Awakening to Life. Alexander Meshcheryakov 1974
What does a deaf-blind child represent before it receives any special tuition and training?
All those who have observed such children, describe them as absolutely helpless and deprived of the capacities of human behaviour and thought.
The well-known French girl Marie Heurtin, who had been deaf-blind from birth, behaved at the age of nine “like a wild animal”; she was removed first from a school for deaf-mutes and then from one for the blind and placed in an isolation ward of a mental hospital, classed as an “idiot.”
After specialist intervention, however, it was established that her brain was normal and that she could respond to teaching.
Children who are not born deaf-blind but become so at an early age find themselves in a similar position. On losing its sight and hearing a child usually loses all its behavioural habits hitherto acquired.
S. Gofgaardt (14) in a paper read at the IV Congress devoted to the education of handicapped children, told of a girl by the name of Kaata Ragnhild who at the age of three had lost her senses of hearing, sight, taste and smell. Until the age of fourteen she lived at home. It was not until she was fifteen that she was admitted to a school for the deaf-blind.
She possessed few human traits at that time: she would often sit in one spot for a whole day at a stretch without showing the slightest interest in what was going on around her, only emitting an occasional groan. If someone came up to her she began to stamp her feet, roar and scratch like a wild animal. However, once she started to receive tuition she developed more rapidly than the average deaf-blind child.
The Soviet psychologist A. N. Yarmolenko in her study of extreme pedagogical neglect in the cases of deaf-blind children describes such children in the following terms: “In the manifestations and type of their behaviour children of this group resemble most closely ‘classical examples’ of the deaf-blind, who have not experienced the ‘beneficial, revitalising influence of teaching, the divine spark’, as seen by Arnould, Lemoine and many other writers in this field. These ‘inert masses’ or ‘frenzied* animals’, as they appear to the outside observer, are shut out from ordinary life by the absence of aural and visual impressions. Passive and immobile, they would sit in the same spot for hours at a stretch, sometimes even in the same pose. They do not use their faculty of touch to investigate spatial relationships or to familiarise themselves with new objects: even the processes of eating, dressing and undressing and the satisfaction of their most basic physiological needs are only carried out after external stimulus, without which the processes concerned might be postponed in time until an extreme degree of need be reached, which in its turn would produce an outbreak of fury. They do not manifest even the most elementary urge for contact with other people” (81, 82, p. 82).
Observations made by the Soviet psychologist Ivan Sokolyansky (74, 78, 79) show that the deaf-blind, deprived of tuition, can spend many years in bed, in a corner of a room fenced off from others, with no effort to make contact with people and objects, appearing to achieve no mental development, failing to learn to walk or to eat and drink at all normally.
Sokolyansky also describes a case of incorrect rearing in an educated prosperous family of a child completely normal as far as his brain and nervous system were concerned despite his lack of sight and hearing.
“Volodya had lost his hearing in his fifth year. Prior to his illness he had been developing completely normally. He had been a happy, lively little boy; had been talking well and had enjoyed contact with those around him. He had been an only child.
“At the time I got to know Volodya he was already twenty-four. His mother gave me brief details of his background. Volodya no longer showed any interest in anything around him. Indeed, his mother pointed out that his was the life of a vegetable pure and simple, he was the prisoner of his physical sensations.
“Volodya’s outward appearance meanwhile was impressive. He was tall and according to his mother possessed rare strength. If her stories are to be given credit, he once, with no particular effort or strain, broke a metal ring from a mincing-machine and on another occasion unbent a horse-shoe.
“However, Volodya was only able to walk with the help of other people: on his own he could scarcely move, placing his legs wide apart and bending his head right down. In his bedroom he could find his way about quite well and knew where things were to be found; he manipulated the bedclothes fairly easily. He was able to dress himself, make his bed and pull back the covers at night. He was very cleanly and used the toilet without outside help. Yet all this he did in his own room. Beyond the confines of that room he was completely helpless and when left to himself he immediately sat down on the ground, flapping his hands around him and expressing his anxiety by means of grunts.
“In the course of my visit a number of his skills were demonstrated to me: after being placed on his knees and having his head bent down for him, he stood on his head raising first one leg and then the other. He stayed in that position for about three minutes. He only put down his legs when someone touched them. His mother added that he could stand on his head for even longer. Who had taught him to do this and in what circumstances, the mother was unable to say.
“It was difficult to feed Volodya, for he used to throw his food around and also try and take food from his neighbours’ plates. For this reason he had to be fed on his own. If someone banged on the table, Volodya put his hands in his lap and sat motionless.
“He only became active when mealtimes drew near; the rest of the time he used almost always to sit motionless in his bedroom, with head hung low as if asleep. In actual fact, he was just patiently waiting to be led to his meal.
“During my visit he was given a handful of cherries. He grabbed the cherries and began to eat them greedily although his mother had given him a good meal just before my arrival.
“Nevertheless, there were sufficient indications that given proper teaching Volodya could have attained a normal level of mental development and engaged in productive labour.
“What had turned him into the kind of being I met during my visit? It was of course the incorrect care in the family. An excess of love for their ill child had led the parents to turn him into a complete invalid, without realising it or seeking to do so” (78, p. 141-42).
When selecting pupils for a special school for the deaf-blind in Zagorsk, we made a study of a group of children whose training had been neglected and who had come to us straight from their families. Some of them were absolutely incapable of independent existence. Since they had been carried about by their mothers all the time they were not even able to regulate their body temperature. In this respect it was difficult to regard them as independent organisms, they were really appendages of their mothers’ bodies. They were unable to sleep away from their mothers at night, or to remain even a minute without her in the day-time. It was extremely difficult to wrest them away from their mothers, teach them to sleep on their own, to forego being carried around or to eat by themselves.
One of the boys who came to us at the age of six, was unusual in that he would suddenly freeze over, as it were, and remain motionless for long periods. It emerged that in his family there had been no one to stay with him at home during working hours and he had had to stay by himself. He had thus grown “accustomed” over the previous three years to wait for hours on end for someone to come up to him. He had no interest in anything except food. He was completely unable to look after himself or to use the pot. After systematic training he quickly learnt self-care habits and was able to find his way about.
There were other pupils sent to us from various homes for sick children who were comparable to this boy. Some of these were unable to walk, others were only prepared to walk in a confined, familiar space. They were unable to eat on their own, even hold a spoon or use the toilet, dress and undress. Their habitual occupation was to sit in bed or on a mat swaying their bodies to and fro with the monotonous regularity of a pendulum. These children do not take hold of or feel over any objects. They are not familiar with toys and do not understand what they are. They manifest no need for contact with other people. They respond negatively to any attempts to touch them: they either move away from or push away an adult’s hands.
The whole of these children’s mental activity is confined to the perception of the most elementary physical needs and the experience of elementary pleasure at the satisfaction of those needs or displeasure if the needs are not satisfied. Elements of human behaviour are for all intents and purposes missing altogether. In its place we find stereotyped motor activity that allows the children to expend their energy.
This means that deaf-blindness in unfavourable conditions, ruling out as it does all ordinary forms of human contact between a child and people around it, condemns such a child to isolation and a semi-animal existence. In such cases development of the human mind virtually fails to take place, despite the fact that the child’s brain, from the medical point of view, can be completely normal and adequate for the execution of all higher mental functions.
The French psychologist Lemoine in an attempt to convey the psychological changes connected with the loss of hearing and sight, writes that the fear of the unknown, and darkness that close in on the deaf-blind, their lack of confidence and inability to communicate make them lose all sense of reason and moderation. This is why they are often held to be idiots or lunatics. He also writes of the “fatal influence” of the simultaneous onset of deafness and blindness upon the mental development of a small child with as yet unconsolidated speech skills. The speech skills of such children, that were only just emerging, quickly disappear. Not only their powers of reason and judgement, but also their emotional development, will and imagination are severely impaired. Their imagination is reduced to a minimum and only exists within the framework of their tactile sensations. These unfortunate children robbed of the two most vital senses soon begin to appear stupid and insensitive to any external impressions (29). Lemoine attributes to the deaf-blind traits that are not intrinsic to them, attempting to imagine the results of the loss of hearing and sight. It is therefore not surprising that he eventually arrives at the incorrect conclusion to the effect that the deaf-blind are uneducable. But he is right, when he speaks of the “almost fatal” effect (“shock” would perhaps be a more apt expression) of the simultaneous onset of deafness and blindness upon a child’s speech, indeed, not only on his speech, but on his whole behaviour and mental make-up. Until he begins to receive special instruction a deaf-blind child may fail to manifest any signs of human behaviour or mental capacities, so that the specific nature of the teacher’s task in such cases is the need deliberately to build up patterns of human thought and behaviour in all their rich diversity.
Yet how should the teacher set about moulding these patterns of human behaviour and thought in the deaf-blind child? What is the foundation on which the edifice of a human mind must be built up? We shall attempt to provide answers to these questions in the next section of this chapter.
The mistake made by most teachers of the deaf-blind in the past was that they started by attempting to develop speech skills in their pupils. They started out from the principle that the main difference between man and animals was the “gift of speech,” and they went out of their way to develop the “gift” in oral or written form or as finger-speech. However, this speech, with no roots in a system of immediate images reflecting the child’s environment, had no foundation and thus could not provide a basis for the child’s mental development.
Work carried out in teaching the deaf-blind has shown that fostering speech skills in such children is not and indeed cannot be tackled as the first objective in the nurturing of a human mind.
I shall now permit myself a small digression from the survey of the problems of deaf-blindness to try and formulate the more general theoretical principles on the basis of which questions connected with the psychological development of deaf-blind children were analysed. Reference was made earlier to the idea put forward by Karl Marx to the effect that man shapes his mind, his ideas and attitudes, while transforming the world around him, an idea that was to prove profoundly important for the science of psychology.
The humanising influence of objects, as the products of social labour, and the importance of teaching a child to manipulate them correctly are to this day underestimated both by teachers and in psychological theory. Yet it is precisely this behaviour with objects, that is, the ability to use objects in accordance with their intrinsic logic, which constitutes the essence of human behaviour. In this connection Marx wrote: “Each of his human relations to the world – seeing, hearing, smelling, tasting, feeling, thinking, observing, experiencing, wanting, acting, loving – in short, all the organs of his individual being ... are in their objective orientation, or in their orientation to the object, the appropriation of the object, the appropriation of human reality” (2, pp. 299-300).
Human behaviour and thought in an individual take shape and develop on the strength of the availability of objects created by human labour, in which man’s skills are made tangible.
“The appropriation of a totality of instruments of production is, for this very reason, the development of a totality of capacities in the individuals themselves” (3, p. 87).
Alexei Leontiev noted the decisive significance of these fundamental utterings by Karl Marx for scientific psychology.
“In the course of his ontogenetic development man is drawn into distinct, specific relationships with the world of objects and phenomena around him, that have been created by preceding generations, “ wrote Leontiev. “In relations to these (tools, instruments, everyday objects. – A.M.) a child must carry out a practical or cognitive activity which adequately corresponds (but which is not identical) to the human activity embodied in them” (56, p. 21).
