Dsflf and HARD of HERRIRG 
CHILDRER 
in 
ILLII10IS 
(Second Edition) 
STATE OF ILLINOIS 
ADLAI E. STEVENSON, Governor 
commission for Hnnoicuppeo 
CHILDRCn DEAF 
and 
HARD OF HEARING 
CHILDREN " 
in 
ILLINOIS 
(Second Edition) 
Illinois Commission for Handicapped Children 
160.North LaSalle - Chicago 
1949 STATE OF ILLINOIS 
Adlai E. Stevenson, Governor 
COMMISSION FOR HANDICAPPED CHILDREN 
Mrs. Henry G. Dormitzer, Chairman, Chicago 
Gerard M. Ungaro, Vice-Chairman, Winnetka 
Frank Annunzio, Chicago 
Robert Bell Browne, Ph.D., Urbana 
Gerald M. Cline, M.D., Bloomington 
Roland R. Cross, M.D., Springfield 
Mrs. Margaret Pope Hovey, Chicago 
Vernon L. Nickell, Springfield 
Frank A. Norris, M.D., Jacksonville 
Irving F. Pearson, Springfield 
Fred K. Hochler, Springfield 
Edward H. Stullken, Chicago 
Henry C. Warner, Dixon 
Jane Bull, Executive Director ADVISORY COMMITTEE 
on 
HEARING CONSERVATION AND 
REHABILITATION 
MEMBERS 
Mary L. Thompson, Chairman 
Martha B. Black 
Maude B. Carson, R. N. 
E. C. Cline, Ph. D. 
Daniel T. Cloud 
Jeannette Frasier 
Lester R. Gerber 
Werner K. Gottstein, M. D. 
Herbert R. Kobes, M. D. 
Herbert Koepp-Bakcr, Ph. D. 
Francis L. Lcdcrer, M. D. 
Helmer Myklebust, Ph. D. 
Marion Quinn 
Charles F. Sutton, M. D. 
Myrtle Wolff TABLE OF CONTENTS 
PAGE 
Nature and Significance of Defective Hearing . . 9 
Extent of the Problem 17 
An Ideal Statewide Program 21 
Resources in Illinois 38 
Unmet Needs 45 
Recommendations 50 
Suggestions for Further Reading 56 FOREWORD 
Those who are familiar with the first edition of this 
pamphlet, issued in 1947, will realize that the revisions 
included in this second edition do not represent a change 
in philosophy but do represent a growth in the program 
for Illinois children with defective hearing. 
Several recommendations made in the first edition 
have been carried out during these past two years. It is 
our hope that further developments may be reported in 
the future. 
Acknowledgement was made in the first edition to 
Miss Mary Thompson, Mr. Daniel Cloud, Dr. Walter H. 
Theobald, Miss Evelyn Horton, and Miss Jayne Shover, 
who gave generously of their time in reading the manu- 
script and advising the staff, and to Miss Elizabeth Mills 
who compiled the material and prepared the original 
manuscript. Revisions in the content of this edition have 
been made by the staff of this commission. 
Mrs. Henry C. Dormitzer 
Chairman 
June 1949 DEAF AND HARD OF HEARING CHILDREN 
IN ILLINOIS 
llature and oj - Jdearintj 
Those who have defective hearing have long recog- 
nized that it is a serious handicap, but only within com- 
paratively modern times have medical science, and a 
greater public understanding of the problems which an 
impaired sense of hearing can cause, made it possible by 
painstaking effort to overcome these problems. It is a 
far cry from the situation in Roman days, when under 
church and civil law the deaf were classified as minors, 
i.e., mentally irresponsible because they could not talk, 
to the present, when with proper education and training, 
a congenitally deaf child may learn how to share in the 
activities of the hearing world through the use of speech 
and lip reading and so may achieve the full privileges 
and responsibilities of normal adult life. 
This does not imply that it is easy for a deaf child 
to reach such a degree of normalcy or that existing pro- 
grams are adequate to assure each child the service he 
needs to reach his maximum potentialities. In many 
ways, those with defective hearing have been the most 
neglected of physically handicapped children, and the 
problem of meeting their needs fully has been compli- 
cated by certain long standing differences of terminology 
and of opinion regarding educational methods. There is 
also a lack of coordination in the services that do exist. 
9 and piecemeal efforts have not resulted in a complete 
and continued service to the child during the whole 
period of his need. 
Our present philosophy recognizes that the child 
with hearing loss has the same educational and social 
needs as other children, and if he is to have equivalent 
opportunity to become a happy and useful adult, he must 
have highly skilled services from his earliest years. If 
we are to assure him his basic right to communication, 
to education, to work and to participate in the life of his 
community, we must find him early and make available 
to him all necessary medical care and offer him the edu- 
cational program especially adapted to his individual 
need. We must train him for work which he can perform 
well, which he enjoys and in which opportunity for em- 
ployment is available to him. We must prepare him for 
and accept him into the social life of his community. 
Throughout this program we must always see the child 
as an individual and recognize his individual abilities 
and needs. He is primarily a child and then a child with 
special needs. 
In a discussion of the problems of defective hearing 
it is necessary to understand certain terms which arc 
commonly used. These include: 
Audiometer—A device for measuring degree of 
hearing loss. There are two principal 
types, the group or phonograph audio- 
meter by which a number of persons 
can be tested simultaneously, and the 
puretone or individual audiometer by 
which more exact individual tests can 
be given. 
10 Decibel—The minimum unit of prcceptible hear- 
ing for a human ear. Degrees of hear- 
ing loss are commonly expressed in 
numbers of decibels. 
Otologist—A physician specially trained in treat- 
ment of diseases of the ear. Otological 
examination means examination by 
such a medical specialist. 
Definition—The term “deaf5 is used glibly in re- 
ferring to persons with auditory defects. Strictly speak- 
ing, deafness is the inability to perceive sound. In 
reality, only a small number of those persons popularly 
called deaf are wholly deprived of their sense of hearing. 
Persons with defective hearing arc distributed into what 
is almost a normal curve, with the degree of hearing 
deficiency or decibel loss ranging from total deafness to 
slight deviations from “normal” hearing. A hearing 
loss of more than nine decibels, as shown on a group 
audiometer test, is considered to be significant and to 
indicate a need for special attention. 
Persons with defective hearing fall into two main 
groups, the deaf and the hard of hearing. There has 
been much discussion and disagreement among special- 
ists in the field as to what criteria should be adopted in 
differentiating between these two groups. The following 
terminology was recommended by the 1930 White House 
Conference Committee on Child Health and Protection:1 
“The deaf are those who were born either to- 
tally deaf or sufficiently deaf to prevent the 
establishment of speech and natural language; 
those who become deaf in childhood before 
language and speech were developed; or those 
1White House Conference on Child Health and Protection, Volume III 
F, Special Education: The Handicapped and the Gifted, p. 277. 
11 who became deaf in childhood so soon after the 
natural establishment of speech and language 
that the ability to speak and understand speech 
and language has been practically lost to them. 
“The hard of hearing are those who established 
speech and ability to understand speech and 
language, and subsequently developed impair- 
ment of hearing. These children are sound 
conscious and have normal or almost normal 
attitudes toward the world of speech in which 
they live.” 
From the standpoint of education, the differentiation 
is made on the basis of ability to use language both in 
hearing and speaking. Because the avenues of instruc- 
tion open to the deaf child are not the same as those for 
the hard of hearing child, it is important that they be 
taught separately. This does not mean that both groups 
should not be taught to use oral speech as a means of 
communication, but that the methods employed in teach- 
ing each group must of necessity be different. The deaf 
child is dependent upon the avenue of sight and much 
must be presented to him visually. On the other hand, 
when a child has some residual hearing this must be 
utilized in the teaching process, if it is to be saved from 
deterioration. There may be a need to supplement use- 
able hearing by the use of hearing aids and lip reading 
depending upon the severity of the hearing loss. 
While there are many persons who have total or 
partial hearing loss from birth, the majority of hearing 
defects are acquired. The age of the person at the onset 
of the impairment determines in large measure the 
degree to which he is handicapped by the loss, thus in- 
struction of the congenitally deaf and those whose 
hearing was lost before speech developed is most difficult 
12 because the former have never heard sound and neither 
has any natural speech. 
Significance to the Individual and Society—It is 
evident that the ability to communicate with others is 
vital to the growth and development of a young child. 
When a child attains the age at which he seeks an ex- 
planation of the world about him, he begins by asking the 
“why” of the things he sees and hears, touches, tastes 
and smells. In so doing, he is building the foundation 
for more formalized instruction. 
