1

EXPERIMENTAL STUDY OF THE HIGHER NERVOUS

ACTIVITY OF THE ABNORMAL CHILD
By A. R. LURIA
Institute of Defectology, Moscow

IN a previous paper* we made an attempt to advance some important

theoretical principle.? of child psychopathology and dwelt on the proposition
that general derangements in the mental development of the child may be
caused hy relatively limited particular defects. We also tried to show that the
analysis of anomalous development may be highly efficient if it succeeds in
approaching the mental ability of the child as a secondary consequence of such
a particular primary defect.
There is no douht, however, that cases when the mental development of the
child has assumed an ahnonnal character due to a limited, strictly localized
defect, by no means cover all the forms which are knowTi in child psycho-
pathol<^y. There are more frequent cases when children exhibit no particular
defects in vision or audition, in writing or reading, but manifest gross and
much more general derangements in their intellectual development, or in their
behaviour. Clinical investigations of such children are full of records showing
certain derangements of their ability to concentrate; they are easily distractable,
impulsive, disinhibited, inert and sluggish. All these symptoms indicate a
tendency to early fatigue, susceptihility to asthenia, and, finally, general
retardation of mental development, not accompanied hy any marked particular
defects. Some of these children can attend nonnal schools, but they do not
remain there for a long time, not being able to cope with the general pro-
gramme; they require special medical measures, and subject to special help,
can show good progress in their studies; other children reveal distinct symptoms
of mental Ijackwardness and must attend special schools for feeble-minded.
However, the following question naturally arise.s : must we confine our
research to the external clinical description of such children, or should we, in
accordance with our general principle, go farther and set ourselves the task of
qualijyinii their disturbances? Should we attempt to disclose the changes which
underlie the anomalous development and to express the disturtiances in more
profound pathophysiological units?
We contest the viewpoint-incompatible with modern medicine—which is
inclined to deduce peculiarities of development from different inborn abilities.

* A. R. LuRiA. Dynamic approach to the mental development nf the abnormal child.

(Received on October 7. 1958)

2 HIGHER NERVOUS ACTIVITY OF ABNORMAL CHILD

The assertion of some authors that a considerable part of the population is

hereditarily "subnormal", or exhibits traits of "constitutional psychopathy",
can be hardly regarded as a worthy contribution to science.
Thorough investigations carried out by Soviet specialists in the field of child
psychiatry (Sukhareva. Osipova. Pevzner, and others) give firm grounds for
stating that the overwhelming majority of children who cannot attend ordinary
schools, suffered in their early, or intra-uterine childhood from severe organic
lesions (traumas or inflammatory processes, infections or metalwlic disorders)
which adversely affected their subsequent development. Therefore, the patho-
logical state of disinhibition, pathological .sluggishness and exhaustibility, as well
as retardations of mental development hindering the nonnal studies of children,
in a considerable number (and even overwhelming majority) of cases result
from pathological processes endured long before; they modify the cerebral
suljstratuni and inevitably lead to a defective development of the child.
If in these cases we are actually confronted not with various forms of normal
development but with sick children whose nervous processes, as a result of
lesions endured in the past, have assumed certain pathological peculiarities,
then, naturally, the following questions arise : How can we characterise these
peculiarities of the nervous processes and can we study the pathologically
changed nervous activity of these children? Only hy answering these questions
shall we be able to make a substantial step forward, to pass from the external
description of deviations in behaviour to the study of the ncurophysioloiiical
mechanisms which are responsible for anomalous development.
The achievements of modern normal and pathological neurophysiology, and,
above all, the classical investigations of I. P. Pavlov, which during the last
two decades have heen extensively applied to man, make it possible to accom-
plish this task; they arm us not only with a system of notions, which can express
the principal deviations in the dynamics of human nervous processes, but also
(and this is particularly important) with experimental methods by means of
which these peculiarities can he objectively ascertained.
Let us dwell for a short while on the physiological symptoms indicating lx>th
the normal development of the higher nervous processes and derangements in
their dynamics in pathological cases; in otir further exposition we shall have to
deal with these symptoms repeatedly.
Any nervous processes which, as we know, are reducible to the basic processes
of excitation and inhibition, may manifest a definite strength expressed in
the rapidity with which new connections are formed, as well as in the stahility
and concentration of these processes; normally the strength of the hasic nervous
processes is sufficient to effect a relatively quick coupling of the new connec-
tions, to inhibit inadequate reactions and to keep up the elahorated systems
of connections for a long time without yielding to th<' influence of other
 A. R. LURIA 3