“Thus the intellectual or mental development of the individual is the product of a highly distinctive process of appropriation, which is not to be found at all in animals, just as they do not manifest the opposite process of objectivisation of their abilities in the products of their activity” (56, p. 22). Further: “A man’s adequate relation to a tool is expressed first and foremost in his appropriation of the operations which are embodied in it, thus developing his human abilities. This naturally applies also to all other human objects” (56, p. 23).
The Soviet psychologist Pyotr Galperin (48) noted that for a child an implement which he needs to master (as indeed any thing that is the product of human hands) constitutes an object in which are represented socially evolved operations pertaining to it.
A child’s mind takes shape and develops as a result of its interaction with the world of things and the world of people. The things with which a child interacts are the products of human labour. The essence of interaction with things and people consists in the fact that in both cases this is interaction with a human factor. Expressing this idea in somewhat paradoxical terms we may say that the individual’s relationships with other people are realised through things and his relationship to things through his relationship to other people.
The socially evolved method of using a thing is a human factor; at the same time in that method are reflected the objective characteristics of the given thing following from the fact that it is the product of practical actions (i.e., labour).
This socially evolved method of utilising a thing which inevitably reflects its objective properties, also constitutes the social significance of each thing.
In the course of being taught to behave in the world of things, as it masters actions correlated with various things, a child comes to grasp their social significance, their essence. These are the general principles underlying the moulding of a child’s behaviour and mind, that we have tried to follow in evolving a theory of deaf-blindness and also in the practical work of teaching deaf-blind children. Now let us relate these principles directly to the deaf-blind child.
Until he begins to receive proper training, the deaf-blind child’s world is empty and devoid of objects. For him the objects that loom so large in our life do not exist, that is they are discovered by him only insofar as he knocks into them, but they do not exist for him with functions and designations – with their social significance as we may say now.
In what way, as we seek to mould and develop the deaf-blind child’s behaviour and mind, can we bring about this appropriation of human skills objectivised in a humanised environment? How should a non-seeing and non-hearing child be made aware of the diversity of objects in the world around him? It is clear that the path to knowledge of the world can follow only one course for such an individual; it must be effected via analysis through touch and movement. It might seem that there is a simple solution: a child should be given objects to hold, then lie will feel them over and in this way he will gradually come to create for himself an infinitely large number of images of the objects around him.
However, experience in teaching deaf-blind children has shown that such a path is impracticable. Deaf-blind children, before they receive special training, are completely bereft of any, aspects of human mental processes – these exist only in potential (which, if realised, can promise the highest level of development). Initially, they, have no need to discover the world, and possess no skills enabling them to find their bearings within it or analyse what they encounter.
If such a child is given objects to “peruse” he drops them at once without even bothering to familiarise himself with them. This is understandable insofar as the objects given to such a child have no significance for him. Regardless of how novel tactile stimuli might be when attempts are made to place various objects in the hands of a child they. do not arouse any orientative reaction.[3]
How can a deaf-blind child be made to handle objects” It is necessary to provide conditions in which getting to know objects would become a need for the child.
Any deaf-blind child has a number of basic natural wants (to cat, excrete and protect himself). Initially these wants do not in themselves constitute true needs in the psychological sense of that word. They do not exist as human needs in the strict sense, they cannot as yet provide the motive force behind purposeful behaviour, and for this reason no human behaviour is to be observed in the early stages. These wants become true needs only after they start to be objectivised and satisfied through human methods involving tools and implements.
A child’s familiarisation with objects from the world around him takes place in the course of his activity directed towards the satisfaction of these elementary natural wants. This means that during the early stages of a deaf-blind child’s development, the appropriation of social experience, which is humanising him, must be linked with concrete practical activity, activity directed towards the satisfaction of his real (at first organic but later more diverse) needs that will expand in pace with the range of his activity.
In order to satisfy his natural wants, at meal-times for example, man uses a number of “tools” – spoons, forks, plates, etc. This fact is utilised to familiarise deaf-blind children with objects. The adult teacher, while feeding a child, teaches it to use a spoon, plate or napkin, holding the child’s hands in his own.
In the course of this practical activity a child is obliged to become familiar with various objects. “Obliged” insofar as this encounter with objects at meal-times is essential if he is to receive direct sustenance in the form of food. At other times outside the meal-time situation these objects did not produce an orientative reaction (after being placed in the child’s hands they immediately fell or were dropped or pushed away by the child), but at table the child’s perception of these objects is reinforced, they become significant for him and he begins to feel them. Gradually, in the course of this unconditioned fixation (in this case in association with food), the child’s orientative and analytical activity begins to develop.
In the physiology of higher nervous activity it has been established that in order for a conditioned reflex to a specific stimulus to develop it is essential that an orientative reflex to that same irritant be present. This principle should be regarded as indisputable. However, it should also be pointed out that the scientists who established this principle were considering higher nervous activity already in its more or less definitive form. We, on the other hand, were observing the emergence of children’s behavioural reactions. It soon became clear that during the initial stages of a deaf-blind child’s development, preliminary reinforcement of an orientative reflex to a particular stimulus Is essential for that reflex to become properly established.
Those engaged in the practical rearing of these children have to come to terms with their lack of any orientative reactions to new stimuli and to the need to foster such reactions during the early stages of their development.
A completely unfamiliar object placed in the hands of a deaf-blind child does not stimulate any tactile investigation on the latter’s part: a pen, a box of matches or a pencil will be dropped or thrown away by the child. However, a blocked teat from which a child can no longer suck in milk or water or the changed shape of a spoon give rise to an energetic orientative reaction (handling).
So the “What’s this? “ reflex (to use Ivan Pavlov’s term) is a later achievement in the case of the deaf-blind child. We have never observed the “What’s this? “ reflex in the early stages of a deaf-blind child’s development. In its place we observed more concrete reactions such as “Is it safe? “ or “Is it edible?” If it emerges that the stimulus is not linked to the body in a practical relationship, the orientative reaction to it does not evolve.
The emergence and degree of the orientative reaction are determined not by the novelty of the stimulus, but, on the contrary, by the similarity between the new stimulus and those which have already become signals and have previously been fixed. The newer the stimulus the less chance of it producing an orientative reaction in the deaf-blind child. The situation in which an orientative reaction is most likely to evolve is when a child is presented with an altered variant of a stimulus previously fixed.
There probably are forms of behaviour which appear innate, because they evolve easily in the course of ontogenesis. The emergence of new forms of reaction in a changing environment is something vitally important, and so some forms of behaviour evolve very quickly; only one reinforcement is required before the necessary association is formed. Some other reactions evolve thanks to generalisation, which can be elective from a very early age. Such reactions function thanks to the fact that a similar link was formed earlier, and this similarity does not need to be self-evident.
Such a situation is to be found with regard to man’s cognitive behaviour, starting with the orientative-investigatory reflex and ending with his search for the truth. It is hardly correct to link this activity with so-called innate unconditioned orientative reflex; most probably there exists no reflex as a result of which orientative behaviour develops, nor are there any other biological preconditions for the emergence of specifically human mentality. Yet it should be remembered that orientative-analytical behaviour starts to take shape as soon as the influence of the external environment, beneficial or harmful to the organism, is felt. The resultant need does not manifest itself like a biological want, which, once satisfied, disappears. While for instance the need for food once satisfied fades away, the orientative-learning need, once satisfied, moves on a step further.
Orientative-investigatory activity emerges as activity directed towards knowledge of an object that has previously figured in a practical activity. It is thanks to such activity that a child is able to actualise the image of a thing, with the help of which one or other of its physical wants were previously satisfied.
The widening of the range of objects used to satisfy the child’s basic wants places new demands on orientative-investigatory activity, which at this stage must include the choice of one from a group of things, which vary in their suitability for the achievement of the objectives inherent in the practical activity.
But an overwhelming increase in the now of objects brought into the practical activity not only complicates the activity in quantitative terms but also leads to qualitative restructuring. In order for objectives to be reached this or that practical activity has to be effected in different ways depending upon the conditions. The range of objects used to carry out this activity is not merely extended but also changes depending upon the changed situation. In different conditions one and the same activity requires now one set of objects, now another. Consequently the tasks of orientative activity also change and grow more complex: it consists in the search for the necessary object. In this search the child comes across a large number of diverse objects, both those which have some bearing on the practical activity, and those which are divorced from it. In order to find the thing he is looking for, the child has to compare objects he lights upon with the image he carries in his mind and measure up the real object against the ideal image.
This comparison of an object. with an image that has grown up in a child’s mind gives rise to new knowledge, to new images for articles that have no direct bearing on his practical activity.
In this way there takes shape, as an aspect of the practical activity, the orientative-investigatory function, which then gradually emerges as an independent activity, giving rise in its turn to a secondary, “superstructural” need for the knowledge of objects in the surrounding world.
At this stage occurs not only the actualisation of images directly necessary for the success of the practical activity but also the accumulation of knowledge “for future use.” Now the orientative reflex can in itself provide a sort of reinforcement, and on that basis an enormous number of temporary links can be formed making possible the attainment of more and more new knowledge.
However, at this stage, too, the final selection and consolidation of emergent images take place in the context of concrete practical activity that is in some way beneficial to the organism , although this “benefit” must be understood in a wider sense, not confined to food, protection from pain or cold, etc.
Images that have taken shape as a result of orientative-investigatory activity “for future use” provide a reference point with relation to much more complex behaviour on the part of the child: by this time he has been taught to walk, to put on his own clothes and shoes, overcome obstacles in his path and use correctly a large number of everyday household objects (furniture, clothes, toilet articles, toys, etc.). New objects which the child encounters or is given are carefully examined (via his hands) with the guidance of his teacher, and he learns the purpose of each new object.
With what “tools” does the deaf-blind child become familiar during the early stages of his training, what functions associated with these “tools” does he master? Initially one can count such “tools” in tens, later in hundreds and thousands. First of all there are the numerous household objects, the mastering of which proceeds imperceptibly in the case of an ordinary child possessed of normal sight and hearing, is taken for granted as it were. A child learns to eat with a spoon and fork from a plate, sitting on a chair at a table, biting off a piece of bread and then taking a spoonful of soup, later stirring a drink in a cup or glass with a teaspoon, drinking but of that cup or glass and finally wiping his mouth with a napkin. He is taught, in accordance with a clearly defined timetable, to go to bed, lie on a sheet, put his head on a pillow, cover himself up with a blanket, to wake up and get up at a set time, then to make his bed, use the pot or lavatory, do his morning exercises, go to the bathroom, turn taps on and off, regulate the flow of warm and cold water coming out of the mixer-tap, soap his hands and face, then wash the soap off, brush his teeth, rub himself down with a towel and comb his hair; to put on and take off pants, stockings, trousers and a shirt or a dress, to put on and take off socks, slippers, shoes, felt boots and galoshes, coat and hat; he learns to open and shut doors, go up and down stairs, play ball or dolls and enjoy other toys as well.
This list is not a haphazard string of activities because a deaf-blind child really does have to be taught to do all these things one by one by specially devised methods. In practical terms the whole life of a deaf-blind child is an unending learning programme.
