360 C89/e I9ZI 1 UB 360 C891e 1921 14030760R NLM D5D1flMA2 b NATIONAL LIBRARY OF MEDICINE SURGEON GENERAL'S OFFICE LIBRARY. Section No. 113, W.D.S.G.O. No.Z...¥AlS ^ NLM050984826 /ItBRARi r SURGEON GENETS./ MAY 17 1922 vsi OFFICE EDUCATION FOR THE DISABLED IN WAR AND INDUSTRY Army Hospital Schools: A Demonstration for the Education of Disabled in Industry V By A. G. CRANE, Ph.D. ♦»« Principal, Edinboro State Normal School, Formerly Major, Sanitary Corps, and Director of Educational Service, Division of Physical Reconstruction, United States A rmy Teachers College, Columbia University Contributions to Education, No. iio H BRA ' t published by {Eeacfjer* Callage, Columbia Umberaitp NEW YORK CITY 1921 Copyright, 1921, by A. G. Crane c. PREFACE T N the world war, United States army hospitals used educational *- activities on an extensive scale as a new form of treatment for sick and disabled soldiers. The use of school activities for a curative purpose is unique in medicine and in education. Its novelty, the greatness of the occasion, the extent of the experi- ment, and its importance to education, to the military army, and to the greater industrial army, all demand an accurate record. The army hospital schools, or the educational service as it was called, was but part of the work known officially as the work of physical reconstruction in army hospitals. This monograph will be devoted exclusively to the educational service in United States army hospitals and to only such parts of it as are likely to have a bearing upon public education and upon the reeducation of those disabled in industry. The statistics and the charts in this monograph are cited from The Official Medical History of the War, the volume on Physical Reconstruction, by the author, then Major in the Sanitary Corps. The larger work contains a complete account of the work of physical reconstruction, the splendid achievements in physio- therapy, the organization, administration, detailed statistical tables, and chapters on special topics by eminent contributors. The statistics were compiled from official reports in the Sur- geon General's Office. Miss Mary Carufel, Miss Ruth Pope, and Miss Emily Huger prepared the monthly statistical sum- maries from which tables of enrollments were compiled. Captain Charles Harlan, Sanitary Corps, and Captain Calvin P. Stone, Sanitary Corps, prepared the longer studies based upon the reconstruction registers and personnel records. Without this assistance and hearty cooperation, it would have been impossible to present the facts in concise and analytic form. CONTENTS PAGE I. Physical Reconstruction and Educational Service............. i II. Factors of the Problem........ 3 III. Achievement............12 IV. Organization and Administration.....44 V. Methods of Survey, Guidance and Instruction 51 VI. Lessons for Schools and for the Education of the Disabled in Industry.......59 Appendix: Studies of Individual Cases .... 79 IV CHAPTER I PHYSICAL RECONSTRUCTION AND EDUCATIONAL SERVICE Physical reconstruction was officially defined as "complete medical and surgical treatment, carried to the point where maximum functional restoration, mental and physical, has been secured. In securing this result, the use of work, mental and manual, will often be required during the convalescent period." Prior to January I, 1920, 147,682 sick and wounded soldiers were returned to American hospitals from overseas. Other thousands were received by the hospitals from cantonments over here. These men were given the best medical, surgical, nursing, and sanitary service that science could command. Remarkable indeed were the cures wrought by the army medical department. In addition to these services the educational service provided for the patients happy, useful, curative occupations. The physi- cians and surgeons said to the school, "These men will profit by a limited amount of activity, suited to their special disabilities, tastes, and requirements." The school filled and administered the prescriptions. Educational activity was a new curative treatment in medical and army practice, but in reality it is among the oldest curative agencies known to man. In its simplest terms it is work and play. Every human being has experienced the beneficial value of steady employment. Idleness is not conducive to physical or mental health. In the army schools, work and play were capable of a great variety of forms, each suited to the peculiar condition of the patient. Mental and physical activities were combined. The young men in hospitals, many of them undergoing long periods of convalescence, while receiving final medical and surgi- cal treatment, responded wonderfully to the curative benefits of happy, interesting occupation. Physical reconstruction, as a whole, proved of great value in the maintenance of good morale and of discipline itself. There was more in physical reconstruc- 2 Education for the Disabled in War and Industry tion than the mere physical. It coordinated the active curative forces of mind and body. The procedure was simple. All schooling was conducted under medical supervision and direction, though the selection of the im- mediate educational activity was left to the educational staff. A complete study was made of each individual man; the medical and surgical officers furnished a complete statement of his physi- cal condition, and probable condition upon recovery; the army records gave his army history; the man himself gave an account of his social, educational, and vocational experience. In con- ference with him, his plans for the future were discussed. Expert educational, vocational advisors then planned hospital