external stimuli, or to the influence of the on-coming exhaustion. As is known,

in pathological states of the l)rain the strength of the hasic nervous processes
may markedly sufler; the concentrated character of the nervous processes
gives way to a diffused, generalized irradiation of excitation; the nerve cell
quickly falls into a state of transmarginal inhihition; its reactions to strong
stimuli hecome weaker, while its responses to weak stimuli assume a paradoxi-
cally strong character. It is likewise well known that in such cases any
extraneous stimulus may easily disrupt the already estahlished system of
connections; even slight fatigue may evoke appreciable disturbances in the
norma! course of its nervous processes.
Further, any higher nervous activity consisting of the excitatory and
inhiliitory processes may be characterized by a different degree of equilibrium
between these processes. Normally this equilibrium reaches a very high level.
Because of this we do not react to a negative, inhibitory stimulus with an
impulsive response, or to a positive signal requiring a rapid reaction with a
delayed or disappearing response. But. pathological states of the lirjiin very often
lead to a disturbance of the equilibrium hetween the two nervous processes. In
some cases this disturbance is expressed in the predominance of excitation over
inhil>ition; then the ability to abstain from premature responses is elaborated
with great difficulty, and inhibitory signals frequently begin to evoke involuntary
impulsive reactions. In other cases this disturbance is expressed in the predomi-
nance of elementary inhibition; then sluggishness and torpidity arise in the
higher nervous activity, new positive reactions are elaborated slowly, and in the
presence of a certain complicating factor entirely disappear. Although in
normal subjects the predominance of this or other process is a symptom of
temperament, under pathological states of the brain (as we shall see later)
the disequilil)riuin hetween lioth nervous processes may assume strongly pro-
nounced abnormal forms.
Finally, any higher nervous activity possesses a third property which until
recently has not received sufficient attention. Nervous processes may differ
in their mobility. Normally this mobility is manifested in the fact that a human
being proves to he able rapidly to inhibit certain systems of connections and
pass to others; this faculty of the nervous .system (genetically connected with
the physiological property of lability which was investigated by the outstanding
Russian physiologist Wedensky) is one of the most important faculties and
ensures successful adaptation to quickly changing natural conditions. Under
pathological states of the brain this faculty may particularly deteriorate. When
this occurs the patient is no longer able quickly to inhibit the connections that
were once established, and to pass easily from certain systems of connections to
new ones. The well-known fact of perseveration may be interpreted as an
external manifestation of the inertness of the nervous processes which, as shown
by investigations, is one of the most essential symptoms of the onset of a patho-
logical state in the brain. Later we shall see how important these features are
4 HIGHER NERVOUS ACTIVITY OF ABNORMAL CHILD

for the diagnostics of pathological .slates of the higher nervous activity of the
child.
However, we .should commit a serious mistake if we did not make another
important .step in our reasoning. The characteristic propcrtie.s of the l)a.sic
nervous proce.sses- -their strength, equilibrium and niohiiity—as well as changes
which take place under pathological states, are quite sufficient to qualify the
peculiarities of the higher nervous activity in animals, l)ut they are by no
means .sufficient to qualify the peculiarities of the higher nervous activity in
man. The behaviour of man, which always bears a reflex character, in the
broad sense of these words (each action being invariably a response to certain
conditions arising in his interrelation with the outer world), is at the .same time
a conscious and voluntary nature. This, first of all, means that a human being
responds with this or other action to the verbal instructions of the people with
whom he is associated; he orients himself in the surrounding reality with the
help of language through which he .systematizes his impressions, realizes his
own actions, and, what is particularly important, subordinates his behaviour to
verbally formulated intentions. Along with the system of direct signals of
reality, man is constantly influenced I)y language and speech. The ".second
signalling sy.stem" consists of words which embody and express our social
experience, and of connections between them. The second signalling system
possesses the properties of abstraction and special generalization and constitutes
the foundation of our thinking, it forms a component part of the mental reality
in which man lives. At the .same time it is a powerful means of regulatini^ his
behaviour; there is hardly anybody who knows it better than the physician or
teacher engaged in the treatment and instruction of children.
This essential feature of man's behaviour makes it necessary to introduce an
important additional factor in the study of the principal indicators of huinan
higher nervous activity. In order to express the specific properties of the human
higher nervous processes in units which are peculiar to man, we must not
confine ourselves to the characteristics of general .strength, equilibrium and
mobility of the nervous processes; we must also specially ascertain the specific
features which characterize the dynamics of his speech processes (or processes
developing at the level of the second signalling system) and, alx>ve all, establish
to what extent these speech processes organize the course of his more elemen-
tary reaction-, and to what degree the connectiom of hii second .njjnalling
system are able to regulate the acts of his behaviour.
Precisely this physiological characteristic of the processes of regulation of
behaviour, or, in a broader sense, the interaction of the two signalling system.s,
will serve us as a fundamental indicator in the study of the normal and patho-
logically modified behaviour of the child. Therein we expect to find the basic
"units" which will allow us to make a proper step towards a more precise
qualification of various forms of abnormal development.
 A. R. LURIA 5

II
The simplest way of studying the specific features of the higher nervous
processes in the child and the role of speech in the regulation of its actions is
the method—well known in psychology—of recording motor reactions arising
as a result of verbal instruction.
We give the child the following simplest instruction : "When a light appears,
press the balloon". Thereby we actually try to solve two problems : firstly, we
are able to find out whether a most elementary temporary connection can be
established in the child in this way (i.e., whether the flash of an electric bulb
assumes a new signalling property; secondly, we get the opportunity to ascer-
tain the degree of stahility and mobility of the connection which has been
evoked hy the verbal instruction. By performing this experiment more or le.ss
protractedly, presenting the child with extraneous stimuli, using signals of
different strength, and observing the intensity and quickness of the motor
reactions, we are able to judge the relative strength of the induced nervous
processes.
By asking the child to perform a somewhat more complicated task, for
example to pre.ss the halloon in response to a red signal (positive reaction) and
to abstain from this movement in response to a green signal (inhil)itory
reaction), we are in a position to observe both the strength of its active inhihi-
tion and the degree of equilitjrium between the excitatory and inhibitory
processes : a child with a predominance of excitation over inhibition will easily
replace the abstention from reactions by impulsive pressures, while a child
highly susceptible to inhibition will often miss the required positive reactions,
exhibit reactions of an ever-diminishing intensity and, finally, cease to react to
positive signals altogether.
By observing the ease with which the transition from positive to inhibitory
reactions is effected, when a given instruction is replaced by a reverse one, or
by a new instruction, and by noting both the speed and the correctness of
the reactions, we shall he able to judge the mobility of the nervous processes.
Finally, by finding out to what degree the child realizes its incorrect reactions
and how it endeavours to rectify them, by reinforcing the speech signals and
hy applying a number of additional methods, we shall be able to establish the
role played by the child's own speech in the regulation of its motor processes.
Does this seemingly very simple task always prove to be so ea.sy and within
the powers of a normal child ? Experience shows that this is far from being the
case. A thorough study of the evolution of motor reactions in children of
different ages may provide very instructive material for the genetic investiga-
tion of the higher nervous activity of children.
If we attempt to offer such a task to a two-year-old child by a direct order
to pre.ss the bailoon. or l)y saying : "When light appears, press the balloon".
6 HIGHER NERVOUS ACTIVITY OF ABNORMAL CHILD

