ance and are easily discouraged. A few rebuffs destroy what little confidence we have been able to instill into them during training. They sometimes have the idea that if they are given employment it is due to sympathy for their unfortunate condition and that it is more or less an act of charity.

I had a young man who lost his left hand. It happened that he was left handed, even writing with his left hand. He was given training and fitted to hold a good position but he was very sensitive about his hand and was constantly trying to hide it, never allowing himself to forget that he had lost his hand. He did not want people to feel sorry for him and dreaded expressions of sympathy. He was finally persuaded to take a position. He is now making good as an accountant, and has lost his supersensitive attitude.

Another obstacle incurred in industrial accident cases is the fear of losing a part of their compensation. The more ignorant and shiftless prefer to live in idleness, existing on the small compensation allowance, rather than to fit themselves for employment at a wage which would operate to reduce their compensation. We have found it necessary in several such cases to arrange with the industrial commission for a lump-sum settlement before we could induce them to accept employment.

In the case of those who have been handicapped for a long time, there are some who have a feeling that the world-that is, societyowes them a living, and there is a very strong inclination to collect it without work.

When I began my work in rehabilitation every cripple I saw was a potential rehabilitation case. One day I saw and accosted a nicely dressed man who had lost a leg below the knee. He evaded the questions put for some time but finally said: "My friend, I like the way you talk, but I will be frank with you. I haven't done a bit of work for 20 years and I never intend to. The world owes me a living and I am collecting it."

I saw him a few weeks later at the main gate of our State fair. He was poorly dressed, and pitiful looking. His good leg was carefully doubled under him and his stump exhibited most prominently and his ragged hat was persistently extended to every passer by. I am satisfied that he was collecting to the extent of approximately $100 per day. Physically and mentally he was perfectly able to work, but it was impossible to change his perverted idea and get him to accept honest self-respecting employment.

It is sometimes impossible to get handicapped people in remote sections to leave their communities for training or employment. We have had great difficulty along this line, especially with those from our mountain sections. In a number of cases where such

have been placed in employment or employment training, they have become dissatisfied and homesick and have quit the job and returned to their homes. In most cases of this kind it is not possible to get them to make a second attempt.

In conclusion, I will say I have touched on only a few of the obstacles encountered. They are almost as numerous as the individuals handled. There are few who do not present a problem to be solved before they are successfully placed in employment.

Chairman COPP. Mr. Bynum will lead the discussion on this subject. Mr. Bynum.

DISCUSSION

PREJUDICES ENCOUNTERED IN THE PLACEMENT OF DISABLED PERSONS

R. L. BYNUM, Supervisor of Rehabilitation, Tennessee

It is my pleasure to discuss some obstacles presented by disabled persons who have been trained and are ready for employment. My experience has convinced me that the following factors make up most of the outstanding obstacles presented by disabled persons to placement:

1. Lack of self-confidence.

2. Home environment.

3. Personality.

4. Morale.

5. Lack of social contact.

6. Lack of power of initiative.

7. Lack of faith in all things human.

1. Lack of self-confidence.

In some cases we find a condition approaching what the scientists are pleased to call "an inferiority complex." If such a state of mind exists in a trainee during the period of adolescence, it may be overcome to some extent, but there is only a ray of hope after the period of adolescence is passed. Lack of self-confidence can be overcome in a large measure by close, sympathetic, and expert supervision during the training period; hence, it goes without saying that this obstacle presents a challenge to the rehabilitation worker. If the rehabilitation agent has been diligent and has studied the individual case as he should, this obstacle to employment will be considerably overcome.

2. Home environment.

We are influenced by our environment, beginning several generations back, and it follows as a matter of course that this factor will present itself during the training period and also at the time of employment. Home environment will tell while at work, will assert itself in every activity and every phase of life, and will be passed

down through the ages, but the contact of trained rehabilitation workers will at least leaven the yeast of the trainee's social life. 3. Personality.

This presents a large factor in the placement problem. The lack of personality on the part of the disabled person may become a barrier or obstacle which will try the wit, the tact, the ingenuity, the energy, and the very soul of the rehabilitation officer. Anyone can supervise and place a trainee who has a pleasing personality, a bright mind, and who is full of energy and pep, but it takes an expert to supervise a trainee and place one who is badly physically handicapped, who has an unattractive personality, no initiative, no outlock upon life, and without encouragement financial, or otherwise. 4. Morale.

This presents a problem which is one of the great obstacles to be overcome by contact with the rehabilitation agent. Many disabled persons, especially where much time has elapsed since their disability, have come to believe that there is nothing they can do but to eke out an existence. Some of them become confirmed mendicants, some of them confirmed malingerers, and many of them have been chloroformed into this state of mind by their friends and relatives and by the attitude of the public in general. However, there is a possibility that the lack of morale on the part of the trainee may be overcome by expert treatment, guidance, advice, and inspiration offered by the rehabilitation officials, but such treatment can not be given by one who is not sympathetic, interested, and trained for the work. If the rehabilitation workers meet the conditions named above, this obstacle may be overcome during the training period. 5. Lack of social contact.