To a child with defective hearing this range of 
experience is limited by the nature of his handicap. Not 
only is he unable to perceive many of the sounds in his 
environment, he is also unable to understand many of 
the sense impressions which he is physically capable of 
receiving. Frequently, awkward speech limits his ability 
to ask questions. When questions are posed, explanations 
may be so oversimplified that in the end the child is left 
with erroneous impressions. Because so much of early 
learning is transmitted by word of mouth, his education 
and social development are apt to be retarded unless 
special provision is made when he is very young to help 
him overcome his handicap. The child with a hearing 
loss must be taught how to overcome the barriers which 
separate him from the hearing world if he is to benefit by 
the type of education which will help him to build a life 
as normal and satisfying as possible. 
There are many such children who are not going to 
achieve this goal either because their hearing losses are 
unsuspected or because the training and educational 
program available to them is inadequate and unrealistic. 
These children are socially and educationally handi- 
capped now and will be additionally so in adult life 
13 because of their difficulties in finding satisfying employ- 
ment and in their social adjustment. 
A hypothetical but typical case study will serve to 
illustrate the problems facing the child with an undis- 
covered hearing loss: 
Alice is an eight-year-old whose hearing defect has 
gone unnoticed by her parents and teachers. Because 
the defect is not recognized she has not had the benefit 
of medical care which might have improved her hearing, 
nor has she had the benefits of special training to break 
down the barriers. Among her playmates Alice is re- 
garded as “dumb" and is ridiculed by them, for she 
always seems to do and say things which are out of place. 
These scenes have been a source of painful embarrass- 
ment to her and more and more she tends to shy away 
from group activities and withdraw into herself. The 
emotional strain of attempting to live a normal life in a 
“hearing world" is proving too hard a battle for her. 
At school Alice cannot use the intelligence which she 
possesses because she cannot always understand the 
questions which arc asked of her nor can she hear the 
explanations of the teacher, so she has had to repeat a 
grade. 'This failure has increased her dislike for school 
and her sense of frustration. The teacher finds her in- 
attentive, indifferent and restless. 
What will become of Alice after a year or more of 
education which ignores her special needs? She may 
become a behavior problem as well as an educational one. 
She may try to compensate for her inadequacy by resort- 
ing to antisocial acts and become one of the delinquents 
of the community. She may merely leave school at an 
early age, totally unequipped to meet the problems which 
will face her. 
14 When this child reaches adulthood, what are her 
prospects of finding employment? She has a physical 
handicap; she has a personality problem; she has an 
inadequate education; and she has been given no guid- 
ance in planning or preparing for a suitable vocation in 
which she can find satisfaction. In short, Alice has been 
offered the same training as the normal hearing child, 
but since it was improper training she has not only been 
unable to profit by it, but it has actually contributed to 
her personality difficulties and social maladjustment. 
Special training for the acoustically handicapped 
child often fails to cope with every phase of his problem. 
The child who is educated in the residential school may 
not have been taught to communicate orally. The child 
who is in a special class for the hard of hearing but has 
had no vocational training or guidance, the child who has 
been taught lip reading but whose speech has gone un- 
corrected, has not received all the training necessary to 
afford as complete an adjustment as possible to his 
handicap. 
It must be remembered that the final goal of educa- 
tion is as normal an adjustment to life as is possible. To 
achieve that goal every aspect of the problem confronting 
the child must be understood and the coordinated services 
of all of the health, educational and welfare agencies of 
the state should be employed to help him make the ad- 
justment successfully. 
Our society cannot afford to lose or deprive itself of 
the active participation of those individuals whose hear- 
ing is defective. The activities in which they can engage, 
when properly trained, far outnumber those into which 
they cannot enter, and it is essential that they be given 
the same opportunity as other citizens to share in the 
responsibilities and satisfactions of community living. 
15 The costs of the special services which make it possible 
for them to become full members of society are suffi- 
ciently great so that measures to prevent the occurence 
or progress of hearing loss more than pay for themselves. 
However, for those whose hearing is already defective 
the cost of adequate medical, educational, psychological, 
social and vocational service is much less than that of 
allowing them to grow up poorly educated, isolated 
socially, and dependent upon or enemies to society in- 
stead of being independent adults contributing to the 
general welfare. 
Association with Other Defects—Deafness is com- 
monly accompanied by defective speech because speech is 
learned by imitation and the deaf child has had no oppor- 
tunity to hear either his own voice or that of others. 
Some variation from normal speech is associated with 
any severe hearing loss and corrective speech work is 
therefore one of the essential services to the acoustically 
handicapped. 
Mental retardation does not occur in any greater 
proportion among children with hearing loss than among 
other children. Not infrequently there is confusion and 
failure to distinguish between mental retardation and 
the child’s difficulty in learning because he does not hear 
speech. Complete medical and psychological study 
should be recognized as preliminary to classifying any 
child as mentally defective, since the child with unrecog- 
nized severe hearing defect may be so handicapped as 
to appear to have defective intelligence though poten- 
tially he has normal or near normal learning capacity. 
Hearing defects are frequently found among chil- 
dren with cerebral palsy, since the damage to the brain 
causing this condition may involve the center controlling 
16 hearing. When such a double handicap is present, the 
treatment must take into consideration the child's total 
need and help as far as possible both the hearing defect 
and the faulty motor control resulting from the cerebral 
palsy. Since cerebral palsy is more obvious than the 
hearing defect there is a danger that it alone will receive 
treatment and the problems resulting from the child’s 
hearing loss will be ignored or incorrectly classified as 
mental retardation. 
Extent oj the jf^roliem 
There has been no actual count of deaf and hard of 
hearing children in Illinois, and arriving at an estimate 
of their numbers is not easy since previous studies in 
Illinois and elsewhere, from which we might derive a 
rate of incidence of hearing loss among children, either 
cover very small numbers, used inadequate study 
methods, or concern groups not strictly comparable in 
age. Despite these difficulties a review of such studies 
helps us arrive at a tentative figure for the probable num- 
ber of children with defective hearing in Illinois. 
Studies Outside of Illinois—The White House Con- 
ference on Child Health and Protection in 1930 estimat- 
ed, on the basis of previous group audiometer tests on 
school children and reports on World War I draftees, that 
there were ten million people in the country whose hear- 
ing was impaired to a degree which interfered seriously 
with their educational and vocational progress and with 
proper social adjustment. It also estimated that three mil- 
lion children in the country suffer from impaired hearing. 
(The White House Conference was concerned with all 
children under 21 years of age.) This figure of three 
17 million acoustically handicapped children has been rather 
widely quoted and has been cited by the American Acad- 
emy of Ophthalmology and Otolaryngology in some of 
its published material on conservation of hearing. 
In 1935-1936, the United States Public Health 
Service made an extensive survey of the health status of 
the general population in the United States, including a 
special study to find persons with hearing loss.2 The 
study methods used included individual audiomctric and 
otological examinations. Since the National Health 
Survey made its breakdown by ten-year-groups only 
above the age of five years, some adjustment is necessary 
to apply its rates to the Illinois population under 21. 
Assuming for our purposes that the rate of hearing loss 
for persons 15 to 24 is reasonably applicable to those 15 
to 20, we get the following figures when we apply the 
rates to Illinois population figures: Number of persons 
with fairly severe hearing impairment under 5 years of 
age—252; 5 to 14 years of age—3,019; 15 to 20 years of 
age—2,583; a total of 5,854. Averaging rates for all 
degrees of hearing loss, and between males and females, 
the following percentages were obtained for persons in 
the age groups in which we are interested: Under 5 
years of age—.046 per cent; 5 to 14 years of age—.26 
per cent; 15 to 24 years of age—.32 per cent. Persons 
reported by the study as having impaired hearing were 
those with an average hearing loss for both ears of 47 
decibels or more in the speech range, a fairly severe im- 
pairment. Any child of school age with so severe a hear- 
ing loss would need special education facilities. The 
study showed that the incidence of hearing loss increased 
with advancing age and that in all age groups, except 
1 Willis C. Beasley, “The General Problem of Deafness in the Popula- 
tion,” The Laryngoscope, (September, 1940), pp. 856-905. 
18 that from 25 to 34 years, there was more impaired hear- 
ing among males than among females. The population 
sample study was entirely urban, but there is no factual 
information that would indicate any significant rate of 
difference in rate of hearing defect between urban and 
rural population. 
The American Hearing Society has, for some years, 
collected figures on hearing tests made on school chil- 
dren in different parts of the country. Their figures 
published in June, 1945 cover 2,478,883 cases tested by 
either group or puretone audiometers. One hundred nine 
thousand two hundred twenty-four of these children, or 
4.4 per cent of all tested, showed evidence of hearing im- 
pairment. It is interesting to note that during the years 
the American Hearing Society has been collecting these 
figures there has been a definite and rather steady de- 
crease in the percentage of hearing defects found, and it 
seems fair to assume that as hearing testing programs 
have been carried on there has been concurrently a con- 
siderable amount of successful preventive work done. 
