Systemic Motor & Sensory Training in Mental Diseases



The more complex motor activities may be developed even where physical stigmata are marked, by careful attention to suitable apparatus and by persistence in regular exercise. Simple and complex peg-boards, swelling-boards, etc., are all of great value. All of these objects should be very large. The common apparatus used in the kindergarten is too small even for the normal child, and is quite useless in the hands of the subnormal.

The pegs for peg-board work should measure not less than 22 inches in length and 2 inch in diameter. The child should be able to grasp them with the whole hand. The sewing-board consists of a light pine board 14 inches square, in which are several rows of 12 inch holes well reamed out on both sides. The child is taught to pass an 8 inch wooden needle, “threaded” with soft 3/8 inch rope, in and out of these holes, imitating various stitches. A child who would find it impossible to take a single stitch with an ordinary needle will learn to use this board in a few weeks and by changing to smaller apparatus will eventually be able to sew very well.

The weaving-board is a 20 inch frame covered with 1 1/4 inch webbing, stretched tightly across in one direction only. The child is taught to weave a long flat needle in and out across the bands of webbing, drawing through detached strips of webbing, the final result being much like a very large kindergarten mat. The webbing may be dyed to form appropriate combinations of color.

The value of these forms of co-ordinative motor training lies not alone in the fact that they develop the motor apparatus, and help the child to acquire facility in the complex movements necessary in daily life. They are also important because of the relation between motor activity and mental growth. They stimulate nutrition in the motor areas of the cerebral cortex, wake up the gray cells of the cerebellum, and encourage the formation and active functioning of association fibres.

They thus indirectly aid in the development of memory, thought, will and other mental faculties, Dr. Boris Sidis is of the opinion that motor elements form the nucleus of consciousness. He says in this connection: “Motor consciousness forms the main body of our mental activity. The great majority of mankind still leads a life closely allied to animal sensory-motor states. Instances the delight of children in their play, and the all-absorbing interest of college students in their baseball and football games.

Even in the highest and most developed forms of mental activity, motor ideas and representations are by far the most predominant. Without motor elements ideational life is arrested. It is these sensory-motor and ideo-motor elements that constitute the stream, the flow, the current of our mental life. Motor elements enter freely into combinations with all other elements of mental life.” (“Analysis of Sleep.” Boris Sidis, Boston, 109.).

The training of the special senses is best carried on by drilling one sensory mechanism at a time. Keeping in mind that the chief aim is development of physical structures, the exercises and apparatus are to be selected with a view to excluding as far as possible every apperception, association or memory concept, except those related specifically to the sense under training.

In training the visual sense the aim should be to develop speed and accuracy in the recognition of form, color and arrangement. For this purpose the following objects are selected: A sphere, a cube, a cylinder, a pyramid and a cone. These objects should be of good size (not less than three inches in the smallest dimension). They should be of one color, and if color- training is associated with exercises in form, a set of models in each color should be provided.

A square of dull black felt should be at hand as a background for the objects. Geometric forms are selected for these exercises because they are almost entirely without associational relations in the childs mind. The results of the training are thus due to the exercises only, and not to associated memories, and the progress of the work can hence be safely measured.

In the first exercise a white sphere is placed upon the square of black felt, hidden beneath an appropriate cover. The pupil is seated about 30 inches from the object, and is required to name it after it has been uncovered a short time and then re- covered. The other forms are treated in like manner, the period of exposure being shortened as the pupil becomes familiar with the exercise.

The color of the objects may be varied, and several models may be used in a group, the order of their arrangement being changed. When these exercises can be readily performed, correlation with familiar objects may be introduced, and similar exercises with other objects may be introduced, and similar exercises with other objects attempted.

These exercises afford an efficient training for the visual apparatus, not only as regards the retinal and central structures, but also the mechanism of accommodation. Children who can not even talk will in time learn to recognize the objects, and will show their recognition by pointing out a similar object in a group of forms.

