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OCR for page 23
Problems of the Deaf and Hard of Hearing Ad,
actions of other sorts); and the decision between the two tech-
niques of presentation probably available; namely, by film record,
which at present appears to be the more accurate, and by living
facial expression.
3. That there be developed a, method of measuring the intelli~-
bility of speech. One technique would be the use of a scaled
series of words, phrases and sentences, well below the child's
grade of reading ability, to be spoken by the child to a group
of trained observers, who should rate the intelligibility of the
child's speech. Another technique would be the mechanical
recording of similar samples of the child's speech to be re-
produced later and rated by trained observers. Such methods
as wax recording or film recording or any other devices which
might be invented should be thoroughly investigated as to their
practicability.
V. PROBLEMS OF INFANCY AND EARLY CHILDHOOD
The Committee would point out that the auditorily deficient child,
from birth to seven years of age, is at the present time virtually a closed
book. This dearth of knowledge available about auditorily deficient
children in these early ages indicates a field of research which is almost
new. With but few exceptions, existing schools for the deaf take chil-
dren at the age of seven or eight. When we consider the stress now
being placed upon the significance of the early years in general develop-
ment, and the increasing recognition throughout the medical, psy-
chological and educational fields of the importance of adequate handling
of the child in these years, it seems astounding that there should be
such a great gap in our knowledge. We know little about methods of
testing hearing at the early ages, little of the retardation effect of audi-
tory deficiency upon general development, and relatively little of the
significance of one or two or three years of partial hearing at early
ages with reference to the later general development of the individual.
There are, however, some scientifically established facts which indicate
the importance of the' early period in the lives of the auditorily deficient.
In the first place, after the average " deaf " child has been in a school
for the deaf for a period of six to eight years, he can read no better
than the average seven or eight year old hearing child. In other words,
it requires about eight to ten years of instruction in special schools to
bring the " deaf " child to the level which the ordinary child reaches
within one or two years of schooling. In view of the indications that
there is greater plasticity in the earlier years, we may well ask whether
OCR for page 24
~4 Problems of the Deaf and Hard: of Hearing
the slow improvement of the deafened child taken into the schools at the
age of seven or eight years. is not due, in large part, to the fact that he
is taken so late in his period of development.
A second significant and interesting fact is revealed by the comparison
of blind children and " deaf " children of the same ages on mental tests.
Blind children are relatively slightly retarded in comparison with " deaf "
children. In other words, " deafness " appears to be many times as great
a handicap with reference to development as is' blindness. Further, there
is some indication that " deadness '' retards the development of all proc-
esses. It would seem to be an easy task for a person with vision to
reproduce digits from memory when. such digits are presented visually.
This is, howler, a task which is practically impossible for the " deaf "
child, not because of any defect in vision, but primarily because of the
failure of the associated language processes which make such visual
memory possible.
A third interesting point which should be taken into account arises
from a comparison of progress of deafened children through schools for
the deaf in relation to the age at which hearing was lost. The rapidity
of progress is related quite directly to the length of time they had
hearing. Children who are born deaf are much more handicapped than
children who have had hearing up to the age of three. Children who have
been deafened at the age of three seem to be much moire handicapped
than children who have been deafened at the age of six. Although this
relationship hats not, perhaps, been analyzed as adequately as it might,
nevertheless, it points to a most significant relationship between early
auditory stimulation and general development.
A. A NURSERY SCHOOL FOR DEAF CHILDREN
The Conference recommends the establishment of a nursery
school for deaf children, as the necessary basis for a systematic and
comprehensive study of the problems of the early period of life.
i. Location and type. The nursery school should be located in a
city and provision should be made for the care of boarding
pupils as well as of day pupils, in order that a sufficient number
of young deaf children can be assured for purposes of study
and training.
In the absence of material with reference to the frequency
of auditory deficiency in very young children, and on the basis
of the best information available with reference to the frequency
of the deficiency among older children., it seems necessary that a
school, if established, be located where considerable numbers of
children will be available.
OCR for page 25
Problems of the Deaf and Hard of Hearing ~5
a. AfFlia.tions. The school or schools should be organized as an in-
depend.ent administrative unit. The most preferable auspices
under which such a project could be placed would be a large
University with extensive research facilities and personnel. Cm
operative relationships should be maintained with any or all of
the following: established institutes of child welfare, research
nursery school organizations, and schools for the deaf.
