Cruel practices
Helen is a disabled child but a loved one. Her parents tried everything they could to make sure their child receives the best medical treatment possible. When some family member suggest Helen be sent to an asylum, Helen's mother becomes livid, not wanting to accept this. The way in which Helen's mother reacts to this possibility helps portray the asylum as a cruel place, where those sent there are abused and treated in inhumane manners. Because of this, it is no wonder why the parents were so reluctant to send their child there
Medicine and butchering
In the second act, the children are pretending they are doctors while trying to make better one of their dolls. While playing, the children start butchering the doll, cutting away small pieces from it. This type of play portrays medicine and doctors of the time in an extremely cruel way, making them seem even barbaric.
Hands in mouth
Helen tries to communicate with those around them by putting her fingers on a person's mouth while they speak. Few understand her efforts to try and communicate and they see her as wild because of her actions. Whenever Helen is described as putting her fingers on a person's lips or in their mouths, the author portrays the young girl as desperate to communicate and desperate to be understood by those around her.
Animal
James is Helen's half-brother and he is one of the main people who insist Helen must be sent away because she is not human. James portrays Helen as an animal, a creature unable to take care of herself, who does not even know how to keep herself clean. This point of view is shared by the rest of the characters as well, who think Helen must be sent away as far away as possible.
