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The Story of Genie Wiley

What her tragic story revealed about language and development

Who Was Genie Wiley?

Why was the genie wiley case so famous, did genie learn to speak, ethical concerns.

While there have been a number of cases of feral children raised in social isolation with little or no human contact, few have captured public and scientific attention, like that of Genie Wiley.

Genie spent almost her entire childhood locked in a bedroom, isolated, and abused for over a decade. Her case was one of the first to put the critical period theory to the test. Could a child reared in utter deprivation and isolation develop language? Could a nurturing environment make up for a horrifying past?

In order to understand Genie's story, it is important to look at what is known about her early life, the discovery of the abuse she had endured, and the subsequent efforts to treat and study her.

Early Life (1957-1970)

Genie's life prior to her discovery was one of utter deprivation. She spent most of her days tied naked to a potty chair, only able to move her hands and feet. When she made noise, her father would beat her. The rare times her father did interact with her, it was to bark or growl. Genie Wiley's brother, who was five years older than Genie, also suffered abuse under their father.

Discovery and Study (1970-1975)

Genie's story came to light on November 4, 1970, in Los Angeles, California. A social worker discovered the 13-year old girl after her mother sought out services for her own health. The social worker soon discovered that the girl had been confined to a small room, and an investigation by authorities quickly revealed that the child had spent most of her life in this room, often tied to a potty chair.

A Genie Wiley documentary was made in 1997 called "Secrets of the Wild Child." In it, Susan Curtiss, PhD, a linguist and researcher who worked with Genie, explained that the name Genie was used in case files to protect the girl's identity and privacy.

The case name is Genie. This is not the person's real name, but when we think about what a genie is, a genie is a creature that comes out of a bottle or whatever but emerges into human society past childhood. We assume that it really isn't a creature that had a human childhood.

Both parents were charged with abuse , but Genie's father died by suicide the day before he was due to appear in court, leaving behind a note stating that "the world will never understand."

The story of Genie's case soon spread, drawing attention from both the public and the scientific community. The case was important, said psycholinguist and author Harlan Lane, PhD, because "our morality doesn’t allow us to conduct deprivation experiments with human beings; these unfortunate people are all we have to go on."

With so much interest in her case, the question became what should be done to help her. A team of psychologists and language experts began the process of rehabilitating Genie.

The National Institute of Mental Health (NIMH) provided funding for scientific research on Genie’s case. Psychologist David Rigler, PhD, was part of the "Genie team" and he explained the process.

I think everybody who came in contact with her was attracted to her. She had a quality of somehow connecting with people, which developed more and more but was present, really, from the start. She had a way of reaching out without saying anything, but just somehow by the kind of look in her eyes, and people wanted to do things for her.

Genie's rehabilitation team also included graduate student Susan Curtiss and psychologist James Kent. Upon her initial arrival at UCLA, Genie weighed just 59 pounds and moved with a strange "bunny walk." She often spat and was unable to straighten her arms and legs. Silent, incontinent, and unable to chew, she initially seemed only able to recognize her own name and the word "sorry."

After assessing Genie's emotional and cognitive abilities, Kent described her as "the most profoundly damaged child I've ever seen … Genie's life is a wasteland." Her silence and inability to use language made it difficult to assess her mental abilities, but on tests, she scored at about the level of a 1-year-old.

Genie Wiley's Rehabilitation and the Forbidden Experiment

She soon began to rapidly progress in specific areas, quickly learning how to use the toilet and dress herself. Over the next few months, she began to experience more developmental progress but remained poor in areas such as language. She enjoyed going out on day trips outside of the hospital and explored her new environment with an intensity that amazed her caregivers and strangers alike.

Curtiss suggested that Genie had a strong ability to communicate nonverbally , often receiving gifts from total strangers who seemed to understand the young girl's powerful need to explore the world around her.

Psychiatrist Jay Shurley, MD, helped assess Genie after she was first discovered, and he noted that since situations like hers were so rare, she quickly became the center of a battle between the researchers involved in her case. Arguments over the research and the course of her treatment soon erupted. Genie occasionally spent the night at the home of Jean Butler, one of her teachers.

After an outbreak of measles, Genie was quarantined at her teacher's home. Butler soon became protective and began restricting access to Genie. Other members of the team felt that Butler's goal was to become famous from the case, at one point claiming that Butler had called herself the next Anne Sullivan, the teacher famous for helping Helen Keller learn to communicate.  

Genie was partially treated like an asset and an opportunity for recognition, significantly interfering with their roles, and the researchers fought with each other for access to their perceived power source.

Eventually, Genie was removed from Butler's care and went to live in the home of psychologist David Rigler, where she remained for the next four years. Despite some difficulties, she appeared to do well in the Rigler household. She enjoyed listening to classical music on the piano and loved to draw, often finding it easier to communicate through drawing than through other methods.

After Genie was discovered, a group of researchers began the process of rehabilitation. However, this work also coincided with research to study her ability to acquire and use language. These two interests led to conflicts in her treatment and between the researchers and therapists working on her case.

State Custody (1975-Present)

NIMH withdrew funding in 1974, due to the lack of scientific findings. Linguist Susan Curtiss had found that while Genie could use words, she could not produce grammar. She could not arrange these words in a meaningful way, supporting the idea of a critical period in language development.

Rigler's research was disorganized and largely anecdotal. Without funds to continue the research and care for Genie, she was moved from the Riglers' care.

In 1975, Genie returned to live with her birth mother. When her mother found the task too difficult, Genie was moved through a series of foster homes, where she was often subjected to further abuse and neglect .

Genie’s situation continued to worsen. After spending a significant amount of time in foster homes, she returned to Children’s Hospital. Unfortunately, the progress that had occurred during her first stay had been severely compromised by the subsequent treatment she received in foster care. Genie was afraid to open her mouth and had regressed back into silence.

Genie’s birth mother then sued the Children’s Hospital of Los Angeles and the research team, charging them with excessive testing. While the lawsuit was eventually settled, it raised important questions about the treatment and care of Genie. Did the research interfere with the girl's therapeutic treatment?

Psychiatrist Jay Shurley visited her on her 27th and 29th birthdays and characterized her as largely silent, depressed , and chronically institutionalized. Little is known about Genie's present condition, although an anonymous individual hired a private investigator to track her down in 2000 and described her as happy. But this contrasts with other reports.

Genie Wiley Today

Today, Genie Wiley's whereabouts are unknown; though, if she is still living, she is presumed to be a ward of the state of California, living in an adult care home. As of 2024, Genie would be 66-67 years old.

Part of the reason why Genie's case fascinated psychologists and linguists so deeply was that it presented a unique opportunity to study a hotly contested debate about language development.

Essentially, it boils down to the age-old nature versus nurture debate. Does genetics or environment play a greater role in the development of language?

Nativists believe that the capacity for language is innate, while empiricists suggest that environmental variables play a key role. Nativist Noam Chomsky suggested that acquiring language could not be fully explained by learning alone.

Instead, Chomsky proposed that children are born with a language acquisition device (LAD), an innate ability to understand the principles of language. Once exposed to language, the LAD allows children to learn the language at a remarkable pace.

Critical Periods

Linguist Eric Lenneberg suggests that like many other human behaviors, the ability to acquire language is subject to critical periods. A critical period is a limited span of time during which an organism is sensitive to external stimuli and capable of acquiring certain skills.

According to Lenneberg, the critical period for language acquisition lasts until around age 12. After the onset of puberty, he argued, the organization of the brain becomes set and no longer able to learn and use language in a fully functional manner.

Genie's case presented researchers with a unique opportunity. If given an enriched learning environment, could she overcome her deprived childhood and learn language even though she had missed the critical period?

If Genie could learn language, it would suggest that the critical period hypothesis of language development was wrong. If she could not, it would indicate that Lenneberg's theory was correct.

Despite scoring at the level of a 1-year-old upon her initial assessment, Genie quickly began adding new words to her vocabulary. She started by learning single words and eventually began putting two words together much the way young children do. Curtiss began to feel that Genie would be fully capable of acquiring language.

After a year of treatment, Genie started putting three words together occasionally. In children going through normal language development, this stage is followed by what is known as a language explosion. Children rapidly acquire new words and begin putting them together in novel ways.

Unfortunately, this never happened for Genie. Her language abilities remained stuck at this stage and she appeared unable to apply grammatical rules and use language in a meaningful way. At this point, her progress leveled off and her acquisition of new language halted.

While Genie was able to learn some language after puberty, her inability to use grammar (which Chomsky suggests is what separates human language from animal communication) offers evidence for the critical period hypothesis.

Of course, Genie's case is not so simple. Not only did she miss the critical period for learning language, but she was also horrifically abused. She was malnourished and deprived of cognitive stimulation for most of her childhood.

Researchers were also never able to fully determine if Genie had any pre-existing cognitive deficits. As an infant, a pediatrician had identified her as having some type of mental delay. So researchers were left to wonder whether Genie had experienced cognitive deficits caused by her years of abuse or if she had been born with some degree of intellectual disability.

There are many ethical concerns surrounding Genie's story. Arguments among those in charge of Genie's care and rehabilitation reflect some of these concerns.

"If you want to do rigorous science, then Genie's interests are going to come second some of the time. If you only care about helping Genie, then you wouldn't do a lot of the scientific research," suggested psycholinguist Harlan Lane in the NOVA documentary focused on her life.

In Genie's case, some of the researchers held multiple roles of caretaker-teacher-researcher-housemate. which, by modern standards, we would deem unethical. For example, the Riglers benefitted financially by taking Genie in (David received a large grant and was released from certain duties at the children's hospital without loss of pay). Butler also played a role in removing Genie from the Riglers' home, filing multiple complaints against him.

While Genie's story may be studied for its implications in our understanding of language acquisition and development, it is also a case that will continue to be studied over its serious ethical issues.

"I think future generations are going to study Genie's case not only for what it can teach us about human development but also for what it can teach us about the rewards and the risks of conducting 'the forbidden experiment,'" Lane explained.

Bottom Line

Genie Wiley's story perhaps leaves us with more questions than answers. Though it was difficult for Genie to learn language, she was able to communicate through body language, music, and art once she was in a safe home environment. Unfortunately, we don't know what her progress could have been had adequate care not been taken away from her.

Ultimately, her case is so important for the psychology and research field because we must learn from this experience not to revictimize and exploit the very people we set out to help. This is an important lesson because Genie's original abuse by her parents was perpetuated by the neglect and abandonment she faced later in her life. We must always strive to maintain objectivity and consider the best interest of the subject before our own.

Frequently Asked Questions

Genie, now in her 60s, is believed to be living in an adult care facility in California. Efforts by journalists to learn more about her location and current condition have been rejected by authorities due to confidentiality rules. Curtiss has also reported attempting to contact Genie without success.

Along with her husband, Irene Wiley was charged with abuse, but these charges were eventually dropped. Irene was blind and reportedly mentally ill, so it is believed that Genie's father was the child's primary caretaker. Genie's father, Clark Wiley, also abused his wife and other children. Two of the couple's children died in infancy under suspicious circumstances.

Genie's story suggests that the acquisition of language has a critical period of development. Her case is complex, however, since it is unclear if her language deficits were due to deprivation or if there was an underlying mental disability that played a role. The severe abuse she experienced may have also affected her mental development and language acquisition.

Collection of research materials related to linguistic-psychological studies of Genie (pseudonym) (collection 800) . UCLA Library Special Collections, Charles E. Young Research Library, University of California, Los Angeles.

Schoneberger T. Three myths from the language acquisition literature . Anal Verbal Behav. 2010;26(1):107–131. doi:10.1007/bf03393086

APA Dictionary of Psychology. Language acquisition device . American Psychological Association.

Vanhove J. The critical period hypothesis in second language acquisition: A statistical critique and a reanalysis .  PLoS One . 2013;8(7):e69172. doi:10.1371/journal.pone.0069172

Carroll R. Starved, tortured, forgotten: Genie, the feral child who left a mark on researchers . The Guardian .

James SD. Raised by a tyrant, suffering a sibling's abuse . ABC News .