we shall immediately witness marked difficulties experienced by the child. A

child of this age, as a rule, is not yet in a position to make at once the rela-
tively complex connection wbich figures in the two parts of tbe verbal
instruction; the child reacts to each fragment separately : on hearing the first
part of the instruction—"when light appears . . ."—it begins to look for the
light, while to the second part— "press the balloon"^—it reacts by affecting an
immediate pressure, without waiting for the appearance of the conditioned
signal. This means that the movements of a child of this age are not yet
properly regulated by verbal instruction; they begin before the appearance of
the signal and sometimes are even discontinued with the actual presentation of
the stimulus {the latter proves to distract the attention of the child and there-
fore often acts as an inhibitory agent). Even if we succeed in obtaining the
necessary motor response to the signal, there arises another difficulty : once
evoked, the motor impulse proves to be so inert that the child goes on pre.ssing
the balloon endlessly even in the absence of the signal, thus manifesting a series
of uncoordinated reactions not subordinated to the verbal instruction. This
feature is so characteristic of a little child that if we make an attempt to
reinforce the inhibitory part of the verbal instruction by stressing additionally
that the child must be attentive and should not press the balloon before the
light appears, the required effect will not be achieved; on the contrary, this
will evoke even more intense and irradiated pressing (Fig. 1).

Press when a light! Don't press without a fight

Fig. 1. Motor reactions in children of 2-2i years.

 A. R. LURIA 7

Thu.s whereas in the more elementary sy.stems (sucking, grasping) the nervoas
processes of a normal child ot" this age are already adequately concentrated,
it M .'itill impossible to evoke in such a child with the help of verbal imtructiov,
stable, co-ordinated motor reactions. Each attempt to do so is greatly impeded
l)y the high diffuseriess of the child's nervous processe.\.
Only at the age of 3—3^ years do appreciable changes in the higher nervous
processes of a child occur; in conditions of the same experiment a child at this
age will demonstrate only single "inter-signal" reactions. However, if we
.somewhat complicate the task hy asking the child to press the halloon in
response to a red signal and not to press it in response to a green signal, we
shall clearly see that the verbal regulation of such an act will prove impossible
to the child; a child of this age will very soon begin to produce uncontrolled
motor reactions in response to any signal, l)oth positive and inhibitory. It is
characteristic that here, too, no additional verbal instruction yields any stable
effect; while continuing to produce many inappropriate or inter-signal
reactions, the child, as a rule, will try to convince the experimenter that it
acts properly and presses the balloon only in response to the red signals. Iliere
is another characteristic fact : if we strongly reinforce the inhibitory instruction
and once more tell the child not to press the balloon in response to green
signals, the wave of inhibition, which arises in the child, spreads to all subse-
quent reactions, and then, following the inhibitory (green) signal, no positive
(red) signals will evoke any reactions either.
This means that even at this age the higher nervous processes of the child
continue to manifest a marked diffuseness, the child easily yields to the
influence of direct stinmli, and the verbal regulation of its inotor processes is
impeded. Only with the help of certain methods aimed at strengthening the
influence of verbal instruction (for example, by a transition to a repeated verbal
reinforcement of the positive and inhibitory signals by the child (cf. Fig. 2)
or by special methods on which we shall dwell later) is it possible to ensure
the necessary concentration of the nervous processes and to obtain distinct and
co-ordinated motor reactions. However, it is interesting to note that even these
co-ordinated motor reactions of a child of this age are still very unstable : the
child has only to fall ill with a comparatively mild form of influenza or
dyspepsia, and even the prodromal stage of the disease manifests itself in the
weakening of the inhibitory processes and in the emergence of impulsive
reactions to inhibitory signals.
Only at the age of 5—5^ years does this diffuseness of the nervous processes
disappear, and the verbal system begin firmly to regulate tbe motor reactions
of the child. But even at this age a comparatively slight complication of the
experimental conditions, for example, a transition to complex forms of inter-
change of positive and inhihitory reactions, or to shorter signals in more rapid
succession may result in the reappearance of symptoms of disequilibrium and
difTusene.s.s of the nervous processes.
 8 HIGHER NERVOUS ACTIVITY OF ABNORMAL CHILD

a) Simpla R/czactfbn (Speechless)

b) Simp/a fleactt'on with speech raactions

c) Simp/0 (Speechless)
Fig. 2. Organization of motor reactions in a child of 3^ years by means of its own speech.