This presents a real problem and a real obstacle in the way of placement and, of course, can not be entirely overcome in a short training period, whether in school training or in employment training, but much can be done to adjust the trainee to his new social order and to teach him something of human behavior. 6. Lack of power of initiative.

This power is not given to everyone in the same degree, but it may be acquired and developed very much by proper training and encouragement and by placing responsibility upon the timid, unresponsive, and reticent disabled person. Again, I would say that expert service on the part of rehabilitation officials can be of much. help in overcoming this obstacle of placement, but the lack of initiative is somewhat akin to the minus quantity in mental make-up. The lack of initiative is the missing of the spark plug. The power of initiative is the dynamo which will solve most all the problems of even the rehabilitation worker.

7. Lack of faith in all things human.

This factor is a real obstacle presented by many applicants for vocational training and placement. This obstacle blocks the passage= ways to most every enterprise and will certainly close the avenues of good will between the employer and employee, between labor and capital, and between the adviser and advised. We must then, of necessity, inspire confidence in our Government, our Government officials, society in general, employers of labor, and last but not least, in ourselves, both as to our integrity and our ability to lead and advise. If we will sell ourselves to our trainees, we can then sell our work and it will follow that we have solved the probem of overcoming distruct and lack of faith in all things necessary to rehabilitation and placement.

Chairman COPP. We shall now consider our second subject, "Surveys and studies that may be made." The first speaker is Mr. Sullivan.

SURVEYS AND STUDIES THAT MAY BE MADE: BY STATES ALONE

OSCAR M. SULLIVAN, Director of Reeducation, Minnesota

The kinds of surveys or studies that are peculiarly appropriate for the States alone are those which are intensive. The States have the first-hand information and first-hand contacts. They can therefore conduct a study in a limited field in much greater detail than would ordinarily be possible for the Federal Government.

Almost any special phase of rehabilitation or special development of the work would be worthy of a careful research. Those which are listed here are merely the ones which occur as most likely to give abundant data for study. The initial step in most rehabilitation work is vocational advisement. A study in advisement technique would be immediately helpful in any State and would offer much by way of suggestion to other States. Rehabilitation workers are probably doing the largest and most practical work of advisement in the country. There are other activities, no doubt, which are dealing and have dealt with larger numbers but I do not believe that any have dealt or are dealing with their wards in such complete fashion as the rehabilitation workers, nor are they following them long enough to be certain of the outcome. Notwithstanding that so much advisement is being done by the rehabilitation workers, however, the whole process is still very much on an empirical basis. Every hint that has been given by psychologists and personnel men is no doubt being utilized. What is needed, however, is a more careful study of advisement technique and a checking with the results secured. A more definite procedure, more reliable criteria of

suitability of applicants for various occupations, greater efficiency in results, all these are possible of attainment.

Another subject worthy of study is the question of how to secure improved morale. All those who have been in rehabilitation work for some time are convinced that the variation in morale is probably the most significant thing in the variation in results secured. In some cases an improved morale would practically effect the rehabilitation, in many others it would be a very important factor. Certainly, as psychiatric and psychopathic clinics become more common in the country, the rehabilitation agencies should secure greater cooperation from them, and a study of the methods followed, together with the outcome in each case should throw a great deal of light upon this side of the work. Progress in the direction indicated may disclose methods effecting the rehabilitation of quite a few of the cases that now have to be given up as failures.

Little progress has been made as yet in effecting a correlation of occupational therapy with rehabilitation. Undoubtedly there must be many instances where a vocational course could entirely replace the traditional occupational therapy. A greater study of possibilities in this line is greatly needed. It would be of benefit both to the occupational therapy movement and to the rehabilitation movement. Although in many of the States vocational training is the chief feature of rehabilitation, little if any study has as yet been made of what special adapations in vocational training are desirable for rehabilitation students. Certainly here is a field which warrants study and for which there are at hand many staff members well qualified to conduct the study. Are any variations in method required for rehabilitation trainees? Do rehabilitation students make better progress in classes composed of other handicapped persons or in classes of normal students? Has the tendency to short unit courses received an impetus from the rehabilitation movement? Should rehabilitation courses be stripped to the very essentials or should they include a fair amount of incidental study along related lines that will be inspirational and quasi-cultural? Some definite and valuable researches could be made in the direction indicated.

Again, some of the special solutions in rehabilitation work would repay an intensive study. Factors that are conducive to success in small business enterprises might be suggested as one. Many badly disabled persons are almost impossible of placement but are fully capable of managing their own businesses if they have the opportunity. The kinds of businesses best adapted for such a plan, the capital amounts required, the best training for efficiency, all these are worthy of investigation. The same is true of "sheltered employment" plans. Enterprises of this nature are functioning