school activities which were best calculated to enlist the man's interest and exert the highest curative effect. The ideals of physical reconstruction marked a new era for men disabled by war. They were considered not as individuals who have become the flotsam upon the tide of war, not as unavoidable wreckage from the strife, but as men still capable of becoming efficient, active, independent units in society. The educational service particularly considered soldiers not as mere physical fighting machines, but as citizens, complete beings. More wide- spread acceptance of these ideals in military practice and train- ing as well as in military hospitals will do much to humanize the army machine and to make it generally respected in peace as well as in war. Greater recognition of these same ideals in industry, in civil hospitals and other institutions will have a like effect, besides increasing their immediate curative efficiency. If the addition of such educational treatment will restore to society vocationally competent individuals, contented and independent, instead of vocationally helpless, unhappy and dependent indi- viduals, it will be eminently worth while. This has undoubtedly been done for thousands of American soldiers. If it can be done for American men in uniform, it can be done for American civilians. CHAPTER II FACTORS OF THE PROBLEM In any teaching problem the factor of paramount importance is the student. In the army schools the students were young American soldiers. Prior to December 31, 1919, 110,648 men were enrolled in some form of educational service. Chart I (p. 14) shows the subject student enrollment, the total num- ber of individuals enrolled in any month, and the number of new registrants month by month. The striking fact shown by this chart is the exceedingly rapid rise in hospital populations and school enrollments from January to March and the equally rapid decline from April to August. The task was that of providing schooling for 100,000 men in the short space of six months. The large numbers of men to be provided for were thus an important factor of the problem; the second great factor was the physical condition of the patients. That this should be of primary importance in the hospitals is evident, but there appears no good reason why it is not of equal importance in any educational in- stitution. In the hospital schools educational activities were so conducted as to improve physical condition. In educational institutions physical condition should be maintained in order to achieve educational results. Conservation of health should be included in every curriculum. Table I shows the prevailing types of disabilities during the months of December, 1918, to April, 1919. The table is not all- inclusive, but contains the data from a large enough number of hospitals to give an idea of the relative distribution of disa- bilities among the men registered for educational treatment. Of any single disability, pulmonary tuberculosis is in the lead. Orthopedic cases show the larger number, but this includes almost any injury which involves the motion of a joint. The convalescent cases are also large in number, including those recovering from sickness. Cardio-vascular cases are more numer- ous in December than at any time later, because many of these 3 4 Education for the Disabled in War and Industry cases were undoubtedly detected on this side and taken direct to hospitals from cantonments in the United States. TABLE I Types of Cases Registered for Educational Work 1918 1919 February March .4 pril December January Pulmonary Tuberculosis. 1,(510 1,907 1,004 3,139 2,376 Orthopedic............ LOOS 1,75S 3,962 5,016 5,228 Cardio-Vascular........ 635 227 340 313 336 Amputation........... 496 644 865 1,125 1,040 Diseases and Wounds . . . 323 665 2,338 1,689 1,757 Injury to Nervous System 308 384 481 837 1,191 Eye, Ear, Nose and Throat.............. 306 318 336 536 071 Functional Neurosis .... 283 169 435 730 773 Insanity............... 112 142 165 636 289 Other General Medical 467 419 760 1,326 1,413 Other General Surgical 212 445 732 1,567 1,296 Convalescent........ 315 239 1,044 1,610 2,167 Arthritis.............. 248 158 246 199 225 Nephritis.............. 242 Gassed................ 154 106 323 154 391 Gastro-Intestinal....... 211 Severe Injury—Face and Jaw.............. 98 120 236 Venereal Disease or Se- quela) ............. 73 68 91 Blindness............... 53 64 66 34 32 101 Skin Disease........... 37 49 Neurasthenia.......... 41 Next to the factor of disability came the consideration of a man's previous schooling. The choice of an educational activity depended very largely upon the man's capacity and previous training. A study of 12,067 records received by the Surgeon General's Office prior to April, 1919, gives the results shown in Table II. Of these men 14.4 per cent had either received no schooling or recorded none. It is probable that with the majority of these unrecorded cases there was no schooling to record. It is probable that these young men represented quite fairly the average which would be found among civilians, 7.7 per cent of whom are illiterate according to the United States Census of 1910. It should also be borne in mind that for all practical purposes Factors of the Problem 6 Education for the Disabled in War and Industry TABLE II Schooling of 12,067 Patients Registered in Educational Department1 April 30, 1919 Men Per Cent Schooling not recorded............................ 466 3.9 Schooling not classified............................ 675 5.6 No schooling.................................... 595 4.9 Total....................................... 