Since the problem of auditory deficiency is a problem which
is related to almost every feature of the physical and mental life
of young children, it is necessary that the school be located in an
institution which already has upon its staff capable investigators
in the various fundamental sciences who can cooperate on the
projects outlined. While it would be possible to develop a
school with a primary staff consisting of capable individuals in
various scientific fields, such a procedure would involve the ex-
penditure of great sums of money. If, however, these specialists
are already available on the staff of a large institution, their
services can be utilized with a relatively small expenditure and
much more effective scientific work done. Such a school would
need the services of a pediatrician, a psychologist, an anatomist,
a dentist, an otola.ryngolo~gist, a sociologist, and a biom.etrician,
in addition to general medical, hospital and laboratory facilities.
The character and quality of the research done in such an
organization depends in large part upon the scientific qualifica-
tions of these affiliated experts. If the funds are to be expended
so as to result in the greatest accomplishment, extreme care
must be exerted in locating the school, in order that there be
available for the school the most capable individuals possible.
There are already in existence institutes of child welfare
which have on their staffs, or affiliated thereto, capable research
men from many fields, and which have brought together experts
in the care and training of young children. The Conference in-
clines to the opinion that there does not exist at the present
time a school for the deaf or an institution for the care of deaf
children which has a scientific staff adequate to the problems
which are projected in later sections of this report. It further
feels that it would probably be better to approach the whole
group of problems from a general scientific point of view rather
than from the viewpoint of a specific training or treatment pro-
gram. As the whole project is exploratory, it should be so
planned as to secure the maximum scientific and practical returns.
OCR for page 26
26 Problems of the Deaf and Hard of Hearing
3. Organization. The school should be under a director selected
primarily on the basis of scientific capability and administrative
experience; and in the development of the school, the director
should be given a relatively free henry The (~nf~rPnrm ~xrm.~1lA
_ _ ~,.~..~, me ~ YV V ~
suggest the desirability, in setting up the organization, of de-
veloping an advisory committee to be composed of representa-
tives of the various departments which are affiliated with the
school, if it is organized in cooperation with a university. The
advisory committee should consist of specialists in the various
scientific fields. Its primary function would be conferring with
the director on the organization and functions. of the general
program. This advisory committee, if included in the original
plan for such a school, would make it possible for the director to
secure cooperation immediately from various scientific fields,
and would also make it possible for him to educate a selected
group of scientific men, in the particular university in which it
was located, as to the possibility and desirability of experimenta-
tion and study of problems of auditory deficiency.
Number of pupils. In contemplating the organization of such
a school, the Conference has in view a minimum of at least
thirty pupils and as many more as possible. It does not seem
advisable to organize or start such a school if less than thirty
pupils are available. Fifty is a more desirable number than
thirty, but thirty represents a sound minimum.
Age limit. No lower age limit should be set, and the upper age
limit should be set at approximately six years, depending upon
the educational opportunities available for auditorily deficient
children in the community in which the school is located. The
school should be effectively a nursery school with the emphasis
J
upon young children.
B. S CIENTIFIC PROBLEM S
The Conference proposes the following list of scientific problems
as indications of the scope of the work which could be undertaken
in a properly organized nursery school.
~.
1
Some of these problems
are of a fundamental character, others are of a practical nature.
They range over a considerable number of scientific fields, and in
most cases represent problems to which answers.cannot be given
at the present time.
:. ~4 study of the hereditary relations of auditory deficiency, lo
be made in two directions. In the operation of a nursery school
there would have accumulated a considerable amount of data
-
OCR for page 27
Problems of the Deaf and Hard of Hearing ~7
with reference to auditory deficiency among young children in
the general population. It should be possible to organize this
material so that information would be obtained as to the sources
of deficiency, if particular care is taken to secure information
upon the antecedents of all the children with whom the school
comes in contact. Later, a more intensive study can be made
by securing complete data on the family background and the
history of every individual child in the school. Such an inten-
sive history, in addition to throwing light upon the particular
individual child, might also throw into relief general problems
which could be attacked on a wider scale. Record forms and
methods developed in the school might be widely adopted in
schools for the deaf.
2. The dez~elotwlent of adequate tests of hearing for young
children:
a.
b.
