delinquency field, because his experience comes from working with and teaching delinquents or managing delinquents. It seems to me that this is very often short-term training, not longterm that is involved. We provide practicum with the special type of youngster that we are gong to be concerned with, i.e. the norm violating type. We are also concerned with the need for some special facilities within the school and the community to deal with the sick younster. Since the public schools are concerned with educating all the children of all the people, we must concede that there is a fraction of a percent who are too ill to come to school, even under compulsory legislation. This raises the question of how you can identify these youngsters. Once we do, do we place them within the school operated facility or do we find an outside facility? And, since illness exists on a continuum, it is a very difficult decision. We don't yet know how to decide which youngster is too sick to stay in school. This calls for professional judgment that must be made by professional, trained people. Senator CLARK. Is this pretty much the same problem as that of dealing with the retarded and handicapped child, or is it different? Mr. KVARACEUS. This problem is not quite as clear as that. We can identify rather clearly the youngster who is mentally retarded, who probably will not function effectively in the regular classroom, but there are two types, Senator. I think the two types are being very much mixed up in placement. One type is this first youngster we mentioned, the one who engaged in violating behavior as sport and adventure and in order to achieve status. Then, there is the youngster who is quite sick and engages in this type of behavior with heavy emotional involvement. If we mix these two groups up in a school facility, we are really going to have ourselves a good headache. Senator CLARK. Do you not think the first type is also mentally ill? Mr. KVARACEUS. Mentally ill, Senator? Senator CLARK. You used the word "sick." I was using the words "mentally ill." Perhaps they are not synonymous. The fellow who is out for status, to that extent, one could question whether there was not Mr. KVARACEUS. From my vantage point we might call him ill, but from his primary point of reference, his peer group that has been mentioned here earlier, he is engaging in demand behavior. This is the way you make a living with your group and achieve recognition in this particular group. This may look warped to us from middle class norms, but from his frame of reference this is the way of life. We have been concerned with the upward diffusion of lower class norms into middle class culture, seen evidenced today, for example, in the complete taking over of rock and roll in terms of the lyrics, the beat, the dress, the clothes, and the language pattern. One last point: I would like to point to a tremendous necessity in evaluating current efforts. For example, the outstanding current publication happens to be "The Annals." "The Annals" of March 1959 entitled "Prevention of Juvenile Delinquency" gives a dozen programs, Senator, none of which has been adequately evaluated. Very often it may be the maturity level of the youngster that causes him to improve rather than the program. Senator CLARK. I think one of the most significant things about the volume of "The Annals" which I read over the weekend was the lack of conviction of any of the authors of the articles that they had found a way out. Mr. KVARACEUS. That is right. In a sense they have been writing on a very scientific and sophisticated basis, putting it out on the line clearly as they should, but the researchers have not been able to effect a checkout to see if what they did has actually been effective in reducing delinquency. Senator CLARK. I think for the purposes of the record we had better identify the volume which we have been talking about. It is the volume on "Prevention of Juvenile Delinquency" published by "The Annals of the American Academy of Political and Social Science," volume 322, March 1959. Mr. KVARACEUS. I hope in reading this, Senator, you were touched by the fact that all these methods, almost without exception, move into the community. Instead of inviting the youngster into a clinic, we are now moving into this neighborhood, into the peer group, and perhaps this is closer to the payoff rather than through the psychiatrist's couch, far removed from where the problem originates-not that we don't need more and better couches. Senator CLARK. We need both, don't we? Mr. KVARACEUS. We need both of them. The team with which I have been working includes psychiatric personnel, and we feel that the large bulk of the current problem we face reflects a milieu problem, a problem that invites us to look at the community or the neighborhood first rather than the individual, although both types of problems exist. A last point: Delinquency is not the major problem. I would say we cannot solve this problem of delinquency without cutting through the apathy, the ignorance, the denial within the population at large. Can we get the enlightened kind of interest and understanding that will help us move ahead? It seems we cannot, unless publicly many people address themselves to the issues involved and we request more data, facts. I would hope that the Senator would be besieged by an alarmed, concerned public. Senator CLARK. It becomes a matter of public relations, does it not, then? Mr. KVARACEUS. Public education, too. There is a great deal of mythology, of folklore, of half-truth being expressed everywhere, and we may be contributing to a part of it in terms of the dysfunctioning of some of our own points of view. Senator CLARK. A part of the mythology is the absolute necessity of balancing the budget