1,736 14.4 Stopped with 1st grade............. 133 1.1 Stopped with 2nd grade............. 215 1.8 Stopped with 3rd grade............. 388 3.2 Elementary Stopped with 4th grade............. 705 5.9 School Stopped with 5th grade............. 778 6.4 Stopped with 6th grade............. 841 7.0 Stopped with 7th grade............. 1,110 9.2 Stopped with 8th grade............. 3,067 25.4 Total......................... 7,237 60.0 Stopped with 1st year.............. 855 7.1 Stopped with 2nd year.............. 679 5.6 Stopped with 3rd year.............. 359 3.0 Stopped with 4th year.............. 676 5.6 Total......................... 2,569 21.3 Stopped with 1st year.............. 179 1.5 Stopped with 2nd year.............. 158 1.3 Stopped with 3rd year.............. 76 .6 Stopped with 4th year.............. 112 .9 Total...................... . 525 4.3 Grand Total............. 12,067 100.0 education which stops with the third grade in school leaves the pupil illiterate, if one considers that literacy should mean ability to readily comprehend written matter. Men who in their youth received third-grade education, however, and have since been of studious habits should be thoroughly literate at the age of these soldiers. It should also be borne in mind that the education of men who enrolled in hospital schools is likely to be higher for the 1 Facts are taken from physical reconstruction registers received at the Sur- geon General's Office. Factors of the Problem 7 group than for those who did not enroll in the hospital schools. It is evident, then, that there is a surprising degree of illiteracy. Sixty per cent of 12,000 men attended school, but stopped with the eighth grade, or below. Twenty-one per cent had some high- school training and 4 per cent had attended college. The following table summarizes reports from four hospitals: TABLE III Schooling of Soldiers in Hospital Schools Fort Sheridan Illinois...... Fort Snelling, Minnesota . . Walter Reed. D. C....... Colonia, New Jersey Xo. of Men Xo Schooling (irades I-VI (Irades VII-VIII Stopped in Hiqh School Stopped in College 596 1.5'c 23.2% 47.0'c 22.S', 5.5% 1,332 1.3 29.2 47.7 19.5 2.3 735 3.6 37.3 36.4 IS. S 3.4 703 13.5 25.5 38.6 18.5 4 In cases of patients whose mentality seemed to warrant, the army psychologist gave special psychological examinations by means of the army intelligence tests. Table IV shows the dis- tribution of scores of 782 patients examined by the Alpha Test at Fort Snelling, Minnesota. It appears from this table that the scores range from 5 to 195, with a mode of 55, and a median at 76. At the same place 548 patients showed mental ages dis- tributed from 6| years to over 18 years, with a mode of 13 to 14, and a median at 13.4. A comparison of 555 men registered in the educational department and 465 men not enrolled, showed a higher rating for the men in school. The most noticeable dif- ference was in the percentage of men in the higher groups. Before programs of work could be selected for the different men, it was necessary to know something of their past vocations and their future plans. Information regarding the man's voca- tion was secured largely from the man himself. A survey of 1,270 unselected overseas men enrolled in the educational de- partment at Fort Sheridan, Illinois, showed that 509, or 40 per cent, desired a change of vocation. Of this number 135, or io| 8 Education for the Disabled in War and Industry TABLE IV Distribution of the Scores of 7S2 Patients Ivxamined by Alpha Test at United States Army General Hospital No. 29, Fort Snelling, Minnesota Scores 1-10..... No. of Men ......................... 5 11- 20.. .............. 31 21-30...................... 31-40................. ........... 4(5 ......................... 56 41- 50.. ......................... 63 51-60........................ ......................... 80 61- 70.. . ........... ......................... 71 71-80 ...... ......................... 69 SI- 90 ..................... 71 91-100 62 101-110.. ............ ......................... 53 111-120 ......................... 36 121-130 .......... 42 131-140 ................. 29 141-150..........'......... ......................... 20 151-160................... ......................... 29 161-170 ................... 11 171-180. ................. ......................... 5 181-190................. ......................... 2 191-200. ......................... 1 201-212.......................... ......................... 0 Total........................ ......................... 7S2 per cent of the total number of men, were uncertain as to the choice of new vocation. The vocations to which the largest number of men were anxious to return were as follows: electri- cians, 87 per cent; auto repair men, 83 per cent; salesmen, 75 per cent; firemen, 75 per cent; farmers, 75 per cent; carpenters, 61 per cent; machinists, 58 per cent; miners, 55 per cent; stu- dents, 51 per cent; office clerks, 46 per cent; laborers, 44 per cent; factory helpers, 43 per cent; auto drivers, 42 per cent. The most popular new vocations were auto repair men, 72; farmers, 35; electricians, 35; office clerks, 30; salesmen, 15. A survey of 860 men in the tuberculosis hospital at Denver, Colorado, showed that 230, or 26.6 per cent, were farmers; 172 desired to continue farming, and 48 desired to enter it for the first time. There were 56 machinists, 44 of whom desired to remain and 12 new ones desired to enter; 34, or 3 per cent, were Factors of the Problem 9 auto mechanics, 10 of whom desired to continue, and 24 new men desired to enter. Vocations which lost heavily in the men's choices were those of factory