  NOVA . The secret of the wild child [transcript]. PBS,

Pines M. The civilizing of Genie. In: Kasper LF, ed., Teaching English Through the Disciplines: Psychology . Whittier.

Rolls G.  Classic Case Studies in Psychology (2nd ed.). Hodder Arnold.

Rymer R. Genie: A Scientific Tragedy.  Harper-Collins.

By Kendra Cherry, MSEd Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."

The Feral Child Nicknamed Genie

Sad case of child abuse sheds light on language production versus comprehension..

Posted July 10, 2017 | Reviewed by Jessica Schrader

Genie was born to deranged parents. Her father was extremely intolerant of loud noises and didn't want children, but he and his wife ended up having babies. Lots of them. Most of them died from child neglect. Genie was one of few who survived.

Because of her father's sensitivity to noice and lack of care for others, Genie spent the first 13 years of her life strapped to a potty or a chair in a homemade straightjacket. If she made any noise whatsoever, her dad would beat her with a baseball bat. She was never spoken to. She was a true feral child.

When Child Protective Services finally intervened, Genie had virtually no physical abilities beyond those of a toddler. She was severely underweight and couldn't speak.

Linguist Susan Curtiss befriended her and attempted to teach her language and challenge her mental abilities. Susan Curtiss quickly learned that Genie was highly intelligent. She was able to tell sophisticated stories, not in words, but in pictures. Using pictures, she could tell intricate narratives.

Susan Curtiss worked with Genie to teach her English. Genie soon developed a rather large lexicon and was able to express herself. But despite extensive training, she remained unable to produce grammatical sentences. Here is a transcript of one of her reports of her time in the hands of her father:

Father hit arm. Big wood. Genie cry ... Not spit. Father. Hit face—spit ... Father hit big stick. Father angry. Father hit Genie big stick. Father take piece wood hit. Cry. Me cry.

Despite the tragedy that surrounds the case of Genie, her case teaches us an important lesson about language abilities. Telling a story (not necessarily in a grammatical way or even by using words) as well as understanding language are very different from being able to produce grammatical sentences in a language.

The language areas of the brain are actually divided between Wernicke's area and Broca's area (among other important language facilitating areas). Wernicke's area sits on the left side of the head (just above the ear) in the temporal lope, whereas the Broca area is located at the beginning of the frontal part of the brain (a bit further front). Wernicke's area is responsible for understanding speech and other communicative signals, whereas Broca's area is mainly in charge of producing grammatical sentences (alongside the motor area, which is needed to express what you want to say verbally—using lip movement and gestures, for instance).

The case of Genie confirms that there is a certain window of opportunity that sets the limit for when you can become relatively fluent in a language. Of course, if you already are fluent in another language, the brain is already primed for language acquisition and you may well succeed in becoming fluent in a second or third language. If you have no experience with grammar, however, Broca's area remains relatively hard to change: you cannot learn grammatical language production later on in life. But the abilities to understand language and produce language in ways that do not rely on grammar largely make use of Wernicke's area in the temporal lope. This area is capable of expanding and rewiring throughout life—even after the teen years. The case of Genie confirms this. Grammar was beyond reach for her. But language comprehension and storytelling were not.

The takeaway of this tragic case sits well with the established idea that Wernicke's area in the brain—the area for language comprehension—absorbs various languages and meaningful signals in a unified way, whereas the Broca area—the area of the brain that is in charge of grammatical speech production—stores native (or first) languages and (second) languages learned later in life in separate areas.

Berit "Brit" Brogaard is an author of The Superhuman Mind .

Berit Brogaard, D.M.Sci., Ph.D. , is a professor of philosophy and the Director of the Brogaard Lab for Multisensory Research at the University of Miami.

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• A unique opportunity to study a unique individual in great detail.
• A unique case that may not be generalisable to the whole population.
• It is not known what underlying abnormalities Genie may have had when she was born. Her father stated that she was 'mentally retarded', but we only have his word for that. We can never know, therefore, if Genie failed to develop skills in all areas including language because of her privation or because she was born with an underlying learning difficulty.
• Genie was studied at length by the researchers who adopted her, and she formed a degree of attachment to them. However it could be argued that they treated her unethically by using her as a research subject instead of simply giving her the love and caring she needed. It is possible that the researchers had their own agendas that were not completely in Genie's best interests.
• The twins were discovered at the age of 7 which may explain why they recovered from the effects of privation where Genie, who was discovered at the age of 13, did not.
• The twins were not completely isolated as they had each other. Being able to form an attachment to another person, in this case the other twin rather than a caregiver, may have protected them from some of the negative effects of privation.
• Although the twins developed to be described as 'above average', it is not known how well they may have developed had they not suffered privation, and so it is not known exactly how well the negative effects were reversed.
• Again, this is a case study of unique individuals and so the findings may not be generalisable to the whole population.

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Genie – The Feral Child

What do you think of when you hear the words, “feral child?” You might have come across a feral cat or feral dog at a shelter, but feral children are not anywhere near as common. They seem to only exist in stories, like The Jungle Book or Tarzan. You might be surprised to learn that not all feral children are raised in the wilderness by wolves or gorillas. Some modern cases of feral children, like the case of Genie, are still alive today. Genie’s story is one of mental health, forbidden experiments, and the failures of society to protect people who have been left behind.

Who Is Genie?

Genie was a child who was born healthy, but raised in an environment with severe neglect and abuse. Due to this, she was unable to learn how to speak and function in society. Genie is used as an example of feral child syndrome and has been studied in developmental psychology. 

Feral children may grow up in the wilderness, completely abandoned by their parents. They may also grow up in a home, like Genie did. Genie, born Susan Wiley, was born in April 1957 to parents Clark and Dorothy Wiley. Dorothy was 90% blind, and had migrated to California from Oklahoma during the Dust Bowl. Clark was the son of a brother owner, who had been bounced around from foster home to foster home his whole life.

Genie was born at a healthy weight and height. She had a five-year-old brother with allegedly no developmental disabilities. In her infancy, Genie appeared fairly normal. She was, however, diagnosed with a congenital hip dislocation. The issue resulted in Genie wearing a splint through her infancy and delays in walking. At the time, Genie’s father Clark believed that his child had mental disabilities, along with physical. Many psychologists believe that Clark felt that he had to protect Genie, partially explaining his horrific behavior later in Genie’s life. Others believe that Clark was delusional, spurred by intense feelings of rage and grief after the death of Clark’s mother. At 20 months old, Genie’s family moved into Clark’s mother’s home, and Genie was shielded from the world for the next 12 years.

(Her childhood home is featured on this Reddit post .)

Severe Neglect and Abuse

This isolation is what made Genie a “feral child.” During the day, Clark strapped Genie to a child’s toilet with a diaper and DIY straightjacket. At night, Genie was confined to a crib, bound by wires.

She failed to develop language, partially because she never attended formal education, but also partially because her father would growl and bark at Genie like a dog. If Genie (or any member of the family) were to make any sort of noise or fuss, Clark would beat them with a plank. Although Genie’s mother claimed that Clark would feed Genie three square meals a day, these meals consisted of baby food. Clark would spoon-feed Genie, sometimes rubbing her face in the food.

Clark ran his household like a cult, and was extremely paranoid. He continued to threaten his wife, and only allowed his son to leave the house to go to school. When his son came back to the house, he had to identify himself in various ways to be let in. Clark would sit in the living room with his shotgun on his lap, sometimes falling asleep in front of the front door with said shotgun.

When Genie’s brother was 18, he ran away from home. That year, Genie and her mother were allowed out of the house after a huge fight with Clark. Genie’s mother brought Genie into what she thought was a state office to apply for disabilities. Her near-blindness led her to the state social services office. Upon seeing Genie, who was severely malnourished and had a strange “bunny walk” (with her hands poised at her chest like a bunny,) employees thought that the girl was 6 or 7 - she was almost 14. Genie was taken into protective care and her parents were arrested.

Clark committed suicide before he could go to court and face his crimes. All charges against Genie’s mother were dropped after she cited that the abuse she suffered from Clark prevented her from being able to care for Genie. Her case made national headlines, and because she was a minor, her true name was never used in stories. Instead of Susan Wiley, the “Wild Child” became known as “Genie.”

Studies on Language Acquisition

One distinct feature of feral children is that they never develop a first language. Genie could only understand a handful of words when she first examined at the Children’s Hospital Los Angeles. Her ability to speak was limited further. Eerily, the two phrases linguists recorded her saying were “no more” and “stop it.”

Genie became infamous not only because her case was one of the most horrific incidents of child abuse in modern history, but also because her situation was known to psychologists as a “forbidden experiment.” At the time that Genie was rescued from her parents, Noam Chomsky’s theory of innateness was popular in the linguistic psychology world. Chomsky believed that humans have an innate ability to acquire language. His theory of universal grammar appeared to support the idea that language is wired into our brains. Think nature, rather than nurture.

This theory can be supported to a degree, but experts could not prove universal grammar or innate language acquisition through experiments with children. Isolating one child from language for the sake of a psychological study, much less enough children to prove the theory, is highly unethical. Genie provided researchers a unique chance to look at the way that language is developed or stunted due to nature or nurture. From the moment that Genie was rescued, she was examined. An entire team of researchers visited her for years, sometimes on a daily basis. They monitored her brain activity, observing that she had an estimated mental age of a 5- to 8-year-old. Her linguistic development was that of a 1- or 2-year-old. She exhibited bizarre behaviors, some that could be explained by her childhood and others that appeared to have no explanation. Many questions, including that of whether she really had a mental disability like her father suggested, have gone unanswered.

This is partially due to the custody battles and ethical questions that went on throughout Genie’s later teenage years. The first “foster home” that Genie had was the home of her special education teacher, Jean Butler. Butler butted heads with the scientists who were observing Genie throughout her teenage years. Some questioned Butler’s intentions, even recalling Butler saying that Genie could make Butler “the next Anne Sullivan.” (Anne Sullivan is known for being Helen Keller’s teacher. Their story has been told in countless movies.)

David Rigler, the chief psychologist at Children’s Hospital Los Angeles, took custody of her next. He observed her behavior and worked with her for many years. During this time, she was able to learn some sign language and communicate through drawings. But her foster care with David Rigler ended at the age of 18. Throughout her teens, Genie had been in contact with her mother. At 18, she moved back in with her mother. Genie’s father was dead, but living with her mother was not the happy ending that anyone would have hoped for. Within a year, Genie’s mother sued many of the researchers involved in Genie’s case. She claimed that the researchers had crossed boundaries, breached confidentiality agreements, and overworked Genie. The next year, her mother forbade any of the research team from interacting with or studying Genie. But she also relinquished care of Genie, leaving her to be bounced around from foster home to foster home. When the researchers did try to reach out or find Genie, they were often disappointed to hear that she was not making the progress that she had been making as a teenager.

Where Is Genie Now?

Genie is only in her 60s now. She remains a ward of the state, and has not been in direct contact with the researchers that studied and took care of her after her rescue. Investigators who looked into her well-being reported back that she was happy, and although she didn’t use much verbal communication, she did take to sign language.

Still Many Questions to Be Answered

When Genie was rescued in the 1970s, researchers jumped at the opportunity to work with a “forbidden experiment.” Their passion for the research, and their eventual attachment and care for Genie, ultimately ended in unfinished work and estrangement from Genie. To this day, one researcher has repeatedly tried to make contact with her. Many researchers were drawn to Genie’s charisma, despite her being nonverbal and developmentally delayed due to severe childhood trauma.

What does Genie’s case say about innate language acquisition? It depends on who you ask. Some say that her case is evidence for innate language acquisitions . Others argue that the case supports the critical-period hypothesis, which argues that we can “tap into” our innate ability to acquire language, but only during a specific period of development.

Nature vs. Nurture

What about nature vs. nurture ? The jury is out on this one, too. Although the cruelty and trauma endured by Genie undoubtedly slowed her development, other research argues that her developmental disabilities were also due to her genetic makeup. If she did have mental and developmental disabilities, like her father believed as an infant, the impact of his cruelty would be a less prominent factor in her delays.

