III.
MARY
By Eleanor Milgram
and Arthur Phillips, University of Pennsylvania
Clinic
Teacher,
Mary is no isolated phenomenon; there are hundreds of Marys, thousands of them?we see them washing our clothes, scrubbing our office buildings, working in any factory that we may chance to enter. They run elevators, and wheel baby-carriages for busy mothers. In short, they all are members of a large group of conscientious and willing workers, who can be satisfactorily trained to Perform efficiently a simple manual operation?but who are too dull to desire or to retain a position requiring a higher degree of intellectual organization. As a group, we ignore them?as long as these menial tasks are performed we are content to remain oblivious ?f the human machines behind. We do not seek to analyze the Personality makeup of our laundress?we are interested only in
freshly
ironed linen.
member is selected from such a group What has led a source of interest and speculation. her to such a vocation ? Who are her family and friends and how does she spend her leisure? Does she resent the ignominy of her to something higher?or is she Position?is this a
However,
when
a
single
??she becomes
stepping-stone completely adjusted and happy with her life ? I have recently had the opportunity of studying a young girl who must occupy eventually such a niche in society. This work is not being forced on her: she has had adequate educational opportunity, her physical condition is quite normal and she has no specific mental defect. Why then is she doomed? Mary's family live in a poor hamlet where the inhabitants are
?f native American stock but so out-of-touch with modern culture as to be analogous to the mountaineers of Kentucky and Tennessee. Her father is a weaver in a local mill and a barber during his spare time; her mother is a woman upon whose nerves
loquacious
and health the bearing of seven children has left its impression. Mary, who is now fifteen years and four months, is the oldest of the brood. Her appearance is not one that creates a positive imShe is neither pretty nor ugly, thin nor fat, light nor She is just an ordinary looking girl more closely allied to childhood than to maturity. Her clothing is neat and her manners pression.
dark.
very polite and conformed.
64
THE PSYCHOLOGICAL CLINIC
Mary was brought to the clinic by a visiting nurse and her mother because of retardation in school. The child's school history is fantastic in this day of scientific education. Since her sixth year, she has been a pupil in a parochial school in the community where she lives. Now she is completing the first year of the commercial high school course, but it may be significant to know that reading at the time of the preliminary examination was 4th Grade, in spelling?5th B, and in arithmetic? 3rd B, except for a total incapacity in division. In spite of her inability to grasp the subject matter and her utter lack of comprehension of what was happening about her?she received no individual coaching and has never repeated a single grade. When I asked her to clarify the miracle of her presence in high school, she explained naively that there is a deadly competition between the two parochial schools in the neighborhood so that, as an inducement to newcomers, the pupils in her school are always promoted, regardless of merit. Mary's medical record was insignificant, except for poor vision which has been corrected by glasses. At the time of her first visit to the clinic, she was diagnosed as a probable physical weakling due to a defective circulatory system, evidenced by her cold, blue, clammy hands and splotchy complexion. It was also suggested that she was anemic and perhaps tubercular. It is obvious now, Mary's proficiency
in
however, that her condition at that time was unusual and may have I a temporary indisposition caused by nervousness. have observed her carefully for the past three months and have never noticed the symptoms displayed on the first examination. been due to
Her hands have been warm and she says that her hands and feet are warm as a rule and her complexion is generally free from all blem-
By recommendation of the clinical examiner here, Mary was given a thorough medical examination which produced a negative report except for bad tonsils. Tonsillectomy was advised. At the time of her first examination, several months ago, Mary ishes.
given board, the was
the usual first trial
battery was
39
of tests.
With the Witmer Formher in a group of
seconds?placing
90 per cent superior to 1 per cent, and inferior to 90 per cent of girls at the Ten-year Level. In this test, her form discrimination was good, but her motor discharge slow. In the Witmer Cylinder Test, her first score was 250 seconds and her second 80 seconds, both putting her in a group inferior to 90 per cent of
ten-year-old girls.