hands, clerks, laborers, miners, tailors, blacksmiths, and printers. In all, 58 vocations were reported in the survey. The numbers in many of the vocations were too small to be reliable for any generalizations. It is ap- Agricclture Camp Grant, Illinois Becoming convinced of the value and simplicity of scientific milk testing parent, however, that the tendency was toward vocations which promised to be more healthful for tuberculous patients. The survey of the men at Fort Sheridan showed representatives of 83 vocations, with agriculturists, automobile drivers and re- pair men, carpenters, electricians, firemen, laborers, machinists, coal miners, clerks, printers, salesmen, and students being the largest groups. An essential factor in planning work for the men was the length of hospital time available. Thousands of men were re- io Education for the Disabled in War and Industry turned to this country as hospital patients who were so nearly recovered that all that remained for hospital authorities on this side was to give them final physical examinations and discharge them. It was of little use to start these men on any educa- tional activity. There were others whose time was short, and still others who remained for months. At first it was thought that the period of time available for hospital school instruction would be too short for any respectable progress in education. Had this been the case all the school could have done would have been to furnish temporary diversion. Even this might have been well worth while from the standpoint of curative effects, morale, and discipline. A study of the reports of 12,067 men sent into the Surgeon General's Office showed that the largest group attended less than ten days; the surprising fact is that the median man had an actual school attendance of 19.5 days. This chart was prepared from reports received during the winter at a time when there was the largest proportion of short-time patients in the hospital. Moreover, the reports for the longest time cases had naturally not been received, as these reports are not forwarded until the men have been discharged from the hospitals. A later study based upon reports received during the summer of 1919 showed for 1,091 men a median attendance of 56 days. It is certain that were the time ascertained for those in the hospital after August, 1919, the median time would be still longer. From the foregoing discussion it appears that the task was that of providing curative, educational activity for 100,000 men in fifty army hospitals. These men had suffered a great variety of disabilities, had schooling ranging from none to graduation from college, with a median at about the sixth grade. In intel- ligence rating they did not differ from the other men in the army and were probably higher than the men of like age in civil life. In vocations, both past and future, they represented fairly the industries of the nation. They had periods of time available for hospital study, ranging from a few days to many months, with a median of probably thirty days. This was the student factor in the task. Other factors to receive immediate attention were the matters of physical equipment, personnel, the rush of the emergency and the accomplishment of the whole task within a military medical Factors of the Problem n organization. Most of the instructors were ignorant of military or even hospital procedure. Well intentioned efforts often went astray through ignorance of established military channels, pro- cedure, or custom. The machine was big and ponderous. It moved slowly, particularly as it was a new service whose chan- nels and routine had not yet been established. The ideals and methods of the service were new to educators and to the medical staff. To the medical and surgical officers it seemed often like an unwarranted innovation in hospital procedure. Regular army officers who were generally in positions of administrative authority had to be converted to the newer ideals of the service. The educational officers expressed it by saying that it was neces- sary to "sell the service" to everyone in the hospital. Physical equipment was difficult to procure on short notice, or through military channels. Seldom was there sufficient room. Fortunately it was possible to use improvised shops and equip- ment. Work was done outdoors, in basements, in old residences, in quartermasters' shops, in corridors, on porches, and in tents. Gradually, as the congestion decreased, it was possible to secure abandoned hospital wards, which made very satisfactory shops, laboratories, and school rooms. Never before were teachers with thorough preparation, and the highest grade of scholarship, experience, and personality, so badly needed. Men who were practical, experienced, expert vocational teachers were needed. There are few such in the whole nation. With the armistice all recruiting was stopped, promotions within the army ceased, and the educational service had to find its instructors within an army that was unanimous for discharge. Twenty-five hundred capable instructors had to be found immediately if the service was to benefit the thousands of disabled men streaming through the hospitals. The task outlined for the educational service was to secure within the army instructors, equipment, and space for shops and school rooms; to organize instruction to fit hospital conditions; to give curative benefit to 100,000 soldiers disabled in many ways, varying in schooling from none to complete college courses, representing in experience and preferences all the vocations of the country, varying in all degrees of intelligence, and possessing limited periods of time in which to achieve any