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.