Genie is far from the only case of recent feral children, but is one of the most infamous. Her case also shows that issues of ethics and great debates in psychology are more blurry than they appear on paper.

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Genie Wiley, the Feral Child

Tom Need / Getty Images

• Archaeology

• Ph.D., Psychology, Fielding Graduate University
• M.A., Psychology, Fielding Graduate University
• B.A., Film Studies, Cornell University

Genie Wiley (born April 1957) was a severely neglected and abused child who was discovered and taken into custody by authorities when she was 13 years old. While her circumstances until that point were undeniably tragic, they also presented an opportunity for psychologists, linguists, and other researchers to study psychosocial, emotional, and cognitive development in an individual who had suffered from severe social isolation and deprivation. In particular, the discovery of Genie presented an opportunity to study whether a child who was past the so-called "critical period" for language acquisition could learn to speak a first language.

Key Takeaways: Genie Wiley

• Genie Wiley was abused and neglected for over a decade until she was discovered in 1970 when she was 13 years old.
• Known as the feral child, Genie became an important subject of research. Of special interest was whether she could acquire language, as she was no longer within the "critical period" for language development.
• Genie's case presented an ethical dilemma between prioritizing her care or prioritizing research on her development.

Early Life and Discovery

The case of Genie Wiley came to light on November 4, 1970. Genie was discovered by a social worker when her mother, who was partially blind, went to apply for social services. Genie had been isolated in a small room starting at the age of 20 months until her discovery at 13 years and 9 months old. She spent most of her time naked and tied to a potty chair where she was given limited use of her hands and feet. She was completely cut off from any kind of stimulation. The windows were curtained and the door was kept closed. She was only fed cereal and baby food and wasn’t spoken to. Although she lived with her father, mother, and brother, her father and brother would only bark or growl at her and her mother was only permitted very brief interactions. Genie’s father was intolerant of noise, so no TV or radio was played in the house. If Genie made any noise, she was physically beaten.

Upon her discovery, Genie was admitted to Children’s Hospital of Los Angeles for evaluation. She was severely underdeveloped. She was thin and looked like a child of six or seven. She couldn’t stand up straight and could only walk with a hunched “bunny walk.” She was unable to chew, had trouble swallowing, and spat frequently. She was incontinent and mute. At first, the only words she recognized were her name and “sorry.” Testing shortly after she came to the hospital revealed that her social maturity and mental abilities were at the level of a one-year-old.

Genie didn’t walk at a normal age, so her father came to believe she was developmentally disabled. However, the researchers brought onto the case after Genie’s discovery found little evidence of this in her early history. It appeared she never suffered from brain damage, mental disability, or autism. Therefore, the impairments and developmental delays Genie exhibited upon being assessed were the result of the isolation and deprivation she was subjected to.

Both of Genie’s parents were charged with abuse , but Genie’s 70-year-old father committed suicide the day he was supposed to appear in court. The note he left said, “The world will never understand.”

The Rush to Research

Genie’s case drew media attention as well as great interest from the research community, which considered it a rare opportunity to discover whether it was possible for Genie to mentally develop after such severe deprivation. Researchers would never deliberately conduct deprivation experiments with people on moral grounds. So, Genie’s sad case was ripe for study. Genie was not the child’s real name, but the name given to the case in order to protect her privacy.

The National Institute of Mental Health (NIMH) provided funding for research and a team was assembled whose goal was to rehabilitate and study Genie’s progress. Genie soon learned basic social skills like using the toilet and dressing herself. She was fascinated by her environment and would study it intensely. She especially enjoyed visiting places outside the hospital. She was talented at nonverbal communication, but her ability to use language did not proceed rapidly. As a result, psychologist David Rigler decided to focus the research on Genie's language acquisition.

Language Acquisition

The discovery of Genie coincided with a debate about language acquisition in the scholarly community. Linguist Noam Chomsky, from the Massachusetts Institute of Technology, claimed humans are born with an innate ability to develop language. He believed language isn’t acquired because we learn it, but because it’s part of our genetic inheritance. Then, neuropsychologist Eric Lenneberg added a caveat to Chomsky’s ideas. Lenneberg agreed that humans are born with the ability to develop language, but suggested that if a language wasn’t acquired by puberty, it might never be. Lenneberg’s proposal was called the “critical period hypothesis.” Yet, there was no ability to test the theory until Genie came along.

Within the first seven months after her discovery, Genie learned many new words . She had even begun to speak but only in single words. By July 1971, Genie could put two words together and by November she could put together three. Despite signs of progress, Genie never learned to ask questions and she didn’t seem to understand the rules of grammar.

After beginning to speak in two-word phrases, normal children experience a language “explosion” a few weeks later in which speech develops quickly. Genie never experienced such an explosion. Her speech seemed to plateau at creating two to three-word strings, despite four years of additional work and research with her.

Genie demonstrated that it’s possible for an individual to learn some language after the critical period. Yet, her inability to learn grammar, which Chomsky believed was key to human language, indicated that passing the critical period was detrimental to the complete acquisition of a first language.

Arguments and Ethical Considerations

During Genie’s treatment, there were disputes amongst the members of her team. In the early days after her discovery, she entered her first foster home with her teacher Jean Butler. Butler claimed she felt that Genie was being subject to too many tests and attempted to make changes to Genie’s treatment. She wouldn’t allow the linguist Susan Curtiss or the psychologist James Kent into her house to see Genie. Other team members claimed Butler thought she could become famous through her work with Genie and didn’t want anyone else to get credit. Butler’s application to become Genie’s permanent foster parent was rejected about a month later.

Psychologist David Rigler and his wife Marilyn stepped in and fostered Genie for the next four years. They continued to work with her and let others continue their research throughout that time. However, Genie left the Riglers’ home after NIMH stopped funding the project due to problems with data collection.

Throughout the four years in which Genie was being tested and studied, there was debate about whether she could be a research subject and a rehabilitation patient at the same time. The ethics of the situation were murky.

In 1975, Genie’s mother regained custody after being acquitted of all charges of child abuse. Genie’s care quickly became too much for her to handle, though, so Genie began to bounce from foster home to foster home. She was once again subjected to abuse in those homes. Soon, she stopped talking and refused to open her mouth entirely.

Meanwhile, Genie’s mother filed a lawsuit against Genie’s team and the Children's Hospital alleging that the researchers prioritized testing Genie over her welfare. She contended that they pushed Genie to the point of exhaustion. The case was eventually settled but the debate continues. Some believe the researchers exploited Genie, and therefore, didn’t help her as much as they could have. However, the researchers say they treated Genie to the best of their ability.

Historian and psychologist Harlan Lane points out that “there's an ethical dilemma in this kind of research. If you want to do rigorous science, then Genie's interests are going to come second some of the time. If you only care about helping Genie, then you wouldn't do a lot of the scientific research. So, what are you going to do?”

Genie Today

Genie is believed to be alive and living in an adult foster home as a ward of the state of California. While the linguist who worked with Genie, Susan Curtiss, has attempted to get in touch with her, she’s been repeatedly rebuffed. However, she said that when she calls the authorities, they inform her that Genie is well. Yet, when journalist Russ Rymer saw Genie at her 27 th birthday party, he painted a much bleaker picture. Similarly, psychiatrist Jay Shurley, who was at Genie’s 27 th and 29 th birthdays, claimed Genie was depressed and had withdrawn into herself.

• Cherry, Kendra. “Overview of Feral Child Genie Wiley.” Verywell Mind , 9 March 2019. https://www.verywellmind.com/genie-the-story-of-the-wild-child-2795241
• Pines, Maya. "The Civilizing of Genie." Teaching English Through the Disciplines: Psychology , edited by Loretta F. Kasper. Whittier Publications, 1997. http://kccesl.tripod.com/genie.html
• NOVA. "Secret of the Wild Child." PBS , 4 March, 1997. https://www.pbs.org/wgbh/nova/transcripts/2112gchild.html
• Fromkin, Victoria, Krashen, Stephen, Curtiss, Susan, Rigler, David, and Rigler, Marilyn. "The Development of Language in Genie: A Case of Language Acquisition Beyond the 'Critical Period'" Brain and Language , vol. 1, no. 1, 1974, pp. 81-107. http://dx.doi.org/10.1016/0093-934X(74)90027-3
• Carroll, Rory. "Starved, Tortured, Forgotten: Genie, the Feral Child Who Left a Mark on Researchers." The Guardian , 14 July 2016. https://www.theguardian.com/society/2016/jul/14/genie-feral-child-los-angeles-researchers
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She hobbled into a Los Angeles county welfare office in October 1970, a stooped, withered waif with a curious way of holding up her hands, like a rabbit. She looked about six or seven. Her mother, stricken with cataracts, was seeking an office with services for the blind and had entered the wrong room.

But the girl transfixed welfare officers.

At first they assumed autism. Then they discovered she could not talk. She was incontinent and salivated and spat. She had two nearly complete sets of teeth - extra teeth in such cases are known as supernumeraries, a rare dental condition. She could barely chew or swallow, and could not fully focus her eyes or extend her limbs. She weighed just 59lb (26kg). And she was, it turned out, 13 years old.

Her name – the name given to protect her identity – was Genie. Her deranged father had strapped her into a handmade straitjacket and tied her to a chair in a silent room of a suburban house since she was a toddler. He had forbidden her to cry, speak or make noise and had beaten and growled at her, like a dog.

It made news as one of the US’s worst cases of child abuse. How, asked Walter Cronkite, could a quiet residential street, Golden West Avenue, in Temple City, a sleepy Californian town, produce a feral child – a child so bereft of human touch she evoked cases like the wolf child of Hesse in the 14th century, the bear child of Lithuania in 1661 and Victor of Aveyron, a boy reared in the forests of revolutionary France?

Over time, Genie slipped from headlines – Vietnam was burning, the Beatles were in the midst of breaking up – but she retained the attention of scientists, especially linguists. She was a prize specimen for having grown up without language or social training. Could she now learn language?

Jostling for access, they took brain scans and audio recordings, performed countless tests, compiled reams of data, published papers. And gradually they, too, with a few exceptions,...

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Genie Wiley: A Story of Abuse, Rescue, and Lingering Questions

• by Psychologs Magazine
• January 9, 2024
• 5 minutes read

People who are passionate about the academic discipline of psychology will surely be aware of the multiple controversial experiments that have been conducted throughout its history. Most of these experiments had ethical and moral considerations. Some of the most infamous and unethical experiments that psychologists have ever designed and implemented include the Little Albert Experiment, Milgram’s Prison experiment etc.

Through this article, however, we are delving deep, not into an unethical experiment that was conducted by the pioneers of the discipline, but rather into the intricacies of a case study that turned eyes towards the fate of feral children. Genie Wiley was a feral child who was raised with no human contact and was forced to spend over a decade locked and abused in her bedroom and was later rescued. Hers became the first case to be used to test the critical period theory in developmental psychology. To understand her case, we need to delve deep into the nuances of her life story.

Read More: The Psychology Behind Morality

The Case of Genie Wiley

Genie’s existence before her discovery was one of complete deprivation. She spent the majority of her days strapped naked to a potty chair, only able to move her hands and feet. When she made a noise, her father beat her. Her father’s interactions with her were limited to barking or growling. Genie’s narrative was revealed on November 4, 1970, in Los Angeles, California. A social worker discovered the 13-year-old kid when her mother sought help for her health. The social worker discovered that the girl had been confined to a small room, and an investigation by authorities swiftly revealed that the youngster had spent the majority of her life in this room, often tied to a potty chair. Both of Genie’s parents were charged in court for abuse.

Read More: Understanding the Role of Psychiatric Social Workers

However, Genie’s father committed suicide the day before his scheduled court appearance, leaving behind a note that said, “The world will never understand.” The tale of Genie’s case quickly spread, gaining attention from both the general public and the scholarly world. Harlan Lane, PhD, who was an author and a renowned psycholinguist later quoted this case to be groundbreaking and highly significant for research in the discipline since “our morality does not allow us to conduct deprivation experiments on humans; these unfortunate people are all we have to go on.”