This test
was
completed only
MARY
65
through a trial and error method. There was no comprehension of the problem involved and no discrimination between the height and width of the various cylinders. Although Mary was past fourteen years at the time, her scores were compared with ten-year norms instead of fifteen-year standards because, as I mentioned before, her orientation is
like that of a young child. Her auditory 7 and on three trials, 8?a score placing memory span her in a group of 10 per cent superior to 80 per cent and inferior to 10 per cent; her visual span was 7 so that here she is in a group of 40 per cent superior to 40 per cent and inferior to 20 per cent;
forward
more
was
but in that which is most significant, the reverse memory span, Mary can score only 3, marking her in a class of 20 per cent inferior to 80 per cent. In the Stanford Revision of the Binet-Simon
girl's I.Q. was 60 with a basal age of 7 and a mental age We are beginning to see then why Mary's career is so irrevocably planned out before her. It was recommended that Mary come for clinic teaching to permit some estimate to be made of her educability and personality. How much of her school failure was due to faulty teaching ? How
Test,
the
of 9.
far could she progress up the intellectual ladder? How can she earn a living? These were my problems. I began with arithmetic because it was in this subject that Mary was most retarded. I soon discovered that she could add, with occasional errors, and was familiar with the principles of subtraction and multiplication in a vague and unreliable sort of way.
Division, however, tirely at sea with the others.
This
practically nothing to her. She was enthe tables beyond the fifth and uncertain with girl was being taught algebra and bookkeeping meant
at school.
We started at once with the tables and I explained the meaning and significance of multiplication. I thought that if she were made to understand the purpose and the method of the operation, the results would be better than those achieved by a process of pure
memory. I soon learned, however, that numbers, beyond addition, are meaningless symbols for Mary. She can't conceive of a definite For them. instance, she would tell me relationship existing among next breath, she would that 6 X 8 48. Then in the correctly 32. An incorrect answer might be just the result say that 9 X 8 =
=
study?but an irrational answer where the product of numbers is made less than the product of small numbers large shows an inherent defect in thought and reason. Persistent errors of lack of
THE PSYCHOLOGICAL CLINIC
66
of this nature, where the of
comprehension,
more
she
were
source was not
at first very
carlessness but
discouraging.
a
true lack
My pupil
was
She put forth all the effort of which capable, and her attention was persistently
than eager to learn.
was
apparently
Nevertheless it beon the problem of the moment. evident after weeks of teaching that Mary would learn arithmetic only as a parrot might learn it?sheerly through imitation and drill and repetition. Every session began with a review of the tables?she wrote them on the board, she recited them aloud, I concentrated
came
asked her combinations at random. The visual, auditory and kinaesthetic sense avenues were all utilized in an effort to impress the numbers in Mary's mind. We even played games with forfeits for the number of errors. Mary also studied the tables at home and
suggested every possible method to her. It was only at the session, after about twenty hours of teaching, that she got
I
last
her This answered with time a readiness she tables entirely and facility that I hope will not be shaken from her. During this time, I also taught Mary long division, addition, subtraction and multiplication of fractions, reduction to lowest terms, and other work that would bring her up to about 5B in arithmetic. Howcorrect.
ever,
Mary would
in
public
a
not be able to retain her
school.
place in a 5B classroom proceed in her work from any truth?it is purely mechanical action
She does not
inner conviction of logic or that has been drilled into her. For this reason, even if she has learned the form of procedure of a certain type of problem, she is constantly making ridiculous and irrational errors. She can
complete an example correctly only suggestion.
under constant
supervision
and
I also spent considerable time in drilling Mary in problems of computing price and change. Since she must inevitably handle money in shopping and traveling and since she is very eager to secure a position?I regarded this as a very important phase of her training. Mary's computations are very slow and inaccurate. If the problem requires any thought or several operations, she is helpless until I analyse several similar examples. After the first few lessons, I thought it would be beneficial to break the monotony of the arithmetic with a little reading. I was anxious to see whether the mental processes involved in reading were
any
that in
more
spite
in the first
efficient than her tools for arithmetic. I found comparatively poorer showing that Mary made
of the
examination,
she could read
quite creditably
from
a
67
MARY
Sixth Year Reader and that she could spell school
proficiency
the words in the 6B
the
reading was mechanically very little impression on the
But, although
list.