A deaf-blind child is taught not only to do the things listed above but also to do tens and hundreds of other things, to apprehend and acquaint himself with tens and hundreds of objects made by man, and to master and understand the functions that are inherent in these objects. As he comes to master and manipulate numerous household and everyday objects, such a child makes his first real contact with his fellow-men, and, as he assimilates the experience accumulated by men over thousands of years and embodied in these objects and their functions, the child himself comes into his own as a human being.
Instruction of such children in the skills of self-care, that is aimed, essentially, at enabling them to satisfy their individual needs using socially evolved methods, is a fundamentally important stage within the overall programme of rearing and teaching the deaf-blind child: it constitutes the laying of the foundation for his subsequent development.
At the initial stage of a child’s development the relationship and interaction between practical forms of activity, aimed at satisfying basic wants, and orientative-investigatory activity with cognitive objectives are as follows.
Cognitive activity arises within the practical activity and for the satisfaction of the latter’s requirements (indeed this is the only way in which it can come into being); it emerges as an indispensable condition for the realisation of the practical activity. However, after first emerging within practical activity, cognitive activity assumes relative independence. As a result of its relative independence, a child acquires knowledge of the Outside world (Images of objects) which extends beyond the narrow range of knowledge essential for the execution of concrete types of practical activity. In this way conditions are created for the mastering of more complicated forms of practical activity, and new forms of activity emerge. Practical activity becomes more varied and extends beyond the simple satisfaction of the child’s physical needs, and this, in its turn, makes possible the further advance in learning.
The relative independence of cognitive activity enables the teacher of the deaf-blind child to enlarge his knowledge, not merely in the course of practical activity but also through special tuition and games.
It is essential to understand that not until a child begins to be instructed in practical activity and not until relatively independent cognitive activity starts to emerge within the framework of the latter, will the conditions be provided for special lessons to promote the child’s so-called sensorimotor culture. To encourage a child’s sensorimotor development before he has mastered elementary skills of self-care is not only futile but harmful because the child will become profoundly hostile to the very process of instruction.
The need to establish self-care skills is acknowledged by all those who have had anything to do with the teaching 0 f deaf-blind children. Deaf-blind children in the United States and Britain are instructed in the skills of self-care. However, in those countries these skills are seen as just one of the objectives in the teaching of these children, and by, no means the most important one.
While in this country the main objective at the first stage of instruction provided for these children is to teach them the skills of self-care. At the Condover school for the deaf-blind in Britain, for example, the main emphasis at the initial stage is laid upon sensorimotor development. Children are taught to perceive such things as toys and bricks, to develop their sense of rhythm. Special attention is paid to the development of their tactile perception by means of special exercises, moulding activities, etc. Their motoric function is developed via outdoor games with large budding blocks, walks, swimming in the pool provided at the school; they are taught to work with clay, sand and water.
It should be pointed out that such forms of activity for deaf-blind children can be extremely valuable, indeed, they are quite indispensable, if we bear in mind all the time that the main form of activity at the first stage of such children’s development should be the training of self-care skills and that non-practical forms of activity should arise within the framework of practical ones. As it acquires relative independence, non-practical activity serves to promote the children’s sensorimotor development, and this in its turn creates the prerequisites for the further development of practical activity.
The main teaching task at this period should be to instruct deaf-blind children in the skills of self-care. This of course does not in any way rule out exercises to promote their sensory development and develop their motor skills. Objectives connected with sensory and motor development of deaf-blind children can be attained both in the course of their training in self-care and also through special exercises, if such children have already achieved relative independence in their cognitive activity.
The previous chapter provided only the barest of outlines for the pattern of the deaf-blind child’s initial development. The path of development for each individual child can be significantly more complex, depending upon the conditions he lived in before he began to receive instruction.
One factor which frequently complicates the teacher’s task in the initial stage of his work with a deaf-blind child is the previous neglect with regard to training. Parents often fail to consult a specialist before several years elapse after the onset of deaf-blindness. During this intervening period and as a result of misguided handling, a deaf-blind child’s activity and need for movement can be inhibited to a large degree.
These children often find an outlet for their energy in aimless, meaningless movements, such as the swaying of the body to and fro pendulum fashion while in a sitting position, or in abrupt, jerky movements of the hands and trunk reminiscent of convulsions, etc. Such behaviour combined with complete lack of mental development gives rise to the impression that these children have suffered severe brain damage. In the case histories of such children one may often find the diagnosis “mental retardation.”
A great deal of work and meticulous teaching are necessary to overcome the child’s persistent passive-defensive reaction, to nurture natural needs in him, to get rid of inert patterns of movement and establish habits of normal behaviour.
In overcoming inert motor stereotypes and physical inhibition in the deaf-blind child, the training in new motor habits should correspond to the level of development of the child’s needs. Re-education in this context should not be of a coercive character. In all cases it is essential to take account of the child’s readiness to apprehend what people are trying to teach him. Direct coercion should not be used even when incorrect methods for the satisfaction of needs have taken root (for example, eating with fingers instead of spoons). However, the teacher’s approach should not only be adapted to the development of a child’s needs at the moment in question, but also anticipate the further development of those needs.
While a child is being trained in one or other set of skills it is essential to keep careful track of his manifestations of active behaviour. It is important not to miss a single trace of an independent execution of the particular movement in which the child is currently being trained. The deaf-blind child easily grows used to having everything done for him by an adult and if a barely perceptible manifestation of independence is passed over, then this independence may vanish and give way to total passivity.
An idea of the versatility and subtlety required of the teacher fostering a deaf-blind child’s elementary behavioural skills can be provided in the description of several actual cases.
One of the deaf-blind children under our observation was Nina H. She had contracted meningitis at the age of eight months. On recuperation she became sleepy, stopped sitting up and standing. When she was taken to a neurological hospital and an eye clinic at the age of eighteen months it was established that she could not see or hear. At the age of four she was sent to a home for handicapped children. At the time when we first began a study of this case, her customary pose and way of passing the time were as follows: she would sit on her bed swaying her trunk to and fro, stopping occasionally as if she were listening to something; she would then shake her head two or three times from side to side and then start swinging her body again; each time she leant forward she used to breathe out hard through clenched teeth. Sometimes she would raise her right arm and leg at the same time, turning her head to the right as she did so. She made the same movements with her left arm and leg sometimes, but less frequently. From a lying position she would sit up on her own but usually she would not lie down independently; sometimes she even fell asleep sitting up. The little girl’s right arm was considerably more active than her left. Sometimes she would put her right fist up against her cheek or gently tap her face round the right eye, on the forehead or the bridge of her nose. She used to rub her right eye with her right hand. When sitting she would independently change the position of her body, turning, bending up and then stretching out her legs. She was able to stand if holding on to a support, but she never stood up on her own. If someone stood her up but then left her without support she would sit down again immediately. If someone touched her in order to dress or undress her, or to stop her swaying to and fro, the little girl would freeze over for a moment as if expecting some
thing to happen and then start to whimper. If she was then left alone the whimpering would stop. She used to cry loudly, throwing her head back convulsively as she did so, occasionally throwing her legs up into the air or to one side. Her behaviour at bedtime varied: sometimes she would fall asleep as soon as she was made to lie down, other times she was reluctant to lie down. At night she slept peacefully and sometimes could sleep through breakfast if not woken up for it. The movements of her tongue and lips were very varied: sometimes she used to stick her lips out in a pout, other times she would stick out her tongue either down towards her chin or up towards her nose, etc., and she used to utter a number of inarticulate sounds. That was to the best of our knowledge all that Nina H. was capable of; she could not walk, feed herself, use a pot, dress or undress herself. She would not take hold of or handle any object. Any object (except the dummy) put in her hand. she would limply let go of, and if it was put in her hand again she would push it away; she would not make any attempt to handle a toy or anything else, even if it was actually put into her hand. Meticulous observation of Nina’s day-to-day timetable and her whole life and attempts to train her in the most elementary behavioural skills revealed several factors which made work with this child particularly difficult. For instance, the little girl’s attitude to the process of feeding was resolutely negative. During feeding she would cry, try and clench her teeth, turn away from the spoon, spit food out, etc. The nurse in charge of her told us that when Nina was having tantrums and refusing to eat, they had to lie her down on her back and forcibly pour food into her, and then, although still crying, she did at least cat.
We used special methods to encourage a more active approach to food. A teaspoon was used to feed her. Only the first spoonful was poured into the child’s mouth, while she remained completely passive. The second spoonful would then be placed into the child’s mouth, but the food not poured in immediately, only after she had taken hold of the food with her top teeth and top lip, after which the spoon would be drawn out, while the food gripped by the upper lip would remain in her mouth. This constituted the manifestation of the child’s first active response to food, and it was vital, come what might, not to overlook that activity and let it die out. It was essential that the next spoonful of food should not simply be poured into her mouth; that it should be taken by the child actively moving its lips. This way, gradually and in measured doses, holding back the moment when food would actually be poured into the child’s mouth, we encouraged the child to make an active movement with her upper lip, and later to carry out a more difficult movement – that of sucking in food, i.e. the introduction of food from the spoon into the mouth, by means of active movements of the upper and lower lip, together with a stream of air. The child’s active movements during feeding gradually and slowly increased. The spoon no longer needed to be placed in the child’s mouth but merely brought up to her mouth where it was just touching her lips. In response to that touch of the spoon Nina learnt to bend her head forward, open her mouth and suck in the food. The spoon was then brought to her lips in a number of different places. Gradually the range of movements made by the little girl with her head and mouth increased so that she could take hold of the spoon regardless where the spoon might touch her lips. In this way the signalling zone within which the response to grasp food was aroused, was gradually developed and extended. This response was produced most effectively of all when the middle part of the lips, was touched. It gradually emerged that she responded more precisely when the upper lip was touched with the spoon, rather than the lower lip The extension of the receptor zone for feeding signals had to be done most carefully and at a strictly measured rate: if the child’s lips were touched with a spoon too far from the receptor zone, where the feeding response could reliably be produced, then the food-grasping response might not ensue. When for the first few times the spoon touched the child’s face beneath her lower lip, Nina refused to grasp at the food, although later she learnt to take in food in response to a touch of the spoon in that place as well.
Further extension of the signals to produce the food-grasping response included variation of the actual signalling method. Attempts were made to teach the child to respond to the smell of food brought near her mouth, or to the warmth emanating from it. The quality and pattern of activity in feeding also altered. To movements of the head and lips the child later, admittedly with the help of an adult, added movement of its hand which followed the feeding hand of the adult and was supposed to eventually take over from it. In this way a child comes gradually to learn to lift a spoon to its mouth and open the mouth according to the position of its hand in space. Thus, a complex series of coordinated movements of hand, head and mouth takes shape which is necessary for the correct execution of the eating procedure.