at $77 billion, even if it results in chaos. Mr. KVARACEUS. To conclude on the point of public knowledge and understanding: We need certain kinds of information. Three levels of it, it seems to me, Senator, are required. One is a level in terms of the theoretical concepts involved; that is, what is the definition of a delinquent? What are the causes? I think we have had some eloquent testimony on this to an extent. I would expect we would only be practical with whatever funds might be made available at the Fed eral level to the extent to which we integrate a point of view and act from a clear frame of reference. There are many "practical-impractical operators" in the community who are gimmick-minded, who will pass a curfew because this appears to be the solution. For one thing, it does not cost anything, and secondly, it appears that they have come to grips with the problem and have registered themselves on the right side, when the delinquency clock indicates that most of the difficulties take place before the curfew hours. Senator CLARK. If you had $5 million of Federal funds to spend as a result of the passage of one or more of these bills, what would you do with it? That is, annually? Mr. KVARACEUS. To be very specific, I think we should select in every State a particular kind of agency that is actually dealing with the problem, set up some evaluative techniques, either in the area of social work, a school system, a police unit, and within each of these States we would develop techniques so we would know whether we had in effect done anything relevant to the problem. Senator CLARK. Would you not want to retain the flexibility of going into the more densely populated States at a greater level than you would some where there were, as I have said on occasion, more trees, stones, and water than there are people? Mr.KVARACEUS. I would like to focus on the 15 cities in the United States with 500,000 population and over, and, let us say, do an honest attempt where the volume of the business is heaviest. There we have something to start with, and there the problem exists in large numbers. Senator CLARK. Would it not be important, however, to have at least one or two studies going to determine the extent to which the underlying causation of the difficulty is, independent of whether you are in a rural or an urban community? Mr. KVARACEUS. I think this rural-urban dichotomy is a false one. Rural youth is becoming heavily urbanized. In a few years rural youth with the help of the automobile and mass media will not be a rural youth such as we think of today. Senator CLARK. What you say is true, but politically there is that lag. When you are dealing in terms of getting a bill through either Congress or the State legislature, you are not realistic if you don't give some emphasis to Mr. KVARACEUS. I would assume that the greater political wisdom, Senator, is with you in terms of how we get funds, in terms of what appeals. We don't really know very much about the rural problem, and we do know that the city mice are busier than country mice in a sense. But I would like to see a bit of research go into the extent of hidden delinquency in the rural areas, particularly with reference to the low frustration tolerance that exists within the city as against the country. It does not take much, in the anonymity of a large housing project, to raise your arm and hit somebody in the chin. Senator CLARK. Some of the earlier witnesses I remember specifically gave opinions that there was proportionately just about as much delinquency in rural areas as there was in the urban. Mr. KVARACEUS. I would like to see the data. I would like to stimulate a study with Federal funds to see the exact nature of the problem and as to how it develops. I am not so sure we can answer that categorically. We have all of these impressions, but we do know that in the lower class milieu, in the big, dirty city we have a large amount of business that concerns us greatly. I began by saying that we need a level of fact as to theory. This is the only practical approach, in spite of the slur on the "egghead" approach. We have impractical-practical action people who are running to the woodshed, using big or small sticks or switches and using curfew gimmicks. This is being "impractically practical." We have a second level of knowledge that we might use these funds for, and that is determining exactly what kind of a problem the city has, where it is, and what it is. We do not have the facts. We go by impression. We act in terms of opinion unsupported by any facts. Third, we need a level of facts involving the individual youngster himself. We cannot solve his problem unless we come to know him and his family, because all these youngsters vary in terms of causes and backgrounds. Thank you, Senator. Senator CLARK. Thank you very much. Your testimony has been most helpful to us. Dr. Eliot? Doctor, would it be very inconvenient for you to come back at 2 o'clock? I would appreciate it if you could, because then we could take a little more time to explore your testimony, and I have an engagement at 12:30 that I cannot very well get out of. If it is satisfactory to you, the subcommittee will stand in recess until 2 o'clock this afternoon, at which time we will have the statement of Dr. Eliot. (Whereupon, at 12:25 p.m., the subcommittee recessed, to resume the hearing at 2 p.m. the same day.) AFTERNOON SESSION Present: Senators Clark (presiding), and Javits. Senator CLARK. The subcommittee will be in session a little ahead of time but I do not think we are going to have very many more customers in the gallery or the press. STATEMENT OF DR. MARTHA M. ELIOT, PROFESSOR OF MATERNAL AND CHILD HEALTH, HARVARD SCHOOL OF PUBLIC HEALTH I will ask Dr. Martha Eliot if she will come