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Testimony of Dr. Gunnar Dybwad, Executive Director National Association for Retarded Children, Inc.

Before the New Jersey Youth Study Commission, Trenton, New Jersey February 13, 1958

Madame Chairman; Members of the Commission:

I wish to thank you for the opportunity of appearing before you on behalf of the National Association for Retarded Children. We always take pleasure in cooperating with state governmental agencies and commissions, but we are particularly glad to participate in your investigation of mental retardation and delinquency. This is a subject that has been ignored too long. During the past ten years when mental retardation has become the subject of inquiry by many disciplines, its relationship to delinquency received but little attention.

Because I feel that this observation is of significance to your work and might influence the course of your investigation, let me document it briefly. In 1930, Dr. Stanley Powell Davies wrote one of the standard texts in the field of mental retardation entitled "Social Control of the Mentally Deficient". This month, Dr. Davies, now General Secretary of the Community Service Society of New York City, completed a revision of this original text, written in collaboration with Miss Katherine Ecob, a well-known expert in the field of mental retardation. When I asked Dr. Davies if he had been able to record considerable progress pertaining to the defective delinquent he said that it had been most astonishing to him how little had transpired during the intervening 28 years in this special area of mental deficiency. He added: "I described the Napanoch (New York) institution and its training plan in the first edition of my book and this still seems to be in the forefront."

Equally as striking as Dr. Davies' comment is the fact that the librarian of the National Probation and Parole Association, the most distinguished national organization in the field of crime and delinquency, could not direct me to a single article in either their Journal or any of their Year Books that dealt with the subject of the defective or mentally retarded delinquent.

I have dwelt on this lack of activity at length because it is well to remember that much of the testimony you will hear on this subject, including my own, is based on observations and impressions rather than on rigorous, exacting research and comprehensive statistical study. It is my sincere hope that out of the hearings you are now holding and out of your subsequent explorations and deliberations, there will come an emphatic demand for needed research efforts and demonstration projects in addition to the ameliorating administrative and legislative measures that will be urged upon you.

Your Commission asks, "What is the relationship between mental retardation and delinquent behavior in children and youth?" A good deal of misinformation is bandied about by the general public as well as by seemingly well-informed writers and lecturers to the effect that mental deficiency or mental retardation (and I shall use here these words interchangeably) are a major cause of criminality and delinquency. It is further implied that this refers to major criminality and delinquency.

This subject is so entangled in confusion that it would take far more time than is available at this hearing to analyze it thoroughly. Let me merely point up a few highlights: Much time has been wasted in the past to differentiate between defective delinquents and delinquent defectives, in an attempt to allocate administrative responsibility. I shall proceed on the assumption that we are concerned with individuals whose basic impairment is mental deficiency and whose degree of retardation precludes complete independence and self-management in society in spite of special education and training. Too often individuals have been classed as defective delinquents merely on the basis of poor academic performance and often even, as one recent author (1) has pointed out, on the basis of faulty, hurried testing.

Confusion is engendered by a misconception which holds that the more severely retarded individual has a greater susceptibility to delinquency. In considering the relationship of drug addiction to crime, it is readily assumed that the more serious the drug addiction the more serious is the criminal potential. This analogy is definitely not the case in mental retardation. The severity of the handicap, to the contrary, acts as a roadblock to delinquent activity. It is in the upper ranges of mental retardation that we find delinquent activities.

Next, efforts to establish an easily recognized "type" of defective delinquent have not been successful. (2)

I am appending to my remarks quotations from seven authors (3) who are in substantial agreement that earlier statements regarding the high incidence of criminal activity among retarded individuals as a total group do not stand up under scrutiny. This does not imply that defective delinquents do not pose a considerable problem. Even if not as large in numbers as once had been believed, they still pose very vexing problems in both prevention and treatment.

In terms of specific causation of delinquent activity, prevailing studies seem to show that we have as wide a gamut of motivation in the defective or retarded delinquent as in the intellectually average delinquent. In the case of the retarded, the painfully obvious lack or inadequacy of facilities in school, home and community often points up sharply the circumstances leading to delinquent activity.

So far, my comments have followed the usual pattern of thinking on the relationship between mental retardation and delinquent behavior in terms of aggressive behavior, of antisocial activity, if you please. However, I hope your Commission will highlight the reverse side of this picture, as well The presence of inadequately provided for, poorly trained and supervised retardates in the community is a distinct social liability, and a very specific factor in delinquent activity of non-retarded children and adults.

I would summarize my comments as follows:

While there is evidence that the incidence of delinquency is higher among the total group of retardates as compared to the general population, the handicap of inferior intellectual endowment does constitute a specific causative factor in delinquent behavior, particularly in the upper ranges of mental defect.