Nina’s previous living conditions had also repressed any versatile motor activity. When Nina was brought to the home of handicapped children she was not used to sleeping in a cot. Her activities had not been ordered in accordance with a natural pattern: she had not been taught to stand, walk, dress and undress herself or to use a pot. All these processes – dressing, eating, moving from one part of a room to another – had been carried out by the nurse rapidly, with no thought for the child’s needs and no effort to develop her activity the while. For the little girl this had meant – a constantly chaotic and incomprehensible series of contacts, as a result of which she would freeze over with fear on finding herself “airborne,” as it were, without any firm support when being carried from one place to another, suddenly find herself in water when being bathed, or being dressed and undressed, all for no apparent reason. Her first natural manifestations of activity, if they had existed at all, had been virtually snuffed out. By the time we came to examine her, Nina reacted to any touch by drawing away from it: if more persistent efforts at contact were made, she would then start to whimper or even cry. She satisfied her need for movement by swaying her body forwards and backwards for hours at a stretch. All other movements were forced and carried out without any active participation on the part of the child. It was essential to determine the potential for developing the child’s motor activity and the ways in which that could be effected. Further examination revealed that it was quite possible for motor activity to be brought about and developed.
This can be illustrated by an account of how Nina was taught to stand up from a sitting position.
Usually, when Nina had to be moved from one place to another, to the bathroom, etc., she was quickly grasped under the armpits, lifted, carried to the required place and then sat down. In the process Nina’s legs would remain in a sitting position in mid-air just as they had been on the bed. When I attempted to lift her, she also kept her legs bent up at first. In order to stop her bending her legs into a sitting position when lifted the following steps were taken: a support was placed under the soles of her feet, the hand of the nurse if nothing else, and her trunk was lifted up much more slowly than usual. On feeling constant support beneath her feet, the child began to let her legs unbend; as her body was lifted up from its support, the feet remained pressing lightly on it. Gradually the teacher provided less and less support for the child’s body and at last the moment came when no more support whatsoever was required.
In the act of standing up as described above the child’s activity is minimal, it is only just taking shape. Here the lifting of the body is. still carried out by the adult at the child’s side, and not by the child’s own muscular activity. Later the child’s active participation in the standing up procedure increases. The teacher places her hands beneath the child’s armpits and begins to lift the child; however, this lifting is deliberately carried out slowly and in such a way as to provide only weak support, in order that the child itself with its own muscles should begin to participate in the work of standing up.
In this way joint action on the part of the adult and the child comes into being: the adult begins the action, but the child carries it forward. This is a vital step in the early training of a deaf-blind child.
Soon Nina learnt to stand up from her bed independently holding on to the mesh at the side of it, and then to stand up from a chair. Next, work began on teaching the little girl to walk. One of the teachers would take hold of both her hands and pull her gently forward, while another would lift the little girl’s feet and move them forward one after another. Later Nina began to move her feet forward herself, when her hands were pulled. After making several steps in this way she would bend her legs and sit down or just hang on the hands of the teacher. However, with each day that passed the number of steps she took grew. Soon she no longer needed to be helped along by both hands, but could be supported by one alone, and later Nina learnt to walk holding on just to a single finger of the teacher. Then she was given a child’s chair to hold on to, which was gradually moved from one part of the room to another. At first she held on to it with two hands but later with only one.
This instruction in walking became an integral part of Nina’s schedule. In the morning, holding on to the hand of the teacher Nina covered the distance from her bedroom to the bathroom and back again, was then taken to the playroom, where she was taught to move independently, holding onto the sides of the play-pen, in which she was placed. She was not carried out for her walks outdoors but led outside. Soon she was able to take between ten and twelve steps without holding onto either a chair or a teacher’s hand. At the same time as this child was being taught to walk, attempts were also made to train her in skills of self-care. At first during the processes of dressing, undressing, washing, using the toilet or eating, Nina was not merely passive but resisted all efforts to teach her independent habits, pulling her hands away from her teachers and turning her face away from them. With Nina everything had to be carried out extremely slowly and calmly, because abrupt movements frightened the little girl. In the morning she was lifted out of bed carefully, with gentle movements. She was washed with warm water which did not seem to frighten her, but produced positive emotions. At the pleasant touch of that water Nina not only stopped pulling her hands away but actually held them under the tap. The teacher, holding the child’s hands in her own, would carry out the necessary movements, rubbing the palms of the little girl’s hands against each other, lifting them up to her face and moving them across and round it. Soon signs of active participation were to be observed: when Nina felt the teacher lifting her hands to her face, she then actively joined in subsequent movements of the washing procedure and drying with a towel.
Nina was then taught to eat solid food; gradually she learnt to bite off pieces of solid food and chew them. Then she was taught to use a spoon: she did not hold it herself at first, so the teacher would hold her hand on the spoon and thus raise the spoon to Nina’s mouth with her own hand. In this way Nina learnt eventually to hold a spoon in her own hand and began to try and lift it up to her mouth. More often than not the spoon did not land in her mouth, but as soon as the spoon touched her face Nina would accurately move it over to her mouth and then drop in the food properly. Gradually she learnt also to bite off pieces of bread (initially this had been crumbled into her soup for her).
In dressing as well Nina began to be more active; she would lift up her foot as a stocking was pulled on or raise her hands as her dress was put on, etc.
As can be seen from the above account, important physical needs such as those for food and movement had not taken root in Nina’s behaviour at the outset or had been suppressed after they had taken root in infancy before she fell ill. Any need for communication with other people was also completely absent. The need for food had been stamped out by an abnormal feeding procedure, the need for activity had been satisfied in stereotyped movements of her trunk to and fro pendulum-fashion, and the need for communication with others had not developed or had been destroyed by incorrect handling of the child consisting of abrupt contacts and movements beyond the child’s understanding as its everyday requirements were attended to.
These examples from work undertaken by Nina H.’s teachers illustrate the gradual way in which such a child’s activity can be “revived” and developed at the early stage of its training programme.
Now let us turn to other examples concerned with the fostering of somewhat more complex habits of human behaviour.
Rita L. came from her own home to our school for the deaf-blind at the age of two years and eight months. Her diagnosis read: “congenital deafness and congenital cataract in both eyes.” The small girl had some residual vision left, insofar as she was still sensitive to light and darkness. No hearing at all was present though, and she had no speech skills whatever. At home Rita had not been taught any self-care skills at all. She was carried around by her mother almost all the time: she was able to walk but only when holding on to an adult’s hand and over an even surface, she was unable to go up or down steps, even when holding on to an adult’s hand. At our school she initially was quite lost when left alone: she would cry and as soon as she felt an adult come up to her and touch her she would stretch out her hands “asking” to be picked up. She was not accustomed to any kind of regular timetable whatever. No pattern of day or night existed for her. It was a struggle to put her to bed in the evening, she kept getting up and crying, while in the day-time she was often limp and sleepy. She could not use a spoon and used to eat with her fingers. She could drink from a cup if the cup was held to her lips by an adult, but she could not manage a cup by herself. At home she had been held on an adult’s lap while being fed and she was unable to sit independently on a small chair at a table during meals. If she was not held back from doing so she would stand up and sweep everything off the table on to the floor. She had not been taught to use a pot. She did not use a single gesture for purposes of communication. The only way she used to demand attention was by shouting out and this she used to do regularly.
When she was being dressed, she would sit there passively without taking part in the procedure and sometimes putting up resistance. Rita did not know how to imitate in any way the adults and children around her: she could not apprehend what other people were doing. She did not know how to play, and toys did not interest her. Either she pushed them away, moved them from one place to another or used them to knock against other things. She treated all toys in exactly the same way.
All these skills now had to be taught her.
The first thing which Rita had to be taught at the home for the deaf-blind was to get used to a regular time-table. At first she resisted this new arrangement of her life. She was reluctant to lie down for her afternoon nap, she would stand up, cry and throw her pillow or blanket off the bed. The teacher would take Rita’s hands in her own and lead her over to the beds of the other children, to show her that they had undressed and lain (town to sleep, then she would place the little girl’s hands together in the gesture that meant “sleep.” Of course, Rita did not understand that sign at first, but it was repeated without fail at the appointed times, before the little girl was put to bed or when she was shown any other sleeping child. If Rita did not wake up early enough in the morning, she was woken with a light touch; she was also fed, dressed, taken for walks and put to bed at strictly appointed times. At home her family had been unable to teach her habits of tidiness, she had often been put on the pot when her pants were already wet and kept there for a long time. That had not only been a futile activity, but even harmful for the child. It had developed in Rita a deep-seated revulsion for the potting procedure. In the special home she was Put on the pot at strictly appointed times and for short periods. Special care was taken to see that the pot was not cold. Soon she stopped resisting the procedure.
In the very first day that Rita spent at the children’s home it was also discovered that she had a deep-seated aversion to washing her hands as indeed to washing in general. She was frightened of water, would turn away, scream and struggle, when she was taken into the washroom. It was clear that washing had been carried out forcibly at home. Warm water and a slow pace for the washing procedure and encouragement of independent movements during it soon made washing her hands and body a pleasant event for the child.
Rita took four months to grow accustomed to the new ordering of her day. By then she would go calmly into the wash-room and stretch out her hands under the running water from the tap. She had learnt the basic movements required for washing – she could rub her palms together, carry her soap and towel to the wash-room unaided and then back again from the bathroom to her dormitory. She had not yet learnt to dry her face and hands with a towel properly, but it was clear that she would soon master those skills as well.
As soon as her teachers began dressing and undressing Rita slowly, encouraging even the slightest traces of independent movements, the little girl’s active role in this procedure began to increase from day to day. She learnt to raise her arms when a blouse or cardigan were being taken off, and to raise her leg when a stocking was being put on. Her teacher, after taking Rita’s hands into her own, used to teach her to do this, giving her a chance to manifest independence at any stage as they went along. First of all Rita learnt to take off her shoes, after her teacher had first undone the laces, and then to take off her stockings once the suspenders had been unfastened. Then she learnt to undo the buttons on her cardigan or dress. Four months after she came to the home she was taking off her dress, shoes, pants and stockings (these last she could not yet unfasten admittedly) as she got ready for bed. Initially she had just thrown on the floor the garments she took off. Now she attempted to hang them over the back of a chair. She, had learnt more complex skills as well, those involved in putting on dress, cardigan, pants, shoes (although she could not yet do up or undo the laces). When it was time to go out for walks she would also attempt to put on her coat and hat.
Rita was also taught to go up and downstairs on her own. At first she could only move up or down stairs while holding onto a teacher’s hand, but later she learnt to go upstairs holding on to the banisters. Going downstairs proved more difficult but by the fourth month of training she had mastered that skill as well. Admittedly, she had not yet the courage to go downstairs without holding onto the banisters, but that she gradually mastered as well, just as she had learnt to go up without holding on.
Rita was also deliberately taught to follow what adults and children around her were doing. Gradually the range of actions which Rita “observed,” at first together with her teacher, and later on her own merely supervised by the teacher, widened. Rita learnt to find her way about her room, then in the corridor; later she learnt to find her way to the wash-room, to the dining room and how to go outside into the garden to play.
