"Fannie had been two years in the first grade of a Philadelphia school, and had made in that time so little progress that there was no possibility of promoting her to the next grade at the end of that school year. During the first year her attendance had been somewhat irregular, but despite the regular attendance of the second year she had profited little, and had come to be overlooked because she was thought to be too feeble-minded to progress in a school for normal children." Taken to the psychological clinic, she was given a thorough physical and mental examination. She was found to be afflicted both with adenoid growths and enlarged tonsils, and was sent to a hospital to be operated on for these. Later she was entered in the hospital school connected with Professor Witmer's clinic at the University of Pennsylvania. Here she remained a year, part of that time attending also one of the city's public schools. Both mentally and morally she made satisfactory progress. Her sullenness rapidly disappeared under sympathetic handling. Though "at first she did not seem to understand affection," by the end of six weeks "she was the most demonstratively affectionate child in the school." Professor Witmer adds: "During the first summer she appeared extremely sluggish. She showed very little tendency to play, and preferred to sit more or less motionless. As good food, better air, sunlight, and kindly treatment began to take effect, she burst forth with such excessive vitality, such exuberant spirits, that once when I had her before the psychological clinic one of the teachers asked if the lively movements were not the result of St. Vitus's Dance. This first outburst of vitality gradually subsided, leaving her a normally active child." Undeniably, of course, even though a vicious household environment was chiefly responsible for this girl's backwardness, the adenoids and enlarged tonsils were also responsible for it in some degree. Parents cannot too keenly appreciate the hurtful effect bodily defects like these may have on mental development. Doctor Ayres, who has made an exhaustive study of this factor in retardation, estimates that it alone accounts for about 9 per cent. of the laggards in our schools, and clinical psychologists are disposed to put the percentage still higher. On the other hand, their experience with retarded children has led them to the important conclusion that, helpful as spectacles, the ear syringe, and the surgeon's knife may be, "after-treatment" in the form of careful individual training usually is indispensable, if only for the reason that while handicapped by the bodily defect the child may have acquired faulty mental habits which need to be corrected before education by ordinary schoolroom methods can count for much.