creditable curative and educational results. CHAPTER III ACHIEVEMENT The work achieved in physical reconstruction by the Surgeon General's Office is one of the bright chapters in the history of the world war. Some idea of the difficulties of the task has already been given in the previous chapter. Chart I shows the very rapid rise of the educational service and its rapid decline within the short period of a few months. Chart 2 shows the number of hospitals in which educational centers were formally estab- lished and operated. The fact that these hospitals were widely scattered from New York to San Francisco and from St. Paul to Sam Houston added much to the difficulties. Much of the direction had to be given through correspondence. It was fre- quently impossible to secure experienced directors to inaugurate the work in new centers, as there was a constant shortage in per- sonnel. Had it been possible to make preparation before the actual emergency arose, personnel might have been secured and trained, equipment gathered and stored, building space secured; immediate establishment of new centers would then have been comparatively simple and rapid. It will be noted from the chart that at one time there were fifty-two reconstruction centers operating. A few hospitals started operations early in 1918, but at the time of the armistice there were but seventeen hos- pitals in actual operation. In the main, patients were sent to the hospitals nearest their homes, unless the disabilities were such as to require treatment in hospitals with special equipment. Table V shows hospital population and men in educational service by months. The peak of the load was reached in May, with 30,096 men in educational service. The percentage of men in the hospitals in educational service shows a gratifying increase which continued through December, though the peak of the hospital populations was reached in March. In this is unmistakable evidence of the efficient organization of the service and its increased popularity. 12 Achievement 13 TABLE V A Comparison of Hospital Population and Men in Educational Service January... February.. March . ". . . April..... May...... June...... July..... August. . . September October. . . November. December. Total, 1919 Hospital Population 28, 63 74 66 62 55 37 30 24 24 22 19 023 428 ,946 ,640 ,964 ,554 ,546 ,258 ,737 ,112 ,305 ,616 510,129 Men in Educational Service 8,167 16,296 24,969 28,500 30,096 26,339 20,578 15,944 14,224 14,072 13,598 11,895 224,678 Per Cent in Educational Service 29 26 33 43 48 47 55 53 58 58 61 61 44 In March, with 75,000 patients in reconstruction hospitals, there wTere 33 per cent of them enrolled in educational service, while in December, with 19,616 men, there were 61 per cent enrolled in educational service. At first thought the enrollment in edu- cational service, of less than 50 per cent of the whole number of patients, appears disappointing. There were, however, at all times, large numbers of men in hospitals who were not eligible for educational service, exactly as not all men in hospitals needed the same kind of medical or surgical treatment. The school activity was prescribed for those whom it was expected to benefit. Men likely to be in hospitals less than seven days were not ex- pected to benefit by educational activity. A large number of men in final stages of recovery were received from overseas for hospital examination, and discharged soon after reaching this country. Furloughs were granted very liberally, it being an approved policy to offer furloughs initially to men from overseas, if their physical condition warranted. During the winter months 14 per cent of the patient population was usually absent on fur- lough. Other patients were in contagious wards, inaccessible to the school service. Officers, as a rule, were not as ready to register in school activities. It is a conservative estimate that 14 Education for the Disabled in War and Industry % ._: / / \ \ \ - \ > \ 46,006 44,000 —o~ -TOTAL INDIVIDUAL ENROLLS -TOTAL ENROLLMENTS / / / 1 \ \ / / / \ \ , 36000 / / / \ / / / . \ \ 1 / 1 \ i n \ N ^ I I 1 i >' \ \ ■ ^ \ V I I / / * l \ \ t 1 / / / 16000 \ 1 12,000 1 1 ( / \ >-—, ■—^ / / / ( / / / > < ,x <' ^ >--- 0 MONTH-.AUG SEPT OCT NOV DEC JAN FEB MAQ APR MAY JUNE JULY AUG SEPT OCT NOV DEC NO. H05P. 8 14 16 17 25 25 Al 44 42 40 3B 23 17 16 15 14 13 REPORTING Chart i. Registrants and Enrollment in Army Hospital Schools 35 per cent of the patient population was ineligible. Upon this basis the school reached 63 per cent of the eligible men from January, 1919, to December, 1919. This period includes months when the service was still unorganized. During the latest months of more complete organization, the percentage of patient popula- tion enrolled in educational service in many hospitals exceeded 90 per cent. Achievement 15 191a Chart 2. Number of United States Army Hospitals Cfhcially Functioning in Physical Reconstruction, month by month from April, 1918, to October, 1919 Chart 1 also shows the number of individual subject enroll- ments. The figures upon which this chart is based are given in the table below. 1918 August. . . September. October. . . November. December. TABLE VI Enrollments in Army Hospital Schools 3,234 5,217 6,289 7,867 12,757 1919 January............... 18,172 February.............. 29,733 Total to June 30, 1919..... Total to August 31, 1919. . . Total to December 31, 1919. March................ 44,917 April................. 52,739 May............ June............ ......... 56,850 .......... 49,798 July................ 40,175 August. . . September October. . November December. 