Ill
There arises the following essential question : Ls it not possible to make use
of this simplest mode of investigation of the child's voluntary behaviour and
to turn it into a means of analyzing pathologically modified higlier nervous
activity? Will not this experience reflect in a more accessible form the changes
which arise in the dynamics of the nervous processes of an abnormal child?
Shall we not be able to disclose in this way the physiological mechanisms which
underlie the pathological behaviour of the child ?
We shall begin our analy.sis with the data ol)tained from the investigation
of children with the cerebro-asihemc syndrome and we shall then show how
difTerent are the data which we obtain from the investigation of feeble-minded
children.
 A. R. LURIA 9

At the beginning ot thi.s article we briefly characterized such children who

are quite often met with in school. These are children who at an early age
suffered from traumas of the head, inftaininatory processes, arachnitis, severe
tjeneral infections, and sometimes early dyspepsias with resulting protracted
dystrophic disorders. In the first few years after the second world war and
Gennan occupation the number of such children was particularly great.
In many of these children gress intellectual derangenienis can hardly be
e.stahUshed ; they can read relatively well, they can count and are sufficiently
quick-witted. Their principal defect lies in the extreme instal)ility of their
connections, in the utter fragility of their behaviour.
As a rule, these children display high distractahility; the mere appearance of
a stranger during the experiment is sufficient to change the results. Sometimes
they prove unable to solve a task which is immeasurably easier than one which
has just been accomplished. They soon tire; after 5 to 7 minutes of studies
their efficiency drastically declines, and they begin to make mistakes wliich
were not observed earlier. Sometimes they demonstrate paradoxically violent
reactions to insignificant factors, thus revealing syniptom.s of the "excitatory
weakness" which is always characteristic of the syndrome of cerebral asthenia.
Usually they take their defects to heart and react strongly to them, sometimes
trying to conceal their failure in school studies, or stating that they will do
their hest to overcome it in the next school year.
Is it possible with the help of the alK>ve-described simple method of investiga-
tion to solve our principal task—to define more exactly the phy.siological
mechanisms which are responsible for the syndrome just mentioned? Can we
elaborate experimental methods which facilitate the diagnosis of this defect?
The experiments carried out in recent years in my laboratory by E. D.
Homskaya enable us to answer this question.
If we take a child aged from 9 to 12, a typical representative of the group
displaying distinct traits of pathological excitability, and offer a simple task—to
press the balloon in response to each red signal, l)ut to abstain from tbis move-
ment in response to eacb green signal (or to a signal of some otber colour),
we shall observe a picture sharply differing from that wbicb is displayed by a
normal child of the same age.
Already when the signals are presented at a relatively low frequency, the
cbild usually begins to manifest a weakness of its inhibitory processes and
sometimes produces impulsive reactions even to inbibitory signals, reactions that
are little susceptible to inhibition. If we complicate tbe conditions of tbe
experiment and begin to present shorter signals, or if we present tbese signals
at a bigher frequency (tbereby making greater demands of tbe inbibitory
process), tbis picture assumes a still more pronounced character; the over-
whelming majority of the inbibitory signals l)egin to evoke disinbibited
impulsive reactions (Fig. 3a). Exact measurement of the latent periods of these
10 HIGHER NERVOUS ACTIVITY OF ABNORMAL CHILD

I REGIME II REGIME

-31 -3Z -33 -35 -36

A Normal child (Sib)

I REGIME "REGIME

. -39 -40 -42 -43 -44

a) Simpia Choice Reactions
yes no yes no ycs yes no yCS tw yes yes
76 77 ye 19 80 81 82
G
-67 -68 -70

-lol -102 -103 '(04

c) Combuied Motor and Speech fZeactions
B Cerebro-aithenic child (9 yean)

Fig. 3. Organization of motor reactions in a cerebro-astheiiic child by means of its own

speech.
 .\. R. LURIA 11

reactions makes it possible to disclose some mechanisms of this defect. It proves

that when certain positive signals are repeatedly presented, the level of
excitability steadily rises and .shorten.s the latent period of the reaction to an
ever-increasing degree; as a result, there arise conditions which break the
inhil>iti(>n and call forth impulsive reactions to the inhibitory signal (Fig. 4a).
It is characteristic that the child itself is well aware of the erroneousness of
its impulsive reactions and accompanies almost all inappropriate reactions by
the exclamation ; "Oil, it's wrong! . . .", t)ut in .spite of that, repeats the same
mistake at the presentation of tlic next inhibitory stimulus.
We, therefore, have good grounds for stating that the weakness of the
nervous processes in these cases develops against a background of high excitO'
bility in a person with particularly deteriorated inhibitory process and that

0.6
\J
•*-+©
T
(a) Simple Motor fleoctions QChoice •+•=".
- = nagativa, sign.; 0 = disinhih'it&i nzQctionS

1"

O.fc vK^

(b) Combined Motor and Speech Reactions

CCh'az + s pos. sg& = ne^citJ

Fig. 4. Reaction times of motor reactions in a child with cercbro-aslhenic .syndrome

(a) Motor reactions withnui speecli
(b) Motor reactions combined with the child's own speech (go ! K*'')
12 HIGHER NERVOUS ACTIVITY OF ABNORMAL. CHILD

