Psychoclinical diagnosis
in infancy.
From the standpoint of child adoption, therefore, the situation
involved a paradox which contains an element of hazard as well as
of promise. Infancy is the best time for adoption, but in the nature
of things it is also the time when developmental prediction is most
difficult. Can the hazard be reduced?
It can, if the development of infancy is essentially lawful; because
all lawful phenomena, even the most complex, are theoretically within
the scope of scientific formulation and forecast. It will be a long
time before astronomical accuracy is attained in this field, because
a child’s orbit is not so simple as that of the sun and the
moon. But that it is necessary to remain indefinitely in the dark
would not be admitted even by those students who have gained the
most knowledge of the intricacy of living things.
Infancy is the period of most rapid growth in the whole life cycle,
except, of course, the intrauterine period of which it is but an
extension. This very fact simplifies, more than it encumbers, the
task of developmental diagnosis. The infant to be sure is very immature
which tends to make him inscrutable; but on the other hand, he matures
at an extremely rapid rate, and this tide of maturation brings him
more repeatedly and more cogently within the purview of systematic
observation. . . .
In principle, these considerations have a bearing on the question
whether in time the adoption of infants may be brought under more
adequate clinical control. The greater speed of growth has very
practical diagnostic implications. It means that a probationary
year prior to adoption may be made to yield more evidence in infancy
than in any later period. In the first year of life four periodic
developmental examinations may readily be made to determine the
increments of mental growth, whereas a few years would be necessary
to observe as many comparable increments in later childhood. The
older a child is the longer it takes to make a definite developmental
advance; and so it follows that the diagnostic values of a probationary
year tend to vary inversely with the age of the child. . . .
An Attractive Infant, but Subnormal—Child B (age 26 months)
This child was not seen before the age of 2 years. She was born
out of wedlock. Concerning the mother there was only the brief annal,
“she is untruthful and peculiar.” The child was boarded
in a high-grade family home where the foster mother became deeply
attached to her and made plans for her adoption and education.
Postponement of adoption has been urged, because the child just
now seems much brighter and “more acceptable” than she
really is. She is in the “cute” stage of development
which conceals her limitations.
In physical appearance she is attractive; in demeanor she is smiling,
responsive, playful. She waves “bye-bye” very genially
and plays gleefully with a ball. She is just the kind of child who
would smite the heart of questioning adoptive parents. If they yielded
to the impulse of affection on the first sight, they would then
and there resolve to take her into their own home, give her every
educational advantage, and rear her as a charming, refined daughter.
These parents would not be entirely disappointed, because the child
is not definitely mentally deficient and her personality make-up
is relatively favorable. However, the examination proved that she
approximates the 18-month level much more consistently than the
2-year level, and the general quality of her attention was far from
satisfactory. On the basis of all the clinical evidence it is extremely
doubtful that she will ever be able to complete a high school education.
She may have some difficulty in completing the grammar grades. In
10 fleeting years at least the educational limitations of this child
will be more palpably revealed; and there may be genuine pangs of
regret.
The economic status and educational purpose of the parents are
an important factor in this particular adoptive situation. If at
the outset the parents are not ready to relinquish their educational
expectations, another child should be sought. Some parents are quite
content with a favorable, likable personality irrespective of grammar-school
success. Clinical safeguards and a probationary period will help
to define the issues in advance and protect the interests of both
child and parents. . . .
Clinical control of child adoption should be closely related to
all precautionary and investigatory procedures. It should reenforce
and direct rather than displace other methods of control.
Systematic psychoclinical examinations not only will reduce the
wastes of error and miscarriage but will serve to reveal children
of normal and superior endowment beneath the concealment of neglect
of poverty or of poor repute.
Clinical safeguards can not solve all the problems of child adoptions
but they can steadily improve its methods and make them both more
scientific and humane. Most of all in the appealing but undefined
period of infancy do we need a clearer light for faith.
|