2X7,573 359,423 460,013 31,675 28,773 27,543 23,453 20,821 It is evident that the men were enrolled in more than one subject each. Using these figures it appears that each man on the aver- age was enrolled in three subjects. The months from January to December, 1919, when the organization could reasonably be 16 Education for the Disabled in War and Industry expected to be in full operation, showed each man registered in 1.9 courses. PERSONNEL OF THE TEACHING STAFF The personnel of the teaching staff in various hospitals was recruited from several sources. During the summer of 1918, men were selected from civil life and commissioned direct into educational service. A large number of well-qualified men had been located during the summer and commissions for these were pending at the time of the armistice. All these were annulled and it was necessary to abandon all further induction of men direct from civil life. A few of these men were later engaged on a civilian basis. The next large source of men, after the armistice, was found in the disbanding armies. Canvass was made in demobilization camps and men with promising qualifications desirous of entering the service were found and transferred to educational work. It was a difficult matter to find qualified vocational teachers under these sharply limiting conditions. The army was unanimous for discharge, and even when qualified men were found they did not wish to continue in service. When found, it was necessary that they request transfer to educational service, and that their organizations consent to such transfer. Despite these handicaps many excellent men were found, but only after expensive delays at a time when every minute counted. The next large group of instructors was a group of women known as reconstruction aides in occupational therapy. These women were recruited freely from groups of experienced teachers throughout the United States. Their qualifications were scrutin- ized carefully by the central office, and their selection, location, transfer, and discharge remained in the hands of the central office. This free recruiting and complete control of this portion of the educational staff was one of the largest factors making for the wonderful success of these women teachers. Their educa- tional qualifications were high. They possessed special training and almost universally long teaching experience. The facts of their education, special training, and experience are shown in Charts 3, 4, and 5. The qualifications of enlisted men on the educational staff are also shown in the same charts. It is evident that as a group the women had higher general education, more special training and more teaching experience than did the men. Achievement 17 20 2RECONSTRUCTION AIDES \ENLI5TEDMEN Chart 3. Education of Reconstruction Aides and Enlisted Men, Educational Service TRADES HAND- BUSINESS VOCATl SOCIAL PSYCHO- GEN'L LIBRARY NONE CRAFTS TEACHING SERVICE PATHIC HOSPITAL Chart 4. Special Training of Reconstruction Aides and Enlisted Men, Educational Service 18 Education for the Disabled in War and Industry The selection of this group of highly qualified women was one of the most notable achievements in reconstruction. The fact that such a large group of capable instructors was secured at modest salaries demonstrates the possibility for civilian institutions. It must be borne in mind, however, that TEACH- STU-TRADE AGPh CLER- BUS I- HOSPI- SOC. SALES- PR0FE6- LIB- ART MIS- NONE ING DENT CULT. ICAL NESS TAL SEC. MAN 5I0N RARY CEL. Chart 5. Previous Experience of Reconstruction Aides and Enlisted Men, Educational Service the patriotic appeal for the war service was strong. Many splendid women accepted war service at financial loss and great personal inconvenience. Table VII shows the number of instructors in the principal groups month by month. SUBJECTS OF INSTRUCTION From the educational viewpoint the most astonishing feature of the army hospital schools was the variety of subjects of instruction. The prescription of the medical officers simply called for some form of activity appropriate to the man's physical condition. Naturally the activity likely to be most helpful in promoting recovery was one which presented the greatest interest to the man. Interest stimulated cooperation and effort, caused forgetfulness of troubles and disabilities and promoted a more TABLE VII Number of Instructors in Army Hospital Schools October, 1918, to December, 1919 Oct. Xov. Dec. Jan. Feb. Mar. Apr. May ,/ une July 16 37 335 124 17 43 314 157 25 102 695 337 25 125 681 449 41 210 809 806 44 270 XXX 1,163 42 264 808 1,290 40 252 750 1,383 38 250 603 1,288 23 167 375 1,040 Non-Commissioned Officers Enlisted Men........... and Reconstruction Aides and Other Total on Staff.............. 496 514 1,134 1,255 1,825 2,321 2,362 2,385 2,141 1,582 20 Education for the Disabled in War and Industry helpful and hopeful attitude of mind. The task for the educa- tional department then became this, to find activities suited to the man's physical needs and appealing to his interest. Here it was exceedingly gratifying to find that the apparent conflict between educational values and curative benefits vanished in a majority of cases. During periods of great weakness the physical con- Spelling, English, and Lettering East View, New York Illiterate men learned to read and write English in two hours a day for three months or less dition sometimes craved and demanded activity that was merely diversional, that was not exacting; mere play, in fact. Occa- sionally cases were found where the physical disability demanded specific forms of exercise which did not harmonize with the man's personal interest. In the majority of