29.1 per cent of the English-speaking group and 30.3 per cent of the total group. It will be noted that this gives an increase of about 6 per cent over the estimate based on the Yerkes data alone. This means that a few cases ranked by the Yerkes standard as "subnormal" but very close to the lower dividing line are moved over, in our judgment, into the lower group.

TABLE II

CLASSIFICATION ON BASIS OF ACTUAL PSYCHOLOGICAL DIAGNOSIS (1) OF 110 ENGLISH-SPEAKING WOMEN AND (2) OF 119 WOMEN, INCLUDING BOTH ENGLISH-SPEAKING AND NON-ENGLISH-SPEAKING CASES, ADMITTED TO THE REFORMATORY BETWEEN JULY 1, 1916, AND JUNE 30, 1917, INCLUSIVE

*This case was in an acute pyschosis at the time of the mental examination so that the significance of her performance is not entirely clear.

The range represented by these two sets of figures, approximately 23 per cent to approximately 29 per cent gives, in our opinion, the minimum estimate which can be accepted regarding the number of feeble-minded cases in the present group. On the other hand, we are entirely open-minded concerning the possibility of making the standard less rigid and designating as feebleminded many of those referred to as "border-line" or even “dull normal." By the criterion of feeble-mindedness recommended by Dr. Terman in connection with the Stanford Revision, namely, for adults a mental age of less than 11 years, approximately 50 per cent1 of this group would be designated as feeble-minded. The

1 The exact percentage for the group cannot be given since the Stanford Revision was given to only 91 of the 110 cases.

discrepancy between this estimate and the preceding ones need not be disconcerting since it is due primarily to a lack of exact definition as to what constitutes the "feeble-minded" and where the line is to be drawn between the high grade feeble-minded and the very dull or questionably normal case. We have preferred not to concern ourselves with this controversy at present but to accept the more conservative estimates, which pick out for consideration the group which all measures agree in designating as surely defective. As long as from 23 per cent to 29 per cent of our cases are beyond question feeble-minded and in need of either permanent custodial care or extraordinary supervision on the outside, and yet cannot be given places in existing institutions, it would appear pointless to quarrel over a still higher group of cases who should perhaps have the same type of treatment when an ideal solution of the problem of the defective delinquent is reached. For the present, then, we favor accepting the lower criterion as the starting point of diagnosis, considering the group just above this dividing line a questionable range, calling for other tests and further observation to determine finally their status.

Chart I presents these points with regard to intellectual status in graphic form. The abscissae, distances along the horizontal line, represent various coefficients of intelligence; the ordinates, distances along the horizontal line, represent number of cases. The portion of solid black represents the group of clearly feebleminded, who present no particular problems of diagnosis as to their intellectual status. The cross-hatched portion indicates a questionable range, who may be classified, on the basis of further observation, as either "feeble-minded" or very dull normal. The dotted area contains individuals who may, on the basis of further observation, be designated as normal without qualification or, on the other hand, may be classed with the very dull normal who border closely on the feeble-minded. The white area contains cases so clearly normal as to intelligence that in our judgment, they cannot be considered candidates for the feeble-minded group. They may be very unstable emotionally, psychopathic or even

Coefficient of
Intelligence

insane, obviously far from "normal" individuals, all things considered, but with this grade of intelligence they cannot reasonably be thought of as contributing to the problem of feeble-mindedness.

Chart I. Yerkes-Bridges Point Scale:Coefficient of Intelligence.
Distribution of 110 English-Speaking Commitments

B

Feeble-minded

Questionable range, tending

toward feeble-minded

Questionable range, tend ing toward normal

Clearly normal intellectually

The further problem of the psychopathic individual cannot, however, be overlooked in the consideration of any delinquent The fact of the establishment of the Psychopathic group. Hospital in connection with the Laboratory is itself an indication of the recognition given to this problem. Since the middle of

August all new commitments to the Reformatory, who have been received at the Elizabeth Fry Hall, have been observed, from the psychiatric point of view by one or the other of the physicians of the Psychopathic Hospital: Dr. Edith R. Spaulding or Dr. Cornelia B. J. Schorer. Of the cases commited prior to this time certain individuals showing marked irregularities of behavior were referred to them for observation but other cases were not seen. No exact statement of the numbers of psychopathic cases received during this fiscal year can, therefore, be offered and percentages cannot be given. The following estimate, however, gives a rough indication of the number of cases of this group whom they consider as deviating markedly from the normal, or even as legally insane:

This classification cuts across our previous grouping in terms of intelligence alone. Of the cases designated "insane," 2, including 1 non-English-speaking case, fall in the group which we have called "feeble-minded," 3 in the "border-line" group, 2 in the group of "normal" and 1 unclassified as to intelligence. Of the "epileptic," 3 fall in the "feeble-minded" group and 1 in the "border-line." Of the "psychopathic " 3, including 1 nonEnglish-speaking, fall in the feeble-minded group, 1 in the "border-line," 4 in the "dull normal" and 7, including 1 nonEnglish-speaking case, in the group of "intellectually normal." Thus of the total 27 cases, including 3 non-English-speaking, 8 fall in the group referred to as "feeble-minded," 5 in the "border-line" group, 4 in the group of "dull normal," 9 in the group of "intellectually normal," and 1 unclassified.

This data, although representing merely a rough estimate, indicates the importance of psychiatric examinations in conjunction with psychological examinations in order that psychopathic cases

In

may be promptly recognized and given suitable treatment. cases of marked abnormality along the lines indicated above it is always possible that the performance in the psychological examination may have been influenced unfavorably by the general mental condition. In all such cases of marked disturbance we should, therefore, recognize that the diagnosis of "feeble-minded" or "border-line” is, to a special degree, only tentative.

In the light of the data presented above, concerning both the distribution of the group in terms of intellectual ability and the number of cases recognized as markedly aberrant in terms of general mental organization, it is obvious that the problem which the institution is called upon to meet is no simple one.

That the psychopathic type of case is certain to present difficulties is evident. The effort to work out a method of meeting these difficulties in the case of individuals who are not in a sufficiently serious condition to call for immediate commitment to a hospital for the insane is described in the report of the opening year of the Psychopathic Hospital.

With reference to the remainder of the group, it is significant to note that the institution is called upon to handle a very wide range of cases from the unquestionably feeble-minded to the unquestionably normal, with even a few unusually able individuals. For the whole normal group it is of prime importance that the constructive training be given to prepare the individual for the assumption of responsibilities on leaving the institution. For the feeble-minded group, on the other hand, adjustment to institutional routine, involving training in the simpler, habitual tasks and the acceptance of a maximum supervision, seems indicated as the only useful type of treatment. The presence of such considerable numbers of defectives in the group clogs the machinery and delays the adjustment of the institution to the needs of the higher grade type of case, which should constitute the main problem of a "reformatory" institution.

In addition to this problem of institutional management, the further fact must be recognized that this group of feeble-minded cases goes back into the community at the expiration of the commitment term subject to no authorized supervision. The necessity of providing adequate institutional care for the group of