despite this neurodynamic derangement, the verbal .system of the child remains
relatively intact. 1 he child recognises the mistakes committed perfectly, but
Is unable to regulate the excessively heightened excitation.
If a drastic derangement of the general neurodynamics accompanied by a
relatively intact second signalling system really constitutes the principal
symptom of this group of cerebro-asthenic states, then is it not possible to
compensate the defects of the neurodynamics peculiar to the given child with
the support of relatively intact speech, and thus to ensure the necessary regula-
tion of the motor reactions? The solution of this question would arm us with
a new essential basic symptom in the diagnosis of various pathological states
of cerebral activity.
In order to solve this question we must, first of all, find out what are the
physiological characteristics of the child's speech activity and resort to its
compensatory role only if the strength, equilibrium and mobility of speech
activity are bigher than these of direct motor reactions.
The most effective method in this respect is very simple : for this purpose
it is sufficient to cancel the motor reactions of the child by asking him to react
to each signal with appropriate words—to pronounce the word "press" in
response to each positive signal and the words "don't press" in response to each
inhibitory signal. Experiments performed on numerous children with the
cerebro-asthenic syndrome demonstrate that a child who makes many impulsive
motor reactions to inhibitory signals when the conditions of the experiment
are relatively complicated, will, under the same experimental conditions, make
no mistakes, but will be able to pass rapidly from a positive verbal response to
an inhibitory one at tbe presentation of corresponding stimuli, if asked to giv<*
verbal and not manual responses. [Fig. 3b).
These experiments show that, if in these cases the neurodynamics of the
speech processes are relatively intact (Fig. 3c.), they may be successfully
utilized for compensating the neurodynamic defects in the motor processes
of the child.
For thi.s purpose we combine the motor and verbal reactions of thr child;
we ask the child to pronounce the word "press" and simultaneously to press
the balloon at the presentation of the po.sitive signal, and, in response to the
inhibitory signal, to pronounce the words "don't press" and at the same time
to abstain from the act of pressing. In this way we bring the verbal response
closer to the motor reaction and utilize the relatively intact speech of the child
for the regulation of its motor reactions.
Experiments showed that in a considerable number of children with the
cerebro-asthenic syndrome this method produced a marked effect. Whereas
in the case of silent motor reactions the child under certain conditions effected
from 60 to 70 per cent of impulsive disinhibited pressures of the balloon, in
 A. R. LURIA 13

the case of combined verlial and inotor responses sucb movements were not
observed at all, or were reduced to 10-15 per cent; a subsequent return to silent
motor reactions again resulted in a predominance of the excitatory processes
and in the reappearance of inappropriate and uncontrolled impulsive reactions.
Here, too, exact measurements of the latent periods enable us to
approximate to the analysis of the mechanisms which underlie this influence
of speech; they .show that the latent periods in this experiment become longer,
that the general growth of excitability stops, and that speech acts in a regula-
tive way raising the tone of the inhibitory processes and modifying the
d> namics of excitability in the cortical apparatus (Fig. 4b).
Similar results may be obtained in those children with the cerebro-asthenic
syndrome in whom the weakness of the excitatory processes associated with a
distinct predominance of elementary forms of inhibition and who are well
known as children with a torpid form of this syndrome.
Any more or less marked complication of the experimental conditions leads
in such children to the disappearance of reactions to positive stimuli and, in
the end, to the disappearance of motor reactions in general; the mechanism
of this prtxiess consists in the steady increase of the latent periods, which
testifies to a considerable exhaustion of the excitatory processes.
As in tbe case of tbe excital)le children, inhibited children also will give
correct verbal responses even in experimental conditions which led to the
inhibition of motor reactions; the coinbination of verbal and motor reactions
tones up tbe activity of the child, and correct motor reactions, reinforced by
relatively normal speecb, persist even in these more complicated experiinental
conditions. The mechanism of this compensatory influence of speech,
apparently, consists in the heightened tone of the excitatory processes. In the
case of combined verbal and niotor reactions the latent periods are greatly
shortened, their growth being di.scontinued.
This shows that there exists a group of children with the cerebro-asthenic
syndrome, whose principal defect consists in their weakened basic nervous
proce.sses, as well as in the violation of the normal equilibrium between these
processes, and in whom a marked compensatory effect may be achieved with
the help of the regulating role of their relatively normal verbal system. How
this compensatory influence of speech manifests itself depends on the nature
of the disequilibrium between the basic nervous processes and on the kind of
nervous mechanisms underlying the neurodynamic defect under ol)servation.
We have dwelt on a numerous group of children with the syndrome of
cerebral asthenia, who exhil)it derangements in behaviour bearing a general,
diffuse character, and whose relatively normal speech processes make it possible
to find proper means for compensating their functional defect.
Our physiological analysis of the symptom proves to be equally effective
when the lesion, evoked by an inflammatory process or trauma, is not of a
14 HIGHER NERVOUS ACrilVITY OF ABNORMAL CHILD

diffuse, l>ut of local character; in such cases there develops a limited local
asthenia of certain cortical functions, and precisely the same methods enable
us to reveal the specific pathology of these or other functional systems.
For example, if the pathological process has deranged the normal activity of
the cortical parts of the auditory analy.sfr, the child is still able to produce
distinct reactions to optic signals, l)ut will display an appreciable derangement
of reactions to acoustic signals. In such cases the inclusion of verbal reactions
in the experiment leads to the compensation of the neurodynamic defects.
The disturbance of the cortical parts of the kinesthetic (motor) analyser
allows us to examine phenomena of functional cerebral asthenia of a different
kind. While producing relatively accurate differentiated reactions under any
of the just descril)ed conditions, such a child begins to reveal marked derange-
ments as soon as we pass to an experiment iti which it is necessary to
differentiate between two moveiiicnts differing in strength (for example, to
press the balloon with force in response to the red signal and without force
in response to the green signal). In this case, too, tbe inclusion of verbal
responses (the words "hard" and "gently") proves to he a factor regulating
the deranged work of the damaged motor analyser. In cases of very gross
lesions of the motor parts of tbe cortex such compensation witb the help of
speech remains unfeasible.
Tbe disturbance of cortical neurodynamics and the possibility of compensat-
ing for these dynamic di.sorders by tbe inclusion of the relatively more normal
.speech into the functional system is, therefore, both in its diffuse and local
forms, of great clinical importance.