If we take 4.5 per cent as maximum for the occur- 
rence of any hearing defect for children of school age and 
apply this rate to the Illinois population, we get a figure 
of 88,575 children between the ages of 5 and 20. This 
figure probably represents the greatest number of chil- 
dren of school age whose hearing might require some 
investigation beyond the initial group test. 
Studies in Illinois—In 1940, the State Superin- 
tendent of Public Instruction asked 180 school superin- 
tendents to estimate numbers of handicapped children 
within their districts. Those reporting indicated that 0.9 
per cent of their students were either deaf or had a hear- 
19 ing impairment so severe that they were in need of 
special education facilities.3 This rate, applied to the 
total Illinois population between the ages of 5 and 20 in 
1940, would indicate that there were 17,750 children with 
hearing defects sufficiently severe to need a special edu- 
cational program. 
The most extensive hearing tests on school children 
in Illinois were made by a vision and hearing survey 
done by WPA and sponsored by the Illinois Society for 
the Prevention of Blindness, Group audiometer tests 
were given by specially trained lay people and nurses. 
Figures for the period October 1, 1941, to January 31, 
1943,4 covering a majority of counties in the state and 
including rural and urban public and parochial schools, 
showed a total of 158,956 children tested, with evidence 
of hearing defects in 7,309 or 4,6 per cent of the total, 
and with medical follow-up on 2,782, or 3.1 per cent of 
those showing auditory defects. Approximately 1 per cent, 
or 19,683 of the children tested, appeared to have a hear- 
ing loss sufficient to necessitate some special educational 
program. These figures are in substantial agreement 
with those of the American Hearing Society and with 
other more limited studies not recorded here. 
The 1930 United States Census attempted to count 
the number of totally deaf persons in each state. These 
were defined as those who had become totally deaf before 
the age of 8 years. As this count depended on verbal 
reports to lay enumerators without any examination 
procedure, the figures are unreliable and probably 
definitely too low. Six hundred and twenty-live such per- 
sons under 20 years of age were reported in Illinois. 
3 The Illinois Plan for Special Education of Exceptional Children—The 
Physically Handicapped, Superintendent of Public Instruction, Circular 
Series “A”, No. 12, p. 10. 
4 Unpublished figures secured from Chicago Hearing Society. 
20 Since 1930, the Census Bureau has not attempted to count 
the deaf or blind because of the difficulty in securing 
reliable figures through available methods of enumera- 
tion. 
Summary—From a review of these studies, we can 
arrive at a general estimate of the number of children in 
the state who may be in need of some special services 
because of impairment of hearing. The maximum esti- 
mate is that there are 100,000 children of school age 
whose hearing needs investigation beyond a group audio- 
meter test. The majority of these will prove to have 
normal hearing upon purctonc audiometric examination. 
A sizeable group, however, will need medical examina- 
tion to establish the diagnosis and necessary medical 
treatment which may prevent further loss of hearing or 
improve or restore hearing to normal. From 5,000 to 
20,000 of these children will have sufficiently defective 
hearing to make a special educational program necessary. 
In all probability there are at least 250 children of pre- 
school age who have rather severe hearing loss and whose 
need for special medical and educational services is 
extremely important. 
Statewide program 
What are the elements that make up an ideal pro- 
gram of service to acoustically handicapped children? 
These services group themselves under prevention, case- 
finding, medical care, education, vocational training and 
placement, personal adjustment services and research. 
The problem of financing this ideal program is allied to 
the effective carrying out of all of these components. 
The exact amount and the nature of the services needed 
21 by any given child will depend on the degree of his hear- 
ing loss, at what age the loss occurred, whether it is 
stationary or progressive, the child’s intelligence, health 
and personality, the experiences he has had before such 
services are given, and the attitude of his family and his 
community toward his handicap. Not all children will 
require all the services described here, but unless all are 
available the urgent needs of some child will not be met. 
Prevention—The desirability of preventing hearing 
loss when possible is obvious from the standpoint of hu- 
manity and of sound economics. Effective preventive 
measures differ according to whether the hearing loss is 
congenital or acquired. There is no known method of 
preventing some congenital hearing defects—these are. 
in effect, biological accidents which science does not know 
how to avoid. Certain other types of hearing defects, 
either present at birth or developed during later years, 
show a definite familial tendency and the prevention of 
their occurrence is a matter of eugenics. (The danger 
of transmitting defective hearing from parent to child 
increases with the intermarriage of persons from fam- 
ilies showing such tendencies.) 
The greater portion of defective hearing occurs as 
a result of disease or of accidents after birth. Various 
communicable diseases, including syphilis, meningitis, 
smallpox, and ordinary diseases of childhood, such as 
measles and scarlet fever, may cause hearing loss. Any 
measures which prevent such diseases, such as immuniza- 
tion, strict quarantine procedures and venereal disease 
control programs, are helpful in preventing the develop- 
ment of hearing defects through the control of the dis- 
eases which cause them. Such measures are closely 
22 related to the presence of effective public health services 
in each community. 
Good medical care for every person suffering from a 
condition which might lead to a hearing loss, including 
both the communicable diseases just referred to and dis- 
eases of the ears, nose, and throat, will prevent much loss 
of hearing. The ability to secure such medical care de- 
pends upon several factors, among these the education of 
the public to the recognition of its importance, the avail- 
ability of properly qualified general and specialized med- 
ical practitioners, and provision of care at public expense 
for those for whom private care is not available. 
Studies made to date, although not extensive, tend to 
indicate that elimination of preventable noise, especially 
in industrial and manufacturing processes, is of impor- 
tance in hearing conservation. General safety programs, 
which are effective in accident prevention, will result in 
the prevention of some loss of hearing. 
Case-finding—Case-finding is of major importance 
in any program for handicapped children and serves a 
dual purpose: as part of a program of prevention and as 
the first step in bringing about rehabilitation to those 
requiring it. In order to avoid hearing defects which may 
never be able to be alleviated in later years and to pro- 
vide educational services which will be as effective as 
possible in preparing these children to take their places 
as contributing members of society, it is imperative that 
they be located at an early age. 
The essentials of a case-finding program are; 
1) A child accounting system which makes an an- 
nual survey of all children from birth to 21 years of age, 
noting those with obvious defects so that they may be 
referred to needed corrective and educational services. 
23 This is a particularly important way of reaching pre- 
school and out-of-school children. 
2) A hearing testing program covering all school 
children. Ideally, this should involve testing every child 
every year, but where this is not possible testing each 
child on entering school and every three years thereafter 
should be considered a minimum standard. In addition, 
children who have been under otological treatment or 
who have had one of the childhood diseases which might 
cause loss of hearing should be examined upon termina- 
tion of medical treatment. Tests should be administered 
by trained personnel using the group audiometer for 
preliminary testing and the puretonc audiometer for 
children showing signs of defective hearing in two group 
tests, for very young children, and for those being tested 
following medical treatment. 
3) An annual medical examination of each school 
child. If this is done following the hearing test, children 
who have defective hearing can then be referred by the 
general physician to an otologist for further examination 
and treatment as indicated. In the course of the general 
examination any health factors which may have a bearing 
on hearing can be checked. 
4) The education of the public, and especially 
parents and teachers, to recognize behavior which may 
suggest the presence of a hearing defect, and to recognize 
the conditions which may result in a hearing loss, such 
as frequent colds, running ears, and certain childhood 
communicable diseases. The importance of early medical 
examination upon recognition of this condition needs to 
be stressed in such education. 
5) Follow-up service is an integral part of case- 
finding in all instances in order that the child with actual 
24 or potential hearing loss is examined by the otologist 
promptly and is referred to other specialized services ac- 
cording to his need. 
Medical Care—Adequate medical care is of the 
utmost importance in preventing hearing loss and in 
checking and slowing its progress when it is present. This 
means both good general medical care for those condi- 
tions which might result in complications leading to hear- 
ing defects and specialized care by highly trained physi- 
cians skilled in treating the ears. In an ideal program we 
will have, therefore, both general medical care of high 
quality and specialized services available to every child 
regardless of where he lives or the financial status of his 
family. This involves problems of distribution of general 
and specialized physicians and of organizing and financing 
medical care programs. There is increasing recognition 
today of the importance of assuring to the whole popula- 
tion adequate medical care of high quality. Certainly, 
measures which lead to better general medical care will 
result in the prevention of hearing loss in some cases. 
In addition to private medical care, there are several 
different ways of providing care by medical specialists for 
children with actual or potential defective hearing. Ear- 
clinics, both in established dispensaries or hospitals and 
on a traveling basis, are one way. While it is desirable 
that such specialized services be distributed throughout 
the state, most ear conditions are not acute medical emer- 
gencies and it is therefore usually feasible, when necessary, 
to take the child to the population center where special- 
ists practice. The problem may be met in some instances, 
therefore, by providing transportation for the child to the 
specialist. 