Read More: Suicide Awareness: Unveiling the Truth

Her State After Being Rescued

Her rehabilitation team noted that when Genie first arrived at UCLA, she weighed only 59 pounds and moved with a weird “bunny walk.” She spat frequently and was unable to straighten her arms and legs. She was silent, incontinent, and unable to eat at first, appearing to recognize only her name and the word “sorry.” They described Genie as “the most profoundly damaged child I’ve ever seen,” based on her emotional and cognitive capacities. “Genie’s life is a wasteland.”

Her quietness and inability to communicate made it difficult to judge her mental capacities, but on tests, she performed at the level of a one-year-old. She quickly progressed in certain areas, learning how to use the toilet and dress herself. Over the next three months, she made more developmental gains, but her verbal skills remained weak. She adored going on day outings outside of the hospital and exploring her new surroundings with the zeal that astounded her carers and outsiders alike. The theories of nativism and that of the earlier mentioned critical period come up into question as soon as we discuss Genie’s case. Nativism is a renowned theory in psychology that believes and propagates that language or the ability to handle language present in human beings is innate for every individual.

While various behaviourists, during those days of the discipline development claimed that language is learnt through the various proposed models of learning, nativists like Noam Chomsky, who was also a linguist, argued that acquiring language in human beings is an innate process, i.e., each person is born with a language acquisition device that would aid them completely in acquiring and using the language. Once the child at a young age is exposed to their mother tongue or any other language for that matter, the Language Acquisition Device that they are mentally equipped with would completely take over the process of language.

Linguist Eric Lenneberg contends that, like many other human behaviours, the ability to acquire language is subject to critical periods. A critical period is a limited period during which an organism is sensitive to external stimuli and capable of learning specific skills. According to Lenneberg, the key time for language acquisition lasts until approximately age 12. He argued that once puberty sets in, the brain’s organization becomes fixed, and it is no longer capable of learning and using language fully functionally. Despite scoring at the level of a one-year-old on her initial evaluation, Genie quickly expanded her vocabulary.

She began by memorizing individual words and gradually progressed to combining two words. Following a year of treatment, she began to form three-word sentences on occasion. In children undergoing normal language development, this stage is followed by a language explosion. Unfortunately, this never occurred to Genie. Her language skills were stalled at this point, and she appeared unable to apply grammatical principles or utilize language in a meaningful way. Her progress stalled at this time, and her learning of a new language came to an end. This provides great evidence for the propagation of critical period theory.

The National Institute of Mental Health which had earlier provided the funds to the rehabilitation team to conduct scientific research to comprehend the linguistic and developmental intricacies of Genie’s life, now retrieved the funds once and for all in 1974, given the fact that there were no much scientific findings. Further, it was found that the main researcher under which Genie was left to be “studied”, a renowned linguist Susan Curtiss, had conducted her research in a disorganized and anecdotal manner which was not quite useful in addition to the required scientific findings.

In 1975, Genie went back to live with her birth mother. When her mother found the work too tough, Genie was placed in a series of foster homes, where she was frequently subjected to additional cruelty and neglect. Genie’s circumstances worsened. She returned to Children’s Hospital after being in foster care for a long time. Unfortunately, the progress made during her first stay was greatly hampered by the subsequent treatment she got in foster care. Genie was terrified to speak and had relapsed into silence.

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https://www.verywellmind.com/genie-the-story-of-the-wild-child-2795241

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History Uncovered Episode 36: Genie Wiley, The ‘Feral Child’

In one of the most infamous cases of child abuse in modern American history, Genie Wiley was isolated and terrorized for 13 years before she was finally rescued from her father's horrifying clutches.

In October 1970, a woman walked into a Los Angeles welfare office with a child at her side. The woman had walked into the wrong room — she was looking for services for the blind — but the girl who was with her caught the welfare workers’ attention. They didn’t know it yet, but one of the worst victims of child abuse in U.S. history had just walked through their door.

The girl, who appeared to be seven or eight years old, was actually 13, but clearly malnourished and undersized. She had a fluttering, unfocused gaze, she couldn’t speak, and she walked only in a strange bunny hop.

Soon, authorities discovered that this girl — since given the alias Genie Wiley in case files — had spent most of her life up until that point bound and locked away in isolation, either chained to a training toilet or confined in a crib-like cage. From the time she was an infant, her father had subjected her to this severe abuse; meanwhile, her mother simply ignored it.

Wikimedia Commons Genie Wiley was returned to foster care after the research on her ended. She regressed in these environments and never regained speech.

Believing Genie to be mentally disabled, her father locked her away and forbade anyone from engaging with her in any way. He tied her naked to a potty chair or threw her into a crib covered with chicken wire. Genie’s father deprived her of stimulation or affection, beat her with a wooden board, and fed her only milk or Pablum, a processed cereal for babies.

After welfare workers rescued her, Genie became a case study for researchers at UCLA’s Children’s Hospital. They studied how the abuse had impacted her, attempted to see if she had the capability to learn and speak, and began to care deeply for this fragile teenager.

Eventually, Genie the “feral child” started to get better. She even started communicating in halting, choppy phrases about her abusive father, saying:

“Father hit arm. Big wood. Genie cry… Not spit. Father. Hit face — spit. Father hit big stick. Father is angry. Father hit Genie big stick. Father take piece wood hit. Cry. Father make me cry.”

But these years in the hands of researchers and doctors offered only a reprieve — not an escape — from the nightmare that was Genie’s life. Eventually, conflict would tear her care team apart and Genie would be sent to foster care, then to adult home care. Today, she’s a ward of the state of California, her whereabouts and condition unknown to the public.

Discover the full story behind the tragic life of Genie Wiley .

Learn more about the music used in our podcast. History Uncovered is part of the Airwave Media network . Learn more about your ad choices by visiting megaphone.fm/adchoices .

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Genie Wiley’s Case Study: Implications for Critical Period Hypothesis and Child Abuse and Neglect

Genie wiley- case study.

Genie Wiley was a young girl who was kept in severe isolation and abuse for most of her childhood, restricting her ability to learn language, social skills, and normal emotional expressions. As a result, she suffered from severe mental and physical disabilities that lasted throughout her life. Her case study is often cited in studies related to the critical period hypothesis and the importance of early childhood experiences on cognitive and emotional development.

1) What is the critical period hypothesis?

The critical period hypothesis is a theory that states that there is a time during early childhood when the brain is most susceptible to developing certain cognitive and physical abilities. It is believed that if experiences critical to development do not occur during this period, it may be difficult or impossible for individuals to acquire certain skills later in life.

2) How did Genie’s early childhood experiences affect her cognitive development?

Genie’s early childhood experiences had a significant impact on her cognitive development. She was deprived of language stimulation and normal social interactions during her crucial developmental years, resulting in a lack of basic cognitive and social skills. As a result, she suffered from severe developmental delays, intellectual disabilities, and a limited ability to communicate with verbal language. Genie’s case is often used to study the effects of deprivation, neglect, and abuse on child development.

3) How might Genie’s case study inform our understanding of child abuse and neglect?

Genie’s case highlights the severe consequences of child abuse and neglect on a child’s cognitive, social, and emotional development. It is evident from her case that prolonged deprivation of normal social interactions can have a lasting impact on a child’s cognitive abilities. Her case emphasizes the importance of providing children with safe and nurturing environments where they can receive proper care and positive stimulation, particularly during their early childhood years.

4) What might have been done differently to help Genie during her childhood years?

In hindsight, several things could have been done differently to help Genie during her childhood years. She needed a safe, nurturing, and stimulating environment that provided her with love, attention, and social interaction. If she had been discovered earlier, she could have been placed in a foster home where she could have received specialized support and therapy. Furthermore, social workers and psychologists could have provided language and cognitive therapy to help her overcome her developmental setbacks.

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The Emotional Learner

Privation: Development in the absence of attachment

Deprivation refers to the breaking of the attachment bond once it had been established. As discussed in a previous article, this would include temporary separations, such as a brief stay in hospital, or permanent separations such as the death of a parent. The key point here (regardless of time length) is that the bond between…

Deprivation refers to the breaking of the attachment bond once it had been established. As discussed in a previous article , this would include temporary separations, such as a brief stay in hospital, or permanent separations such as the death of a parent. The key point here (regardless of time length) is that the bond between the child and the primary caregiver exists or had existed.

Privation refers to a situation where no attachment bond has ever had the opportunity to develop. Such cases are, thankfully, relatively rare and, because they are so rare, we rely on a very different kind of research method to investigate them.

While studies of maternal deprivation can look at large samples and correlate these samples with later outcomes, studies of privation must rely on case studies, that is, a detailed investigation of a single participant, a very small group of individuals.

Case studies are fairly common in psychological research and we have learned a great deal about cognitive and social functions from those small number of people who have suffered specific impairments in, for example, their short-term memory (and therefore their ability to create new memories). At the other extreme, a very small number of individuals have exceedingly good memories, some of them for specific things such as faces. By examining these extremes (these individual differences), we can learn a great deal more about how memory functions.

In the same way, by investigating the often tragic and heart-wrenching lives of individuals who have never been provided with the opportunity to bond with another human being, we begin to learn more about how attachment functions and how individuals thrive or flounder when raised in extremely challenging conditions.

Stories abound of children surviving in the absence of any kind of attachment figure, from fictional characters such as Tarzan and Mowgli to real life feral children who have seemingly survived hardship against all odds. Some have been kept in confinement while others have seemingly been raised by non-human primates, wolves, dogs and even sheep. While the validity of some of these stories remains tenuous at best, there are many modern and well-documented accounts of feral children who have suffered varying levels of privation, abuse and neglect and survived to lead relatively normal lives. Others, however, haven’t fared as well, lacking the ability to learn language and other cognitive skills as well as physical and psychological impairment.

Case Study 1: The Bulldog Banks Six

The first example was documented by Anna Freud and Sophie Dann in 1951 and involved a group who became known as the Bulldog Banks children, six refugees discovered by Russian troops at the Terezin concentration camp in what is now the Czech Republic.

It is believed that the children were orphaned at only a few months old and, therefore, had little or no time to form any adult attachments. While at the reception centre for refugee children in Windermere, it was decided that all six of the children should stay together. They were eventually housed at the Bulldog Banks Centre in West Sussex.

The care of the children was placed in the hands of sisters Sophie and Gertrud Dann, who had been brought to the centre from the Hampstead nursery run by Anna Freud (sixth and youngest daughter of Sigmund Freud). Two other members of staff (Maureen Wolfison and Judith Gaulton) had previously been at the Windermere centre.

It’s impossible to imagine the existence the six children (aged between three and four years) had endured during their short lives and their behaviour certainly reflected the environment in which they had been raised – to use the term loosely. They could be highly aggressive and spit and hit or smack adults who attempted to restrict their movements or behaviour; they had no idea what toys were for and would regularly destroy them.

Their language skills were limited, which perhaps increased their levels of aggression and hostility and they would only engage with staff if they needed something. They were, however, devoted to each other and displayed a heightened sense of fairness, for example, insisting that each member of the group received the same share of food at mealtimes.

Leadership was passed around the group, with each child taking their turn. Staff noted that it was impossible to treat them as individuals due to their tight-knit connection to each other. In the camp they had been cared for by other inmates but the nature of life there meant that they never formed attachments to adults, indeed, in a 2016 interview one of the children (Bela Rosenthal) stated that being around adults was one of the hardest things she had to deal with at Bulldog Banks, ‘In the camp we only saw grown-ups when there was food,’ she said.

By 1946 all children had begun to display consideration and helpfulness to the staff, as well as identifying with adults in ways previously not seen. Eventually, it was decided that they were ready to be adopted and spent some time with prospective adoptive parents. On later follow-up investigations, the children appeared to have made good progress and were able to cope well with adult relationships.

There are a couple of important factors to note here. The first is that, while the children were never given the opportunity to attach to adults, they did have each other and, as noted, that bond was extremely strong. The second point is that, not only were the staff at the Bulldog Banks Centre sensitive to their needs, they were also continually available, providing at least some opportunity to experience a limited adult attachment.