correct, the thought content made girl. When we completed the reading of a story, she was unable to give even the sketchiest resume. There were simply no ideas
present. I concluded this failure was due to lack of interest in the material, since the reader was prepared for children of about eleven, and even though Mary does not have the normal intellect of a girl of fifteen, she is no longer interested in fairies and elves. I decided therefore to abandon the reader and substitute a newspaper. This in itself I felt would have a strong motivating influof normalcy and adulthood. Each day Mary selected her own article (but sometimes with discrete advice on my part) and read it aloud, a paragraph at a time. I soon learned of Mary's astonishing limitation of vocabulary and ence since it would act as
a
symbol
instance, we once read an article that Canadian newspaper describing the discovery of a coal mine and the stampede that followed. How could such a paragraph have any meaning when Mary had 110 idea what common was
knowledge. dispatched from
For a
where Canada is, whether a mine is under or above ground, or such a discovery should cause excitement? It mentioned that the would-be miners used horses, rafts, or shoe leather to rush to the scene. Mary knew what a horse and a raft were, but shoe or
why
leather she considered meaningless and rather ridiculous. What would they do with shoe leather? After coming to the clinic alone for three months, the girl could not tell me in what city the University of Pennsylvania was located, what a canoe was used for, what a dungeon, a canal, or ivory was. Mary laughed bewilderedly at
a
the
journalistic reference man
to man's descent from the
must be crazy.
This
was
Mary's
anthropoid?
comment despite the
fact that she claims that she "reads" the Philadelphia newspapers and "jokes" every day. Our progress in reading then was necessarily slow. I had to explain the meaning of every other word and most frequently repeat the context in elementary language before Then after a few a glimmer of light would dawn in Mary's eyes. the new words. of the she confused meanings moments, generally I frequently talked with Mary on subjects foreign to arith-
rewarded with many glimpses of her Her father is a poorly paid laborer and the whole community functions at a low economic level. Incidental to the opportunities for work, I learned that no one in
metic and
reading
and
was
home life and personality.
THE PSYCHOLOGICAL CLINIC
68
locality keeps a maid and that there are only two stores. The girl's mother is frequently ill and since Mary is the eldest?the If Mary's reports are care of the household devolves upon her. forte. She her often told me the is this that it seems creditable, menu she was planning for the following meal and once discussed the
the relative merits of two cuts of beef. I confess that here I was stepping on uncertain ground. As final proof of her culinary talent, she once brought "teacher" a large slice of layer cake? I was very agreeably surprised when I ventured to taste it. Mary is also interested in sewing, but has had no experience outside of darning and sewing buttons. Although she is still attending the parochial school three days a week, she says that she gets absolutely nothing out of her attendIt is no marvel that even she ance and is very anxious to leave. of her education?the the curriculum for realizes futility present her
grade ligion.
consists of shorthand and
typewriting, history,
and
re-
result of my teaching, I feel convinced that Mary's reis due not to any specific defect that can be overcome by tardation experimentation and a change of method, but to an inherently inferior intellectual equipment. Her mental endowment was very meager and she has very nearly reached the outer limits of her As
a
Her
original examiner made a diagnosis of Middle Grade Imbecile (Barr Classification) on the intellectual scale. I think my teaching has verified this estimate. However, in spite
educability.
of Mary's intellectual
rating,
she can function
as a
perfectly
normal
member of society?if we regard normality by the standards of selfsupport and marriageability. There is no doubt that this girl can earn a living if she is actuated by the same motivation that urged her to learn the tables. Mary can be easily trained to perform any routine duty and her politeness, conformed manner, and eagerness to please will be great assets in her search for work. Of course, there are definite limits to the vocational field for which
simple
eligible?she cannot handle independent thinking or take the she is
money
or
figures, she
initiative in
cannot do
emergency?but factory girls who have no an
efficient housemaids and than she. It is to be hoped that there will always be In that someone able to give Mary a decent home environment. case, there is no indication that the girl will be unhappy with her
there
are many
more
ability
lot.