25 Many persons feel that a means of bringing more 
adequate medical services to children with actual or 
potential hearing loss is to be found in the broadening of 
medical care programs. Such programs are established 
on a basis of complete service to the handicapped child 
and assure statewide services to children with defects 
which come within the scope of the program. 
Education—The ideal educational program for chil- 
dren with defective hearing must be based on the prin- 
ciples of a sound educational system for all children, 
using the best that is known in theory and method. It 
must constantly see the child as a unique personality, and 
be sufficiently flexible to meet his individual needs, care- 
fully and scientifically determined. It must have as its 
principal objective preparing the child for full participa- 
tion in the society around him, in as nearly normal a 
fashion as possible, and it should therefore be based on 
speech as the child’s exclusive method of communication, 
accepting speech as “The God-given right of every deaf 
child to be equipped to meet the world in as normal a 
method as possible.'’5 Any usable hearing which the 
child has, however little, should be trained and utilized to 
the maximum, in order to facilitate his education and to 
give him as rich an experience as possible. To this end, 
every child for whom a hearing aid has been recom- 
mended by medical specialists should have one, paid for 
from public funds if no private resources are available. 
The total program of special education for the child with 
defective hearing in both day and residential schools 
should be under the general supervision of the state 
superintendent of public instruction, to assure coordina- 
tion of all educational efforts, and continuity of service to 
5Coordination of Effort for the Education of Exceptional Children, U.S. 
Department of the Interior, Office of Education, (Bulletin 1935, No. 7), 
p. 21. 
26 the child throughout his education, regardless of where 
he lives. 
Preschool Deaf Child—Present-day experience in 
the education of the deaf points unmistakably to the fact 
that the success of the child in acquiring speech, skill in 
lip reading, and general academic knowledge is very 
directly related to how early intensive special training is 
begun. Many of the limitations noted in the educational 
achievement of deaf children are due to the fact that 
education was not begun early enough, or that there has 
not been close correlation between training in school and 
at home. 
If the deaf child is to avoid several years of educa- 
tional retardation, he must be taught before reaching the 
normal school age to acquire language which the hearing 
child picks up unconsciously in his preschool experience. 
Strong evidence in the actual recorded achievement of 
deaf boys and girls indicates that the deaf child of nor- 
mal mentality whose special education is begun by the 
time he is three years old, who continues under the best 
type of modern instruction in speech, lip reading, and 
use of remaining hearing, may be expected to develop 
understandable and reasonably pleasant and fluent 
speech, and a high degree of skill in lip reading which 
enables him to understand all ordinary conversation in 
which he can observe the lips of the speaker, and to 
achieve progress through the academic grades close to 
that of hearing children of the same age. Since we know 
this ideal can be achieved, we must not be satisfied with 
less. 
To attain maximum results, the education of the 
deaf child should begin in the home as soon as it is known 
that his hearing is impaired, and the ideal program 
27 should provide expert counseling to his family so that 
they may give him the proper training in the home 
setting. Under such guidance the family can help the 
child to acquire the habit of reading lips and a good deal 
of skill in doing so. Through games and play exercises 
he can be trained in the coordination and habits of atten- 
tion which will be useful to him in his later education. 
The counselor could also help the family in under- 
standing and meeting the child's special needs, direct 
them as needed to medical and psychological resources 
which would assure adequate medical care and an evalua- 
tion of individual aptitudes, and assist in making plans 
for his education. 
The deaf child should have the benefit of association 
with other children of his own age, but because of his 
inability to communicate, this may be more difficult to 
achieve for him than for hearing children. This should 
be taken into consideration in determining whether he 
should attend nursery school. The desirability of this 
experience for the deaf child, as for any child, should be 
considered on an individual basis. When such experience 
seems indicated it should be offered in a regular nursery 
school setting with hearing children in attendance. This 
assumes a really good nursery school program, since 
such a program is highly flexible and geared to meet the 
individual needs of each child. 
Formal speech training is not a function of the home 
since it must be given by highly trained special teachers, 
but the family, if given some guidance, can encourage 
and help the deaf child to make his first efforts in speech. 
Training in speech and lip reading by the special teachers 
should be started when the child is three years old. The 
three-year-old deaf child has, however, all the other needs 
of any other child his age and it is therefore most im- 
28 portant that the special instruction in speech and lip 
reading be part of a total program of training which 
takes into consideration his physical, mental, social and 
emotional development. 
Special Classes—Classes for the deaf in the local 
public schools should be established wherever enough 
children can come together to form such a class. 
Assuming that education of these children is begun by the 
time they are three years old, in some school systems 
they are expected by the age of eleven, after eight years 
of specialized instruction, to be able to join the regular 
classes of hearing children of their own age, returning to 
the special teacher for supplementary speech correction, 
lip reading, and acoustic training. Whether or not the 
majority of children can make progress as rapid as this, 
it is generally agreed that under this plan there should 
be little grade retardation, and that by high school they 
should be able to attend all classes with hearing children, 
continuing to have some corrective speech training. It 
is obvious that this early experience in school work with 
hearing children is important to the normal social adjust- 
ment of the deaf child. In addition, he continues to live 
at home and have the same kinds of experience with his 
family and neighbors as do other children of the same 
age. Adaptation of the educational program to the hard 
of hearing child will involve—depending on the degree 
of his hearing loss—one or more of the following ele- 
ments : advantageous position in the classroom and 
understanding of the handicap on the part of the regular 
teacher; lip reading; speech correction; acoustic training, 
i.e., training of remaining hearing with use of hearing 
aids. Lip reading, speech correction, and acoustic train- 
ing are given as supplements to the regular classroom 
instruction with hearing children. 
29 Given sufficient flexibility in organization and finan- 
cing of public school districts, it should be possible to 
meet the needs of practically all hard of hearing children 
through day schools, using special classes or itinerant 
teachers as the needs of children indicate. The child with 
very severe hearing loss who needs a period of intensive 
instruction such as cannot be provided in the local public 
schools, should attend the State residential school for 
the deaf. In some instances arrangements might be made 
for boarding home care in a community maintaining 
special teaching service until the child reaches a point 
where he can manage satisfactorily with the help of an 
itinerant speech teacher. Intensive instruction at a uni- 
versity clinic or on the campus of a residential school 
during the summer vacation period might be another way 
of helping such children. 
Residential Schools — The residential school will 
serve those children with severe hearing loss living in 
sparsely populated areas where it is impossible to estab- 
lish in the local schools those special educational and 
vocational services which they require. It will also serve 
other children whose special needs, determined on an 
individual basis, can best be met in such a school. 
Since a residential school serves as a substitute home 
while the child is in residence, it should offer, in addition 
to a complete educational program, a setting in which 
the child has supervision of his physical welfare and an 
opportunity for the social experiences and emotional 
growth which he would have in his own home. This 
means small living groups, with an adequate number of 
counselors and cottage parents who can hear. It means a 
definite plan for as much association as can be arranged 
with hearing children, using freely such devices as mixed 
30 Scout troops, and other recreational arrangements. It 
means adequate field service, so that a close tie can be 
maintained between school and home. The five-day week 
should be encouraged where travel distances are not too 
great, so that children can spend week ends at home. 
There should be careful integration of the classroom 
and out-of-school program, so that the child is helped, 
through all his waking hours, to get the full benefit of 
the special instruction for which he has come to the 
school. This means, for instance, that he shall be expected 
and helped to use speech and lip reading at all times, 
not just in classes. 
In general, by the time a student of the residential 
school is ready for high school, he should be prepared to 
enter a regular school with hearing students. However 
the residential school should offer a high school program 
for students who, because of a late start in school or be- 
cause of loss of hearing during or just prior to entrance 
into high school, cannot attend the local public schools. 
Double Handicaps—The deaf-blind are a very small 
group who present a most difficult and complicated 
educational problem. Experience has shown that with 
expert and intensive instruction it is possible to teach 
deaf-blind children to care for themselves, to communi- 
cate with others, and in some instances to receive a 
standard academic education. It is, therefore, a responsi- 
bility of society to see that they have an opportunity to 
receive this specialized education, and to make the prog- 
ress of which they are capable. 
Because there are so few deaf-blind children, it has 
proved feasible to undertake their special education only 
in residential centers. Actually only a small number of 
schools for the deaf or blind have developed facilities for 
31 this group of children. Two schools for the blind in the 
East, and one in California have established special units 
for the deaf-blind, where expert staffs give their full 
attention to the educational problem of these children. 
For the present it is probably more sound for other states 
to make provision to send these children to such centers, 
where enough deaf-blind children come together to make 
possible exhaustive study of the most effective methods 
of teaching them, than to try to educate them in their 
own state residential schools. 