cases, however, the men had reached periods of convalescence and were beginning to think seriously of life after discharge. For all such the probable usefulness of the schooling presented a strong appeal. Voca- tional and educational values thus intensified the curative bene- fits because of the strong motive which the man's personal in- Achievement 21 terest gave. The whole field of educational activity was open to the schools. Anything which presented strong appeal to the men and which could be taught was a proper subject for instruction. The men's interests naturally varied through a large range. Availability of instructors and equipment were influencing fac- tors, but as the service became better established it was possible English East View, New York English is indisputably worth while from any standpoint to introduce practically all subjects for which there was a reason- able demand. Over one hundred and fifty different vocations or subjects of instruction were presented in various hospitals. One surprising development was the popularity and efficacy of academic studies. The army experience had made the men realize the necessity of a better command of the common arts of English communication. There is no question as to the usefulness of reading, writing, spelling and calculating. The three "R's" attracted a surprisingly large number of men who were faithful and studious. Thousands learned to read and write, while other 22 Education for the Disabled in War and Industry thousands improved their ability along these lines. They began their work in bed and carried it on through convalescence; some even after recovery begged to remain in the hospital. Thousands undoubtedly continued their studies with the Federal Board for Vocational Education. Table VIII presents more information regarding the subjects of instruction than could be put into a volume of descriptive matter. Bearing in mind the very free selective principles, the table gives an indication of the relative popularity of subjects. It also shows the relative fitness of subjects for instruction under hospital conditions. Some subjects gradually decrease, showing a lessening of demand and probable usefulness of these subjects in hospital schools. Other subjects show steadily increasing popularity. The large groups appear in the academic subjects, typewriting, auto mechanics, crafts, etc. Each of these large groups consists of a special class of patients. The academic subjects appeal to men with inferior education and to foreigners studying English. Typewriting appeals to men of good education who realize the value of typewriting skill, either as a vocation or for personal convenience. It has an almost universal appeal. Mechanical vocations appeal to young men living in a mechanical age, men whose army experience had been in a war of machinery. They appeal, like typewriting, both to those who expect to follow mechanical pursuits as a vocation and to those who wish a knowledge of machine practices and automo- bile repair, for their personal convenience. Crafts show a large enrollment because crafts were so well suited to the acute cases who were still confined to beds or to the wards. Those interested in the problems of rehabilitation for the disabled in industry will find this table of army experience exceedingly suggestive and helpful. EXTENT OF CURATIVE EFFECTS Since the whole service was established primarily for curative purposes, it is important that the curative benefits be clearly known'and evaluated. To present absolute proof of the curative effects of; a form of treatment, which was but part of the total treatment received by a soldier, is very difficult, if not impos- sible. A soldier under treatment received benefit from surgical service, medical service, nursing service, physiotherapy, and TABLE VIII Enrollment in Educational Service, January to June, 1919 Subject of Instruction January February March April May June Total Jan. to Shop Ward Total Shop Ward Total Shop Ward Total Shop Ward Total Shop Ward Total Shop Ward Total S3 4 1,359 1,091 819 1,952 65 1,850 345 69 48 133 206 95 433 June, 1919 General (Academic) 284 382 358 294 630 16 575 121 30 9 88 22 87 153 53 90 132 9 23 11 16 5 371 535 358 347 720 16 707 130 53 20 104 27 389 680 690 426 988 101 1,021 222 48 75 112 63 7 168 199 85 146 173 18 17 9 47 8 557 879 690 511 1,134 101 1,194 240 65 84 159 71 7 417 912 1,002 479 1,413 98 1,430 263 58 30 172 88 49 322 336 223 352 "208 68 5 2 43 3 81 6 1 51 352 739 1,248 1,002 702 1.765 98 1,638 331 63 30 174 131 52 81 45 111 6 1 208 319 158 352 349 1,149 971 570 1,436 75 1580 325 73 47 133 66 76 52 133 165 183 426 307 519 199 402 275 88 5 23 24 90 100 1 1 87 95 056 1,668 971 769 1,838 75 1,861 413 78 70 157 156 83 100 54 133 1 1 252 183 521 298 999 1,233 638 1,535 116 1,636 344 69 26 126 105 77 590 595 "375 738 361 106 14 28 31 105 2 888 1,594 1,233 1,013 2,273 116 1,997 450 83 54 157 210 79 311 606 1,094 448 1,187 65 1,341 248 48 25 103 90 91 362 523 753 371 765 509 97 21 23 30 116 4 71 4,045 English...................... 7,283 English for Foreigners and Be- 5,348 4,161 9,682 471 9,247 Higher Mathematics........... 1,909 411 History...................... 306 884 801 316 114 114 48 90 728 Braille Reading............... Lip Reading and Speech Cor- 48 90 36 63 1 18 30 63 1 24 101 45 111 157 319 158 53 140 53 140 125 95 95 504 8 6 101 3 203 227 3 422 33 458 29 57 4 33 732 61 244 224 386 127 120 371 344 386 219 33 231 1,415 879 4(1 73 3,776 257 5,285 107 3 999 361 3 1,960 357 3.044 8,249 Total.................. 6,284 7,201 2,053 9,254 7,815 2,225 10,040 3,192 11,441 6,597 3,716 10,313 50,869 TABLE XIII—Continued Subject op Instruction Technical A.