Gradually a need to imitate those around her took root. It was essential that she be taught to play.. Her teacher would lead Rita up to the other children and show her how they were playing: how they were building and taking apart a sorting pyramid, a matryoshka doll, or laying out bricks. The teacher would pick up a doll and show Rita parts of the doll’s body in association with parts of a human body, and in the same way she was pointed out the link between the doll’s clothes and her own. After learning to dress and undress herself Rita then learnt to dress and undress her doll. She learnt to take apart and build up a sorting pyramid, and also a matryoshka doll. She was not yet able to play in a group. Sitting next to the other children she would try above all to take their toys away from them. With a little help from a teacher she was soon able to sort out toys of different geometrical shapes one from another and put them into separate boxes, for example small cubes and balls.
After Rita had learnt to imitate others she learnt to do morning exercises, and to take part in the children’s action games.
From the very beginning of Rita’s instruction her teacher had made a point of showing the little girl with her hands the manual sign which denoted the action they were about to perform, before they embarked on it. Before Rita had her stockings put on, for instance, her hand was drawn up her leg from her foot to her knee and only then would the stocking be put on. At first these gestures were not apprehended in any way by the little girl, and the real signal to Rita that she was going to get dressed was the teacher beginning to pull the stocking over her foot, after which the stocking would be pulled on, initially by the teacher, then the teacher and the little girl together and later by Rita on her own.
Gradually Rita began to understand simple gestures, but in her contact with others she did not herself make use of them at first. After she had grasped the gesture meaning wash, for instance, she would take her soap and towel and set off to the wash-room, once the gesture was made by the teacher.
Instruction in the first habits of independent eating were recorded on film and then carefully analysed. A micro-analysis, so to speak, of the training in what at first glance appears a simple skill reveals a fairly complex pattern underlying the emergence and development of this activity on the child’s part, as can be seen from the extracts of this analysis below.
In the training of Rita to use a spoon to feed herself it is clear what a complex instrument a spoon really is. The little girl could not grasp why she needed this awkward thing that had to be held in a special way – a particularly difficult undertaking – and from which everything kept falling or spilling out and which was so difficult to steer into the mouth. At first Rita deliberately pushed the spoon away and would only take food out of her plate with her fingers.
Yet the teacher kept on putting the spoon into the child’s hand and making sure it stayed there. Holding in her own the child’s hand which had the spoon in it the teacher scooped up food and lifted it to the little girl’s mouth. This joint action, in which the child did not as yet play an active part, ensured that food landed in Rita’s mouth in larger amounts than had been the case when she used to cat with her fingers and Rita soon stopped resisting. Indeed, soon afterwards, when the little girl had to cat a runny soup, she would take hold of the spoon and wait for the teacher to lift her hand with the spoon in it and begin to feed her. After teaching Rita to grasp food with her lips from the spoon lifted to her mouth, the teacher began to play a less active part in the proceedings. After scooping food up with the spoon and lifting it to the child’s mouth, she would let go of the spoon, giving Rita a chance to keep hold of the spoon on her own. However, the little girl would let go of the spoon as well, and the food spilt out. Then the teacher merely used a lighter grip, then no more than support for the spoon-holding hand, finally the lightest of touches before letting go altogether. Gradually Rita learnt to keep hold of the spoon with food in it near her mouth until the food had landed safely in her mouth.
Initially Rita would only hold the spoonful of food near her mouth if it was actually touching her lips. Gradually the participation in the eating process on the part of the teacher grew smaller and smaller and eventually all she was doing was scoop the soup into the spoon, while the little girl herself lifted the spoon to her mouth and sucked the soup in.
Scooping food up with a spoon proved a much harder operation than learning how to wield a spoon when bringing food to the mouth. First of all, the actual scooping movement was fairly complex (involving a twist of the wrist); secondly, there was no direct link between that movement and actually manoeuvring food into the mouth (the psychological link between scooping and eating is far more remote than, for instance, that between lifting the hand to the mouth and then placing the food in the mouth).
On every “convenient” occasion the child tried to substitute another action for the scooping, one that was simpler and more straightforward for her. Since her left hand had always been fairly active in the feeding process (Rita was always groping around with it in the plate to see what was in there), as soon as she discovered that the consistency of the food was such that she could pick it up in her fingers, she would pick up food in her left hand and lift it to her mouth. Meanwhile her right hand with the spoon in it would remain quite still or more aimlessly without in no way furthering the eating process, i.e., the little girl was using her left hand in a purposeful way, while carrying out incomprehensible manipulations with her right on the teacher’s insistence. In this way Rita was carrying out two parallel processes one of which had a goal while the other remained for her no more than an incomprehensible movement performed out at the behest of the teacher.
Subsequently, to connect the two processes the little girl, while holding the spoon in her right hand, was allowed to put food from the plate into the spoon with her left hand and then lift it to her mouth helping it along with the left hand. In this way a certain relationship between the movements of the two hands was established, movements which differed in their closeness to the natural act of eating.
At first Rita used to let go of her spoon as soon as she had steered its contents into her mouth. Now that it no longer contained any food it had become an object with no purpose and the spoon was just dropped. She did the same with her cup: after sipping a little fruit-juice or milk from a cup, Rita would let go of it. Only after chewing and swallowing some food would she start looking for a new mouthful. Eventually Rita learnt to put down her cup on the table and to put her spoon down next to her plate. It was only through deliberately supporting the child’s hand and gradually loosening that hold, that her teacher persuaded her to keep hold of her spoon, and not abandon it until she finished her first mouthful, in order then to scoop up and lift to her mouth the next one.
Later, and just as gradually, the little girl was taught to understand other rules of behaviour at table. Let us illustrate it with another example. Usually three pupils would be sitting at table at once, each of them eating at an individual speed, adapted to his own particular skills. Sometimes a pupil had to wait until a slower cater had finished his meal. Rita could not understand at all why she had to go on sitting at table, once she had finished eating. She would move her chair back, get up and try to leave the table. She was led over to the chairs on which the other children were sitting, and shown that they were still eating; she was sat down next to them, so that by touching her fellow-pupils with her hand she could follow their progress and as soon as they had finished the children would all leave the room together.
Rita’s “waiting” skill was developed in the following stages: at first, after finishing her meal the little girl used to get up from her chair and leave the table; then she would remain in her chair, held back by her teacher’s hands; next she learnt to wait for her friends to finish their meal, keeping track of their progress with her hand; finally she learnt to wait quietly for a signal from her teacher permitting her to get up and leave the dining room.
Lena G. was moved from her home to the school for the deaf-blind at the age of two. Her diagnosis was the same as Rita’s: “congenital deafness and congenital cataract in both eyes.” While the little girl was completely deaf, she still had some residual vision but how much it was impossible to ascertain. She could not speak at all and did not use gestures. At home she had been carried around by adults almost all the time. Before she was put to bed she would be rocked to sleep in an adult’s arms. She was fed from a spoon and was able to walk well holding on to an adult’s hand. She had not been taught any skills of self-care and did not use the pot. She had not learnt to play at all. If Lena was handed any toy she did not show any interest in it whatsoever. The only thing she could do with toys was to take them out of a box one by one, if sat down on the carpet next to such a box.
The first task embarked upon by Lena’s teachers was to get her used to a regular time-table. This did not prove as difficult an undertaking as it had been in the case of Rita L. Lena did not confuse day and night. What proved more difficult was getting Lena used to no longer being carried around by an adult all the time. For a long time she was unable to reconcile herself to the fact that adults were not constantly picking her up: she protested noisily, cried, slumped down onto the floor, beating her feet and fists against it. On these occasions the child would be left on her own and she would then soon quieten down. Teaching Lena to do without being carried around was made still more difficult by the fact that her system of body temperature control appeared to have been disrupted. She found it quite impossible to get warm on her own, especially at the beginning of the day. After getting up in the morning, still muffled up in her blanket she would “demand” to be picked up at once. It was clear that the little girl was cold, although the room was warm and the other children did not feel cold. At first it proved necessary to pick up Lena wrapped in a blanket and help her get warm by moving her legs and arms about, before finally removing the blanket and embarking on dressing her. Soon Lena only needed to move around a little in her bed with the help of her teacher in order to get warm in the mornings. In the course of the day she would often make requests to be picked up and make a fuss. Before long, however, by dint of experience she came to understand that being held on the lap of a motionless adult was less interesting than walking across the floor with that adult and becoming acquainted with the various objects in the room. Of course, the teacher deliberately made it uninteresting for the child when she was sitting on her lap.
A good deal of perseverance and patience was required on the part of the teachers to train Lena to go to sleep in her bed, without being rocked to sleep in someone’s arms first. At first the little girl refused outright to lie down in the bed and was unable to go to sleep without being rocked in someone’s arms first. She would cry and would sit for hours on end in the bed protesting and not going to sleep. The teachers at this stage were driven to Picking her up and rocking her to sleep. This went on for ten days, but soon it emerged that Lena did not necessarily have to be rocked right to sleep, it was sufficient just to calm her down with a short rock and then lay her down in the bed, where she would then go to sleep. Later this rocking was cut down more and more until it eventually was little more than a symbolic gesture: the teacher would pick up the little girl, rock her to and fro a few times, and then put her down in the bed. In this way the rocking was gradually cut out and was reduced to a mere signal conveying to the child that the time for sleeping had come. It should not of course be assumed that the task of putting Lena to bed always proceeded smoothly. Over a long period the little girl would remember from time to time that she had in the past only gone to sleep in the arms of an adult and then she would begin to make a fuss and refuse to go to sleep in her bed. Later games with dolls made it easier to establish her habit of going to sleep in her bed. When showing Lena how to play with dolls her teacher would show Lena that a doll needed to be put to bed in a toy cot and that it did not need to be rocked for its eyes shut automatically, etc. Before Lena went to sleep, her doll would be tucked up next to her; Lena’s hands would be guided by those of the teacher to tuck up the doll, stroke it and “calm it down.” It took two and a half months to teach Lena to go to sleep calmly on her own in her bed.
During her first two months at the home no success was achieved in teaching Lena to use the pot independently. At first her toilet patterns were merely observed to establish what were the most expedient times for sitting her on the pot. After a month Lena was taught to get her pot out from under her bed. Two months later this action on her part become a signal to show that she needed to use the pot. By the fourth month Lena was able to get the pot out from under the bed by herself, take off her pants, sit down on the pot, get up again, pull up her pants, put the lid on the pot and push it back under the bed again.