Since, with the deaf-feeble-minded, the mental defect 
is the major problem, the needs of these children should 
be met through programs for the mentally defective, with 
provision made for the additional special training made 
necessary by their defective hearing. The education of 
the deaf or hard of hearing is a difficult process at best, 
requiring intelligent responses from the child. For the 
acoustically handicapped child who is also retarded men- 
tally, the academic achievement will be smaller than it 
is with the mentally retarded child who has normal hear- 
ing. The possibility of teaching this child to care for 
himself, to communicate with the hearing to some extent, 
and to do useful and simple work is sufficiently great to 
make it imperative that his needs be given attention. 
The responsibility for the total educational program 
for children with defective hearing, whether in day or 
residential schools, should rest with the state superin- 
tendent of public instruction and his specialized staff. 
Only in this way can the child be assured equality and 
continuity of educational opportunity throughout his 
school years. 
Teacher-Training—Teaching in classes for children 
with defective hearing is a highly specialized activity 
32 which requires training in addition to sound basic 
teacher-training. Many authorities believe that before 
undertaking the instruction of acoustically handicapped 
children the teacher should have, in addition to her 
special training, several years of experience in teaching 
hearing children. The special training will generally 
require at least an additional year of college work, often 
at the graduate level, and should be given in an institu- 
tion which has adequate clinical facilities as part of 
the professional training. Any state maintaining good 
teacher-training programs through universities and nor- 
mal schools should make provision for preparing teachers 
for exceptional children. 
Specific requirements for teachers of the deaf and 
hard of hearing should be outlined by the state superin- 
tendent of public instruction, and teachers in all pro- 
grams receiving state support should meet these standards. 
Vocational Training and Placement—For the handi- 
capped child vocational guidance and training are of 
particular importance, since his physical difference may 
limit the types of work which he can do. A vocational 
program should therefore be an integral part of his 
education. 
Before vocational training must come a good aca- 
demic background upon which to base the vocational 
choice and training. This does not mean that all deaf 
children, any more than all hearing children, have capa- 
city for or interest in continuing their education beyond 
the elementary or high school. It does mean, however, 
that their educational program ought to depend on their 
individual interests and capacities, without hearing loss 
being an insuperable bar to vocational choice at any aca- 
demic level. 
33 In all vocational training of the handicapped, the 
emphasis should be on what the individual can do, and 
not on what he cannot do. Actually, if the educational 
job with the deaf or hard of hearing child has been well 
done, his handicap will limit his choice of a vocation only 
to a small extent. Such limitations would involve chiefly 
work actually utilizing the hearing sense, or work neces- 
sitating contact with the public in which the not entirely 
normal speech of the congenitally deaf might be a disad- 
vantage. To the extent that any deaf or hard of hearing 
person has limited skill in speech or lip reading his voca- 
tional opportunities are of course limited. 
Vocational guidance and counseling should be a part 
of the school program of every child beginning at about 
the junior high school level. This means that the child is 
given a survey of general types of work and an under- 
standing of the sort of education necessary for him. He 
should then have individual study and consultation which 
will help him plan his school program so as to prepare 
for the type of work in which he is interested. This in- 
cludes enough psychological and educational study so 
that his individual aptitudes arc well understood. For 
the child with defective hearing, this study and consulta- 
tion will take a realistic view of the limitations imposed 
by his handicap, and will bring to his attention the broad 
range of work possibilities open to him. A close tie with 
agencies offering specific job training should be main- 
tained, so that there is no chance that the individual may 
be lost between school and training. 
Specific job training should come at the time the 
individual is ready for it. For large numbers of children 
this is during the high school years; for others it is later. 
Residential schools for the deaf pioneered in vocational 
34 education in this country, and continue to have a strong 
vocational emphasis. However, given the ideal education 
outlined above, there is some question as to whether 
special vocational training is needed by the deaf or hard 
of hearing. Given enough individual guidance to bring 
him to those types of work for which hearing is not 
specifically necessary, the deaf or hard of hearing child 
who has fluent speech and good lip reading skill should 
be able to use the same vocational training facilities as 
the hearing child. 
Perhaps one of the greatest services needed by the 
acoustically handicapped is education of the public as to 
what the deaf and hard of hearing can do. The man- 
power shortage during the war gave many of them em- 
ployment opportunities which they did not have earlier 
because of employers' lack of understanding of their 
abilities. Their excellent job performance was of the 
greatest educational value to the employer group. How 
much of this gain can be maintained in a normal labor 
market we do not yet know, but it is fair to assume that 
some of it is permanent. 
In general, persons with defective hearing should be 
able to use the same facilities for job placement as the 
hearing, provided personnel in the employment service 
can interpret their abilities to prospective employers and 
follow up on actual placement to help remove any minor 
causes of difficulty. 
Social Services—An ideal program for children with 
defective hearing must provide remedial services for a 
problem which has been well outlined by a present-day 
authority in special education. Speaking primarily of the 
hard of hearing, but in terms which are also accurate 
for the deaf, and after describing the need of the deaf- 
35 cncd for medical, educational and vocational services, he 
says, 
. . above all they need understanding as 
personalities, help in adjusting as personalities 
to the crisis presented by their loss of hearing. 
Unless we are able to give them this understand- 
ing and help, the other aid we give them may be 
largely, if not wholly, futile. 
“The understanding they seek and need of 
us demands, on our part, a casework approach. 
“To help these personalities, we must first 
understand them—their essential modes of man- 
aging the realities of their living, the meanings 
their experiences have given them (in terms of 
which they interpret their loss of hearing), their 
relationships (the demands that other personali- 
ties make upon them, the reactions of these 
other personalities to their hearing loss.)"6 
Such help and understanding of the child with hear- 
ing loss may be achieved partly through the individual- 
ization of the child’s education, wherein his unique 
experiences are recognized, and by the maintenance of a 
close relationship between school, medical care program, 
and the community. 
Special programs should, in addition, provide 
trained workers whose function it is to assist the child 
to achieve good personality adjustment and to become 
a well-balanced, happy, self-supporting adult. These 
include visiting teachers (school social workers) in the 
schools, caseworkers in vocational guidance and training- 
programs, and medical social workers in ear clinics and 
health programs. 
“Harvey Zorbaugh, “Hearing Loss as an Adjustive Crisis for the Per- 
sonality,” Hearing News, Vol. 13, No. 3, March, 1945. 
36 Every child ought to have access, as needed, to the 
services of visiting teachers, community family and child 
welfare services, and child guidance clinics. However, 
the handicapped child, and particularly the deaf or hard 
of hearing child, whose handicap by its very nature may 
interfere with his relationship with other people, may be 
in special need of these services. 
There is special need to make adjustment service 
immediately available to the individual who suffers sud- 
den, severe loss of hearing. This is particularly true for 
the adolescent and adult. 
Research—An ideal program would include research 
into such problems as the most effective methods of 
teaching the deaf and hard of hearing; methods of stimu- 
lating the use of residual hearing; and the most useful 
type of vocational program. There is every reason to be- 
lieve that such research will ultimately more than pay 
for itself in improving services and achieving better 
results from them. 
Coordination of Services—Only through recognition 
of the importance of all types of services and the necessity 
for their close coordination can the best interests of the 
deaf and hard of hearing children be served. Develop- 
ment of awareness of the whole program and assumption 
of initiative in coordinating it is properly the function of 
a statewide group or agency. 
Such coordination of a program may be effected in 
any one of several ways: (1) through stimulation by 
voluntary organizations, (2) through interdepartmental 
committees representing public and private agencies, 
(3) through assigning the coordinating function to a 
public agency. However accomplished, existing public 
and private agencies should find it possible, through con- 
37 tinued group discussion and planning and by working 
out policies of referral and exchange of information, to 
develop a program under which any child with defective 
hearing receives medical care, special education, voca- 
tional guidance and training, psychological, and welfare 
services as needed. 
in J^dlnois 
What resources do we already have in Illinois on 
which we can build an ideal program such as the one 
outlined? 
Prevention and Case-finding—On both the state and 
local levels, a growing body of trained public health 
specialists is constantly working to prevent communi- 
cable disease and to discover physical defects which can 
be corrected. We have legislation which permits the 
establishment of county health departments' and re- 
quires the development of a school health program with 
physical examination of each student every three years.s 
Both of these laws need to be implemented, but they offer 
a groundwork for better health protection of children, 
and early recognition of physical defects, including de- 
fective hearing which may be corrected or arrested. 
An increasing number of health departments and 
school districts are establishing programs for testing the 
hearing of school children at regular intervals. The 
State Department of Public Health aids in the develop- 
ment of such testing programs by making audiometers 
available on loan to local communities. 
An interesting and encouraging development has 
been the Will County Hearing Conservation Project 
which was inaugurated as a demonstration during the fall 
"'III Rev. St at. 1947, Chap. Ill1/,, Sec. 20c—20c 15. 
sIbid, Chap. 122, Article 27, Sec. 8. 
