Dynamic Assessment of a Clever Boy with Learning Inhibitions*

Ekstein (1969) noted that for a child to be ready to learn formally at school he must have acquired basic trust, autonomy, the capacity to accept controls from outside, inner and outer discipline and socialised initiative. It will become clear from the diagnostic assessment that Terry had not reached such a state, but rather that there were truly pathological difficulties with regressions and fixations to or at the level where there was no learning readiness and where the solution of a task was made impossible because of the lack of a capacity for resolution of any conflict. In the environment of which he was a part his problems could not be recognised until he was thrust into the school situation. The complex phenomena of learning impotence within the school and social setting could then be seen as an expression of the total personality distortion, stultifying development and interfering seriously with all his relationships.

Terry was referred to the hospital at the age of eight years from two sources; from his general practitioner who was concerned about his somewhat bizarre behaviour, his isolation and lack of social relationships; from his school, where his inadequacy in the school situation had become even more apparent with his transfer to the junior department. Originally he had been seen when he was six years old by the paediatricians at the hospital for complaints of recurring sick headaches for which no physical cause was discovered. His mother had appreciated that the headaches were related to Terry's reluctance to attend school where he was considered to be educationally sub-normal. He could not read, write, nor had he any concept of number when he moved to the junior school. He was reported to be a difficult pupil, mostly withdrawn and likely to be violent if pressure were put on him to participate in class activities. However, his new headmistress was impressed by his considerable oral ability and she persuaded him to dictate his disturbingly unreal fan