Since mental defect is the lasting condition and delinquency merely a behavioral episode, no matter how often repeated, the primary guiding principle in dealing with these individuals should be the mental defect.

The unsupervised presence of retardates in the community easily makes such individuals the victims of delinquent conduct on the part of a non-retarded child or adult. The retardate is no less a victim when, through lack of judgment, he is made a dupe or pawn by the non-retarded criminal or delinquent.

Your second question asks; "What are the strengths and weaknesses of educational, vocational and treatment programs for helping mentally retarded children adjust in school and in the community?" May I start out by quoting an English writer. In the American Journal on Mental Deficiency (July 1952, p. 118) she states: "The surest road to the patient does not lead through the broad highway of diagnostic classification but through the narrow trail of individual personality study. " In mental retardation perhaps more than in any other field, we need to make this simple, almost naive statement our daily motto, our constant adminishment -sic-. I say so because I know of no other field where individuals have been judged and so frequently victimized by broad pronouncements and generalizations. We have been all too ready to hang on our retarded children and youth ready-made classification labels. We have prejudged what such an individual could or could not do and then "processed" him accordingly.

If we have to venture into broad generalization, let it be this -- that the strengths and weaknesses of educational, vocational and treatment programs for helping mentally retarded children are first and foremost dependent on the quality (and that, of necessity, includes the factor of quantity) of available, individualized diagnostic facilities. You will have others before you, among them my good friend and former colleague in delinquency work some 20 years ago, Dr. Merrill Hollingshead, who are far better equipped than I am to detail the specific requirements in setting up these diagnostic facilities. Let me limit myself to this emphatic stress on the need for a vast increase in diagnostic facilities, not just a few hours of additional psychological and medical consultation here and there.

My second major point in answer to your question would be that our usual starting point of concern for the mentally retarded child -- and I mean here "official" concern -- which comes during the early school years, is much too late. There is little logic in spending money liberally for the best possible special education and training programs in school (and we surely are far, far away from that millenium) if we allow the child's condition unnecessarily to deteriorate beyond his original handicap, simply because we neglect to aid him and his parents during his early preschool years. Parent guidance and counseling, aid in home care, nurseries for part-time day care under proper educational guidance even for the youngest, and of course diagnostic clinics equipped to give continuing guidance where indicated -- these are the obvious priorities in any well-developed, long-range plan for community services, backed of course by the availability of residential care of whatever type and duration is needed.

To a very considerable extent, the strengths and weaknesses of educational, vocational and treatment programs for retarded children will rest on prevailing community attitudes. There is little use in training a retarded child with painstaking effort to become socially adept and responsive, if misinformed, fearful neighbors will have their children shun him and make him the outcast of the neighborhood. There is little use in teaching a retarded youth work habits, independence in getting about and occupational skills, if misguided townspeople, haunted by old wives tales and superstitions, refuse even to consider that a mental handicap, too, can be partially overcome. I hope your Commission will give close study to the need for educating the public regarding mental retardation and that you will see fit to come forth with specific recommendations in that area.

Another point that will warrant your attention is the question of coordination of services, including provision for sound long-range planning. Here we meet with historical obstacles. In the days when there was but one sure plan for the retarded -- excepting school attendance -- namely the State institution, governmental responsibility rested on the state level and private, voluntary effort was all but non-existent. Today we face a different picture, a picture that has changed so rapidly that it had to grow without benefit of blueprints and master plans. Therefore, your Commission will need to direct its attention to the question of appropriate division of labor and of responsibility as between the state, the county and the municipality, including the school boards, on the one hand and on the other hand the allocation of responsibility as between public and private, voluntary effort. We hardly can expect to make up in short time for the thoroughgoing neglect of past decades if we leave merely to chance or to the initiative of individual administrators or to the interest of an individual legislator the decision as to who should perform what services. Certainly we must avoid duplication -- but that surely is far too negative a caution. We must see to it that services supplement and complement each other and that on each level we perform those services which best fit there. New Jersey is farther ahead than many other states by having initiated the Bureau of Mental Deficiency in the State Department of Institutions and Agencies but I am sure Mr. Tramburg and Dr. Kott would agree that we are still in the beginning stages of this development on the governmental level.

Since my remarks have been so largely concerned with the future -- let me make one additional general observation: As I indicated earlier, much of what we say today about strengths and weaknesses of existing services is based on impressions and informal observations. It is all too evident, then, that we are in urgent need of systematic research efforts in the field of practice. It would appear fair to say that in some measure and regard, these strengths and weaknesses of our programs reflect a lack of knowledge of what are reasonable expectations as we try to plan for retarded children and youth. The spectacular progress we have made in the past decade may lead us to swing the pendulum too far and to expect too much of vocational training or school programs, thus creating a sense of failure and frustration in our children. Hence the importance of having a systematic evaluation as a built-in part in all programs which will be developed.