Tests of hearing should be studied in detail over a period of
time to determine their reliability, consistency and accuracy.
We should know whether there are day to day variations in
hearing deficiency, and in what respect fluctuations in the
individual from day to day affect the accuracy of such
measurement. A host of problems are prospective in this
field.
By the use of the conditioned reflex method. The use of
this method (or modifications of it) has been introduced
into animal psychological laboratories for tests of sensory
discrimination in rats, dogs and other animals, and has im-
pressed some investigators as promising. Investigation of
its possibilities with auditorily deficient children might well
be undertaken. One of the characteristics of the method as
it is presently used is that it requires considerable time to set
up proper conditioning and to make tests. It is possible that
through experimentation there might be developed shorter
methods of more general applicability.
The development of tests zuhich could be used as a basis for
a di/ferential diagnosis between feeble-mi,~dedness and auditory
deficiency.- The young deaf child is frequently thought to be
feeble-minded, and is, with respect to his functioning, actually
feeble-minded. If devices can be developed which will dis-
criminate between constitutional feeble-mindedness and auditory
deficiency, it might be possible to develop an adequate training
program for the young " deaf " child as distinct from the young
OCR for page 28
28 Problems of the Deaf and Hard of Hearing
feeble-minded child. Unquestionably the figures with reference
to the occurrence of feeble-mindedness in young children are
vitiated in part by the inclusion of many cases of young children
who are auditorily deficient. It is possible that a method of dis-
crimination might be worked out on the basis of the conditioned
reflex technique since there is some indication that conditioning
takes place in the normal child in 'quite a different fashion than
it takes place in the feeble-minded child.
4. An extensive study of the p~ossibiEties and limita.tions of hearing
aids for the yo?~n.g auditorily deficient child. Here is perhaps
the outstanding field for investigation on the practical side.
When one realizes the relationship that exists between the onset
of auditory deficiency and the amount of progress the child makes
in subsequent instruction in a deaf school, and the tremendous
acquisition of the hearing child between the ages of two and
five or six years with its correlated effects. upon the development
of all mental processes, it seems highly important that every
effort should be made to study the possibility of meeting the
hearing deficiency in this early period with every mechanical aid
possible. It is doubtful whether any indirect method of instruc-
tion through visual, manual or factual aid can in any way take the
place of or meet the deficiency which results from a loss of the
most important sensory inlet. A half year of hearing at the age
of four may perhaps be the equivalent with respect to general
development of four or Fire years of expert instruction later on.
Any device which may give young auditorily deficient children
some auditory stimulation deserves to be investigated to the
fullest extent.
5. Corl*pa~ratizJe studies by anatowlists and dentists of the dezrelop-
ment of the swath, jaws, teeth and throat structures, together
with the general f acial skeletal d ewelotw~ent of normal and
auditorily deficient children.-Apparently, no such studies. have
been undertaken. They would seem to be of primary importance
in determining the effect of hearing deficiency and attendant
speech deficiency upon development of the speech and oral ap-
paratus. Studies are already available on the development of the
ears and associated sensory structures. We need similar studies
of the development of the structures concerned primarily with
speech response in auditorily deficient and in normal children.
6. ~ study of the basic motor reactions of the tongue, lips, dia-
phra:gm and throat in normal and auditorily deficient children.
Little is known about the accuracy, speed and variability of
OCR for page 29
Problems of the Deaf and Hard of Hearing 29
tongue movements in normal individuals. Is there a relationship
between tongue mobility, for instance, and the ease with which
the individual picks up speech reactions ? We know that in the
accuracy and ease in the movements of other parts of the body
there are wide variations from individual to individual, some
of which persist in spite of training, and some of which can be
overcome by training. A study of the speech apparatus from this
angle might reveal interesting and valuable material.
7. ~ comparc&t~ve study of language development in normal and
auditorily deficient children.-Comparisons should be made be-
tween normal and auditorily deficient children of the same age,
and comparisons between normal children at early ages and
auditorily deficient children at later ages under school in-
struction.
In the statement of an earlier problem we have emphasized
the relationship between language development and general de-
velopment. This study would undertake to compare the prog-
ress of the hearing child and the deaf or partially deaf child.
An interesting and valuable secondary study would be a study
of the maximum vocabulary that could be acquired by a deaf
child under skillful instruction between the ages of two and
seven years, in comparison with the normal vocabulary acquisi-
tions of the hearing child.