Interestingly, this adult support is one factor that arises often in studies of both attachment and resilience. From James Robertson’s observation of young children in hospital to Emmy Werner’s longitudinal studies of the children of Kauai, this focus on a adult support seems to be a key component in supporting young people raised in adversity. But what if even this support is absent?

Case Study 2: Genie*

On November 4, 1970, a woman and her daughter visited a welfare office in Temple City, California to seek benefits for the blind. A social worker spoke with them and thought that the girl was six or seven years old and possibly autistic. When it was revealed that she was actually 13 years old, the social worker became concerned and called her supervisor, who then called the police.

It transpired that the daughter, identified only as Genie , had spent her life locked in her bedroom. During the day, she was tied to a child’s potty-chair in nappies; and most nights, she was bound in a sleeping bag and placed in an enclosed cot with a metal lid to keep her shut inside.

Her father would beat her every time she vocalised and he barked and growled at her like a dog in order to keep her quiet; he also forbade his wife and son to ever speak to her. She became almost entirely mute, and knew only a few short words and phrases, such as ‘stop it’ and ‘no more.’

At the age of 20 months, when Genie was just beginning to learn how to speak, a doctor had told her family that she seemed to be developmentally disabled and possibly mildly ‘retarded’. Her father took the opinion to extremes, believing that she was profoundly so, and subjected her to severe confinement and ritual ill-treatment in an attempt to ‘protect’ her. Following her discovery, her parents were charged with child abuse, and Genie was taken to hospital in Los Angeles.

Genie had developed a strange ‘bunny walk,’ held her hands up in front of her like paws, and constantly sniffed, spat and clawed. She was almost entirely silent. In spite of her condition, hospital staff hoped they could nurture her to normality. When interest in the case widened, Genie became the focus of an investigation to discover if there was a critical age threshold for language acquisition. Within a few months, she had advanced to one-word answers and had learned to dress herself. Her doctors predicted complete success.

The charges against Genie’s mother were dropped and in 1975, now at the age of 18, Genie was returned to her custody. After a few months, the mother found that taking care of Genie was too difficult, and she was transferred to a succession of six more foster homes. In some of the homes she was physically abused and harassed, and her development regressed severely, returning to her coping mechanism of silence.

Genie has spent the remainder of her life in foster homes and institutions. Now in her early 60’s, she remains a ward of the state of California, living her life in an undisclosed location. According to recent reports, she is only capable of uttering a few words but can communicate competently using sign language.

How are we to evaluate the case of the Bulldog Banks children with that of Genie? The focus of attention for researchers has mainly been concentrated on her stunted language development and the search for a critical period in its acquisition. However, there are other interesting, yet tragic, consequences to the story.

While Genie did show an interest in staff during her stay in hospital, she failed to develop any attachment to them or indeed appear to distinguish between people. She would sit on her mother’s lap when instructed to do so but appeared tense, rising quickly when allowed. Her mother appeared oblivious to her daughters’ emotions and actions, lacking any sensitivity or recognition of Genie’s needs. Her unusual social behaviour persisted throughout her life, improving and then regressing dependent upon the environment she found herself in.

The significant difference between Genie and the Bulldog Banks six is one of early social contact. While Genie was raised in near-complete isolation, the Bulldog Banks children had each other, allowing them to experience at least minimal social interaction. The latter group also received a more stable and caring upbringing during and after their arrival at the centre, while Genie was passed from one institution to another or lived in a succession of foster homes (where she was, at times, abused further).

Timing also plays a role. Genie was much older than the Bulldog Banks six so would most likely have past any sensitive period where certain social and cognitive abilities would form. Michael Rutter’s longitudinal study into Romanian orphans adopted by UK parents might also assist us here. Briefly, Rutter found that those children adopted at six months of age or younger showed fewer attachment difficulties than those adopted between six and twenty-four months.

Case Study 3: The Koluchová Twins

Andrei and Vanya are identical twin boys born in 1960. They are often referred to as the Koluchová twins after the Czech researcher Jarmilia Koluchová publicised their case in a number of academic papers. The Koluchová twins lost their mother shortly after birth, and were cared for by a social agency for a year, and then fostered by a maternal aunt for a further six months.

Their development up to this point appeared normal. Their father remarried, but his new wife appeared to dislike the twins, banishing them to the cellar for the next five and a half years and occasionally beating them. The father was often absent from home because of his job.

On discovery at the age of seven, the Koluchová twins were dwarfed in stature, lacking speech, suffering from rickets and did not understand the meaning of pictures. The doctors who examined them confidently predicted permanent physical and mental handicap.

Once removed from their parents, the Koluchová twins underwent a programme of physical remediation and entered a school for children with severe learning disabilities. After some time, the boys were legally adopted into a loving, supportive and caring family.

Both twins caught up with peers of the same age and achieved emotional and intellectual normality. After basic education they went on to technical school, training as typewriter mechanics, but later undertook further education, specialising in electronics. Both were drafted for national service and later married and had children. They are said to be entirely stable, lacking abnormalities and enjoying warm relationships. One is a computer technician and the other a technical training instructor.

The twins were discovered later in life, not as old as Genie but younger than the Bulldog Banks six. Despite losing their mother, they did appear to have a relatively stable life until being returned to their father, nevertheless, it would have been difficult to form permanent attachments within this time.

They did, of course, have each other and we can assume that the bond between them helped during their most difficult times. What distinguishes their experiences from those of Genie appears to have more to do with what happened after they were discovered. Like the Bulldog Banks six, the twins were provided with support and finally adopted into loving families. Genie’s life after her discovery was a series of foster homes and periods of hospitalisation and, in some cases, further abuse.

Many things, therefore, influence our later development and behaviour. Thankfully, most of us won’t suffer the trauma and anxiety witnessed in the above accounts, nevertheless, who we become and the nature of our behaviour is often rooted in our very early experiences with other people, particularly those who are expected to raise us with care and sensitivity.

These case studies also highlight the positive impact of sensitive nurturing and support in later childhood and how good relationships can help even the most wayward or psychologically traumatised individual.

*I have decided to use the name Genie despite her real name being released in the press recently.

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“Genie: Secrets of a Wild Child”: The Documentary Analysis

Genie was a federal child who, for thirteen years since her birth, had been extremely deprived of any form of emotional, moral, and social attachments. Neglected for thirteen years, Genie had no human contact, social behavior, or exposure to any human language. The girl was found in a small room, where she spent most of her time tied to her child’s toilet. The federal child who would be known as Genie was discovered in Los Angeles, California, around 1970. During this time, there were significant debates in the field of psychology. Although the experiment conducted on Genie has been deemed unethical, it ended some of the major psychological disputes regarding the language acquisition process.

One of the major questions involving “Genie: Secrets of a Wild Child” documentary is whether or not her behaviors had been inherited or influenced by her environment. Children need to be exposed to affection, human contact, and interaction in order for them to develop a strong sense of self. As such, the early stages of development are essential to every child’s growth. Children often socialize with micro-level members at an early age. Genie’s case is of profound importance as it shows the results when some fundamental levels of development are absent.

In general, nurture entails helping someone develop particular aspects which are essential to them. Human beings require support in order to develop their full potential. In other words, nurture plays a critical role in enhancing human behavior, personality, and intelligence. Hardwired by nature, humans have the capacity to develop fully; however, their growth is stifled when support is not provided. Genie was deprived of attention and time during her childhood, which are essential aspects of proper development. Humans are naturally capable of acquiring a new language, but Genie could hardly utter any word at thirteen. This phenomenon indicates that even though particular behavioral and cognitive abilities are naturally hardwired, they are enhanced by care and love.

The evidence that supports the importance of language acquisition in a child’s development is usually found in the rare cases of children who were not exposed to a language at an early age. A case example is Genie, who spent most of her early years in isolation. Genie’s imprisonment made it impossible for her to be exposed to social conversations. Although she later learned to utter a few words, Genie did not have enhanced cognitive abilities to acquire a full language. It was hard for her to fully acquire a language since she had not mastered the first language. As a result, Genie’s story supports the critical period hypothesis proposed by Noam Chomsky. Psychologists posit that effective learning of a language must happen before puberty (Mohamad & Rashid, 2018). Genie learned new utterances with trouble, and could not intelligently put them together to convey information.

One of the most significant theories used to educate Genie was Bandura’s social-cognitive learning theory. This theory maintains that humans can learn by observing other humans and deciding which behavior to mimic (Bandura, 2019). It also indicates that rewarded behaviors are more likely to be repeated and vice-versa. According to this theory, role models, especially teachers, are often imitated by their students (Bandura, 2019). This evidence is manifested in the case of Genie, who did not get the privilege to learn a language. Genie, however, would get the opportunity to perform simple tasks on her own such as taking a bath.

Further, Genie was able to learn by observing other people’s behaviors. Her ability to recall the behavior of those teaching her was remarkable. After reproducing the behavior, Genie would find a stimulus to repeat the action. For example, in a particular video of Genie’s teaching, she was caught watching her teacher’s actions. When asked to repeat the behavior, she did and received applause (Nilsen, 2017). It was easy to teach Genie using Bandura’s social-cognitive learning theory since it involved effective participation.

Several theories have been formulated to explain the stages of development in children. These theories can be classified as moral, emotional, or cognitive. Lawrence Kohlberg developed most moral development theories, while Erik Erikson advanced the emotional development theories. Jean Piaget, on the other hand, is attributed to the most common cognitive development theories. According to Turiel (2018), Lawrence Kohlberg’s theory of moral development comprises pre-conventional, conventional, and post-conventional stages. Kohlberg noticed that children start to discern right from wrong at the age of three years as a function of external punishment. As espoused by Kohlberg, a child reaches the conventional moral development level by the age of nine (Turiel, 2018). The conventional stage is marked by the child’s ability to see molarity as an integral part of society. At around nine years, they develop a belief that it is necessary to maintain positive relationships (Turiel, 2018). Genie, who spent thirteen years in confinement, did not have exposure to her environment. As such, her case falls under the pre-conventional stage of moral development, in which an action is judged based on the repercussions.

Additionally, Erikson studied both children and adults and classified them into various stages: love, will, purpose, competence, fidelity, love, care, and wisdom. According to Erikson’s theory, Genie is at the fidelity stage. Eriksen posits that if infants cannot trust adults, they tend to grow up lacking trust, a fundamental aspect of emotional development (Jones & Waite-Stupiansky, 2017). This stage of development explains why Genie would feel insecure around other people. Moreover, Piaget’s theory of cognitive development can explain a decent number of Genie’s traits. Piaget’s cognitive development theory focused on the way kids learn through experiments (Hanfstingl et al., 2019). Simple experiments that involve touching and tasting are usual among young children. This theory comprises preoperational, concrete operational, and formal operations stages. According to Piaget’s cognitive development theory, Genie falls in the formal operations stage, which consists of children above eleven years (Hanfstingl et al., 2019). Genie, for example, can easily learn by observing her teacher’s actions and mimicking them.

From a moral perspective, Genie, being subjected to an agonizing past, was unethical. She had the right to learn from the environment as part of her growth. However, Genie’s father kept her confined, claiming to be protecting her from the dangers of the outside world. Before she was rescued from her imprisonment, Genie had already skipped significant development stages. This ordeal had a severe impact on her emotional, moral, and cognitive development.

In addition to that, linguistics, psychiatrists, and psychologist used her as a human guinea pig for their own agendas. Considering that Genie could not communicate, she must have been involved in scientific studies without having expressed her consent, which is against the APA standards of consent (American Psychological Association, 2017). It was unethical for the researchers to take advantage of Genie’s under-developed cognitive abilities and conduct experiments on her.

In conclusion, “Genie: Secrets of a Wild” video shows the importance of various stages of development in a child’s growth. Genie is a federal child who is socially isolated for more than thirteen years. The story of Genie is an indication that while humans are naturally capable of acquiring new abilities by nature, for effective results, they require a caring and loving environment. Genie’s case provided researchers with a chance to gain more knowledge in controlling language acquisition skills. This video clarifies the importance of each language acquisition stage. Children, who skip some of the essential stages, as characterized by Genie, encounter challenges in learning new languages. The documentary also shows how nature and nurture are significant aspects in language acquisition.