forward and be our next witness. Dr. Eliot, we are very pleased to have you here. As I understand it, you are now the administrative head of the Department of Maternal and Child Health at Harvard University School of Public Health and for many years you served as Chief, U.S. Children's Bureau. You were also U.S. representative on the executive board, United National Children's Fund and a member of the U.S. delegation to the first World Health Assembly in Geneva in 1948. You have a degree of doctor of medicine from Johns Hopkins School of Medicine and we are very much interested in hearing your views on the bills which are before the subcommittee. You have a prepared statement, I think, Doctor, and with your permission I will put it in the record at this point and I will ask you to hit the highlights on it. (The statement referred to follows:) STATEMENT BY DR. MARTHA M. ELIOT, PROFESSOR OF MATERNAL AND CHILD HEALTH, HARVARD SCHOOL OF PUBLIC HEALTH In his statement I would like to outline a few possible ways of meeting the need to prevent and control juvenile delinquency. The upsurge in delinquency which began in 1948 seems to continue essentially unabated in spite of efforts by State and local authorities and voluntary agencies to bring it under control. One cannot measure easily the true effect of these efforts, nor is there any way to tell how much greater the upswing might have been if these efforts had not been made. There are, indeed, some encouraging reports that the incidence of delinquency has decreased in certain areas where intensive efforts over considerable periods of time have been made. That these local efforts have not brought about a decrease in the number and rates of delinquent boys and girls reported by juvenile courts and by the police on a nationwide basis is not surprising. Though these efforts have been many, they are usually quite localized in small community areas and have reached only small numbers of children and families. To bring about a decrease in national rates will require ultimately a far more general application of knowledge and a more general reduction in the number of children who commit acts of a nature that bring them to the attention of the police and the courts than that represented by existing localized efforts. To accomplish this, even more knowledge than we have today must be acquired with respect to ways of overcoming the disadvantageous environmental conditions in the families and communities in which children live and grow up. Many more workers are needed who are trained to understand how families and individual youth can be helped and how cultural, social, and health conditions in high delinquency areas can be sufficiently modified to bring about change in the behavior of children and youth. This may sound like a very long-time undertaking, and it is. We have to remember that the disadvantageous conditions that lie back of the present situation have also been building for a very long time and that the existing deteriorated conditions in our cities, the socialogical and cultural problems, the tensions that bring about disorganization and breakdown of family life have been slowly accumulating. However, because the struggle will still be a long one is no reason not to face it frankly now, and begin a nationwide attack on causes as they are clarified and a concerted effort to meet problems of prevention and control more effectively. The bills before this committee approach this situation in various ways. With the exception of S. 694, introduced by Senator Hill and the chairman of this subcommittee, Senator Clark, they represent approaches taken, in whole or in part, by various Members of the Senate who have introduced bills in the recent past. I have myself appeared before committees of the Senate in support of such bills. I have no reason to question the values of many of the provisions of these bills or the ultimate need for legislation that will provide grantsin-aid to the States to support their efforts to improve the quantity and quality of work on a statewide basis. I was given pause, however, by the discussions that were precipitated by the proposals for grants-in-aid to support State and local programs, especially those related to (1) how to bring about effective coordination at the State level of the efforts of the several State agencies, each of which was contributing in one way or another to meeting the problem, (2) which agency should be given the leadership responsibility, and (3) which approaches to prevention, control, or treatment services were advocated as most effective within our existing knowledge. None of the questions raised, however, seemed to me to be insurmountable if we could but get started on a grant program that would stimulate States, localities, neighborhood groups, the schools, the health, education, correction, and welfare departments, youth service boards, mental health agencies, and research and study groups to get together and decide how some of the administrative problems could be resolved, and what programs and plans were believed the best to press forward. It was for this reason that I welcomed the Hill-Clark bill as an important measure that would open the way for prompt action of this sort. This bill would make it possible for States and communities, for private agencies and university research groups to undertake many kinds of practical projects and studies that would show how to organize and coordinate State and local activities, how to apply more effectively the knowledge we now have, and allow for a wide variety of new research and demonstration projects. Through this process we could add to our knowledge of causes, improve our methodology in diagnosis and treatment of delinquency, show new and better ways of reaching |