I am turning now to your third question; "How can mentally retarded juveniles, delinquent and non-delinquent be most effectively treated within institutional settings?" In answering this question I shall lean on a study I made 19 years ago and subsequently published under the title "The Problem of Institutional Placement for High Grade Mentally Defective Delinquents". (4) It was based on a study of both a state institution for delinquents and one for the mentally deficient. However, while my conclusions then were rather indefinite, at this time I would want to state as my first premise that children and youth who are mentally retarded should be cared for in an institution for the mentally retarded regardless of the nature and extent of any delinquency they may have committed.

Obviously this will call for specialized facilities within such state schools, homes or hospitals but experience would seem to bear out that this cannot reasonably be accomplished by simply drawing a dividing line between delinquent and non-delinquent residents. Rather, our point of departure must be the recognition that any residential facility for the retarded will have to develop a plan providing for different degrees of supervision and custody. Even if an institution for the retarded does not have in its care individuals who have been adjudged delinquent, there will be unruly, disturbing, aggressive individuals who require a restraining, disciplinary regime for their own protection and that of the other residents. Conversely, children and youth may be committed to such a facility on the basis of formal adjudication as delinquents, yet may be in need of protection rather than restraint. In short, it would be my recommendation to have within the residential facility for the retarded, a building plan providing for a variety of structures specifically adapted to disciplinary needs along with other program needs and so distributed on the grounds as to facilitate a fair degree of separation of certain groups from each other. I would submit, however, that few are the states in this nation where such an obviously asymetrical resident-centered plan would get by the State Architect!

Naturally, a question arises as to how large a disciplinary or restraint facility is needed? In inquiring about this from various superintendents I get such widely differing answers that one could only surmise that conditions pertaining to the plant and the management of each particular institution were the key factors rather than the actual extent of delinquent behavior. It would seem necessary, therefore, to take a careful look at the type of problem the administration considers as basic to institutional segregation. Rather than to think of just one special disciplinary or restraint unit for each institution, it would be far more effective and also more economical from a management point of view to have at least two such units. This would not only facilitate a greater differential in treatment, but also anticipate a possible decreasing need for such special treatment as better staff ratios and better auxiliary services produce a more favorable institutional climate. I would rather make this kind of general statement than to comment on any one specific percentage of the institutional population which might require restraint.

There are, as you may know, various superintendents who recommend that rather than building a separate unit on the same grounds, a separate institution altogether be established in their state for these troublesome "delinquent" retardates. Again limiting myself to children and youth, I feel quite strongly that such a move would be undesirable since it would undoubtedly involve unreasonably high costs. Small residential units on a separate basis are feasible when they have a flexible informal program, but not when custody assumes a major proportion.

APPENDIX

Early investigators put undue stress upon the intelligence factor of the delinquent person. They could not understand, and many do not yet realize that the prevalence of mental deficiency found in imprisoned offenders might be due to the fact that they got caught more easily than the intelligent ones. Therefore, the mentally deficient criminal would more often be jailed and, consequently, would turn up more frequently in the statistics. Another point was that if the offender was not outright mentally deficient, then his intelligence was thought to be lower than that of the average man. This, too, is a fallacy. The examination of the delinquent depends not only upon him but also, within certain limits, upon the examiner's attitude and the care with which he carries it out. In our own test material, we have invariably found a higher I.Q. in the offender than did other examiners. In some cases it has not only been a difference of a few points, for instance from 68 to 75, but as much as from 68 to 88. (5)

On the basis of this study it is justifiable to conclude that mental deficiency per se does not seem to play an important role in the causation of criminal behavior as has been assumed heretofore. It was found that the ratio of mental deficiency among the population of a state penitentiary is approximately the same as that of the general population of the United States. This study confirms the fact that criminality represents a bio-psycho-socio-phenomenon, and that a multiplicity of factors are at work in the causation of criminal behavior of which mental deficiency is one, and of importance only in combination with others, and that psychological, biological and cultural factors are equally important in this connection. It also shows that there is no typical "defective" criminal since this study reveals the tremendous range of difference in background, personality, physical, mental and emotional factors. (6)

In the field of criminology, interest is chiefly centered on the moron, since idiots and imbeciles, who are easily recognizable, are usually subject to such care and supervision as to render them harmless to society. Even morons apparently do not constitute a major law-enforcement problem, the available evidence, although admittedly inadequate, indicating that their conflicts with the law tend to involve such crimes as larceny, vagrancy, drunkenness, and the less serious sexual offenses. Often the moronic offender gets into difficulties because he is confused, emotionally unstable, or easily led and exploited by more intelligent companions... (7)