—Shops. Trades Auto Driving................ Auto Repairs................ Auto Mechanics.............. Blacksmithing............. Concrete Working............ Electricity.................. General Mechanics........... Machinery.................. Plumbing and Pipe Fitting Radio Operating............. Radio Electricity............. Telegraphy.................. Sheet Metal Work............ Vulcanizing.................. Welding..................... Painting.................... Cartooning.................. Shoe Repairing.............. Sign Painting................ Tailoring.................... Motion Picture Operation..... Trunk Making............... Applied Arts................. Cable Splicing............... Drafting. . . . .-.............. Printing................... Work with Textiles......... Carpentry (Rough)........... Woodworking................ Cabinet Work............... Bench Woodworking.......... Furniture Repairing......... Woodworking (Carving, etc.) . . Reed, Cane and Fiber Work..... Work in Applied Pattern...... Metal Work.................. Leather, Cardboard and Bind- ing........................ Work in Plastic Materials...... Miscellaneous................. January Shop Ward Total Total. 18 462 339 10 10 183 8 67 10 18 2 258 16 841 797 145 48!) 374 298 18 462 345 10 10 183 8 67 10 18 2 262 18 February 29 434 37 2.352 137 159 '"80 899 797 145 528 387 33S Shop Ward Total 25 708 650 37 54 317 4 s 47 14 35 51 107 5 30 21 470 44 32 127 245 25 380 1 1 .SOS 1,555 281 1,124 651 362 652 4,070 10,139 14,21 2.' 708 650 1)8 1 37 51 323 4 8 4 14 35 March Shop Ward Total 21 555 44 3.644 12' 24; 380 1 1.808 1.587 284 1,189 673 461 733 67 1,166 1,149 14 5 414 37 149 12 50 46 448 12 40 65 99 41 69 145 22 61 4 39 26 789 94 49 221 303 115 401 3 142 73 28 177 361 2.139 2.596 282 2.363 7.018 16,051 23,069 67 1,166 1,149 14 5 414 37 149 1 50 46 4 12 40 65 99 41 69 145 22 61 4 3!) 26 1,022 94 4,835 221 303 115 401 3 2,581 2.669 282 2,445 Shop Ward Total 1,233 1,261 446 623 1,650 2,011 333 581 1,9 11 555 110 229 9 157 10 506 11 104 79 48 50 89 111 29 198 1 96 333 581 1,975 7 11 555 110 229 9 157 10 552 11 104 79 48 50 89 111 29 198 1 96 22 1.033 126 8,599 199 313 109 404 3 2.789 3.914 257 028 60 1.717 1,777 173 1,346 1,519 571 ...... 571 2,588 3,831 257 49S 8,622 19,016 27,638 May Shop Ward Total 163 680 2,238 7 12 555 49 311 6 233 15 480 39 8 109 20 46 85 111 33 106 5 112 834 103 94 196 262 85 415 8,46i 2,684 4,169 373 992 331 616 163 680 2,238 7 12 555 49 311 6 233 15 522 39 87 109 20 46 85 111 33 106 ." 112 1,011 103 9,601 196 262 85 415 6 2,824 4,240 373 1,088 1,997 477 1,105 0,860 29,327 June Total Jan. to June, Shop Ward Total 1919 311 478 1,918 14 14 556 32 254 4 172 32 397 82 86 103 23 13 75 108 19 62 101 8,145 2,144 4,185 379 626 2,173 411 259 18,502 B. Commercial Business Courses.......... 127 107 412 58 199 847 12 79 3 11 10 "i 28 78 4 127 117 434 59 227 925 12 83 3 11 248 163 515 65 359 1,441 167 10 ""23 34 66 169 4 248 186 549 65 425 1,610 2 171 10 131 . 227 751 93 552 2,484 38 213 3 221 62 60 ■> 190 440 16 131 28! 811 95 74: 2,924 3s 22! 3 221 151 349 833 140 546 2,565 30 259 17 165 33 81 6 158 648 3 151 382 914 146 704 3,213 30 252 17 165 31 267 724 126 525 2,629 22 263 46 97 15 178 923 '"is 31 313 821 141 703 3,552 22 278 65 226 567 101 435 2,131 101 220 76 89 25 132 820 7 65 302 656 126 567 2,951 101 227 Business Correspondence....... Bookkeeping and Accounting . . . Commercial Law....... 753 1,589 4,185 Shorthand.............. Typewriting.................. Banking and Insurance........ Salesmanship and Advertising. . . Journalism........... 632 3,368 15,175 205 1,250 Miscellaneous......... 134 134 39 39 296 8 Total................ 1,855 36 75 13 '"468 143 .....5 1,998 36 75 13 '''473 2,970 46 208 152 73 316 11 3,266 46 208 152 73 324 11 4,713 83 272 283 456 151 770 48 5,483 83 272 283 456 199 5,055 175 240 282 120 736 44 9 929 " "97 5,984 175 240 282 120 ,s3.; 44 9 4,721 79 217 235 176 631 132 4 25 118 1,274 5,995 79 217 235 176 631 132 4 25 118 215 147 38 3,885 77 262 167 173 652 58 41 1,149 92 5,034 262 167 173 744 58 41 C. Agriculture—Farm 27,760 Animal Husbandry........... 496 1,274 Machinery................... Farm (General)............... Dairying............. 1,132 998 3,204 Bee-Keeping...... 247 Miscellaneous....... 54 25 Field Gardening............. 14 101 14 101 111 111 16 18 16 18 59 243 67 88 93 67 88 93 78 112 59 28 202 112 59 28 202 Ward Gardening.............. ' 147 38 215 93 93 59 243 481 General Gardening............ 101 101 420 662 Total.................. 808 712 238 669 273 244 40 336 104 5 813 712 238 669 273 244 40 336 104 1,010 50 226 1,279 356 696 146 164 106 30 8 1,018 50 226 1,279 356 696 146 164 106 30 1,565 205 600 1,991 739 906 576 355 66 131 66 1,631 205 600 1,991 739 9(111 571. 66 131 1,932 130 619 2,129 298 2,165 733 577 83 183 97 2,029 130 619 2,129 298 2,165 733 577 83 183 1,802 460 497 2,093 342 2,576 1,164 809 215 2,017 460 497 2,093 342 2,576 1,164 809 1,831 384 668 2,368 552 972 1,229 228 5 288 214 92 1,923 384 668 2,368 552 972 1,229 228 5 288 214 I. Recreational Military Drill................. 9,431 Walks.......... 1,941 Physical Training............ 2,848 Hospital Service........... 111.529 Calisthenics.................. Games....................... 2.560 7,559 3.sss Special Duty............ 2,469 364 Dancing........... 113 95 37 113 132 Miscellaneous............... 745 Total.................. 2,616 10,977 6,218 2,616 17,195 3,053 16,394 11,442 3,053 27,836 5,569 26,066 18,940 5,569 45,006 6,917 30,341 22,267 6,917 52,608 8.149 31.388 37 25.578 1 8,186 56,966 6,908 26,404 23,459 6,908 49,863 Grand Total...... 33,249 249,474 to