of training. ”

“ The effort to work becomes daily more laborious, the task of fixing the attention grows increasingly difficult, thoughts wander, memory fails, the reasoning power is enfeebled; prejudice—the shade of defunct emotion or some past persuasion—takes the place of judgment; physical nerve or brain disturbance may supervene, and the crash will then come suddenly, unexpected by on-lookers, perhaps unperceived by the sufferer himself. This is the history of "worry," or disorder produced by mental disquietude and distraction, occasionally by physical disease. ”

“ Feeble-mindedness may, however, arise from epilepsy or from other diseases or accidents in early life as well as from an inherent incapacity for development. 11Moreover, mental deficiency, or feeble-mindedness, (I use the terms interchangeably) does not imply that the social unfitness is always caused by intellectual deficiency. Mind is a broader term than intellect, as we shall note in the next section. ”

“ It is clear that the intention is to distinguish mental deficiency from senile dementia, from hysteria and from insanity, in which there is a temporary or permanent loss of mental ability rather than a failure to develop. ”

“ It is a lower degree of the same cause which renders continuous seclusion from society so injurious to both mental and bodily health.”
“Inactivity of intellect and of feeling is a very frequent predisposing cause of every form of nervous disease. For demonstrative evidence of this position, we have only to look at the numerous victims to be found among persons who have no call to exertion in gaining the means of subsistence, and no objects of interest on which to exercise their mental faculties, and who consequently sink into a state of mental sloth and nervous weakness.” ”

“ Nothing is more deadening to all mental activity than unmeaning repetitions, a fact easily verified by any one who, wakeful through mental disturbance at night, will take the trouble to repeat and re-repeat any meaningless thing. It is the lounging, deadening brain-work of which we have too much, not the active, vivifying brain-work of which we have too little, that does injure the system. The whole healthy tone of the mind is destroyed, and evils, mental and physical, follow in rapid succession. ”

“ Just as in the case of physical illness, we need to know not merely that the patient is sick, but also why he is sick, what organs are involved, what course the illness will run, and what physical work the patient can safely undertake, so in the case of a retarded child, we need to know the exact degree of intellectual deficiency, what mental functions are chiefly concerned in the defect, whether the deficiency is due to innate endowment, to physical illness, or to faults of education, and what lines of mental activity the child will be able to pursue with reasonable hope of success. ”

“ The mind passes from the control of the will, and wanders hither and thither, or persistently holds on in one channel of thought. Its action may become spasmodic and irregular in all degrees from slight aberrations, or excitement, up to incoherence and mental spasm; or from slight degrees of depression, down to almost inactivity and dementia: in short, such abnormal conditions of mental activity as constitute insanity. ”

“ The pathological method is akin to the genetic, but traces the decay or demoralization of mental life instead of its growth. It traces the gradual decline of mental power with advancing age, the losses due to brain disease, and the maladaptations that appear in insanity and other disturbances. ”

“ When the general instinctive origin of intellectual deficiency is considered along with the incurability of the condition, we seem to be theoretically justified in assuming that the variation will be slight from one year of life to the next. ”

“ Woe to the man who uses up his surplus stock of brain-inhibition too near the bitter end, or too often!... The physiological word inhibition can be used synonymously with the psychological and ethical expression self-control, or with the will when exercised in certain directions. It is the characteristic of most forms of mental disease for self-control to be lost, but this loss is usually part of a general mental affection with melancholic, maniacal, demented, or delusional symptoms as the chief manifestation of the disease. ”

“ There are parents whose behaviour when dealing [82] with a mentally retarded child is—often quite unconsciously—that of a censorious judge upbraiding a criminal. They nag, they harass, they urge the child to greater effort, never questioning that he can of his own accord improve his ability to learn. Perhaps he is mentally deficient, perhaps he is suffering from some remediable physical cause of retardation, perhaps the method by which he is being taught is not suited to his type of mind. To all these possibilities the parents do not give a moment's thought. The child is stupid ”

“ When it is of the same sense, the retardation it causes may be partly due to the distraction of the attention by it, but partly also to the fact that the stimulus to be reacted on stands out less strongly than if alone, and practically becomes a less intense sensation. ”

“ Though only passing incidents, due to overattention to themselves and their ills, real or fancied, and the consequent lack of concentration of mind on a particular subject, the patients fear serious deterioration of their mental condition, or at least of mental control. The neuroglia theory of mental action throws a light on all these phases of mentality that serves to lessen the solicitude of patients and enable them to understand that, in spite of their fears, there is nothing but functional disturbance. ”

“ In this complex diathesis which means greater susceptibility to temptations, there is little doubt that mental deficiency is the main factor. Aschaffenburg has well expressed one effect of this particular causal factor: “The weak-minded are generally children of the moment.... The lessons of experience, which serve normal persons as a guide, in later events, soon fade, be cause they cannot be fitted into the existing condition of the ideas. ”

“ It is not difficult to perceive the relation existing between a defective brain weight, paucity of the gyri, deficiency of properly developed cortical cells and such an elementary form of mental aberration as simple imbecility. The subject of the relation between structure and function gains in interest when we leave this domain of simple mental weakness to analyse the relation between structural defects and the positive symptoms of insanity and degeneracy—that is, moral perversion, mental obliquity, delusions, and morbid impulses. ”