The first step towards teaching Lena to find her way about was to familiarise her with the corner in which she slept. Since the little girl was put to bed in a cot and covered up with a blanket, the drop-side of the cot filled in with netting was raised and lowered at regular intervals, she was soon became acquainted with the bed and bed-clothes; she knew the pillow was soft and the metal head of the bed was hard. In practical terms she was familiar with her corner of the room almost from the outset of her stay at the home. Special activities were organised for the child to extend the knowledge while making practical use of the objects around her. The teacher would take the little girl’s hands in her own and then proceed to make the bed, to raise and lower the drop-side, lead the child along one side of the cot letting her gain an idea of its size through feeling it; Lena would also climb under the cot and with her teacher’s help familiarise herself with the bed-legs, the wheels at the bottom of the legs and then even move the bed. In this way she also investigated the space around her bed; the bedside locker, the rug by the bed, the place next to the bed where her slippers were laid out and the strictly defined place for the pot under the bed, etc. Lena was thus encouraged to familiarise herself with a new world in a consistent and systematic way. The little girl took part in this investigation willingly because everything that she acquainted herself with possessed some practical significance for her. Objects were investigated in the context of their practical functions and in association one with another. The towel, which the little girl used to pick up before going to the wash-room, was always hanging in the strictly appointed place; the pot was always in one and the same place and the outdoor clothes that had to be put on before a walk were also always in the same place. Gradually Lena was taught to find her way about in her room as a whole. not just the corner where her bed stood, then in the corridor, round the whole of her floor, eventually in the entire building, in the yard and garden immediately outside it. When the little girl was being taught to find her bearings in her room, strict emphasis was laid on making sure that every article had its carefully appointed place. After Lena had come to grips with the corner of the room where her bed, bedside locker and rug were, she was then “shown” the communal table at which the three children in her group had their meals, until she learnt to find her way, together with the others, as far as the dining room. Later she was “Introduced” to the carpet in the middle of the room, the windows, the radiators. The teacher together with Lena inspected the wardrobe, the toy-cupboard, the cots used by the other children and the children themselves. When they made their way to the wash-room, Lena accustomed herself to that new territory and learnt to step calmly over the threshold between the wash-room and the corridor, which involved a slight drop onto the lower floor of the wash-room. When she went into the wash-room, the little girl’s hands, guided by the teacher, “inspected” the arrangement of the wall-hooks for towels and clothes, and the basins; she was shown that the basins were at different levels, lower down for the small children and higher up for the taller ones. Lena used to touch the basins and even sniff at them. Initially she used to be led by the hand into the wash-room and then the teacher would walk behind Lena, guiding her by no more than a light touch on the shoulder to make sure she did not go off course. After a week even this minimal guidance was no Ion r necessary for the little girl would find her way to the was room confidently on her own.
Before taking Lena for a walk in the winter months Lena’s teacher would always go with her up to one and the same little cupboard, specially set aside for Lena, “inspect” together with her the outdoor clothes and felt boots, pick them up with her and take them to the chair at which Lena used to get ready for her walk. On returning Lena and the teacher would take off the outdoor clothes in the cloakroom, put the felt boots back in the cupboard and hang the other outdoor clothes back in it as well. A month after she arrived at the home Lena knew perfectly well where her outdoor clothes were kept. As soon as she got inside the cloakroom she would walk up to her cupboard and after the teacher had helped her to take her coat, etc. off the hanger, Lena would then carry it over to her chair on her own.
In the first six months Lena spent at the home she learnt to find her way about her bedroom, the lesson room, the corridor, the toilet and part of the garden. At the end of the sixth month Lena could find the common room she shared with the other children in her group, the wash-room, the sick room, the bathroom and she was able to take herself outside. Lena was also taught to recognise teachers and other members of the staff. At the same time as Lena was being taught to find her way about the home, she also learnt to feed herself with a spoon independently, to use the pot, to undress and dress and to play.
After two weeks Lena was able to lift a spoon with the lightest of guiding touches from the teacher. By the end of the third month of table training Lena was able to pick up food with a spoon and lift it to her mouth. Admittedly she often slobbered food on the table, down her feeder or on her face, but it would make her angry and start her crying by this time, if someone tried to take her spoon and feed her as they had done when she first arrived.
From the very outset efforts were made to teach Lena to pick up a cup by herself and hold it as she drank. It emerged that a full cup was too heavy for her and so she started practising with first a third of a cup and later half. Very rapidly indeed – in the matter of a few days – Lena had learnt to hold the cup firmly and put it down again on the table with care; soon she had learnt to pick it up from the table as well.
Three months later Lena could take her place at the table on her own as well; she could also pick up her spoon, eat with it, draw her plate nearer towards her and move it away, hold bread correctly in her left hand, pick up and put down her cup. During the fourth month of her table training Lena’s teacher started training her to use a napkin on her own. At first the teacher used to wipe the child’s face with a napkin herself. Then she began to hold the child’s hands on the napkin as she did so. Lena learnt very quickly to pick up the napkin from the table, but for a long time she could not manage to wipe her face with it, all she did was to put it up against her face. Lena only learnt to use a napkin correctly and completely independently after she had been at the home for six months.
Training Lena to dress and undress herself was one of the most important tasks in teaching this particular child. Initially Lena resisted the teacher’s efforts when the latter tried to take Lena’s hands in her own and teach her to take off and put on stockings, pants and frock. However, by the third or fourth day the resistance petered out, and Lena began trying actively to help the teacher, when she was dressing or undressing her. Lena was put down on a chair (initially a high one, so that the teacher did not need to bend down too much) and the teacher holding Lena’s hands in her own would feel over with her a particular garment, encouraging any trace of active participation on Lena’s part, and then put it on. At first, of course, it was the teacher who did most of the work, although the little girl tried to help, without as yet achieving any real results. This process was made more difficult by the fact that Lena’s hands were very weak, and she simply did not have the strength to pull on tights, for instance. Yet as the dressing and undressing process was repeated many times in the framework of the day-to-day timetable, the child’s hands began to grow stronger, she performed the necessary movements more efficiently and so her part in first undressing and later dressing herself gradually became more and more active. Lena was helped to “examine” other children, who, sitting on their own on their little chairs, were dressing themselves. She was also shown that these children were not being carried, but walked around on their own two feet. Lena, too, was then taught to sit on a little chair, to pick up her clothes on her own and begin to dress. The little girl learnt the first skills involved in taking off and putting on various garments unusually quickly. Two weeks after this training was begun Lena was able not only to take off, but to put on her pants by herself. At the same time she was making attempts (albeit clumsy, and unsuccessful ones) to take off her frock, cardigan, night dress and slippers. As soon as the teacher began any action involved in the dressing process, such as taking off a cardigan, for instance, Lena would try and take over herself. The beginning of the activity on the teacher’s part served as a signal for Lena to carry it forward. Of course, the child did all these things clumsily at first and the teacher often had to help her. It was vital at this stage to afford assistance in strict “doses” and at all costs avoid discouraging Lena’s own initiative. On several occasions when it so happened that the teacher intervened too obtrusively to correct a mistake, for example, when Lena began putting her dress on back to front, Lena started screaming and then refused categorically to continue her efforts to dress herself. On one occasion, when Lena despite long efforts had not succeeded in untangling her dress which had got caught up in itself, the teacher took the dress out of Lena’s hands and began to put it on: at this Lena pushed the dress away, fell crying to the floor and then refused for a long time to pick up her dress at all. It was in this way that Lena protested when an adult intervened too much. However, the opposite situation could arise as well, although it was rare: all of a sudden Lena would refuse to dress herself on her own, and hold out her clothes in the direction of her teacher indicating that she wanted someone to dress her instead. On one such occasion it emerged that on the day before Lena’s teacher, while hurrying to get her ready for a walk, had not waited for Lena to dress herself independently but had dressed her quickly herself and then taken the children outside for their walk.
Another thing which it took some time to teach Lena to do was to hang the garments she took off over the back of a chair. At first when she had taken her stockings or dress off she would just throw them down, but then she was taught to hand to the teacher any garment she took off. Lena was shown by means of her hands that the teacher hanged each garment over the back of the chair. After a few days Lena stopped throwing her clothes to the floor: when she had taken each garment off she would stretch out her hand with it, expecting the teacher to take it. After that stage had been reached, it was not difficult to teach Lena to hang her clothes over the back of her chair. When Lena, undressing, held out a garment in the direction of her teacher, the latter would steer her hand towards the back of Lena’s chair, and together the two of them would hang it over the back of the chair. Soon Lena tried to do this on her own. For a long time she only managed to put her garments in an untidy heap on the back of the chair without smoothing them out. Smoothing out the clothes proved a difficult task for the little girl and it took her several months to master this complex skill.
A mere twenty days after her training began Lena had grasped well where her clothes, slippers and stockings were kept. By that time she did not need to be shown where to fetch the garments from, she could find them all quickly on her own. Four months after her arrival Lena could find her little chair by herself, put on and take off her vest, pants, dress, cardigan, stockings and slippers. The one task involved in dressing which she had not yet completely grasped was the correct order for putting on and taking off the various garments.
A particularly formidable undertaking for Lena was fastening and unfastening buttons. Although in the course of four months she learnt to dress and undress by herself, she was still unable to fasten and even unfasten buttons. She began to take it for granted that the teacher always had to do that. When preparing to get undressed Lena would walk up to her teacher, take her by the hand and guide the teacher’s hand to her buttons; then again after she had dressed herself she would walk up to an adult expecting that she would do up her buttons for her. She did not even attempt to unfasten or fasten buttons, as if she regarded that as something outside her scope. A chance happening during the eighth month at the home led to Lena’s mastering the art of unfastening buttons at last. One day against Lena’s wishes her teacher quickly put on her cardigan for her. Lena grew angry at this slighting of her independence and pulled at the bottom of her cardigan in an effort to take it off and as a result the buttons came undone. She noticed this and forgetting her grudge, took an interest in what had happened. When the teacher did the buttons up again, Lena again, but more slowly this time, pulled at the bottom of her cardigan and one by one she succeeded in unfastening all the buttons. She repeated this process several times. The teacher then placed Lena’s hands on the buttons and herself pulled the cardigan open, so that Lena could feel how the buttons were coming out of the button-holes. After that chance incident, which the teacher made good use of, Lena started trying to unbutton all her garments by pulling apart their fastened edges. When this did not produce the required result the teacher would guide Lena’s fingers to help her push a button through its hole. In this way Lena gradually came to master this skill too. It proved far more difficult to master the art of fastening buttons. Yet for this the all-important breakthrough had already come, because the incident described above had provided the teacher with an opportunity for attracting the little girl’s attention to the manipulation of buttons in general. From that moment on Lena began to think of buttons as her “responsibility.” Whereas before she had made no attempt to fasten buttons when dressing herself, had been quite content to walk around unbuttoned and had refused to try and fasten them even with the teacher’s help, leaving the whole job completely to the teacher, now she began to make an effort to fasten them herself. At this stage through careful rationing of assistance it was possible gradually to foster this new skill, which really does involve subtle and complex movements. Six weeks after work towards this new objective began, Lena had mastered the skill. She was so fascinated by the process of fastening buttons. that if she discovered someone else had an unbuttoned coat, dress or dressing gown, she would start trying to fasten it for them. Another factor that had helped her to master the skill of fastening and unfastening buttons fairly quickly was the fact that at the same time she was being taught to play. As noted earlier, Lena had not played at home at all and did not understand what toys were for. Special work was undertaken with Lena, as with the other children, to make clear the correlation between toy objects and real ones: comparisons were. made between toy pots and pans and real ones, between toy furniture and the real furniture in the children’s room, between the parts of dolls’ bodies and the parts of Lena’s body and those of other people, and so on and so forth. When playing with her doll Lena was taught to unfasten and fasten the buttons on her doll’s clothes. To this end the button-holes in the doll’s clothes were made wider than really necessary so that the buttons would go through them easily.