There are no reliable comprehensive statistics on the extent of delinquency or criminality among the mentally deficient. Although early studies led to the conclusion that feeble-mindedness was the major cause of crime and delinquency, the work of Murchison, Tulchin, Zeleny, and others helped to correct this misconception. The evidence now indicates that only a small proportion of the feeble-minded are delinquent or criminal, and that offenders and the general population have about the same distribution of intelligence levels. (8)

What can one conclude about the relationship of intelligence to delinquency?

1. The average intelligence level among delinquents who are apprehended and among institutionalized delinquents is lower than that of unselected school children but approximately the same as the intelligence level of non-delinquents who have the same ethnic and socio-economic background.

2. There are delinquents with very high as well as very low intelligence.

3. The exact relationship between intelligence and delinquency is unknown.

4. It is conceivable that in individual cases low intelligence leads to isolation, a sense of inferiority, and aggressive behavior defined as delinquency.

5. The greater suggestibility in some children of low intelligence because they are less critical may lead to delinquency through the example and persuasion of others. (9)

Metfessel and Lovell, after surveying the relationship between intelligence and crime, especially the incidence of feeble-mindedness and the intelligence test scores of offenders, and reviewing the basic studies of this subject, conclude that intelligence is not considered so important a cause of crime as it was formerly.

There is considerable disagreement as to just how important this correlate is, but studies do, in the main, support placing the delinquent in the dull normal class. Any general statement as to the relative intelligence of offenders and non-offenders is difficult. It appears safe to say that most results show inferiority of the test scores of criminals in comparison to the theoretical distribution of the population (the validity of which is doubtful). Smaller differences have been found between offenders and such samples of the population as the Army draft, but no clear-cut conclusion can be drawn from these, because the representative quality of these non-criminal groups is questionable.

The authors point out, in reviewing the studies of intelligence in relation to the age factor, that intelligence is a more significant factor among juvenile delinquents than among adult prisoners. The influence of intelligence as a factor in crime varies also with the type of crime. (10)

The defective delinquent constitutes a very small proportion of the Juvenile Court case load; indeed it is only 7 per cent of the clinic case records. Published reports show the percentage of delinquency amongst delinquents ranging from smaller figures up to more than 50 per cent. Certainly, in our experience, the defective delinquent, by weight of numbers, is not a serious problem. (11)

The meaning of delinquency alone has been sufficiently perplexing; the addition of mental deficiency to the problem makes it even more distressing. Some have felt that the deficiency itself is the entire cause of the delinquency; some believe that the syndrome is a true biological entity. I find the etiological relationship between deficiency and delinquency confusing if only for the fact that the lower the I.Q. the less the incidence of delinquency. In our cases, and in others, nearly all the children fall into the higher grades of deficiency, namely at the moron and borderline levels. Furthermore, modern methods of psychological study seem to indicate that one cannot place too much reliance on the I.Q. Certainly clinical psychiatric opinion has it, in our group, that a very significant section of the cases are of normal intelligence. (12)

The defective delinquent, in our experience, is a heterogeneous group with many characteristics of a true neurosis affecting behavior and intellectual performance together. Even without psychotherapy they do fairly well within three years in the program described. After routine training primarily as a delinquent there remains a group of resistant cases which probably require long term care as defective delinquents in a special institution.

It is suggested that realistic efforts be made to treat at least a representative number with psychotherapy or special retraining techniques in a clinic environment. The use of locally established schools is recommended as the initial step in the rehabilitation of the defective delinquent who is showing signs of development of a serious behavior problem.

Accordance is expressed with already published views that state schools for defective delinquents be transformed into special psychiatric hospitals for children. (13)

Are all the feeble-minded potential offenders? Such a question implies that the feeble-minded are peculiarly susceptible to crime and delinquency because of suggestibility, lack of foresight, poor judgment, and such influences as may induce either active or passive types of offenses. It does not necessarily mean that the feeble-minded are more aggressively antisocial than the normal person. Such generalizations, moreover, are more applicable to juveniles than to adults.

The feeble-minded are easily led and feebly inhibited. They are naive rather than vicious. One may think of the mentally deficient offender, therefore, not so much as an aggressor toward society as a victim of social circumstances. Constructive legislation and the sound administration of justice can do much toward improving the protection of society by well-advised concern for the welfare of its mentally deficient members.

Edgar A. Doll
Director of Research
The Training School
Vineland, New Jersey (14)