[Organizational forms of ambulatory and stationary treatment of imbecilic infants].
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This paper reports the use over a period of five months of operant conditioning methods, which consisted above all in the withdrawal of privileges, in the case of ten preschool-age problem children. In all of the patients, the program of behavioral therapy resulted in a considerable reduction of the rate of occupational malbehavior. "Good conduct" showed a slight decrease as the challenging character of recompense grew smaller, but was still above the initial level. Intelligence, extraversion, and emotional lability are related to the results of behavioral therapy and discussed in detail. Operant conditioning appears effective when a clear reaction is required under simple conditions of stimulation. In the case of more complex situations with a variety of behavioral alternatives, imitiative learning should be far more promising.
Population studied consisted of 727 oligophrenic patients aged 20 to 65 at the stages of pronounced debility and imbecility living in a special boarding-house. The degree of intellectual deficit proved to determine the patients' motives of participation in the labor activities: as the deficit increased, the part of socially mature motives diminished. The overall quantity of actual motives diminished with ageing. These motives completely disappear in imbeciles by 45. In pronounced debility the age-related increase in a part of motives caused by labor attractiveness was observed, in light imbecility the passive submissiveness increased.
After a study of the clinical peculiarities of psychoses of imbecile children and juveniles (18 cases of episodic psychoses, 15 cases of grafted schizophrenia) the following results were obtained: In the group of episodic psychoses in imbeciles the psychopathological symptom complex had to be subdivided into four subgroups. In the first group there predominated affective phenomena, in the second group disturbances of motion, in the third group delirious, and in the fourth group hallucinatory phenomena. The differential-diagnostic criteria show the difference of the episodic psychoses of imbeciles from schizophrenias (grafted schizophrenias). An early recognition of this form of psychoses is quite important to both the prognosis and choice of therapy.
Phenylketonuria is a genetic defect that leads to imbecility, if the diagnosis is not made directly after birth. Since the development of imbecility can be almost totally halted by suitable dietary treatment, phenylketonuria is of more interest to neurochemists than to clinicians. This genetic defect is not known to occur in aminals. It is therefore necessary to develop suitable models for neurochemical analysis. Most successful is the simultaneous application to developing rats of alpha-methyl-phenylalanine (an inhibitor of phenylalanine hydroxylase), together with phenylalanine. With this treatment it is possible to induce changes in the central nervous system which are surprisingly similar to those found in patients with phenylketonuria. This model is therefore of great importance in the analyses of the disturbances of metabolism, which finally causes the severe defects in normal brain function.