She is
community
already seeking part-time light for the
summer.
housework in
a
nearby
MARY
By Eleanor Milgram
and Arthur Phillips, University of Pennsylvania
Clinic
Teacher,
Mary is no isolated phenomenon; there are hundreds of Marys, thousands of them?we see them washing our clothes, scrubbing our office buildings, working in any factory that we may chance to enter. They run elevators, and wheel baby-carriages for busy mothers. In short, they all are members of a large group of conscientious and willing workers, who can be satisfactorily trained to Perform efficiently a simple manual operation?but who are too dull to desire or to retain a position requiring a higher degree of intellectual organization. As a group, we ignore them?as long as these menial tasks are performed we are content to remain oblivious ?f the human machines behind. We do not seek to analyze the Personality makeup of our laundress?we are interested only in
freshly
ironed linen.
member is selected from such a group What has led a source of interest and speculation. her to such a vocation ? Who are her family and friends and how does she spend her leisure? Does she resent the ignominy of her to something higher?or is she Position?is this a
However,
when
a
single
??she becomes
stepping-stone completely adjusted and happy with her life ? I have recently had the opportunity of studying a young girl who must occupy eventually such a niche in society. This work is not being forced on her: she has had adequate educational opportunity, her physical condition is quite normal and she has no specific mental defect. Why then is she doomed? Mary's family live in a poor hamlet where the inhabitants are
?f native American stock but so out-of-touch with modern culture as to be analogous to the mountaineers of Kentucky and Tennessee. Her father is a weaver in a local mill and a barber during his spare time; her mother is a woman upon whose nerves
loquacious
and health the bearing of seven children has left its impression. Mary, who is now fifteen years and four months, is the oldest of the brood. Her appearance is not one that creates a positive imShe is neither pretty nor ugly, thin nor fat, light nor She is just an ordinary looking girl more closely allied to childhood than to maturity. Her clothing is neat and her manners pression.
dark.
very polite and conformed.
64
THE PSYCHOLOGICAL CLINIC
Mary was brought to the clinic by a visiting nurse and her mother because of retardation in school. The child's school history is fantastic in this day of scientific education. Since her sixth year, she has been a pupil in a parochial school in the community where she lives. Now she is completing the first year of the commercial high school course, but it may be significant to know that reading at the time of the preliminary examination was 4th Grade, in spelling?5th B, and in arithmetic? 3rd B, except for a total incapacity in division. In spite of her inability to grasp the subject matter and her utter lack of comprehension of what was happening about her?she received no individual coaching and has never repeated a single grade. When I asked her to clarify the miracle of her presence in high school, she explained naively that there is a deadly competition between the two parochial schools in the neighborhood so that, as an inducement to newcomers, the pupils in her school are always promoted, regardless of merit. Mary's medical record was insignificant, except for poor vision which has been corrected by glasses. At the time of her first visit to the clinic, she was diagnosed as a probable physical weakling due to a defective circulatory system, evidenced by her cold, blue, clammy hands and splotchy complexion. It was also suggested that she was anemic and perhaps tubercular. It is obvious now, Mary's proficiency
in
however, that her condition at that time was unusual and may have I a temporary indisposition caused by nervousness. have observed her carefully for the past three months and have never noticed the symptoms displayed on the first examination. been due to
Her hands have been warm and she says that her hands and feet are warm as a rule and her complexion is generally free from all blem-
By recommendation of the clinical examiner here, Mary was given a thorough medical examination which produced a negative report except for bad tonsils. Tonsillectomy was advised. At the time of her first examination, several months ago, Mary ishes.
given board, the was
the usual first trial
battery was
39
of tests.
With the Witmer Formher in a group of
seconds?placing
90 per cent superior to 1 per cent, and inferior to 90 per cent of girls at the Ten-year Level. In this test, her form discrimination was good, but her motor discharge slow. In the Witmer Cylinder Test, her first score was 250 seconds and her second 80 seconds, both putting her in a group inferior to 90 per cent of
ten-year-old girls.
