Case Study

Children and Disability (19th, 20th c.)

Why I Taught the Source

In studying the historical meaning of disability in the U.S., official reports of the myriad institutions established for the care, education, training, and sometimes merely confinement, of persons whose differences set them apart have been a key source of information. Such documents were typically written by administrators concerned primarily with the need to ensure continued public and institutional support.

These reports can tell us many things and provide a useful resource to help students understand children's experience of disability over time, but they only provide part of the story. For example, they often address the experience of children with physical impairments or who bore such labels as "feeble-minded," but no comparable record exists concerning children with emotional disabilities. In addition, these reports represent the institutional voice. They do not reflect "insiders' views," that is, the perspectives of the persons affected by the services. These reports can be considered alongside memoirs written by those with sensory or other disabilities for multiple perspectives.

How I Introduce the Source

The 19th century was characterized by the establishment of institutions. Records of asylums for persons judged insane from the 19th century, however, make only occasional reference to inmates in their teens or childhood. If childhood emotional disturbance was present in the 19th century, the sparseness of data leads one to ask: Where were the children? Or, alternatively, does the absence of facilities specifically for the treatment of childhood disturbance indicate that the emotionally disturbed child is new to the 20th century?

In teaching a course on the history of childhood, I pose these as alternative hypotheses:

  1. American children have always experienced the same range of mood, conduct, ideational, and other disorders as do children today, but their needs were not appropriately addressed before the 20th century; or
  2. Perhaps owing to a variety of socio-cultural factors (e.g., urbanization, industrialization, economic stressors, immigration, etc.), childhood emotional disturbance became significantly more visible and a cause for concern with the dawn of the 20th century.

In class, we discuss the socially constructed nature of disability. In light of this, students tend to lean toward the first hypothesis, noting further the role of changing societal norms in determining whether certain behaviors are aberrant.

In the 19th century, the U.S. actually presented an array of facilities where children considered different or difficult might be found. In addition to "lunatic asylums," reports from institutions for the "feeble-minded" in the 1880s noted cases of "moral idiocy" and "juvenile affective insanity." The mixed motives driving reformers led to a network of "Houses of Refuge," a euphemism for reformatories. At mid-century, many of the inmates of America's almshouses were children with physical or cognitive impairments including, as Dorothea Dix reported, "insanity."

The nature of these institutions, though, changed over time. Many American orphanages were established during or after the Civil War. In the 1920s, in the context of a broad mental hygiene movement, these asylums began to redefine themselves into mental health agencies now known as residential treatment centers for disturbed children and youth. By the mid-1960s, treatment centers were established in virtually every region of the U.S., as well as in Canada and other industrialized nations.

The records of these institutions provide a picture of change over the course of a century. They address the perceived or actual nature and needs of the children who were served – from dependent and pitiable to "difficult" and disturbed.

The Cleveland Protestant Orphan Asylum (CPOA, later renamed BeechBrook) was established by a religious organization, as many were in this era, and began with what is often described as a child-rescue mission. The 1879 Annual Report of CPOA demonstrates their original purpose of ". . . sheltering orphaned and destitute children."

Reading the Source

The 1879 Report is especially instructive because it describes children who had been served since the agency's founding in 1852: ". . . we found them in good health, happy and contented; their physical wants abundantly supplied and their mental and moral training carefully looked after." With the exception of a few children rescued from alcoholic and abusive parents, the agency's clientele comprised orphaned or "half-orphaned" children. "Half-orphaned" usually involved a mother, or in some cases a father, who was at least temporarily unable to care for her or his child or children.

The annual report describes the goal of physically moving children in response to the "increasing call for shelter for orphans," with the goal of either "returning" or "placing out" with another family every child who was admitted. CPOA's annual reports summarize the agency's success in achieving that goal.

The year 1919 marked the first time in which specific reference was made to "difficult" (though still considered redeemable) children. Of the 296 children served, 85 had been placed in foster homes and 132 had been "returned to friends" (typically a parent or close relative). Over the next few decades, the agency reports document increasing numbers of "difficult" children. The growing discussion of degrees of difficulty, as well as evidence such as engaging psychiatric consultation, indicate movement toward the agency's present role within the mental health system.

To read the report, students work in small groups and address a number of topics:

  1. The role of age, gender, parental socioeconomic level, and geographic location: The documents are informative with respect to many key questions concerning clientele and possible changes over time. For example, in the 1870s, when CPOA and sister agencies were growing rapidly, urban school districts such as Cleveland were starting to establish "classes for unrulies," primarily troublesome male pupils. Did CPOA's clientele tend to come from rural rather than urban surroundings? Did sociocultural characteristics change over time? Were more girls than boys admitted or vice versa? At what ages were children typically admitted, that is, possibly before becoming "unruly"?
  2. Etiological attributions: In describing even "difficult" children as victims rather than menaces, these reports seem to contrast sharply with those of asylums and reformatories. Reports from the latter often ascribed child deviance to parental or child sexual or other "vile" misconduct. Does this reveal differences in perceptions and attitudes, or does there seem to have been a sorting process, whereby children were referred to the type of provider thought best suited to address their needs? Alternatively, do the reports put a rosy face on less salubrious realities – examples of what Goffman termed "cleaning up the front regions"?
  3. Prognoses: Is the goal of returning children to, or placing children with, families consistently evident in the successive reports? Are expressed beliefs about children's "redeemability" inconsistent with apparent societal attitudes during the "period of indictment" and of "negative eugenics?" 1 What factors might help to explain such inconsistencies?
  4. Remedies: Were there strategies for "redeeming" young children in need or in trouble? What were they? Is there evidence that the philosophy of moral treatment that influenced early American, as well as European, psychiatry guided CPOA (and by extension similar agencies)? Specifically, was the ameliorative role of work, a key element of moral treatment emphasized in 19th-century orphanages, in any way different than in the asylums, almshouses, and reformatories?

1There was growing tendency, connected to the rise of the eugenics movement in the U.S., to associate cognitive disability with criminality and to advocate increasingly punitive means of containing and preventing (e.g., through involuntary sterilization) all forms of physical and behavioral deviance.

How to Cite This Source

"Children and Disability (19th, 20th c.)," in Children and Youth in History, Item #110, (accessed August 10, 2021).