Work in teaching Lena to play proceeded parallel to that designed to foster the skills of self-care. At first Lena did not want to take part in any games. It was the teacher who “played” with the doll, while Lena merely “observed” what was going on. The little girl was shown by means of touch how clothes were being made for the doll: stockings, pants, a dress and cardigan. Of course, constant efforts were made to involve Lena in dressing and undressing the doll, but she rejected any such attempts, restricting her involvement to feeling the doll and what the teacher was doing with it. In actual fact, though, she was already deriving pleasure from the game. She could sit for a long time next to the teacher “observing” her actions. Lena’s first attempt at active participation in play came to the fore during procedures aimed at correlating toy objects and real objects. The teacher was showing Lena the doll’s cardigan and then Moved Lena’s hands towards her own cardigan; then she did the same with the doll’s and Lena’s hat. Lena grasped the connection between the two; when her hands were put up against one of her own garments and then moved over to the doll, she would point correctly to the same garment on the doll, whether it be stockings, cardigan or pants, etc. If her attention was drawn to one of the doll’s garments, then she would point correctly to the same article of clothing on herself. This was Lena’s first manifestation of active involvement in play.
A special play corner was set up in the children’s room and toy furniture was set out on the carpet there: a doll’s bed, toy crockery, toy household articles and doll’s clothes. If Lena found any doll’s garment in some other part of the room, such as a doll’s cardigan for example, she would take it over to the toy corner, pick up the doll and bring it over to the teacher, so that the latter might put the cardigan on the doll. Gradually Lena started taking a more active part in games – she was given the doll to hold while a teacher dressed or undressed it. On another occasion Lena held the doll’s slippers while the teacher was putting stockings on the doll’s feet. Soon Lena stopped resisting, when the teacher used her hands to assist in putting on the doll’s stockings, slippers or hat. It was important that Lena should be drawn into this “collaboration” with the teacher gradually and with definite motivation; in other words Lena had to feel that her help was necessary. In this way Lena was gradually drawn into joint games with her teacher, but it took her a long time to learn to play on her own. Not before a year passed after she began to receive instruction was Lena able to sit on her own in the play-corner and play with her doll. By then she had mastered many of the self-care skills and her first gestures had taken shape. Play helped to promote the emergence and consolidation of these gestures, while the use of gestures made play more varied and interesting.
It should be pointed out by way of conclusion that Lena G. was not taught a selection of unconnected skills of self-care, but a whole pattern of behaviour in which actions followed on one from the other in a carefully linked progression.
The objects which the little girl used in her practical activities were all kept in strictly defined places, thus providing a stable object environment. The child’s actions within this situation, particularly as she learnt to master the objects concerned, were performed in a fixed order and sequence. The child’s towel always hung at the head of her bed in one and the same place, her soapdish with soap in it was always kept in the drawer of her bedside locker; every morning, before each meal, and before she went to bed, Lena would go, with the help of her teacher, over to her bedside locker, open the top drawer in it, take out her soapdish, move over to the head of her bed, pick up the towel and then set out for the door (the doors in the home were all of the sliding variety, as found in train compartments) and then walk along the corridor to the wash-room. There she would hang up her towel on a hook, go over to the basin, turn on the cold tap, and then the hot one, try the temperature of the water coming out of the mixer tap, then soap her hands rubbing the palms together, and then the backs of her hands; then Lena would wash her face moving her hands not only up and down her face lengthways, but also round and round as well – something that required far more skill – after which she would pick up her towel, dry her hands and face with it, go back to her room, hang up her towel in its special place and put back the soap.
In this activity one movement followed on from another, and the end of each action provided the signal for the next one to begin. All these actions taken together constituted an integrated, uninterrupted stream of human behaviour. In this way all Lena’s behavioural skills, the progress achieved in orientation, play and self-care developed not separately from each other but as parts of an indivisible whole. As a result, the images of objects which took shape in the child’s mind, as she came to master them and their functions in order to satisfy, her needs, did not constitute a haphazard selection of separate disconnected images but made up a connected system of images linked together in an integrated “vision” of the external world.
After Lena had spent a year at the home medical examinations revealed that she could benefit from an operation on her right eye, after which she did begin to see slightly better with it. Using her improved sight Lena now found her way about the home and garden more easily, and she was also able to take a more active part in the children’s action games. She was now able to apprehend gestures directed at her not merely by means of touch but also visually as well. After this she continued to make good progress.
This section treats certain propositions of the theory of the development of the human mind, in their connection with the first steps to be undertaken in teaching a child.
It is often the case that young deaf-blind children living at home with their families develop a firm habit of being constantly carried around by adults. Even an ordinary child with normal sight and hearing will grow quickly used to being carried around while still a baby, and then finds it inordinately difficult to grow out of the habit. This is seen as an unfortunate habit for the child, and many suggestions and exhortations have been written to the effect that parents should help their child get rid of this harmful habit. Yet the actual urge to be carried by an adult is in itself not really such a bad habit, but rather, as far as the child is concerned, a useful one. During his first days, weeks and months a child is lying down almost all the time, and for most of that time he is lying in one and the same position – on his back. This constant lying in the same position means that the hair on the back of a baby’s head is rubbed away and sometimes his skull is even somewhat deformed. In addition children are often still wrapped round in nappies from the neck down and in the past people went as far as to use special swaddling clothes. This constant lying is only interrupted when a child is picked up to be fed. It is precisely thus that a baby comes to value the benefit to be derived from a change in his position. We only have to compare a child lying almost motionless in his cot, who sees nothing but one and the same part of the ceiling above him, and, when he is lucky, a few toys hanging motionless before him, with a child in the arms of an adult, whose gaze is confronted with an enormous constantly changing world of objects, colours and movements. Picking up a child and holding it in different positions, transferring him from one arm to another, or even rocking him in an adult’s arms or in his pram are all useful procedures for the child, rather than harmful ones. Very early on a child comes to “appreciate” this and soon begins to demand such handling all the time. This extreme, however, becomes burdensome for adults, but we should not assume that what is a burden to adults is harmful for the child. If he lies all the time on his back a normal baby does not learn even to raise its head until the age of seven months. Yet if a child is lifted up frequently and turned over on to its stomach, he can learn to raise his head by, the age of two months. By three months such a child will be able confidently to hold its head up straight and turn it from side to side while held by an adult, which extends a child’s “horizon” no end.
Yet all this applies only to a child who has not yet learnt to move about, who not only has not yet learnt to walk but cannot even crawl, Le. a child of up to Six or seven months. As soon as a child learns to move about independently, long periods in the arms of an adult begin to hamper the emergence of his independence. Once he has learnt to walk by himself, he only, needs to be picked up on occasions when he grows tired, while out for a walk for instance, and has nowhere to sit down and rest.
Deaf-blind children usually come to specialised institutions at an age when they are physically capable of walking. If such a child has been molly-coddled too much at borne and is used to being carried around by adults all the time, it is essential to uproot this habit as quickly as possible and teach him to move about independently. If a child is constantly, being carried for long periods, when he either knows how to walk or is capable of learning, this can seriously hold him back from learning to walk on his own and thus from developing his orientative skills.
To develop these skills a deaf-blind child is first familiarised in the course of his practical activities with the objects situated in the immediate vicinity of the place where he sleeps, and from there his “territory” is gradually extended.
When such a child is being taught to find his way about a room shared with other children, it is essential that pieces of furniture should always stand in one and the same place. Only in ail unchanging setting is it possible for a deaf-blind child to learn to move about freely. After bumping into a chair once or twice, that is not in its proper place, the child will begin to fear such encounters and will be loath to move about freely. The range of his free movement may then be reduced to a tiny space around his bed.
The stability of the deaf-blind child’s tangible environment is essential if lie is to develop proper skills in spatial orientation. It helps him to create an integral picture made up of images of the objects around him, a picture which reflects the external world. As his orientative skills develop, the strict permanence of the positioning of the objects in question is not only no longer necessary for his further development, but is even to be deprecated, insofar as the child in his everyday life will encounter changing environments. Therefore once a deaf-blind child’s orientative skills have been properly developed in a strictly permanent environment, he must then be taught to find his way about in changing external conditions, in other words the siting of familiar objects in his miniature world must gradually be changed. In this way are sown the seeds of searching behaviour in a constantly changing environment.
When working on the formation of new skills in deaf-blind children it often becomes necessary first of all to root out well established habits. A child may be used to being fed always by adults, for instance, and objects when efforts are made to teach him to eat independently. It is very difficult to uproot a firmly entrenched habit. A child resists such innovation with every weapon at his disposal. It would, of course, be easier to feed the child as before, lifting the spoon to his mouth every time, but if that were the approach he would never master the new skill. The same applies to putting on clothes or shoes.
Fostering skills of self-care in the early stages is extremely hard work. Sometimes it requires a great deal of time and considerable effort before progress is achieved in mastering even the most elementary actions. New skills only take root gradually. The first stage in teaching a child to acquire independence consists in weakening the degree of his resistance. It is vital at this juncture that efforts should not be relaxed but rather that work. should continue day, by, day to overcome the child’s resistance and encourage his active behaviour in every way, possible. It is trying work, even physically. However, it is out of the question that work on skill formation be interrupted, that a teacher give way to a child’s resistance and let him revert to former habits: if attempts are resumed later to teach the child the necessary skill, after an adult has once given in, then the child will resist all the more. When working on skill formation, it is necessary to pay attention even to the amount of physical effort required, for example, to lift a spoonful of food to the mouth of the child.
The main difficulty lies in the fact that the emergent active movement on the part of the child is far from perfect, and cannot achieve the necessary goal; on its own it would not produce any results, while in order to be consolidated it has to be reinforced with an achievement, a result.
The emergent activity on the part of the child can easily flicker and die the moment an adult begins to perform the necessary action for the child. The activity also disappears if it is not reinforced by the production of a result, which is often the case in the early stages, when prompt help from an adult is not forthcoming.
When a new skill is first taking shape, it is particularly important to note and take account of the slightest manifestation of active behaviour on the part of the child. Help from an adult must be administered in strictly controlled doses: there must not be too much of it, which would make the child renounce its new-found independence, but it must be sufficient to ensure the necessary result. Each skill involves movements of varying difficulty. For instance, it is much more difficult for a child to scoop up soup out of his plate with a spoon, than to raise the spoon to his mouth. It is easier for the child to pass the palms of his hands up and down over his face when washing than to take them round it. It is easier for a child to thread in the laces, than to tie them in bows. The teacher should analyse each skill dividing it into its component movements and then build up his teaching programme in such a way, as to leave his charge scope for independence in those movements which he has already mastered and to help him with other movements which he still finds difficult, and then finally carry out for the child those movements which he cannot manage at all.
As soon as a skill has been mastered well enough for the child to be able to achieve results (raising a spoon to his mouth and eating from it, or putting on a stocking) he begins to enjoy practising it: then the newly formed skill quickly takes root and is perfected.