38 of 1947. This project, which was conceived and outlined 
by the Advisory Committee on Hearing Conservation of 
the Illinois Commission for Handicapped Children and 
carried out by the Will County Health Department, 
tested the hearing of every school age child in Will 
County. It also arranged the otological examination and 
treatment, if indicated, and did medical and educational 
follow-up. This has become a part of the continuing 
school health program of Will County. Several other 
counties have indicated their interest in similar projects.9 
Medical Care—Illinois is fortunate in the number of 
physicians there are in the state who are specialists in the 
treatment of diseases of the ear, nose, and throat. Accord- 
ing to the 1949 Directory of Medical Specialists, 183 doc- 
tors in Illinois have been certified by the American Board 
of Otolaryngology, and are, therefore, trained to give 
special otological care. Of the certified specialists, 136 
are listed in Cook County and 47 downstatc. 
There are also, in the Chicago area, several ear, nose, 
throat clinics, and at least two hospitals specializing in 
care of ear, nose, throat diseases. One of these is the 
Illinois Eye and Ear Infirmary, which is the state insti- 
tution where diagnostic, out-patient, and hospital facili- 
ties are available without charge to any citizen of the 
state who cannot afford private medical care. 
The Division of Services for Crippled Children of 
the University of Illinois includes in its program children 
with hearing defects. Any child for whom a hearing 
examination is indicated may be examined at one of the 
Division’s field clinics. This examination consists of an 
individual puretone audiometer test, an examination by 
9See report of Advisory Committee on Hearing Conservation and Re- 
habilitation on Will County Hearing Conservation Program published by 
Commission for Handicapped Children. 
39 a speech and hearing consultant, and a general physical 
examination by a pediatrician. After this clinic exam- 
ination the child is referred to an otologist if this is indi- 
cated. After the child has received the necessary medical 
care, the Division hearing consultant assists in making 
recommendations for the child’s special education or 
other needed services, such as lip reading instruction or 
speech correction. The services of the medical social 
service staff of the Division are available to any child 
who is registered in one of its clinics, and through this 
staff the child in need of further social services will be 
referred to the appropriate community agency. 
The Division will purchase hearing aids and provide 
medical care if the child is financially eligible. Through 
its program the Division offers to children with hearing 
defects the most complete service available in the state. 
Education—In recognition of the need for early 
training of deaf children there has been, since the sum- 
mer of 1945, a ten-day Institute for the mothers of pre- 
school deaf children. Held at the Illinois School for the 
Deaf, it is sponsored jointly by the Department of Public 
Welfare, the Division of Services for Crippled Children, 
and the Superintendent of Public Instruction. During 
the session the mothers are helped to understand the 
essential methods of instruction for a deaf child and arc 
taught what they can do for their children at home before 
they reach school age. 
The Illinois Eye and Ear Infirmary and the Chicago 
Hearing Society jointly sponsor a class for the parents of 
preschool deaf and hard of hearing children in the 
Chicago area. This class meets weekly three weeks of the 
month with the exception of the summer months and is 
designed to teach the parents how to prepare these chil- 
40 dren for entrance into school. The Society also has on its 
staff social workers who give guidance and counsel to the 
parents of children with impaired hearing. 
There are two resources for the education of deaf 
children of school age in Illinois—special classes in local 
public schools and the state residential school at Jack- 
sonville. Under present legislation, state financial assist- 
ance is available to local school districts for the main- 
tenance of approved classes for deaf and hard of hearing 
children. This aid is available for services to children 
from three to twenty-one years of age. 
Under this program special classes were being 
maintained in eighteen communities during the 1947-48 
school year. All of these use the oral and acoustic methods 
and are administered by the local school board under the 
general supervision of the State Superintendent of Pub- 
lic Instruction. 
Eleven local school districts in the state have both 
visiting teacher service and special classes for the deaf 
and hard of hearing. In some others a cooperative 
arrangement has been worked out between school dis- 
tricts maintaining such special classes and local child 
guidance clinics. 
A few communities offer a program for children of 
preschool age which combines nursery school experiences 
with rhythm, speech and lip reading training. 
Children from four to eighteen years of age, for 
whom the proper educational program is not available in 
the local communities attend the Illinois School for the 
Deaf at Jacksonville. In March, 1949, the student popula- 
tion of this school was 398. Something over four-fifths of 
the pupils are instructed by use of the oral or acoustic 
method, the others by the manual method. The school 
offers academic work from kindergarten through the 
41 ninth grade, and vocational training in a number of 
trades. Children attend the school without charge, as 
they would any other public school. 
Where there is no special program for deaf children 
in the local public schools, the Division of Services for 
Crippled Children provides acoustic training, lip reading, 
and speech rehabilitation by private therapists to pre- 
school and school age children. 
Intensive speech and rehabilitation centers arc con- 
ducted by four universities each summer for children who 
live in communities where this training is not available. 
In addition to acoustic training, lip reading, and speech 
correction these centers attempt to offer complete psycho- 
logical evaluations, diagnosis of school disabilities and 
remedial work, when possible, and planned group recrea- 
tion and socialization activities. The Division of Services 
for Crippled Children assumes primary responsibility for 
case-finding and reimburses the University for those chil- 
dren who are financially eligible for care under the 
Division’s program. These programs operate from five 
to seven weeks, during which time the children live at 
the center. 
Day centers for intensive speech training also offer 
instruction during the summer months, giving particular 
attention to children who do not have access to special 
services during the school year. The number and location 
of centers in any one summer depends on the availability 
of a speech therapist trained to work with deaf children. 
The center maintained by the School of Speech at North- 
western University also stresses counseling and work with 
parents in addition to the work with the children. 
A new resource for the deaf and hard of hearing was 
provided in the summer of 1948 when the Speech and 
Hearing Rehabilitation Clinic at the Illinois Eye and Ear 
42 Infirmary began operation under the Department of 
Otolaryngology of the University of Illinois, College of 
Medicine. This clinic provides speech and hearing evalu- 
ations, hearing aid fittings, auditory training for children 
and adults, speech therapy for selected cases of children 
and adults, training of deaf and hard of hearing children 
on a highly selective basis, and educational consultation. 
The Ephpheta School for the Deaf, in Chicago, is 
the only private school in Illinois for deaf children. This 
Catholic school accepts both day and five-day boarding 
pupils, and emphasizes the oral method of instruction. 
The Central Institute for the Deaf at St. Louis may 
be considered as among private resources available to 
the citizens of Illinois, since it is in the metropolitan area 
which serves much of southern Illinois. This private, 
nonsectarian school is exclusively oral, and offers instruc- 
tion from nursery school through the elementary grades, 
preparing its students to enter high school with hearing 
students. 
A number of speech therapists qualified to test hear- 
ing and to give speech correction and lip reading instruc- 
tion are in private practice in the State although they 
are concentrated in the Chicago metropolitan area. 
Higher education for deaf Illinois students is fur- 
thered by the State Board of Education for the Blind 
and Deaf, which grants scholarship aid up to a maximum 
of $500 per student in any one year to deaf students 
regularly enrolled in a college, university, or professional 
or vocational school. 
Teacher-Training—Training of teachers of the deaf 
and/or hard of hearing is offered by Illinois State Normal 
University, MacMurray College, Northwestern Univer- 
sity, and the University of Illinois. Training in the 
43 different colleges varies in content and in the clinical 
facilities available for training. These schools at this 
time offer a complete curriculum which prepares teachers 
to meet the standards established by the State Superin- 
tendent of Public Instruction for teachers of special classes 
in local school districts. 
Vocational Training and Placement—The State Vo- 
cational Rehabilitation Service serves persons with defec- 
tive hearing as well as persons with other types of physical 
handicap. The staff includes a special field agent for 
the deaf who uses the manual language, and places in 
employment persons who have no usable speech as well 
as those with lesser hearing defects. Hearing aids may 
be purchased as a necessary part of rehabilitation service. 
Services of a medical social work consultant and clinical 
psychologist specially trained in the examination of 
persons with sensory handicaps are available to assist in 
working out a rehabilitation plan. Funds are available 
for medical care which is of vocational significance. To 
be eligible for service an individual must be over sixteen 
years of age, a resident of Illinois, and have a physical 
disability which constitutes a handicap for employment. 
Psychological Services—In the Chicago school sys- 
tem, children with impaired hearing have access to the 
services of adjustment teachers in the individual schools 
and to the Division of Child Study, which offers special- 
ized psychological services to all school age children as 
needed. 
Psychological and psychiatric services are available 
through the Institute for Juvenile Research, both at the 
Chicago headquarters and through its community child 
guidance clinics in different parts of the state. 
44 Recognizing the need for an all-inclusive, well- 
coordinated hearing conservation program for Illinois 
children, the Advisory Committee on Hearing Conser- 
vation and Rehabilitation of the Commission for Handi- 
capped Children was organized early in 1947. This com- 
mittee is composed of representatives of public and 
private agencies in the state concerned with problems in 
the hearing field. Its aims are (1) to promote the devel- 
opment of an adequate hearing conservation and reha- 
bilitation program for the children of the State of Illinois, 
and (2) to stimulate the development and coordination 
of services for deaf and hard of hearing children. 