8. Studies of tile extent to which the dezreloLwlent of complex
mental processes is affected by the absence of language stimula-
[ior'.-There are a number of studies which should be undertaken
under this general heading. The Conference cites the difference
in the development of blind as compared with deaf children,
which points to the importance of auditory stimulation as a
factor in We development of complex mental processes. The
Conference would also point to the investigations off sensory
discrimination which seem to indicate that sensory discrimination
is improved to a marked degree by the attaching of certain lan-
guage responses to the material which Is to be discriminated, as
contrasted with such discrimination when no such language
responses are involved.
Modern psychology attaches fundamental importance to the
linguistic processes as important {actors in development. When
we realize that the ordinary child at the age of six years has a
vocabulary of between two and three thousand words, uses
every form of sentence and every part of speech, and has the
elementary mechanics of the language pretty thoroughly worked
OCR for page 30
so Problems of the Deaf and Hard of Hearing
out, and when we further realize that the child of eight years is,
in comparison with the adult, virtually at the completion of his
language development except for the addition of more words
and a few more involved forms, we begin to realize something
of the handicap which the auditorily deficient child has borne
in comparison with the normally hearing child.
The public school receives at the age of six in a hearing child,
one who is already very far advanced in the basic manipulation
of linguistic processes. The school for the deaf, taking a child
at the age of eight, receives a child who has made virtually no
progress, and at the best adds but a few words a year to the
child's vocabulary in comparison with the tremendous acquisi-
tion made by the normal child at the age of two, three and four.
It is no wonder, then, that the whole development of complex
mental processes in the auditorily deficient child are affected.
9. ~ study of the role auditory stimulation plays in the spontaneous
beAcz~ior of children.-There seems to, be a general agreement
that the deaf child is usually apathetic and listless as compared
with the average hearing child. It is true that occasionally deaf
children show outbursts of uncontrolled motor energy and
present a picture quite the opposite, but taken as a whole, the
contrast with normal children is marked. Nevertheless, the
spontaneous motor behavior of a child plays a very important
part in his general development; a part which is increasingly
recognized. A study should be undertaken to determine the re-
lationship between auditory stimulation and such behavior.
It is possible that a practical outgrowth of such a study would
be the development of devices by means of which partial com-
pensation could be made. In connection with this study (and
perhaps of sufficient importance to be accorded a separate place)
would be a quantitative study of the development of motor
reflexes in the auditorily deficient. We find little material avail-
able. We do not know whether the general bodily tone of the
deaf is lower than that of the normal, whether their reflexes
are sluggish or accelerated; whether the reflexes appear at the
same time as, or later than, in normal children.
lo. Studies on the effect of auditory deficiency upon the dezrelop-
ment of other senses and upon wtotor ability.- There are many
problems which come under this general head, and which can be
attacked with profit by a variety of methods. First, by the use
of tests on groups of children; second, by the placing of chil-
dren in specific learning situations not directly connected with
OCR for page 31
Problems of the Deaf and Hard of Hearing 3~
the learning of speech; and third, by the experimental isolation
and study of single sensory and motor fields.
Studies should be undertaken on the extent to which com-
pensatory reactions develop or fail to develop in other sense
fields. It is true that investigations on older children and adults
have revealed little evidence of such compensatory reactions.
It is possible, however, that in young children attempts are
made in this direction with varying degrees of success.
Studies should be made on speed of tapping, steadiness of
motor control, accuracy of movement, perception and discrim-
ination of size and shape relationships, development of eye and
hand coordination, development of general motor coordination,
and so on.
There are a host of problems upon which we have relatively
little information about auditorily deficient children. There is
some evidence that the handicap on the motor side is not so
great as is the handicap in the field of complex mental processes.
If so`, it might be possible to develop methods of instruction in
the motor fields that would tend to eliminate or reduce the gen-
eral handicap. Similarly, studies should be undertaken of the
learning off the auditorily deficient in conventional learning
situations, such as those offered by mazes, target experiments
and other motor situations. It is possible that through such
studies practical methods for facilitating development might
be demonstrated. There is evidence that early training, and the
opportunity for practice, affects to a considerable degree the
acquisition of motor skill.