American Psychology Association. (2017). Ethical principles of psychologists and code of conduct . Web.

Bandura, A. (2019). Applying Theory for Human Betterment. Sage Journal 14 (1), 12–15. Web.

Hanfstingl, B., Benke, G., & Zhang, Y. (2019). Comparing variation theory with Piaget’s theory of cognitive development: more similarities than differences? Educational Action Research , 27 (4), 511–526. Web.

Jones, E., & Waite-Stupiansky, S. (2017). The Eriksons’ psychosocial developmental theory. Theories of Early Childhood Education , 31-44. Web.

Mohamad, N. N., & Rashid, R. A. (2018). A review of theoretical perspectives on language learning and acquisition. Kasetsart Journal of Social Sciences , 39 (1), 161–167. Web.

Nilsen, K. (2017). Genie Wiley – TLC Documentary [Video]. YouTube.

Turiel, E. (2018). Moral Development in the Early Years: When and How. Human Development , 61 (4–5), 297–308. Web.

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Contradictions and unanswered questions in the 'Genie' case: a fresh look at the linguistic evidence

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This paper will discuss " Genie " (and briefly two other " wild " children). I will outline her case, the implications for language acquisition and the ethical dilemmas involved. Finally I will suggest an alternative approach to future cases like Genie that may be both ethical and valuable in terms of first and second language acquisition research.

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Abstract: Language is one of the classic examples of the sensitive periodicity of the brain. What it is known so far is that language has a critical period for learning. Babies and children are geniuses until they turn seven, and then there's a systematic decline in their ability to acquire languages. One of the most fascinating examples in this regards is the case of Genie, a young girl who for the first 13 years of her life underwent a degree of social isolation and experiential deprivation not previously reported in contemporary scientific history. A lot of laboratory work was done on this case, and linguists and scientists tries to address head-on hypothesis about language and human mind, however, new studies (2011-2015) indicate that early speech learning is not only limited by the critical period of the first years of life, but it is also severely limited in the absence of social interaction. Moreover, by the age of 5, prior to formal schooling, studies like Patricia Kuhl’s (2011) show that brain activation in the brain areas related to language and literacy are strongly correlated with the social environment of the child’s family. Therefore, scientifically speaking, more than anything Genie’s case proved that complete lack of social interaction has a devastating impact on human language learning, to the extent that normal language skills are never acquired.

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Dissecting the Legacy — What Really Happened to Genie Wiley?

Published Dec. 7 2023, 9:17 a.m. ET

• Genie Wiley is considered the most abused child in history.
• Discovered at 13 years old, Genie became a subject of language and cognitive development studies. Despite progress, she struggled with communication and faced challenges after the study.
• Post-experiment, Genie's life took a tragic turn in foster care. Experiencing further abuse, she regressed into silence, and her current whereabouts are unknown.

Some scientific cases might ring a bell to the average citizen — Pavlov’s dog (bell-ringing pun intended), Schrodinger’s cat, and the Stanford prison experiment are just a few of those mainstream experiments. But the story of Genie Wiley was also circulated for decades as she provided a unique opportunity for scientists.

Genie, a fake name given to protect her identity, is often considered the most abused child in history. Because of this, when she was discovered, she could barely walk, chew, or use the toilet. Most importantly, she couldn’t communicate at all. Scientists used her to study language and cognitive development, but the story doesn’t have such a happy ending. So, what happened to Genie Wiley?

Genie Wiley was extremely abused in her childhood.

Genie was born in April 1957 in Los Angeles, Calif. to an abusive father and a mother who couldn’t defend her. Genie’s mother, Irene, suffered from cataracts, which caused near-blindness and led her to fearfully depend on her husband, Clark. He was considered an abusive psychopath. His mother died when he was younger in a hit-and-run, after which he displayed psychopathic tendencies.

Of the four children Irene and Clark had, one died due to birth complications, one died as an infant locked in a cold garage, and the other two were Genie and her older brother, John. John was essentially Genie’s only caretaker. He fed her baby food, cereal, and milk at the instruction of his father, whom he also greatly feared. John wasn't allowed to speak to Genie.

During the day, Clark harnessed Genie naked to a toilet seat. If she made any sounds, he would beat her with wood. He only barked and growled at her, so Genie rarely heard anyone speak. At night, Genie was straitjacketed inside of a wire-mesh “crib” — essentially a cage.

Genie’s existence was discovered when Irene took her outside when Clark ran out for groceries. Irene was seeking a cure for her blindness and thought she walked into a blindness disability benefits office, but she instead went to social services. The social workers immediately noticed Genie’s strange behavior — her gait mimicked that of a rabbit, she drooled, was incontinent, and looked to be about 7 years old when she was actually 13.

Genie Wiley was “saved” by the social workers, but her whereabouts now are unknown.

At that point, Irene and Clark were arrested for child abuse, although Irene was released on account of being a victim as well. Clark took his own life at 70 years old just before he was due in court. His suicide note just said, “The world will never understand.” No, we won’t!

Genie was raised by doctors, psychologists, therapists, and more, from 1970 to 1975. She was admitted to Children’s Hospital Los Angeles, which applied for a grant to study her. Because withholding a proper childhood would be unethical, Genie’s case was a rare opportunity to study the possibilities of learning linguistics after early childhood.

She quickly learned basic skills, like going to the toilet and dressing herself, but she was never able to excel beyond stringing two to three words together at a time. And she never grasped grammatical concepts, despite linguists’ hard work to teach her. She was fostered by researcher and psychologist David Rigler and his wife, Marilyn, until 1975. At this point, Genie was about 18 years old and the grant had been revoked.

Genie was forced to move back in with her mother, who wasn't able to care for her, so she went into the foster care system. This led to more abuse and Genie regressed and didn't speak, although she was still able to communicate nonverbally. Now, however, it’s unknown where Genie is and if she’s still alive.

On her 27th and 29th birthdays, psychiatrist Jay Shurley said that Genie was “largely silent, depressed, and chronically institutionalized,” according to Very Well Mind . In 2000, a private investigator found that Genie was reportedly living in an adult care facility and was “happy.” Now, there’s no record of where she is, but if she’s still alive, she would be 66 years old.

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Outline and evaluate the effects of privation on children's development.

Outline and evaluate research in to privation.

Privation is when a child never forms attachment. A study of privation includes the case study of Genie and Czech twins. Genie was a young girl who was kept in isolation due to her father’s belief that she was mentally retarded, however as she was discovered at age 13, it was too late to test this. Because Genie never formed attachment, her level of speech was very low and even now, has not recovered as upon discovery she was kept in the care of many different psychologists and then was restored to her original home and kept under the care of her mother.  Another case study which looks at privation is the study of the Czech twins. The Czech twins were kept in an unheated closest and discovered at age 7. Because of their lack of attachment, they were unable to walk or have a grasp of basic speech. Unlike Genie, the twins were fostered in to a loving home and therefore, recovered and now live normal lives.

Another study which investigated privation is Hodges and Tizzard’s natural, longitudinal experiment. They studied 68 children who had all experienced privation due to bad institutional care. Over time, 24 of these children were adopted, 15 were restored to their previous homes, and the others stayed in the same institution. Hodges and Tizzard found that the children were adopted were able to form attachment, and those who were restored and stayed in same institution never formed attachment. Despite this, all children had difficulty forming peer relations.  

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In addition to this study, is a study done by Rutter. Rutter studied 111 Romanian children who all experienced one of the worst cases of institutional care ever recorded however, when the children that came to the UK and were adopted experienced reversal of the effects of privation such developmental dwarfism and insecure attachment  if adopted early enough (usually before 6 months).

A strength of the Genie and Czech twins study is that they are both case studies. Because case studies involve using many different experimental and non experimental techniques, they collect a lot of detailed research and therefore, increase understanding of privation which can generate even more research and psychological breakthroughs and therefore, both studies are strengthened overall.

However, the fact both of the studies is case studies is a weakness as case studies often focus on one particular rare case. Because of this, studies cannot be repeated and therefore, lack reliability and may in fact be incorrect. Therefore, the case studies of Genie and Czech twins are weakened.

Also, the study of Genie in particular may lack validity. As previously mentioned, Genie apparently experienced mental retardation and this could possibly be a reason for her lack of speech and not privation. Because of this, the case study lacks internal validity as researchers may not be measuring what they intended to- the effects of privation and therefore, is weakened as a study to investigate privation.

A weakness of Hodges and Tizzard’s study is the fact it is longitudinal. This means it takes place over a large period of time and therefore, participants drop out. This therefore may lead to sample bias as there may be only a certain type of person in the sample and thus, is not representative. Because of this, the research done by Hodges and Tizzard cannot be generalised to the public and is weakened.

Also, Hodges and Tizzard’s as well as Rutter’s study are both natural experiments and thus means there is a lack of control of variables. This means that the adopted children may not have recovered the effects of privation because of adoption, but may be because they had friendly personalities, or were more socialable and thus, were able to form attachment easier. Because of this, the studies lack internal validity as they may not truly be investigating privation and are weakened.

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Lateral alveolar ridge augmentation with autogenous tooth roots and staged implant placement—5-year follow-up case series.

1. Introduction

2. materials and methods, 2.1. study design, 2.2. inclusion criteria, 2.3. exclusion criteria, 2.4. therapeutic outcomes—alveolar ridge augmentation, 2.5. alveolar ridge augmentation surgery, 2.6. implant prosthodontic rehabilitation, 2.7. therapeutic outcomes—clinical measurements, 2.8. statistical analysis, 3.1. alveolar ridge augmentation outcomes, 3.2. clinical measurements, 4. discussion, 5. conclusions, author contributions, institutional review board statement, informed consent statement, data availability statement, conflicts of interest.

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Share and Cite

Bjelica, R.; Smojver, I.; Vuletić, M.; Gerbl, D.; Marković, L.; Gabrić, D. Lateral Alveolar Ridge Augmentation with Autogenous Tooth Roots and Staged Implant Placement—5-Year Follow-Up Case Series. J. Clin. Med. 2024 , 13 , 5118. https://doi.org/10.3390/jcm13175118

Bjelica R, Smojver I, Vuletić M, Gerbl D, Marković L, Gabrić D. Lateral Alveolar Ridge Augmentation with Autogenous Tooth Roots and Staged Implant Placement—5-Year Follow-Up Case Series. Journal of Clinical Medicine . 2024; 13(17):5118. https://doi.org/10.3390/jcm13175118

Bjelica, Roko, Igor Smojver, Marko Vuletić, Dražena Gerbl, Luka Marković, and Dragana Gabrić. 2024. "Lateral Alveolar Ridge Augmentation with Autogenous Tooth Roots and Staged Implant Placement—5-Year Follow-Up Case Series" Journal of Clinical Medicine 13, no. 17: 5118. https://doi.org/10.3390/jcm13175118

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• Open access
• Published: 28 August 2024

Historical and practical aspects of macular buckle surgery in the treatment of myopic tractional maculopathy: case series and literature review

• Francyne Veiga Reis Cyrino 1 ,
• Moisés Moura de Lucena 1 ,
• Letícia de Oliveira Audi 1 ,
• José Afonso Ribeiro Ramos Filho 1 ,
• João Pedro Romero Braga 1 ,
• Thais Marino de Azeredo Bastos 1 ,
• Igor Neves Coelho 1 &
• Rodrigo Jorge 1  

International Journal of Retina and Vitreous volume  10 , Article number:  60 ( 2024 ) Cite this article

Metrics details

Uncorrected myopia is a leading cause of blindness globally, with a rising prevalence in recent decades. Pathological myopia, often seen in individuals with increased axial length (AXL), can result in severe structural changes in the posterior pole, including myopic tractional maculopathy (MTM). MTM arises from tractional forces at the vitreoretinal interface, leading to progressive macular retinoschisis, macular holes, and retinal detachment (RD). This study aims to outline preoperative evaluation and surgical indication criteria for MTM, based on the MTM staging system, and to share our Brazilian experience with three cases of macular buckle (MB) surgery, all with over a year of follow-up.