This test
was
completed only
MARY
65
through a trial and error method. There was no comprehension of the problem involved and no discrimination between the height and width of the various cylinders. Although Mary was past fourteen years at the time, her scores were compared with ten-year norms instead of fifteen-year standards because, as I mentioned before, her orientation is
like that of a young child. Her auditory 7 and on three trials, 8?a score placing memory span her in a group of 10 per cent superior to 80 per cent and inferior to 10 per cent; her visual span was 7 so that here she is in a group of 40 per cent superior to 40 per cent and inferior to 20 per cent;
forward
more
was
but in that which is most significant, the reverse memory span, Mary can score only 3, marking her in a class of 20 per cent inferior to 80 per cent. In the Stanford Revision of the Binet-Simon
girl's I.Q. was 60 with a basal age of 7 and a mental age We are beginning to see then why Mary's career is so irrevocably planned out before her. It was recommended that Mary come for clinic teaching to permit some estimate to be made of her educability and personality. How much of her school failure was due to faulty teaching ? How
Test,
the
of 9.
far could she progress up the intellectual ladder? How can she earn a living? These were my problems. I began with arithmetic because it was in this subject that Mary was most retarded. I soon discovered that she could add, with occasional errors, and was familiar with the principles of subtraction and multiplication in a vague and unreliable sort of way.
Division, however, tirely at sea with the others.
This
practically nothing to her. She was enthe tables beyond the fifth and uncertain with girl was being taught algebra and bookkeeping meant
at school.
We started at once with the tables and I explained the meaning and significance of multiplication. I thought that if she were made to understand the purpose and the method of the operation, the results would be better than those achieved by a process of pure
memory. I soon learned, however, that numbers, beyond addition, are meaningless symbols for Mary. She can't conceive of a definite For them. instance, she would tell me relationship existing among next breath, she would that 6 X 8 48. Then in the correctly 32. An incorrect answer might be just the result say that 9 X 8 =
=
study?but an irrational answer where the product of numbers is made less than the product of small numbers large shows an inherent defect in thought and reason. Persistent errors of lack of
THE PSYCHOLOGICAL CLINIC
66
of this nature, where the of
comprehension,
more
she
were
source was not
at first very
carlessness but
discouraging.
a
true lack
My pupil
was
She put forth all the effort of which capable, and her attention was persistently
than eager to learn.
was
apparently
Nevertheless it beon the problem of the moment. evident after weeks of teaching that Mary would learn arithmetic only as a parrot might learn it?sheerly through imitation and drill and repetition. Every session began with a review of the tables?she wrote them on the board, she recited them aloud, I concentrated
came
asked her combinations at random. The visual, auditory and kinaesthetic sense avenues were all utilized in an effort to impress the numbers in Mary's mind. We even played games with forfeits for the number of errors. Mary also studied the tables at home and
suggested every possible method to her. It was only at the session, after about twenty hours of teaching, that she got
I
last
her This answered with time a readiness she tables entirely and facility that I hope will not be shaken from her. During this time, I also taught Mary long division, addition, subtraction and multiplication of fractions, reduction to lowest terms, and other work that would bring her up to about 5B in arithmetic. Howcorrect.
ever,
Mary would
in
public
a
not be able to retain her
school.
place in a 5B classroom proceed in her work from any truth?it is purely mechanical action
She does not
inner conviction of logic or that has been drilled into her. For this reason, even if she has learned the form of procedure of a certain type of problem, she is constantly making ridiculous and irrational errors. She can
complete an example correctly only suggestion.
under constant
supervision
and
I also spent considerable time in drilling Mary in problems of computing price and change. Since she must inevitably handle money in shopping and traveling and since she is very eager to secure a position?I regarded this as a very important phase of her training. Mary's computations are very slow and inaccurate. If the problem requires any thought or several operations, she is helpless until I analyse several similar examples. After the first few lessons, I thought it would be beneficial to break the monotony of the arithmetic with a little reading. I was anxious to see whether the mental processes involved in reading were
any
that in
more
spite
in the first
efficient than her tools for arithmetic. I found comparatively poorer showing that Mary made
of the
examination,
she could read
quite creditably
from
a
67
MARY
Sixth Year Reader and that she could spell school
proficiency
the words in the 6B
the
reading was mechanically very little impression on the
But, although
list.