IV
We have described the results of investigations carried out on children with
the cerel)ro-asthenic syndrome, in whom the pathological process entailed a
considerable derangement of the dynamics of the higher nervous processes, but
left relatively intact tbeir most complex forms connected witb the second
signalling system.
Can we expect that similar investigations will enable us to analyze another,
essentially different group of children, feeble-minded or oligophrenic children,
in wbom severe cerebral lesions endured in early (more often, intra-uterine)
childhood engendered profound derangements of the processes of abstraction
and conceptual thinking, and who cannot attend ordinary schools owing to
serious defects in their entire intellectual development?
Caimot we assume that the above mentioned methods will allow us to mark
out the specific features of this form of childhood anomaly and disclose its
underlying neurophysiological mechanisms?
 A. R. LURIA 15

Invcstifjatioiis carried out in recent years jointly willi a group <>l our
collaborators (M. S. Pevzner, V. I. Lul)ovsky, A. 1. Mescheriakov, E. N. Mart-
sinovskaya), as well as by a number of Soviet physiologists, showed that the
dynamics of the higher nervous processes in oligophrenic cliildren are really
characterized by certain gross derangements and that these peculiar features
essentially distinguish this group of children from the above described children
with the cerebro-asthenic syndrome.
Just as in the children described above, and to a still greater degree, the
strength of the nervous processes in oligophrenics proves to be markedly lower;
this finds expression not only in the fact that the overwhelming majority of
oligophrenic children rapidly develop a pronounced state of fatigue, but also
in their impaired formation of complex systems of connections and in their
still more impaired retention of these connections. It is sufficient sometimes to
give such children an instruction containing two or several components (for
example, simultaneously to put out the tongue and to close the eyes, or to
press the balloon in response to red and green signals and to abstain from
this action in response to white and blue signals), and it becomes quite clear
that the accomplishment of this task is beyond their powers. Each connection
established in this way, owing to negative induction, inhibits the neighbouring
connection, and the entire functional system evoked by this instruction
collapses.
In oligophrenics, just as in the al)ove described children, the equilibrium
I)etween the two nervous processes may be greatly deranged; this is why we
often meet liighly excitable and highly inhibited oligophrenics.
However, their characteristic feature is the severely disturbed mobility of
their nervous processes and, what is of importance, that all the above
mentioned changes are not confined to the most elementary forms of the higher
nervous activity, but considerably extend to the complex connections of the
second sij^nalUni; system. These changes make even the speech processes much
more defective than the simjiler forms of l)ehaviour which have been mentioned
earlier; they profoundly disturb the regulatory function of speech, the normal
state of which has been .stressed when analysing the above described syndrome
of cerebral asthenia.
We can prove this liy a series of very simple experiments which, however,
yield quite conclusive results in oligophrenic children.
If we ask a child suffering from a severe form of oligophrenia to pres.s the
balloon in response to each order or to each conditioned signal, we shall see
that its motor reactions are easily separated from the signal and the child
begins to produce a number of inert, perscverated movements. (Fig. 5a).
We can observe the symptoms of this inertia also in children with milder
forms of oligophrenia.
 16 HIGHER NERVOUS ACTIVITY OF ABNORMAL CHILD

Motor responses
press press press press press

Verbal responses

(b)

Fig. 5. Motor reactions in oligophrenic child

(a) Inertness in simple reactions (14 years old)

(b) Inertness: returning to the first (reverted) system after a pause (12 years old)

If we ask such a child to press the halloon at the appearance of a red signal
and to abstam from pressing it m response to a green signal, it will ea.sily
comply with this task; with similar ease will the child fulfil after that another
task—to act in a reverse way, i.e., to press the balloon in response to a green
light and not to press it at the presentation of a red signal. However, if in the
course of the experiment a strong hell is heard, acting on the child as an
external inhibiting agent, the new, reshaped system will disintegrate and give
way to the old, inert connection. The same will he observed if upon reshaping
the connection we interrupt the experiment for 2 or 3 minutes and after a
short interval resume it again. In this case we clearly see that the newly
established second connection has disappeared, and that the child has returned
to the previous, well-established connection, again pre.ssing the balloon in
response to a red signal and abstaining from it in response to a green signal.
(Fig. 5b).
 A. R. LURIA 17

Sonietinies the inertness of the more .stable, old coiiiicctioii is manifested also
in the fact that it reappears in the child's verbal .system, thereby inhibiting the
new, less stable verl)al connection.
If we go on with our experiment and replace the just mentioned instruction
by a new one. asking the oligophrenic child to pres:s the halloon in response to
a long (optic or acoustic) signal and to abstain from pressing it in response to
a similar short signal, this inertia will assume a still more pronounced character;
we shall see that tho child, properly fulfilling the instruction, when asked what
action it performs, will stuhhoriily answer that it presses the lialloon in response
to a red signal and abstains from pre.ssing it in response to a green signal,
though these colours no longer figure in the experiment and Cjuite a difTerent
factor has been imparted a signalling property. This experiment clearly shows
that in these cases pathological inertia may manifest itself with particular force
ill thr verbal .system, whose neurodynamics lag far behind the dynamics of
the motor processes. Somotiincs this inertia m the verbal system proves to be so
considerable that the child under investigation, having successfully reversed
the practical system of reactions, still retains the previously estahlished inert
stereotype in the verhal system; the child, for example, claims that it "pressed
when the light was on for long and did not press when it was on for a short
time", although in fact the child long ago hegan to fulfil a diametrically
opposite task.