We conducted a retrospective analysis of three cases of MTM-associated RD treated with MB surgery, with or without pars plana vitrectomy. Preoperative evaluations included optical coherence tomography (OCT) and ultrasonography (USG) to assess the extent of macular involvement and retinal detachment. Surgical indications were determined based on the MTM staging system. The MB was assembled using customizable and accessible materials. Surgical procedures varied according to the specific needs of each case. An informed consent form regarding the surgical procedure was appropriately obtained for each case. The study was conducted with the proper approval of the institution’s ethics committee.

All three cases demonstrated successful retinal attachment during the mean follow-up of eighteen months. In the first case, combined phacoemulsification, vitrectomy, and MB were performed for MTM with macular hole and RD. The second case required MB and vitrectomy after two failed RD surgeries. In the third case, a macular detachment with an internal lamellar hole was treated with MB alone. These cases highlight the efficacy of MB surgery in managing MTM in highly myopic eyes.

Conclusions

MB surgery is an effective treatment option for MTM-associated RD in highly myopic eyes, providing long-term retinal attachment. Our experience demonstrates that with proper preoperative evaluation and surgical planning, MB can be successfully implemented using accessible materials, offering a viable solution in resource-limited settings. Further studies with larger sample sizes are warranted to validate these findings and refine surgical techniques.

Introduction

Uncorrected myopia is considered one of the leading causes of blindness worldwide [ 1 ], and its prevalence has grown significantly in recent decades [ 2 ]. Specifically, in myopic individuals with increased axial length (AXL), structural changes may occur in the posterior pole that characterizes pathological myopia, including posterior staphyloma, myopic macular degeneration, optic neuropathy associated with myopia, and myopic tractional maculopathy (MTM) [ 3 , 4 ]. The incidence of pathological myopia increases with age but can also occur in younger patients [ 5 ]. The impact of myopic maculopathy lies in its frequent occurrence in both eyes, its irreversibility, and its potential to affect individuals of working age [ 6 ].

MTM is a specific condition of pathological myopia secondary to tangential and anteroposterior tractional alterations at the vitreoretinal interface, where the retina is unable to adapt to the progressive increase in AXL and ends up undergoing structural changes. Characteristically, it involves a progressive combination of macular retinoschisis, lamellar or full-thickness macular holes, and, ultimately, retinal detachment (RD) [ 1 ]. Hence, while antiangiogenic therapy is used to treat neovascular membranes and there is no treatment for atrophic changes, MTM, and its complications require precise surgical interventions, and Macular buckle (MB) surgery, with or without vitrectomy, is one of the surgical techniques options.

In this study, we present the historical aspects of MB, discussing preoperative evaluation and criteria for surgical indication. Hereby we also discuss our experience with MB surgery cases, describing the assembly of a customizable MB using accessible materials.

Historical context and evolution of the macular buckle

The surgical treatment of RD has undergone revolutionary advancements following the theory developed by Jules Gonin in 1921, which involved surgically blocking tears and breaks in the retina [ 2 ]. However, it was soon understood that cases of surgical failure were related to the traction exerted by the vitreous on areas of retinal discontinuity, perpetuating the infiltration of subretinal fluid [ 3 , 4 ]. In an attempt to alleviate this traction by approximating the underlying choroid to the detached retina, several authors proposed techniques such as subchoroidal injection of plasma, transient indentation with gauze, or even a piece of plastic sutured to the sclera near the treated area [ 5 , 6 ]. In 1957, Schepens conceived the technique now known as scleral buckling, revolutionizing retinal surgery, and also proposing some adaptations for the treatment of the macular region in cases of retinal detachment associated with macular holes by positioning the buckle beneath the macular region [ 6 ].

Over time, other MB techniques were developed by different authors [ 7 , 8 , 9 , 10 , 11 , 12 ]. In 1980, Ando [ 13 ] created the first solid silicone MB, facilitating its implantation without the need for muscle disinsertion or suturing of the implant to the thinned posterior sclera. However, it presented limitations such as the adjustment of force and interference in imaging exams due to the presence of embedded metal [ 14 ]. In 2012, Stirpe et al. developed a new MB that did not contain metal wires and had adjustable sutures [ 15 ], while Mateo et al. proposed the coupling of an illuminated probe to facilitate the precise positioning of Ando’s MB beneath the macula [ 16 ].

Unfortunately, Ando’s device presents limitations regarding shape, tension adjustment, and posterior suture thus hindering its reproducibility. Hence, certain authors explored alternative methods to tailor their implants, such as utilizing silicone sponges internally coated with stainless steel [ 17 ] or employing a titanium stent [ 18 , 19 ], as described by Parolini et al. (2013). In their report, Parolini et al. detailed three cases where they utilized MB exclusively for macular detachment unrelated to macular holes. Additionally, they introduced a novel L-shaped design of MB devoid of posterior sutures, enhancing its feasibility for surgical implementation [ 18 ].

In Brazil, there are no commercially available MBs, so we chose to manufacture one following the descriptions provided by Parolini et al. [ 18 ], as we will describe throughout this article.

Preoperative evaluation, imaging exams in myopic tractional maculopathy, and their role in the surgical indication of macular buckle

Macular buckle surgery requires a comprehensive preoperative ophthalmological assessment and complementary imaging exams to assist in the classification of MTM and surgical planning. Here, we highlight and discuss ocular ultrasonography (USG) and optical coherence tomography (OCT).

Ocular ultrasonography

The importance of USG in the surgical planning of MB procedures lies in its ability to assess vitreous and retinal conditions, such as the presence of anteroposterior vitreoretinal tractions (VMT) and/or tears, and to locate and estimate the extent of RD. OCT can also be useful for identifying VTM, but standard OCT does not have sufficient width and depth to capture the entire retinal detachment. Sometimes, in eyes with very high myopia, it is challenging to acquire images of the macular holes and, in these cases, examining with the patient using contact lenses can provide better image acquisition. As wide-field OCT is not available in Brazil, USG is very useful in these situations.

USG also aids in selecting the appropriate surgical technique and determining the indication for MB [ 18 , 19 ]. Moreover, it facilitates the measurement of AXL in cases where optical biometry is unreliable, allows for the accurate calculation of intraocular lens power using the immersion technique to avoid corneal compression [ 21 ], assists in identifying structures in cases of media opacity, and ensures accurate intraoperative positioning and postoperative follow-up of the MB. Regarding the anesthetic procedure, USG is essential in evaluating the size of the staphyloma, helping to select the most suitable anesthetic method for highly myopic eyes (retrobulbar block or subtenon anesthesia) to avoid complications such as ocular perforation or intraocular injection of anesthetic in significantly large eyes [ 22 , 23 , 24 ].

Optical coherence tomography

The diagnosis and monitoring of MTM can be challenging due to the atrophic changes associated with pathological myopia. In this context, OCT has emerged as a fundamental diagnostic method for the non-invasive and detailed evaluation of the vitreoretinal interface, retinal layers, the retinal pigment epithelium, and the choroid, allowing for a better understanding and classification of these structures, as described below [ 25 , 26 , 27 , 28 ].

Classification and criteria for surgical indication in MTM based on OCT findings

The evaluation of OCT and the correct interpretation of findings are essential steps in surgical indication in MTM. In 2021, Parolini et al. [ 27 , 28 , 29 , 30 ] introduced a new OCT classification for MTM, which has strong reproducibility between examiners, intending to streamline information sharing and improve understanding of disease progression. [ 29 ]. The MTM staging system (MSS) categorizes findings into two types of evolution: perpendicular and tangential. Perpendicular evolution describes the anatomical sequence of predominantly internal or inner retinoschisis (stage 1), predominantly external retinoschisis (stage 2), retinoschisis with macular detachment (stage 3), and complete macular detachment without schisis (stage 4). Tangential evolution, in turn, describes the anatomical sequence of preserved foveal contour (a), internal lamellar macular hole (b), and full-thickness macular hole (c). This classification allows for the combination of evolution types, facilitating disease categorization. The occurrence of external lamellar macular holes is described in the classification as “O”, which can happen at any stage, while the presence of epiretinal abnormalities is indicated as “Plus” [ 28 ].

Based on the MSS, a surgical management approach for MTM was proposed. The idea is that comparing MB vitrectomy and pars plana vitrectomy (PPV) alone does not make sense, as each approach has its value in treatment. Early-stage cases warrant observation (stages 1a and 2a), while intervention is reserved for those who experience a progressive decline in visual acuity (stages 1b and 2b). When tangential forces predominate, PPV alone presents good results in stages 1a, with significant epiretinal membrane, and 1b and 1c.

In cases where perpendicular evolution predominates, MB alone has proven effective in stages 2b, 3a, 3b, 4a, and 4b. If epiretinal abnormalities are identified as clinically significant for visual improvement following the MB procedure, rapprochement with PPV remains a viable option. Finally, in cases where perpendicular and tangential forces are present, leading to macular involvement and/or macular or retinal detachment, MB + PPV is indicated (stages 2c, 3c, and 4c). The presence of “plus” alterations may require surgical intervention to improve complaints of metamorphopsia. Table  1 summarizes OCT findings and their implications in surgical indication [ 30 ].

Based on the criteria outlined by Parolini et al. [ 28 , 29 , 30 ], we sought to share our experience in this small case series, where all patients underwent MB surgery, with or without PPV, and have been followed up for over a year. Additionally, we will outline the methodology employed for the MB procedure and offer a concise analysis of the results, correlating them with the current literature.

This retrospective study analyzed three patients with MTM-associated RD treated with MB surgery, with or without PPV. Preoperative evaluations used OCT and USG to determine macular involvement and the extent of RD. Surgical indications were guided by the MTM staging system, and the MB was assembled using customizable materials. Procedures were tailored to the specific needs of each patient. All participants provided written informed consent. The study received approval from the ethics committee of the Clinical Hospital of the University of São Paulo, Ribeirão Preto, SP, Brazil, and adhered to the principles of the Declaration of Helsinki.

Cases report

We describe the surgical management of three cases of highly myopic eyes with MTM, where MB surgery was performed. In cases 1 and 2, RD was associated with a macular hole (MH). In case 2, the indication for MB was due to two previous failures of vitreoretinal surgery (PPV) for the treatment of retinal detachment with a macular hole. In case 3, a macular detachment was associated with an internal lamellar hole. Table  2 summarizes the main findings of each case, and Figs.  1 , 2 and 3 illustrate them.

a : Color fundus photographs of wide-field preoperative imaging, showing retinal detachment in the posterior pole with a macular hole in the left eye (OS); b : Postoperative color fundus photography of the OS with attached retina and a residual gas bubble; c : Preoperative USG evidencing retinal detachment and posterior staphyloma; d : Intraoperative USG evidencing correct positioning of the buckle flattening the posterior staphyloma; e : Preoperative OCT showing a retinal detachment with associated macular hole; f : Postoperative OCT showing a reattached retina with a grade 2 macular hole closure exhibiting applied edges (grade 2 closure, Kang et al.’s classification [ 31 ])

a : Ultrasound of the left eye shows retinal detachment; b : Postoperative OCT reveals attached retina; c : Postoperative color fundus photography of the left eye demonstrates a reattached retina

a : Preoperative USG showing a large posterior staphyloma with macular detachment (arrow); b : Postoperative USG evidencing flattening of the posterior staphyloma due to the positioning of the buckle; c : Preoperative OCT showing an internal lamellar hole with macular detachment and nasal macular retinoschisis. Vitreomacular adhesion can also be observed; d : Postoperative OCT evidencing flattening of the posterior staphyloma, resolution of the lamellar hole, and macular detachment, as well as reduction of retinoschisis; the vitreomacular adhesion remains stable; e : fundus retinography showing attached retina

Description of implant fabrication and the surgical technique

one 1.5-mm titanium microplate for osteosynthesis containing 8 holes Traumec ® (Medical Support, Brazil); one 270 sleeve-type band (Labitician, USA); one 506G oval sponge (Labitician, USA); one 15-degree blade; pliers, and strong scissors (Fig.  4 a).

