Part 3 (1/2)

TABLE B

Table showing how time of improvement of ”operated cases” compares with improvement among children at random.

Period 1 Period 2 Period 3 A--Per cent of 31 cases 322 (operated upon) Per cent of 100 children 42 at random

B--Per cent of 18 children--20 333 666 months (operated upon) Per cent of 100 children at 42 41 random

C--Per cent of 11 cases for 30 363 635 100 months (operated upon) Per cent of 100 children at 42 41 41 random

”... Immediately after operation, there seems to be a dropping off in the quality of school work done,” but thereafter a marked improvement while the random group shows a comparatively static percentage of improvement from year to year. The conclusion of the author is:

”Here seems good reason to believe that the removal of diseased tonsils and adenoids is a factor in beneficially influencing the mental life of the school child. Not only is the health impaired by failure to remove these diseased parts but the mental life and activity of the child as well.”

It is conceivable that pedagogical r.e.t.a.r.dation might exist without any defect of intelligence. The physical effects of adenoids and tonsils might produce a tendency to fatigue, an emotional instability and consequent lack in attention, which would seriously influence the quality of school work, even though the child were of normal or superior intelligence. The relation of physical defects to intelligence has been investigated experimentally by a method which will be employed to some extent in the present investigation. In the two studies to which I refer psychological tests, rather than school standings were used as a basis for judging the intelligence. In each the effects of treatment were measured, and in one, a control group makes possible a more accurate interpretation of results.

The first of these investigations is described by Wallin.[13] It was ”an attempt to determine by controlled, objective, mental measures the influence of hygiene and operative dental treatment upon the intellectual efficiency and working capacity of a squad of twenty-seven public school children in Marion School, Cleveland, Ohio (ten boys and seventeen girls), all of whom were handicapped to a considerable degree with diseased dentures or gums, and an insanitary oral cavity.” The experiment extended over one year, from May, 1910, to May, 1911. The treatment included corrective work upon the teeth and mouth, and also instruction in oral hygiene, and follow-up work by an employed nurse.

Five series of psychological tests were given at stated intervals during the course of the experiment. They included tests of immediate recall, spontaneous and controlled a.s.sociation (opposites), adding, and attention-perception (cancellation). There were six sets of each test, numbered from one to six, of equal difficulty, and given under uniform conditions. Tests 1 and 2 were given before the treatment began, and the average was taken as the ”initial efficiency.” The last four, or the last two, were averaged to represent the pupils' ”terminal efficiency.”

[13]: Wallin: ”Mental Health of the School Child.” 1914.

The results show the following influence of dental treatment upon the working efficiency of the pupils.

1. The indices of improvement are about the same for boys and girls.

2. Improvement was about the same for older and younger pupils.

3. There were great individual differences in initial proficiency and in improvement.

4. Improvement in one test does not presuppose improvement in another.

5. There is a decided gain in every test, ”and not only are the gains decidedly more frequent than the losses but the largest gains are invariably emphatically larger than the largest losses.”

6. The average gains in the tests were:

Memory, 19 per cent with 8 losses and 19 gains.

Spontaneous a.s.sociation, 42 per cent with 2 losses and 25 gains, Addition, 35 per cent with 1 loss and 26 gains.

Controlled a.s.sociation, 29 per cent with 0 losses.

Perception-attention, 69 per cent with 0 losses.

Average gain for all tests, 57 per cent.

Unfortunately, Wallin was unable to form a control group, so that it is impossible to estimate accurately how much of this gain is due to the treatment of the defect, and how much to other causes, such as growth, etc. ”But,” the writer adds, ”if we concede that one-half of the gain--and that is, I believe, a sufficiently liberal concession--is due to a number of extrinsic factors, such as familiarity, practice and increased maturity, the gain solely attributable to the heightened mentation resulting from the physical improvement of the pupils would still be very considerable. There is corroborative evidence to show that there was a general improvement in the mental functioning of these pupils. This evidence is supplied by the examination of the pedagogical record of scholars.h.i.+p, attendance and deportment. Most of the members of this experiment squad were laggards, and repeaters, pedagogically r.e.t.a.r.ded in their school work from one to four years, but during the experiment year only one pupil failed of promotion, while six did thirty-eight weeks of work in twenty-four weeks, and one boy finished two years of work within the experimental year.”

The second investigation was equally careful in its method. It was pursued by the Rockefeller Foundation, under the direction of E. K.