7 In met 1 jeeJs 
Despite the existence of important resources for 
service to deaf and hard of hearing children in Illinois 
when they are examined in the light of an ideal program, 
it is evident that all the needs are not yet being ade- 
quately met. It is important, therefore, as a basis for 
formulating a sound program for these children, to 
examine the situation to see just where there are gaps in 
service. 
Case-finding and Prevention—That much hearing 
loss is preventable has been established beyond question. 
The fact that many children with hearing defects due to 
preventable causes are currently coming to the attention 
of doctors, schools, and other agencies is proof that the 
preventive aspect of the program is not yet adequate. 
Among the preventable causes of hearing loss are the 
complications of communicable diseases, against which 
public health measures such as immunization or quaran- 
45 tine are highly effective. There are others which are not 
entirely preventable, but which respond well to prompt 
and efficient medical care, so that hearing loss is elim- 
inated or minimized. 
Many cases of hearing loss in children are still going 
unrecognized for long periods of time or are not getting 
to special services as they are needed, pointing to inade- 
quate case-finding methods. As a result, the child is more 
handicapped than he needs to be, sometimes temporarily, 
and too often permanently, beyond the ability of medicine 
or education to help. Inadequacies in prevention and 
case-finding of hearing defects may be due not only to 
lack of enough public health services but also to insuffi- 
cient training of public health personnel to date in the 
recognition and handling of hearing loss. 
In the area of medical care, too many children are 
getting too little care too late. This is particularly a 
problem outside the Chicago metropolitan area, since 
downstate there are relatively few otologists in practice, 
and no special ear clinics or hospitals. The problem of 
getting young medical specialists into the more rural 
areas is generally recognized as of great importance in 
meeting the needs of a large share of the population, and 
is of great importance to the acoustically handicapped. 
Education—Educational services to the preschool 
deaf child and his family are not adequate. Although 
several downstate communities have set up facilities in 
the public schools for preschool deaf children, for most of 
the state outside the Chicago metropolitan area the only 
resource for the preschool deaf child is the State School, 
and many families understandably object to removing 
the preschool child from his own home for long periods 
of time. There is now no adequate counseling service to 
46 these families, to help them understand the child’s prob- 
lem, what they can do for him at home, and what educa- 
tional plan will be most helpful to him. 
At the present time public education of the deaf and 
hard of hearing is not integrated, so that the state resi- 
dential school for the deaf and the day school classes for 
the deaf and hard of hearing have little organic relation- 
ship to each other which would facilitate transfer of the 
child from one to the other as his requirements indicate. 
Day school instruction of the deaf and hard of hear- 
ing, with its advantages of keeping the child in his normal 
home setting and in association with hearing children, is 
still not available in most school districts of the state, 
including a number with population sufficiently large to 
be able to maintain such a program. This lack is due to 
a number of factors, including inadequate case-finding, 
lack of understanding of the community’s need for such 
facilities, lack of specially trained teachers at the present 
time, and inadequate financial resources to support the 
program even with state aid. The last of these factors 
is frequently related to the fact that school districts are 
so small that they do not have resources to meet the needs 
of children living in them. Facilities for lip reading 
instruction in the state, including those in the public 
schools, in private centers, and including also the speech 
therapists practising privately, are inadequate. 
The state residential school for the deaf does not have 
a fully adequate program for the children whom it serves, 
and its share of responsibility in the total public educa- 
tional program for the acoustically handicapped child in 
Illinois has not been clearly defined. 
Although the school has a number of modern, well- 
built dormitory buildings, it has such very large living 
47 units, with so few cottage parents, that the child's out-of- 
school hour experience cannot be regarded as even a 
reasonably adequate substitute for his own home. 
The school has a social service worker, and psychi- 
atric consultation available twice a month through the 
Institute for Juvenile Research to assist in solving the 
problems of the individual child. Recreational facilities 
are also a part of the school program. 
Between 15 and 20 per cent of the students at the 
school are taught entirely by the manual method, and 
leave the school unable to communicate with the hearing 
through speech and lip reading. There has not been 
sufficient study to establish whether this percentage is an 
irreducible minimum—the fact that some of the out- 
standing schools for the deaf in the country operate on 
an entirely oral basis raises the question as to whether 
it is actually necessary to retain the manual method of 
instruction, with all its implications for permanent social 
isolation of the deaf individual within the comparatively 
small group of the manual deaf. Although some effort 
has been made to keep children being taught by the 
acoustic and oral methods free from exposure to signs, 
this has not been sufficiently successful. The motivation 
and encouragement in constant use of speech and lip 
reading which are essential to development of skill and 
fluency also appear to be inadequate. 
The vocational program of the school is admittedly 
inadequate, in staff, buildings, equipment, and range of 
instruction. 'There is no plan of prevocational study and 
vocational guidance. Academic instruction is offered 
only through the ninth grade, and no curriculum is 
offered for the student who is ready for high school but 
is not prepared to attend the local public schools with 
48 hearing students. The plan of sending such students to 
Gallaudet College for their preparatory work is not an 
adequate substitute, since Gallaudet uses the manual 
method exclusively. 
Illinois has no adequate facilities especially adapted 
to the needs of children who have both a hearing loss and 
mental retardation. The public schools make no provi- 
sion for mentally retarded children in their deaf-oral 
classes nor any provision for children with impaired 
hearing in their classes for the mentally retarded, and 
the state institutions for the mentally handicapped at 
Lincoln and Dixon make no provision for training deaf 
children committed to them. 
There is ample evidence that the success of educa- 
tional programs for deaf or hard of hearing children 
depends to a considerable extent on close cooperation and 
understanding between the home and the school. There 
is much yet to be done in parent education among the 
families of preschool and school age deaf and hard of 
hearing children. 
Successful education of children with defective hear- 
ing requires an adequate supply of highly trained and 
well qualified teachers. The current shortage of such 
teachers is an important factor in the lack of special 
classes. 
Vocational Guidance and Training—Together with 
their hearing contemporaries, children with hearing de- 
fects are not getting adequate vocational guidance and 
training in the local public schools. However, the schools 
throughout the state are improving this situation each 
year. This is a serious lack for all children, but particu- 
larly for those who are at a disadvantage vocationally 
without special services. The facilities and range of 
49 vocational training in the state residential school should 
be enlarged. 
The State Vocational Rehabilitation Service to the 
young deaf or hard of hearing is improving steadily both 
in quantity and quality. There is a closer coordination 
between the local or residential schools and the Division 
of Vocational Rehabilitation than formerly existed, but 
schools might utilize still more effectively the resources 
offered by this agency. 
Because there are not sufficient local child welfare 
services in Illinois, the child with impaired hearing, as 
well as other children in need of welfare services, may 
not receive the help necessary to him. Such help calls for 
social casework, psychological, and psychiatric services, 
according to the individual need. 
Coordination—Insufficient coordination between pro- 
grams for the deaf and hard of hearing results in gaps 
in service both geographically and functionally. Children 
not only can be but are lost between agencies, and may 
receive very good service of one type, such as education 
or medical care or vocational guidance, but due to in- 
adequate follow-up may not receive the other services 
which they require. This results in ineffective service, 
which is not only costly but which does not attain the 
goal of having every deaf or hard of hearing child be- 
come a happy and useful adult citizen. 
l\ecomm end a t ions 
Certain specific recommendations can be made on 
the basis of examination of existing resources and unmet 
needs of deaf and hard of hearing children in Illinois. 
50 Full time public health units should be established 
in every county and staffed by trained personnel in ade- 
quate numbers. 
School nursing services should be provided for every 
school. 
Training of all public health workers should include 
instruction in the importance of early recognition and 
treatment of hearing loss, and the training of public 
health nurses specifically should include instruction in 
the use of the group audiometer and conduct of a hearing 
testing program. 
Illinois should establish a child accounting system to 
provide for an annual census of all children under twenty- 
one years of age and for reporting to a central agency 
any child showing evidence of a physical or mental defect. 
Such an accounting system might be an appropriate 
responsibility of the State Superintendent of Public In- 
struction. 
The existing school health examination law should 
be implemented, assuring to every school child the bene- 
fits of periodical and thorough medical examination, 
leading to early detection of defects and early remedial 
measures. The medical examination should include or be 
supplemented by a hearing test which follows the stand- 
ards outlined by the American Academy of Ophthal- 
mology and Otolaryngology. 
To assure availability to specialized medical care 
throughout Illinois, some plan must be made to get oto- 
logical service to areas in which it is not now present. 
To make otological service available to the whole popu- 
lation specialists should be encouraged to establish prac- 
tice in areas not now served, and provision should be 
made for traveling or periodic clinics. 