Usually children who have mastered the skills of self-care enjoy doing everything they know how to by themselves. Yet sometimes particularly when a child has been sheltered at home too much and for too long and had everything done for him, he suddenly starts to protest: he might, for example, refuse to dress himself and hold out his clothes to his teacher demanding that she dress him. In such cases it is essential to analyse whether or not there has been some mistake made by the teacher. Often it turns out that in a particular case the teacher did not ration her help to the child strictly enough. A child might, for example, have begun to put on a shirt when an adult started to help thus interrupting the child’s independent action, which interference in turn made the child refuse outright to dress himself. In such cases more often than not a child might make a fuss, throw its clothes around, lie down on the floor and start to scream in protest. Yet children sometimes refuse to dress independently without any apparent reason. This usually happens, as noted earlier, in those cases when a child has been sheltered too much at home. In such cases a child refuses to do what he has already mastered, as if to check, so to speak, whether or not it might be possible to revert to the former order of things, when he had been waited on completely by adults. In such cases the teacher’s perseverance is a vital factor. What is quite indispensable, of course, is full agreement between a child’s various teachers on a unified range of demands to be made on him. Speed, in dressing as in other skills, comes as movements are perfected and become automatic, and it should only be promoted gradually by a constant raising of demands made on the child, but without outstripping his potential too far.
A child acquires skills in stages. At the beginning of self-care training an adult must needs carry out all actions. At this stage, to all intents and purposes, there is no joint action yet the actions all are being carried out by the adult alone. At the next stage there emerges the first activity on the part of the child, who carries out certain operations involved – those that are within its grasp. So far the action is divided up into two unequal parts. The child’s share is small and his activity minimal, but the important thing is that there is activity on his part and it can be extended. The adult, restraining his own activity, encourages that of the child, and organises joint action in such a way as to have the child’s share continuously increasing. For the child increasing his own active role is an essential condition for reaching the goal intrinsic to that particular action. The teaching skill in these circumstances lies in making sure that the task set in each case should not be too difficult for the child, nor too easy, and that the level of difficulty increase with each successive task. When called upon to perform a task that is too difficult for him a child refuses to carry it out, and if he is given too easy a task then he is not learning anything new.
In the ontogenesis of a deaf-blind child the first activity which emerges is that directed towards the satisfaction of his primary physical needs. The most important of these needs, whose satisfaction affords opportunities for moulding behaviour, are those for feeding, self-defence and excretion. In this context the need for feeding includes that for water as well: the need for self-defence embraces the need to maintain proper heat regulation, in other words to guard against over-cooling or over-heating, the avoidance of situations engendering pain or discomfort of any sort.
There is yet another need which a child manifests from the very moment of its birth – the need for movement. From the very first day of life a child starts moving its arms and legs. All subsequent motoric forms, apart from these innate movements and motor reflexes linked with sucking at the breast, are taught the child by adults around him. If this teaching does not take place as a result of lack of contact, in the unfavourable situation of the deaf-blind child, then, as has already been noted, he may satisfy that need in monotonously repeated movements that are not linked with any objects outside himself.
A spontaneous need for movement cannot of itself give rise to any object-linked human behaviour. The emergence of human behaviour and mental processes in a deaf-blind child from the outset of his development consists in the assimilation of human experience, concentrated, firstly, in the objects required for the satisfaction of his physical needs, secondly, in the instruments or tools necessary for the satisfaction of these needs, and, thirdly, in the modes of action linked with these instruments or tools. The child’s assimilation and subsequent appropriation of social experience proceeds in his direct communication with an adult in the course of which the latter instructs the former in practical activity directed towards the satisfaction of the child’s needs.
In the course of this instruction the child’s physical wants now directed towards a humanised object (food, clothes, pot, bed, house, etc.) and necessitating human methods for achieving their satisfaction (the use of a spoon, the donning of clothes and shoes, the use of a pot, living in a house, walking on two legs, etc.) develop into human needs. The satisfaction of the child’s elementary wants that ensues as joint activity of adult and child, in which the adult plays a leading part, gradually develops into independent activity of the child. The methods for carrying out such activity, the operations involved as they are gradually perfected, give rise to new needs – secondary needs.
The independent satisfaction of his need for food and his need to protect his body from any harmful outside influence requires also that the child engage in cognitive activity, as a result of which images both of the objects of his needs (such as various types of food) and of the means and methods of their satisfaction (such as a spoon and the action carried out with it) take shape. Without investigating the objects of his needs and the means for their satisfaction the child will simply, not be able to engage in independent satisfaction of those needs: in such cases he would only be capable of passively accepting an adult’s care.
Initially this cognitive activity is carried out within the context of activity for the satisfaction of physical needs and constitutes one of the operations involved in that activity (the handling o f a spoon during a meal). As the range of means used in this cognitive activity, is perfected, it starts to extend beyond the utilitarian requirements of the activity in the pursuit of which it first emerged, and gives rise to an independent superstructural need for discovery or learning. This new need provides the basis for the formation of new types of activity, which in their turn extend the behavioural patterns of the child beyond the satisfaction of his elementary wants.
It is in a basically similar way that the child’s imitative and motor needs evolve. At this stage of development a child is capable of apprehending, for example, an elementary learning task (e.g., assembling and taking apart a sorting pyramid or a matryoshka doll), the achievement of which does not feed him or warm him. The sensorimotor training involved in the performance of this task will be most important for his cognitive activity in school later.
The emergence of the cognitive, motoric, and imitative activities, which are relatively independent of the satisfaction of primary needs, and the development of independent secondary needs make it possible to teach children to play, a type of activity extremely important for their development.
Self-care is the first activity which a child masters, and it is the first type of work within his capacity. Further development of this activity is also brought about by instruction of the child by an adult: skills of self-care are then extended to embrace a group, when, for example, one child helps another get dressed, when he tidies up a classroom not only for himself but for all his classmates as well (carrying out the duties of class monitor, for instance). It is in these shared activities that the first division of labour takes place, when, for example, one child brings along water and a cloth and another uses the cloth to dust with and waters indoor plants. The next chapter treats in more detail the fostering and development of these forms of activity in somewhat older children.
Some children, when they first came to the school for the deaf-blind, already possessed elementary skills of self-care. The parents of the majority of these had already been in contact with staff members of the department for the instruction of deaf-blind children at the Institute for Research into Physical and Mental Handicaps. They had been given regular advice on methods of caring for their children. Some of them used to come to the Institute for consultations, during which they were given practical demonstrations in instructing deaf-blind children. Parents described their attempts to teach their children to read, write and speak or communicate by means of finger spelling. However, as a rule, attempts to teach children the dactylic alphabet or Braille script did not produce any results, and parents used to write in or come in for advice on how to teach their children to speak, read and write. It was explained to them that the first step in teaching a deaf-blind child was to start by developing the skills of self-care. If a child has learnt, after getting up in the morning, to do his exercises, make his bed, wash and brush his teeth on his own and use the lavatory, to feed himself – first with assistance and later independently – to dress and undress, tidy up, put away his clothes and shoes, and help his mother in the house, then he will be able at a later stage to learn language, he will be able to read, write and master the information transmitted to him at school. The majority of parents understood the importance of this initial stage of instruction, and as far as their ability and time allowed they taught their children these basic skills of self-care. There were others, however, who considered that it was not worthwhile spending time on teaching the child to look after himself. They could feed, dress and undress the child, while what they really wanted was to teach him to read, write and speak, skills which they regarded as essential to the teaching process.
The most important educational objective for children, already possessing basic skills of self-care is to develop their means of communication, first and foremost to develop active sign language. The first task in this connection which we confronted was organisation of their behaviour. Before they had come to the home for the deaf-blind the children had been living in conditions that varied enormously from one case to another. Usually they had had no fixed timetable and there had been no ordering of their lives or behaviour. They had slept and eaten whenever they chose. The parents and other adults around these children had satisfied their slightest whim. The children were not used to having a nap in the day-time: some of them had not liked sleeping at night and had slept in the day-time instead. Some of the children also had strange eating habits: many had never been given soup, others had always been given sweet dishes, and still others had lived on a milk-based diet.
At the home for deaf-blind children a special time-table was worked out, the strict observance of which we held to be an important factor in the upbringing of a deaf-blind child. The behavioural patterns and likewise the mental processes of these children lacked any kind of order. It took time and effort to teach these children to follow this time-table; in this work we proceeded from the principle that strict observance of a regular time-table and “external” discipline would eventually become a habit and then a child would submit to order and discipline, not only on an “external” plane (in its behaviour) but also from “within” (on the mental plane). An “external” ordering would give rise to an “Inner” ordering.
An important part of the work with these children was the perfecting of the skills in self-care they already possessed and the development of new ones that were More complex. This will now be illustrated on concrete cases.
Volodya T. had no powers of sight, hearing or speech at all when he joined the group of deaf-blind children receiving instruction at the Institute for Research into Physical and Mental Handicaps at the age of seven. For two years before Volodya joined the group we had been corresponding with Volodya’s father, urgently recommending that the child be taught the basic skills of self-care and supplying practical pointers as to how this task be approached. When the child came to us, he possessed basic but very important skills enabling him in some respects to look after himself: he could dress and undress himself virtually unaided, eat and wash by himself and he was also toilet-trained.
After losing his sight and the last vestiges of hearing at the age of 3 years and 8 months, the boy virtually stopped walking by, himself, according to his father – all he would do was stand in some very awkward fashion on his heels. Gradually Volodya’s father taught him to walk normally , leading him by the hands. The first few days after he had been discharged from hospital, the boy had ‘not let anyone undress him, as if he was frightened that his clothes might disappear. When attempts were made to do so, Volodya resisted them, cried, lay down on the floor, kicked and tried to bite. In an effort to calm the child and show him that nothing out of the ordinary was being done to him, the father took the child’s hands in his own and took his own clothes off. After that he was able to undress Volodya; at first he did so himself but without encountering resistance on Volodya’s part. The father repeated this practice in all actions which he sought to teach his son: Volodya was shown how his father ate, dressed and washed himself, etc. Soon the father no longer needed to hold Volodya’s hands in his own. It was enough to guide the boy’s hands to “look over” what the father was doing and then the boy. would continue to investigate the father’s actions on his own.
In this way the child’s capacity, for imitating his father was developed, a capacity which provided an important method for fostering Volodya’s behavioural patterns and skills of self-care. If the father wished to teach the child something, he would do it himself, allowing the boy to “observe” his actions, and then the father would help Volodya to do the same. Initially Volodya refused to be separated from his clothes: he would put them all under his pillow and go to sleep with his hand tucked under the pillow on top of them. Gradually he began to reconcile himself to having his clothes put on the chair at his bedside. However, he still went to sleep with one hand touching his clothes.
In order to occupy the child’s time, his father taught Volodya to sort out various screws, nails and bolts, etc. in his tool-box. He taught the boy to thread bolts and metal rings on to a piece of wire. The child would sit at home on the floor and make enormous garlands of metal objects that he threaded onto these wires. Tiny articles that he took a liking to he used to collect in his cap – things such as paperclips, acorns, drawing pins, small screws and other metal articles. The cap which he only took off in order to put some such thing into it, made his own special treasure-house for all this “wealth.” With incredible deftness the boy was able to put the cap back on his head in such a way that none of the numerous things inside it fell out. Not even at night would he take off his cap and he used to go to bed in it. It took a long time first to teach the boy to put the cap under his pillow and later to teach him to do without it altogether and use a special drawer at the bottom of his locker for