Implant fabrication

We used a titanium osteosynthesis plate containing 16 holes, which was cut in half (8 holes) using strong scissors (or pliers), creating the ideal size for our implant. This plate was then inserted into a 270 sleeve-type band (sleeve), covering its entire surface, with the help of Kelly forceps to open the sleeve and facilitate plate insertion, preventing any tearing. Approximately 2.0 mm of the band should be left beyond the plate on the vertical portion to protect the extremity and prevent conjunctival erosion after fixation. The plate is then bent into an “L” shape using pliers, leaving 3 holes horizontally (short arm of the L) and 5 holes vertically (long arm of the L). Next, a tunnel is made in the middle of the linear length of the 506G sponge with a 15-degree blade, ensuring it is longer than the short arm of the titanium plate to cover it, and without letting the tunnel pierce the sponge (to avoid plate exposure). Finally, the short arm of the L-shaped plate is inserted into the 506G sponge through the tunnel, and the 506G sponge should then be cut to cover the short arm of the implant, leaving at least 1.0 mm beyond the implant length to prevent exposure beyond the sponge (Fig.  4 a-c).

Surgical technique

The initial procedures remain similar, whether isolated MB surgery or combined surgery with vitrectomy is performed. The procedure begins with a temporal peritomy at the limbus of the conjunctiva and Tenon’s capsule from 11 to 4 o’clock. The lateral and superior rectus muscles were isolated using a suture of silk thread 2.0 (Ethicon, Johnson & Johnson, Brazil) to promote eye motility. Before positioning the implant, anterior chamber paracentesis is performed to reduce intraocular pressure (IOP) and minimize pressure changes when positioning the MB. Next, the implant is placed in the upper temporal quadrant, where the shorter arm will be positioned under the macula, and the longer arm should be inserted parallel to the lateral rectus muscle (Fig.  4 d). After, a 25-gauge Chandelier optic fiber is positioned at 6 o’clock (Alcon Constellation Vision System, USA) to enable visualization of the fundus.

Subsequently, we confirm the proper positioning of the implant under the macular region using a panoramic visualization system coupled to a microscope (Resight 500 ® , Zeiss) with delicate manipulation of the implant. Once the MB positioning is confirmed, the vertical portion of the device (long arm) is sutured to the sclera using 5.0 Mersilene ® suture (Ethicon, Johnson & Johnson, Brazil) with 2 separate stitches. In order to confirm the proper positioning of the MB, we perform preoperative USG, covering the USG probe and cable with a sterile plastic cover, and at the same time, it is possible to measure the comparative AXL.

a : Material to be used for the fabrication of the macular buckle b : Schematic figure of the shape to be molded for the buckle; c : MB fabricated in the operating room for the described cases; d : Postoperative aspect of the correctly positioned macular buckle; it can be observed under the conjunctiva in the upper temporal quadrant

As reported above, in two cases, where there was retinal detachment associated to MH, we performed combined MB and PPV surgery (cases 1 and 2), and after positioning the MB, we routinely carried out PPV surgery. In case one, besides PPV and MB, phacoemulsification was carried out, and C3F8 was chosen as a vitreous substitute. In case 2, due to the history of previous PPV and retinal re-detachment with MH, it was decided to use silicone oil as a vitreous substitute in addition to MB. One case presenting an internal lamellar hole (stage 4b) with macular detachment and nasal macular retinoschisis (patient 3) was managed only with MB, despite slight vitreomacular adherence, which was not considered significant.

In the immediate postoperative period of the three cases operated at our service, the patients presented with slight hyperemia, mild pain improved with analgesic (dipyrone), and none showed increased IOP. Patient 3 presented with retinal hemorrhage in the posterior pole in the immediate postoperative period, probably due to the significant reduction of the large preoperative staphyloma after MB implantation. The approach was expectant, and there was complete absorption of the hemorrhage, and progressive reabsorption of the subretinal fluid, leading to the repositioning of the macula throughout the following months, despite a stable vitreomacular adhesion may be seen. In patient 1, during follow-up, the attached retina and grade 2 closure of the macular hole were observed (according to Kang et al.’s classification) [ 31 ]. Patient 2 evolved also with retina applied, macular hole closure, and silicon oil. There were no reports of diplopia among the operated patients and/or limitations in ocular mobility.

All three patients (100%) showed visual acuity improvement after surgery, maintaining retina attached and stable vision for more than a year of follow-up. No patient (100%) experienced complications such as conjunctival erosion, displacement/rotation of the MB, endophthalmitis, or anterior chamber reactions throughout the follow-up period.

The use of MB surgery significantly decreased in the 1980s with the advancement of vitrectomy, primarily because of technical difficulties and the lack of related scientific studies at that time [ 32 , 33 ]. Nonetheless, in highly myopic eyes with posterior staphyloma, PPV can result in surgical failures in 26.7 to 50% of cases due to the inability to alter the axial length of the eye and reduce the anteroposterior forces exerted by the staphyloma [ 34 ]. The use of MB in these circumstances can reduce the anteroposterior force, providing positive results. This evidence, combined with the relevant study by Sasoh et al., which demonstrated good results and safety of MB use in the early 2000s, encouraged the resumption of studies and the development of the MB technique [ 35 ].

In 2001, Ripandelli et al. [ 36 ], compared highly myopic patients with retinal detachment and macular holes undergoing vitrectomy via pars plana (group A) and MB surgery (group B). They observed a surgical success rate of 73.3% in group A and 93.3% in group B, with group B also showing a significant improvement in vision, unlike the vitrectomy group. These results suggested anatomical and functional superiority when MB was used. Similarly, Ando et al., in 2007, reported anatomical success in the MB group in 93.3% of cases after the first surgery and 100% after the second procedure, while only 50% of the cases treated with vitrectomy achieved retinal reattachment in the first procedure, and 86% in the second approach, which was associated with MB [ 37 ].

In a literature review, Alkabes and Mateo [ 32 ] showed that after MB surgery, the retinal reattachment rate ranged from 81.8 to 100%, while the MH closure rate ranged from 40 to 93.3%. Although persistent MH was identified as a risk factor for retinal re-detachment, eyes with persistent MH that underwent MB did not experience retinal re-detachment. Furthermore, the literature indicates that patients with AXLs greater than 30 mm have a higher risk of early retinal re-detachment after PPV. Several studies have shown statistically significant higher rates of retinal re-detachment after PPV for treating RD associated with MH in patients with AXL > 30 mm [ 38 , 39 , 40 ]. For these patients, when undergoing the MB procedure, the retina was reattached in 100% of cases and the MH closure rate ranged from 40 to 100%. Notably, no re-detachment was observed in cases of persistent MH [ 32 ]. In our two cases involving RD and MH that underwent combined surgery, both achieved successful outcomes with retinal reattachment and macular hole closure, with no retinal re-detachment observed.

In general, outcomes of both PPV or MB procedures have been shown to be effective in improving retinal anatomy and visual acuity. However, PPV, particularly when combined with internal limiting membrane (ILM) peeling, is associated with a higher incidence of postoperative MH. Due to the lack of randomized studies, it is challenging to determine if MB or PPV is superior for treating progressive macular foveoschisis. Given its progressive nature and potential for RD with MH, surgical intervention should be considered if the schisis progresses or visual acuity decreases. Regular OCT monitoring and early interventions based on physician experience are recommended [ 32 , 41 , 42 ].

Regarding complications, patient 3 experienced retinal hemorrhage following MB surgery, which resolved spontaneously within one month. This patient had a deep staphyloma of the posterior pole, and after MB, the AXL was significantly reduced by 7.9 mm. Despite performing a paracentesis at the beginning of the procedure, no hypotony was observed. We attributed the retinal hemorrhage to the pronounced reduction in AXL. Mateo and colleagues previously described cases where excessive compression of the choroidal vessels could lead to increased local hydrostatic pressure and changes in the RPE, resulting in subretinal fluid and, in some cases, macular atrophy [ 32 , 43 ]. However, we did not observe any of these complications in patient 3 or the other patients.

Other potential complications reported in various case series include scleral perforation, orbital fat prolapse, improper positioning of the explant, and ocular muscle disinsertion during buckle placement [ 32 ]. During the mean follow-up period of eighteen months, no issues such as intraocular pressure changes, strabismus, eye movement restriction, explant displacement, choroidal effusion, choroidal detachment, or posterior pole atrophy were observed.

As demonstrated by Parolini et al., the management of MTM can range from using MB alone to performing combined surgeries. When full-thickness macular holes and macular or retinal detachment are present, a combination of PPV and MB is recommended, as each surgical method targets different force vectors affecting MTM [ 29 , 30 ].

Despite the positive outcomes demonstrated in this report and the literature, MB can present complications. It is essential to carefully evaluate the risk-benefit ratio carefully and reserve its use for cases where it is truly necessary, based on an appropriate classification system. Therefore, we recommend considering MB + PPV surgery as the first choice for highly myopic patients with macular RD associated with MH, given the high rates of retinal re-detachment. In our small case series reported herein, success was achieved with combined surgery in two of our cases and MB alone in one case, proving to be effective in improving anatomical and functional outcomes without the need for additional interventions. None of the patients experienced re-RD with combined surgery or MB alone, which is consistent with the literature.

Finally, it is important to emphasize that the contralateral eye of all three patients continues to be followed up with OCT and fundoscopy. Macular buckling should be considered if any anatomical or visual deterioration occurs, depending on the classification of tractional maculopathy.

MB has proven to be effective in our small experience, whether alone or conjunction with PPV, in managing MTM. Its indication should consider the pathophysiological mechanism of MTM, which is influenced by tangential and anteroposterior forces, with PPV often needing to be combined in many cases. Decision-making should be based on the patient’s evolution regarding symptoms of decreased vision, anatomical findings on fundoscopy, ocular ultrasound, and based on OCT classification. The postoperative results reported here, and in the literature, have shown good anatomical and functional results, the absence of recurrence of retinal detachment, showing that the macular buckle can contribute to better results in eyes with very long axial lengths.

Data availability

No datasets were generated or analysed during the current study.

Abbreviations

Axial length

Counting fingers

Intraocular pressure

Macular buckle

Macular hole

MTM staging system

Myopic tractional maculopathy

Pars plana vitrectomy

Retinal detachment

Silicon oil

Phacoemulsification

Ultrasonography

Visual acuity

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Acknowledgements

We would like to express our sincere gratitude to Dr. Barbara Parolini for her invaluable contributions to the field of macular buckling surgery. Her pioneering work in describing the staging system for myopic tractional maculopathy and the surgical techniques for macular buckling has been instrumental in the execution and development of our study.

The authors received no financial support for the research, authorship, and/or publication of this article.

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Francyne Veiga Reis Cyrino, Moisés Moura de Lucena, Letícia de Oliveira Audi, José Afonso Ribeiro Ramos Filho, João Pedro Romero Braga, Thais Marino de Azeredo Bastos, Igor Neves Coelho & Rodrigo Jorge

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F.C., J.R.F., and R.J. were primarily responsible for the research design. F.C., J.R.F., J.B., T.B., and I.C. were responsible for data acquisition. M.L., L.A., and I.C. performed the data analysis and drafted the initial manuscript. F.C., J.R.F. and R.J. provided critical revisions and contributed to the refinement of the manuscript. All authors reviewed and approved the final version of the manuscript.

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The institutional review board and ethics committee of the Division of Ophthalmology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil, approved this study (CAAE: 79706624.6.0000.5440).

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Cyrino, F.V.R., de Lucena, M.M., de Oliveira Audi, L. et al. Historical and practical aspects of macular buckle surgery in the treatment of myopic tractional maculopathy: case series and literature review. Int J Retin Vitr 10 , 60 (2024). https://doi.org/10.1186/s40942-024-00578-w

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Received : 04 June 2024

Accepted : 20 August 2024

Published : 28 August 2024

DOI : https://doi.org/10.1186/s40942-024-00578-w

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