In the first year, of 409 commitments, only 51 were from the courts, with the rest by transfer. IDD officials complained of inappropriate uses of the new mental deficiency law. The state schools, it was charged, were dumping disciplinary problems on Napanoch: criminal accusations were now brought against patients who before would have been subject to routine institution disciplinary practices, so as to bring them "within the letter of the law" and transfer them to Napanoch. The state prisons, too, took advantage of the new law, sending psychopaths with mental ages above 12.

The result was an improper mix of non-delinquent defectives (from the state schools) with non-defective delinquents (from the prisons). Napanoch's inmates ranged in age from 16 to 70 years, and in intelligence from "ordinary feebleminded to imbeciles and idiots." Many, officials said in the first years of the IDD, "are hysterical, neurotic and easily disturbed.... readily led by men of stronger mentality, as was shown by the mess hall riot." After sending nearly half the transfers back, officials eventually worked out the difficulties. By 1927, 90 percent of commitments were directly from the courts.

In 1943, officials reported that the inmates' average age was 25.3 years, with an average mental age of 9 1/2 years and an IQ of 63. The typical inmate had 10 years of public school instruction, a few years in special classes, was untrained vocationally, and educated poorly in academic subjects. He "is socially and economically incompetent, defective in most skills which bring happiness and successful adjustment to life. He is a first generation American with a history of truancy and delinquency; he comes from the slum of a large city, his parents belong to the lowest social stratum; and, like his family, he has low moral standards."

Though most inmates were clearly limited, we would not today always agree with the diagnosis of "mental deficiency" for all of them. Even Napanoch sometimes disagreed. Direct commitments were "occasionally returned to court as unsuitable... due to high mental capacity" (Dr. Thayer had pressed for legislation -- passed in 1931 -- giving IDD officials this means to remedy abuses of judicial authority).

There were occasional errors in diagnosis. A 1938 survey of the intelligence of all prisoners in NYS found that 24 of Napanoch's committed defectives had IQs between 87 and 106, well within the normal range. In the 1950s, Napanoch's superintendent criticized the Elmira Reception Center's vocational assessments, saying that written tests gave inaccurate results; "exploratory tryouts" (performance tests) often show that Nappies "possess much more ability than is usually credited to them." And in 1954, a Protestant chaplain observed that, "Time and time again one is amazed at the profound thought coming from those labeled as mental defectives." Testers during most of the duration of the IDD never solved the problem how to separate out cultural and educational factors, how to distinguish between retardation and the effects of deafness and learning disabilities. . . .