As physicians, in the broadest sense of the term, we are concerned not only with the alleviation of pain and the cure of disease, but also with the upbuilding of health and the improvement of bodily efficiency. To obtain satisfactory results in this work it is necessary to begin with the child, and we are thus called upon to solve problems and deal with conditions that are closely related to the field of education. The most important problem to be met in this connection is that of the development and training of the motor and sensory apparatus.
In perfectly normal and healthy children this development may without great harm be left to itself, for motor activity and co-ordinate control come spontaneously with the common games and plays of childhood, and sensory development is unconsciously brought about by contact with the childs environment. But even if this be true, systematic training of these activities during childhood is of the highest benefit in after life. We are accustomed to educate the voluntary muscular system; the usefulness of this procedure is universally admitted.
But the sensory apparatus is commonly much neglected. Professor Charles W. Eliot, in discussing Education for Efficiency (Riverside Educational Monographs, 1909, P. 6) says: “The training of sight, hearing, smell, taste and touch has been neglected in education to an extraordinary degree. Quickness and accuracy in all the senses are of high value to the individual throughout life; and in innumerable cases some slight but unusual superiority in one or more of the senses becomes the real basis of success in life.”.
If this training be necessary for the normal child, how much more is it necessary for the child whose physique is impaired by deformity or disease, and whose motor and sensory mechanisms are rendered inefficient by weakness or defect?.
In no class of cases will the physician be called upon to utilize his best knowledge upon this subject more adroitly than in those mental affections of childhood commonly grouped together under the name of mental defect, or, as it is better styled, mental subnormality.
Mental subnormal children very rarely show any spontaneous tendency to clearly co-ordinated muscular or sensory activity, and yet the prognosis of such cases must be based almost wholly upon the possibilities of development of the sensory-motor system. Failure to recognize this fundamental fact has brought about permanent defect in many a subnormal child who might otherwise have been made a useful member of society.
In all forms of mental subnormality it is a familiar axiom that “after treatment comes training.” It is the physicians duty, therefore, when acute symptoms have subsided and chronic conditions have been controlled, to prescribe a suitable and adequate system of training to meet the requirements of the sensory-motor apparatus, and it is the purpose of this paper to outline a series of exercises of this kind that have been found particularly useful in dealing with the class of cases in question.
These exercises are based largely upon the experience of the founder of the Bancroft Training School, who has studied the problems involved in this subject for more than twenty-five years. The exercises have been shown to be of value in all forms of mental defect, whether due to inherited conditions or acquired diseases. They are especially useful in cases of cerebral or cerebrospinal meningitis, encephalitis, intracranial haemorrhage or other conditions accompanied by some form of hemiplegia.
In children of the malnutritional type, also, where rachitis or marasmus has occurred in early life, much can be accomplished. Cases belonging to the hypothyroideal group, such as mild cretinism, mongolianism, certain forms of obesity, etc., are all greatly improved by these systematized motor and sensory exercises.