At. ~4 study of the erect of auditory deficiency upon personality arid
the social relations of young children. This, too, is a topic on
which a number of specific studies could be undertaken, one of
the first of which might be a study of the effects of young
auditorily deficient children associating with other auditorily
deficient children as compared with benefits of association with
hearing children. The study should, however, go much farther.
It should be realized that the individual begins his social train-
ing almost at birth; and that through his relations and inter-
actions with his fellows he builds up a whole complex series of
reactions which are of utmost importance in adjustment and
later development. The effects upon the personality and social
development of the child, due to his isolation from one of the
primary sources of sensory stimulation; the sources of the
OCR for page 32
Problems of the Deaf and Hard of Hearing
attitudes of submission, timidity, and negativism which we as-
sociate with auditory deficiency; the magnitude, qualitatively
and quantitatively of the loss that the deaf child experiences;
these are vital problems.
z. Inz~estigations into the comparative values f or young children
of the different methods of teaching. Investigations into the
comparative values of the different methods (oral, manual, etc.)
elsewhere recommended, should be carried down to the early
ages, where perhaps the problems find their greatest importance.
In the young child, the factors of interference of different
methods, and the transfer of training from one to the other,
should receive definite consideration.
There should be undertaken a study in the values of rhythm
and amplified music in the training of young auditorily de-
ficient children. In our modern training of young children,
rhythm and music play a very important part. Any devices
which could be developed or utilized that would give similar
training to the young auditorily deficient child would undoubtedly
be of considerable value.
In connection with the study of methods of training young
deaf children, a survey should be undertaken of play activities
among them, both from the standpoint of the present activities
ire which such children engage and possible activities in which
they might engage. In this connection, a surrey of the play
equipment available in the home of the child should be under-
tal~en; a study in the nursery should be made of the types of
activities in which young deaf children spontaneously engage,
the educational values of such activities, and the manner in
which such activities can be made to have greater educational
value. We no longer look upon play as wasted effort. It is
now considered ~ vital and significant part of the educational
process and many of our modern procedures for handling young
children are based upon modifications of play situations and
play devices.
I3. ~ Study of auditorily deficient children who reman in their own
homes should be made over a considerable area, and should
concern itself with a description and analysis of the type and
kinds of treatment which the child receives from its own parents.
A study undertaken in this fashion would be a valuable con-
trol upon the studies undertaken in the nursery school of the
progress of auditorily deficient children under expert guidance.
OCR for page 33
Problems of tile Deaf arid Hard of Hearing 33
It would also reveal the nature and extent of parental in-
adequacies in the handling of such children, and lead directly
to the formulation of a positive program of parental education
for the parents of such children. It is obvious that for many
years to come not all the young deaf children cart be placed
in institutions. It is equally obvious that once we develop ade-
quate methods for the measurement of the hearing deficiencies
in young children, such methods, in view of the modern interest
in the pre-school child, will be applied over a wide area to many
thousands of children. One need only bear in mind the pre-
schoo1 surreys which are now conducted in almost every section
of the country and which result in the physical examinations
of hundreds of thousands of children. With the application of
test devices in such situations, hundreds of auditorily deficient
children will be discovered, and the question of their effective
handling will come directly to the fore. The individuals in
charge of the nursery school project, and the National Research
Council should envisage this future possibility and in setting
up its program look toward the meeting of this situation.
. A study of the pathological factors leading to' the causation of
auditory deficiencies in young children.-Very little is available
at present, obtained by modern methods, with reference to these
causative factors; and the knowledge available stands in need
of revision, since most of the data are based upon the results
obtained by a few examiners who have worked in schools for the
deaf, and who used the material, chiefly older children, avail-
able in such schools. A school set up in the fashion prescribed
above might undertake such a survey, and in addition, through
observation over a period of years of individual children, obtain
valuable material with reference to the progress of such path-
ological factors. Among the disorders suggested for study are:
a.
Lues: many of the studies now available in the literature
were made before the development of the Wassermann tech-
nique, and need revision.
b. Tuberculosis.
c. Contagious diseases.
d. Endocrine disturbances.
~5. A study of the development of progressive deafness in young
~r~diuidu~ts. Usually, progressive deafness appears at about the
age of twenty, though individual cases are recorded in which
it appears much earlier. Little is known about the beginning
. .. . ~+ ~r 1 1 ~
Representative terms from entire chapter:
deficient children
