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Published originally in the Ladies' Home Journal for April, 1919, under the caption "What I Did With Don," and reprinted by permission. With this case I am able, for the first time, to prove that an arrest of development amounting to feeblemindedness may be cured and the child entirely restored to normal mentality.
At the age of two years and seven months this boy responded to every test like a feebleminded child and he was diagnosed by competent experts as feebleminded. Today he is a normal boy, not quite seven years old, reading, writing and doing the number work of the second school year. Either he was not feebleminded and the diagnosis was a mistaken one, or feeblemindedness can be cured. What is feeblemindedness—a performance level or an irremediable mental defect? Don's response to treatment shows that he had grave but not irremediable defects. His arrest of development was nearly complete, the result of disease and the psychosis which accompanied the disease.
When a normal adult becomes insane we observe a marked change in character. "He is no longer himself," we say, and a prominent symptom is a reduction of mental level called technically "dementia." Auto-intoxication, disease and shock may cause insanity. Let us suppose that one or all of these causes affect a child in his first or second year. We shall not be able to observe much change in the child's mentality except that his mental development will be arrested. I maintain that one type of feeblemindedness, better called arrested development, is due to the same causes which produce insanity in an adult, and that in some cases the psychosis or mental disorder can be cured and the child restored to completely normal condition, provided the case be taken in hand early enough.
Except to the very observant eye of an experienced expert, these cases look more like feeblemindedness than nsanity. Nevertheless, they are a species of feeblemindedness or insanity, whichever name we choose to apply, very different from the congenital imbecile, one of the mongolian type, for example. The mental disorders of children which cause arrest of development and apparent feeblemindedness are as diverse as the mental disorders observed and classified by the alienists. A child may be either feebleminded or insane, or he may be both feebleminded and insane. Some of the Orthogenic Cases reported in the earlier numbers of the Psychological Clinic, notably Orthogenic Cases Nos. 4, 6, 12 and 13, are not primarily cases of congenital defect, but cases of mental disorder in which there is a greater presumption of possible cure than in the case of the child who is both qualitatively and quantitatively feebleminded.
Orthogenic Case XIV presents a clinical picture of fear, antagonism, anger, and obstinacy, in consequence of which the mental development was arrested until the motivation yielded to orthogenic treatment. The etiology is uncertain, something like hydocephaly was suspected but rejected as the explanatory cause. It may have been malnutrition, but I incline to believe it was only the shock of an attack of whooping cough.
Orthogenic Case XV entitled "The Feminine Absolute" is a case of arrested development, especially in schoo subjects, symptomatically a fear psychosis and an obstinate refusal to take an education: in general, the kind of behavior characterizing hysteria as a type of mental perversion.