In training the color-sense the hypothesis of Hering has been adopted as a provisional basis for the exercises, this being the theory that comes nearest to covering the facts. The accuracy of all of Herings conclusions may perhaps be disputed.

Nevertheless, in practice the application of his general theory certainly appears to accomplish results. Herings three chromochemical substances are accordingly made the basis of the color-training, and the exercises are planned to develop their quantity, activity and distribution. The color pairs, green-red, blue-yellow and black-white, are used at first separately, the anabolic and catabolic colors being alternated.

Later they are used in combination, and the training carried on to a series of the six fundamental spectral colors, and the differentiation of their respective hues, tints and shades. In these exercises the old color theory of Brewster, involving primary, secondary and tertiary colors, is discarded for the more rational classification based upon the spectrum.

The auditory sense is developed by systematizing various sounds. Different instruments, such as the bell, rattle, horn, drum, triangle, etc., are utilized. The child is first taught to make the sounds himself. He is next required to listen while they are repeated without his being able to see their source, and he is then directed to indicate upon which instrument the sound was made. Many exercises may be introduced in this way. The chief points aimed at in the training are the accurate recognition of quality, intensity and pitch.

Gustatory and olfactory training are carried on together. The four gustatory fundamentals, sweet, bitter, salt and sour, are first developed; then a large number of stimuli are introduced, the vivid and striking being used first. A surprising degree of skill in detecting shades of difference may thus be obtained. The child is, of course, to be blind-folded during the exercises, and is required to depend entirely upon the sense under training for his conclusions. In gustatory exercises it is well to select stimuli that are non-volatile, as the possibility of recognizing the substances by simple olfaction is thus minimized.

Pressure, muscle, stereognostic and temperature-senses, which, in combination with pain sense, are commonly grouped together as “touch” should be trained separately.

Pressure-sense is developed by teaching the pupil to recognise such differences in objects as rough, smooth, hard, soft, elastic, etc. The exercises are performed by introducing two or more objects into a small cloth bag and requiring the child to insert one hand and select, by means of pressure-sense only, the rough, or smooth, or hard object, as the case may be.

These objects should be alike in every respect, except the particular quality to be studied. In this way the pupil may finally be taught to make comparatively fine distinctions, such as recognizing raw cotton, raw silk, wool, hair and fur, and differentiating cotton, woollen, linen and silk fabrics of various kinds.

Muscle-sense may be readily trained by using pairs of objects, each pair being of different weight. The best results have been obtained by using large cubes and pyramids (with square bases), colored white and carefully loaded with lead, so that a cube and a pyramid constitute a pair, each object of the pair equal in weight to the other, but differing noticeably from the other pairs. Bottles painted white on the inside and loaded with shot set in paraffin, or, in fact, any other suitable objects, can be employed.

The chief points to be remembered are that the objects must be so constructed that they form equally weighted pairs, each pair differing from the others in weight, but resembling them in every other respect. All the objects are set before the child, and he is required to separate those of equal weight into their respective pairs. This he can do only by lifting the objects and measuring their weight by his muscle-sense. The exercises may be multiplied indefinitely. If cubes and pyramids are used, the pyramids should be set upon the cubes of like weight; the pupil may then be taught to arrange the pairs in a row, the heaviest at one end, the lightest at the other.

E. A. Farrington
E. A. Farrington (1847-1885) was born in Williamsburg, NY, on January 1, 1847. He began his study of medicine under the preceptorship of his brother, Harvey W. Farrington, MD. In 1866 he graduated from the Homoeopathic Medical College of Pennsylvania. In 1867 he entered the Hahnemann Medical College, graduating in 1868. He entered practice immediately after his graduation, establishing himself on Mount Vernon Street. Books by Ernest Farrington: Clinical Materia Medica, Comparative Materia Medica, Lesser Writings With Therapeutic Hints.