Pathological inertia of the nervous proce.sses which are manifested in direct

motor reactions and to a still greater degree in the system of verbal connections,
leads to the clinically important fact of dissociation of speech and motor
reactions, or, as we often cal! it. dissociation of thf two signalling .systems.
This can he experimentally induced with the help of a very simple method.
If we elaborate, in an oligophrenic child, a reaction to one of the just men-
tioned instructions (for example, to press the balloon in response to a long
signal and not to pre.ss it in response to a short signal), and then if we modify
ihe usual course of the experiment hy a repeated presentation of hoth signals
in strict alternation, there wiil very soon arise an inert stereotypy in the child,
which will replace the correct reactions hy a mere alternation of positive and
inhibitory reactions. In these cases the oligophrenic child will ('xhil)it a simple
motor "stereotypy of alternation", at the same time, however, continuing as
inertly to state that it fulfils the given instruction quite properly.
It is characteristic that this may inertly repeat itself even when the child is
offered a very simple task—to react to definite words pronounced hy the
experimenter (for example, "tree", "boy", "horse", "tahle") with one of the
two following attributes—"alive", or "not alive". As shown by the observations
of A. I. Mescheriakov, in these cases, too, it suffices to pronounce the names of
ihe given objects several times, strictly alternating the animate and inanimate
lH HIGHER NERVOUS A C T I V n Y OF ABNORMAL CHILD

ones, and tbe oligophrenic child begins to react to them not with meaningful
responses, but with a stereotypy alternation of the attributes "alive" and "not
alive", divorced from tbe stimulus words spoken by tbe experimenter.
Tbis pathological inertia of once established verbal connections and the
simultaneously arising pathological dissociation of the two signalling systems
constitute a specific feature of tbe bigher nervous activity in oligopbrenic
cbildren; it leads to tbe gravest defects in their mental processes and determines
tbe extreme difficulties with wbicb tbeir training is connected. Not witbout
reason one of the oldest Soviet defectologists once complained that some
cbildren with grave forms of oligophrenia, who firmly memorized the rules :
"After a fuil stop tbe word must begin with a capital letter: when there is
a question mark, tbe voice should l)e raised", at tbe next lesson in arithmetic
read the text of the problem as follows : "Mary had two apples. Full stop.
After a full stop tbe word must begin witb a capital letter. Peter had one
apple. Full stop. Aft:'r a full stop tbe word must begin with a capital letter.
How many apples bad Mary and Peter together? Question mark. When there
is a ({uestion mark, tbe voice should t)C raised ! . . ." Tt is quite clear tbat tbis
pathological inertia, which is tbe most characteristic feature of the liigber
nervous activity in an oligopbrenic child, creates considerable additional diffi-
culties for tbe teacher.
However, tbe pathological inertia of tbe higher nervous processes in an
oligophrenic child, which tells with particular force upon the verbal system,
not only prevents tbe child from fulfilling the given task in a conscious way.
Its still more pernicious effect consists in tbe fart that it f)revrvts the child from
any creative, intellectual activity.
To illustrate this, we iiuist modify the usual methods of our experiment.
This lime we do not give tbe child any preliminary verl)al instruction which
fully discloses tbe action to be performed. We accompany each presentation
of a signal by an additional verbal order, saying the word "press!" after tbe
presentation of each red (or protracted) signal, and "don't press!" after eacb
green {or sbort) signal; thus we shall leave tbe elaboration of a respective
connection to the child itself.

Experiments based on tbe application of tbis method (widely known in the

LT.S.S.R. as the "method of verbal reinforcement" elaborated by Professor A. G.
Ivanov-Smolensky) sbow that already a child aged from 5 to 6 rapidly
generalizes the order it receives by formulating a rule. "It is necessary to press
wben the signal is red (or long) and not to press when it is green (or sbort)!"
Subsequently the child intermediates tbe presentation of eacb signal by sucb
verbally formulated rules. When the experimenter passes to a new system of
signals, the child immediately resorts to its active speech, trying with the help
 A. R. LURIA 19

of verbal stippositions to orient itself in the new situation and to find a solution
of the new task.
Naturally, such use of speech as an orienting factor miparts a specific
character to the formation of a new connection, highly accelerating its elabora-
tion, making tbe newly established connection mobik- and generalized.
Is sucb an active participation of tbe child's own speech in the i-laboratio!!
of new comiections possible in the case of oligopbrenics ?
Practice shows that sucb an active, orienting role of speech is evident in
oligophrenic children only in the most elementary problems, and usually, only
in tbe first experiments. By elaboratitig with the help of the method just
describ'.'d a positive reaction to a red signal and an inhibitory reaction to a
green signal, we ([uite soon obtain in the oligopbrenic child a generalized rule :
"it is necessai-y to press wben there is a red light, and not to press wlien the
light is green". However, as soon as we pass to our subsequent experiments,
especially to the more complicated ones, in which tbe child must inhibit tbe
previously coupled connections and orient itself in a new situation, tbe picture
essentially cbanges : the previous verbal foriiuiiation, owing to the ineitia ol
processes in the verbal system, persists, and speech, far from belping tbe t hild
to orient itself in tbe new situation, even binders tbe transition from its previous
experience to the elaboration of new connections.