correct, the thought content made girl. When we completed the reading of a story, she was unable to give even the sketchiest resume. There were simply no ideas
present. I concluded this failure was due to lack of interest in the material, since the reader was prepared for children of about eleven, and even though Mary does not have the normal intellect of a girl of fifteen, she is no longer interested in fairies and elves. I decided therefore to abandon the reader and substitute a newspaper. This in itself I felt would have a strong motivating influof normalcy and adulthood. Each day Mary selected her own article (but sometimes with discrete advice on my part) and read it aloud, a paragraph at a time. I soon learned of Mary's astonishing limitation of vocabulary and ence since it would act as
a
symbol
instance, we once read an article that Canadian newspaper describing the discovery of a coal mine and the stampede that followed. How could such a paragraph have any meaning when Mary had 110 idea what common was
knowledge. dispatched from
For a
where Canada is, whether a mine is under or above ground, or such a discovery should cause excitement? It mentioned that the would-be miners used horses, rafts, or shoe leather to rush to the scene. Mary knew what a horse and a raft were, but shoe or
why
leather she considered meaningless and rather ridiculous. What would they do with shoe leather? After coming to the clinic alone for three months, the girl could not tell me in what city the University of Pennsylvania was located, what a canoe was used for, what a dungeon, a canal, or ivory was. Mary laughed bewilderedly at
a
the
journalistic reference man
to man's descent from the
must be crazy.
This
was
Mary's
anthropoid?
comment despite the
fact that she claims that she "reads" the Philadelphia newspapers and "jokes" every day. Our progress in reading then was necessarily slow. I had to explain the meaning of every other word and most frequently repeat the context in elementary language before Then after a few a glimmer of light would dawn in Mary's eyes. the new words. of the she confused meanings moments, generally I frequently talked with Mary on subjects foreign to arith-
rewarded with many glimpses of her Her father is a poorly paid laborer and the whole community functions at a low economic level. Incidental to the opportunities for work, I learned that no one in
metic and
reading
and
was
home life and personality.
THE PSYCHOLOGICAL CLINIC
68
locality keeps a maid and that there are only two stores. The girl's mother is frequently ill and since Mary is the eldest?the If Mary's reports are care of the household devolves upon her. forte. She her often told me the is this that it seems creditable, menu she was planning for the following meal and once discussed the
the relative merits of two cuts of beef. I confess that here I was stepping on uncertain ground. As final proof of her culinary talent, she once brought "teacher" a large slice of layer cake? I was very agreeably surprised when I ventured to taste it. Mary is also interested in sewing, but has had no experience outside of darning and sewing buttons. Although she is still attending the parochial school three days a week, she says that she gets absolutely nothing out of her attendIt is no marvel that even she ance and is very anxious to leave. of her education?the the curriculum for realizes futility present her
grade ligion.
consists of shorthand and
typewriting, history,
and
re-
result of my teaching, I feel convinced that Mary's reis due not to any specific defect that can be overcome by tardation experimentation and a change of method, but to an inherently inferior intellectual equipment. Her mental endowment was very meager and she has very nearly reached the outer limits of her As
a
Her
original examiner made a diagnosis of Middle Grade Imbecile (Barr Classification) on the intellectual scale. I think my teaching has verified this estimate. However, in spite
educability.
of Mary's intellectual
rating,
she can function
as a
perfectly
normal
member of society?if we regard normality by the standards of selfsupport and marriageability. There is no doubt that this girl can earn a living if she is actuated by the same motivation that urged her to learn the tables. Mary can be easily trained to perform any routine duty and her politeness, conformed manner, and eagerness to please will be great assets in her search for work. Of course, there are definite limits to the vocational field for which
simple
eligible?she cannot handle independent thinking or take the she is
money
or
figures, she
initiative in
cannot do
emergency?but factory girls who have no an
efficient housemaids and than she. It is to be hoped that there will always be In that someone able to give Mary a decent home environment. case, there is no indication that the girl will be unhappy with her
there
are many
more
ability
lot.
She is
community
already seeking part-time light for the
summer.
housework in
a
nearby