Tbis is particularly manifest in cases when we expect the child lo jjertorm

more complex forms of analysis and synthesis, for example, when we positively
reinforce each protracted yellow signal and ncgativelv reinforce each short
yellow signal : there the child must inhibit tbe property of colour which has
lost its significance and mark out the property of duration uliith has assumed
a signalling character. This task, easily solved by a normal child witb the belp
of the active abstracting and generalizing function of speecb, sometimes creates
insurmountable difficulties for an oligophrenic child. Tbe speech of the latter,
wbich is inert and whose function of abstraction and generalization is in-
complete, is not properly included in tbe analysis of the new situation; often
it stubbornly retains the previous stereotypy wbicb bas already lost its signifi-
cance; sometimes instead of establishing a new elective connection, it crudely
generalizes the order of the experimenter, as a result of which after tbe
reinforcement of tbe positive signal by the order "press!" tbe child begins in
a generalized way to press the balloon in response to all signals, and after the
order "don't press!" accompanying the negative signal, ceases to press the
l)alloon altogether or it presses the balloon witbout any signal after certain
periods of time (Fig. 5 and 6).
Naturally, under tbese conditions, wben active speech no longer partici-
pates in tbe formation of temporary connections, the elaboration of new
temporary connections in oligophrenic cbildren assumes a mecbanical and
 20 HIGHER NERVOUS ACTI\'1TY OF ABNORMAL CHILD

w II ir II
Rainforcemcnt NO R&inforcQm&nt

(b)

G-

Extra ' Stimulus

Fig. 6. Instability nf inhibition in an oligophrenic child 10 years old.

(a) Exhauslion of inhibitory processes after cessation of icinfoicemeni
(b) The same after an extra-siimulus (loud bell)

protracted character; in numerous ca.se.s we could ob.serve how such connectioii.s

were elal)orated in oligophrenic children only gradually, after 70 or 80 coni-
hiiiations, how they were easily destroyed after the discontirutancc of con.stant
reinforcemt-nt (Fig. 6a), after a short interval, or under the influence of any
extraneous stimulus acting as an external inhibiting agent (Fig. 6b), Most
interesting in these experiments is the fact that even after the elaboration of
a relatively stable connection the child cannot realize and verbally formulate
the connections practically established by it long ago.
Can we expect in these conditions to compensate the profound defect of
formation of temporary connections in an oligophrt'iiic child by the .same
method which has lieen successfully applied when compen.sating the defect of
excitatory and inhibitory proce.sses in children with the cerebro-asthenic
syndrome?
The very fact of the pathological inertness of the verbal system, which was
repeatedly stressed as a characteristic feature of the higher nervous processes
in oligophrenic children, makes us profoundly doubt such a possibility.
 A. R. LURIA 21

(A)

Simple Motor Reaction (Choice)

Combu7ed Motor and Speech Reactions

(verbal store-type!)

-8S -86

Combined Motor and Spc<zch Reactions

fB)

(a)

+ + - t
Simpte Mot^r Keactions (Choice)

(b)

"U U U—-i—U—L——I U,^

+ + - + - —
Combined Speech and Motor Reactions
Fig. 7. Deficit of nrsanization nf motor reactions b\- means nf speech in
children.
(A) Disinhibition as a result nf nonspecific influence of speech in a feeble-
minded child (10 years old)
(B) The same In an imbecile child [14 years old)
in both cases: a—motor reaction without speech;
b-—motor reaction with the child's own speecli)
22 HK;HER NERVOUS ACTnri'i' OF ABNORMAL CHILD
Experiments carried out with this aim fully answer this question. They
showed, first of all, that in a nuiiil)er of cases even a merp attempt to switch
the oligophrenic child over from motor reactions to verljal responses proved to
he very difficult; while exhibiting a well established system of motor reactions,
the oligophrenic child, owing to the pathological inertness ol' the nervous
processes, readily returns in these conditions to the stereotyped system of verbal
responses.
It is quite easy to understand that the combination of inert motor reactions
with still more inert verbal responses presents in these cases a very complicated
task, and that these two links often inhibit each other by way of negative
induction. It is likewise easy to understand that the comtiination of motor aiid
verbal reactions, creating additional difficulties for oligophrenic children, does
not compensate, but, on the contrary, still more aggravates the defects which
had been evident in the usual experiment carried out in silence (Fig. 7a).
Characteristic also is the fact that when (in spite of all these difficulties) we
succeed in combining the motor and verbal reactions of the oligophrenic child,
the ver!)al reactions do not produce any regulatory effect, owing to the weak-
ness of the complex, elective connections which lie behind the oligoplirenic's
words, in which therefore a direct impulsive role clearly predominates. While
repeating the order "don't press!" in a loud voice, the child simultaneously
makes an impulsive movement of pressing the balloon which is not inhibited,
l)ut intensified, by this non-specific, exciting influence of the verbal response
(Fig. 7h).
It is clear that our experimental research was of doul)ie benefit ; firstly, it
actually helped us to mark out the principal features of the physiology of the
higher nervous activity in oligophrenic children, and secondly, having disclosed
the basic mechanisms of these disturbances, it enabled us to facilitate the
diflerential diagnosis between oligophrenics and the cerebro-asthenic syndrome,
wliicli in children often present considerable difficulties.
The experimental study of the abnormal child, which reveals the specific
features of its higher nervous processes, is still at its initial stage of development.
Countless special researches still await us ahead.
However, it is obvious that this objective analy.sis of physiological
mechanisms underlying clinical symptoms opens up great new possibilities. By
marking out tbe principal symptoms of pathological disturbances, by studying
their physiological mechanisms, we earnestly try to make a new, substantial
advance towards a scientifically grounded psychopathology of childhood and
its related pedagogics. Our experience, the results of which have been presented
here, gives us grounds for believing that studies uniting clinical medicine,
psychology and pbysiolo.gy, which have demonstrated their effectiveness in
other problems of medicine, may ensure further advances in the study of the
abnormal child^this important and particularly humane branch of knowledge.