51 The whole public educational program for the deaf 
and hard of hearing in Illinois, whether in residential or 
day schools, should be integrated under the supervision 
of the State Department of Public Instruction. This 
would assure that every child with defective hearing 
would attend school in the program best suited to meet 
his educational needs. Such integration is possible by 
interdepartmental agreement between the State Super- 
intendent of Public Instruction and the State School for 
the Deaf. 
Counseling service to the families of all preschool 
deaf children should be a part of the total program, and 
should be given by qualified personnel on the staff of an 
appropriate state agency. Preschool training should be 
available to every deaf child in the state, regardless of 
where he lives. 
The present day-school program for deaf and hard 
of hearing children should be extended and strengthened. 
Every school district which has a sufficient number of 
children with hearing defects to establish a special class 
should do so, and school districts should combine to sup- 
port a special class wherever this procedure makes it 
possible to establish a class which a single district alone 
could not carry. A program of community education as 
to the needs of children with hearing defects should be 
carried on by schools and other interested agencies, in 
order to improve case-finding and to assist in the estab- 
lishment and maintenance of special education facilities. 
The reorganization of school districts throughout the 
state should be continued so the districts will be suffi- 
ciently large to be able to support needed special educa- 
tion. In extremely rural areas where scattered population 
would offer a problem even after reorganization, the use 
52 of itinerant teachers to help acoustically handicapped 
children who can remain in their regular classes should 
be explored. 
There should be reorganization of the State School 
and addition of staff to the point where the child has the 
most adequate possible substitute for his own home while 
he is attending school. Every effort should be made to 
develop smaller living groups. There should be enough 
hearing cottage parents, with suitable background for 
such work, so that the child has adequate personal atten- 
tion. Through cottage parents and recreational person- 
nel, equipment, and planning, the child’s out-of-school 
hours should be satisfying and creative. 
The child who completes the elementary grades at 
the State School should have opportunity to go on 
through high school if his ability and interest justify it, 
just as in the case of the hearing child. The break between 
elementary and high school seems to offer a strategic time 
to get the child who has been attending school in a segre- 
gated setting back into normal contacts with hearing 
people of his age, and it therefore seems wise to plan for 
most of the students to return to high school in their own 
communities if speech therapy is available. 
Use of the facilities of the State School for short- 
time, intensive service in special cases, such as for a sud- 
denly deafened individual, should be explored. 
The state should establish a framework for service 
to deaf-blind children, so that as any such children are 
located, their individual needs can be met. Unless im- 
proved case-finding methods bring to light a sufficient 
number of such children to justify establishment of a 
special center for their care in one of the Illinois state 
schools, the possibility of paying for their care in a special 
center outside the state should be explored. 
53 Educational programs for the mentally handicapped, 
whether in residential or day schools, should include any 
indicated special service to meet the needs of children 
who also have hearing defects. 
Parent education should be regarded as an essential 
part of the educational program for deaf or hard of hear- 
ing children, and all schools serving such children, wheth- 
er day or residential, should recognize this responsibility. 
An active recruitment program should be carried 
on to encourage promising undergraduates and persons 
already engaged in teaching to take the specialized train- 
ing which will prepare them for teaching the deaf and 
hard of hearing. 
The vocational needs of acoustically handicapped 
children will best be met as all children receive better 
vocational services. It is therefore recommended that 
vocational guidance be recognized as an integral part of 
every public school program, beginning at the junior high 
school level and continuing through the high school 
grades. Where the school cannot itself employ qualified 
personnel to carry on such guidance, it should be secured 
through cooperative agreement with other agencies. 
For the deaf child who is not going on with academic 
high school work, vocational training might well be 
offered in the State School, if the child comes from a 
community where vocational training in the schools is 
not well developed. The State School should therefore 
have a rounded vocational program, including individual 
guidance and a broad range of vocational training. 
The total program of the State Vocational Rehabili- 
tation Service should be strengthened and extended 
through the employment of trained personnel and all 
agencies dealing with deaf and hard of hearing children 
54 should establish closer working relationships with this 
Division. 
Wherever possible a school district maintaining 
special classes for the deaf or hard of hearing should 
have visiting teacher and psychological service, available 
to these children as well as to others. Where a local school 
district maintaining a special class cannot itself provide 
social and psychological service, it should establish close 
relationship with local child welfare and family welfare 
agencies or child guidance clinics. The school should 
recognize its responsibility for helping to stimulate com- 
munity awareness of the need for such facilities. 
55 ~Siuj(jeitioni jor further l^eacliny 
Frampton, Merle E,, and Rowell, Hugh Grant. Education 
of the Handicapped. Yonkers-on-Hudson, N. Y.: World 
Book Co., Vol. I, History, 1938. 260 p. Vol. II, Problems, 
1940, 440 p. 
Excellent discussion of problems and procedures in 
education of the handicapped, including the deaf and 
hard of hearing. 
Heck, Arch O. The Education of Exceptional Children. 
New York: McGraw-Hill Book Co., 1940. 536 p. 
A comprehensive discussion of this subject, includ- 
ing sections on education of the deaf and the hard of 
hearing child. 
Hill, Ada Morgan: “Vocational Problems of the Hard 
of Hearing.” Voc at tonal Guidance Magazine. (Now Occu- 
pations) 10:360ff; May 1932. 
A realistic presentation of what the hard of hearing 
person faces in getting a job. 
Illinois State Office of Public Instruction. Basic Plan for 
Health Education and the School Health Program. Spring- 
field, 111.; The Office, The Department of Public Health, 
and the Department of Registration and Education, 
1944. 80 p. 
Outlines a basic plan for school health, including 
prevention and detection of hearing loss, and gives sug- 
gestions as to how local school districts can carry out the 
plan. 
56 McLeod, Beatrice. Teachers’ Problems with Exceptional 
Children, Part IV, Deaf and Hard of Hearing Children. 
U.S. Dept, of the Interior, Office of Education, Pamphlet 
No. 54. Washington, D. C.: Government Printing Office, 
1934. 29p. 
Discusses the problems of acoustically handicapped 
school children, and what the classroom teacher can do 
about them. 
Macnutt, Ena G. “The Hard of Hearing Child in School/' 
Public Health Nursing, 31:47ff; January 1939. 
The public health nurse’s part in a school hearing 
program after hearing loss is diagnosed. 
Martens, Elsie H. Parents’ Problems with Exceptional 
Children. U.S. Dept, of the Interior, Office of Education, 
Bulletin 1932, No. 14. Washington, D. C.: Government 
Printing Office, 1932. 72p. 
Helps parents in understanding what the handi- 
capped child needs. Children with defective hearing are 
covered in the discussion, although most of it applies to 
all handicapped children. 
Martens, Elsie H. Residential Schools for Handicapped 
Children. U.S. Dept, of the Interior, Office of Education, 
Bulletin 1939, No. 9. Washington, D. C.: Government 
Printing Office, 1939. 103p. 
Outlines standards for residential schools for the 
handicapped, including a section on schools for the deaf. 
Montague, Harriet. “The Deaf and the Hard of Hcar- 
57 mg.” Social Work Yearbook. New York: Russell Sage 
Foundation, 1945. p. 129ff. 
An excellent current general discussion covering 
aspects of problems of those with hearing loss of special 
interest to social workers. 
Montague, Harriet. “How to Help the Hard of Hearing 
—Suggestions for their Families and Friends." Volta 
Review. 46:345ff; June 1944. 
Practical suggestions as to how families and friends 
can help those who have lost hearing. 
Montague, Harriet. “Jobs for the Hard of Hearing.” 
Volta Review. 41:219ff; April 1939. 
Sound vocational advice to the hard of hearing, in- 
cluding a description of some of the federal civil service 
jobs held by hard of hearing persons. 
New, Mary C. “Speech Suggestions for the Hard of 
Hearing.” Hearing News. 13:3, p.l2ff; March 1945. 
Describes what may happen to the speech of the 
deafened, and what can be done in both prevention and 
correction. 
Russell, Lillian E. “Beginning Lip Reading—Suggestions 
for Work Mothers Can Do at Home.” Volta Review. 
42:10, p.687ff; October 1940. 
Detailed information for parents on beginning lip 
reading instruction and related activities for preschool 
deaf children. Includes a list of materials to be used in 
instruction, etc. 
58 Simon, Arthur B. “This World and Deaf People." Volta 
Review. 45:485ff; September 1943. 
Good evidence from personal experience on the ad- 
vantages of instruction by the oral method and associ- 
ating deaf children with the hearing. 
Sutherland, Dorothy A. and Miller, Maxine. “Rehabili- 
tating the Hard of Hearing Child." The Child. 9:4, 
p.51ff; October 1944. 
Report on a project for rounded medical and social 
service to hard of hearing children. Shows the function 
of the medical social worker in such service. 
Timberlakc, Josephine. “The Deaf Child and the Hard 
of Hearing Child." Volta Review. 25:9, p.396ff; Septem- 
ber 1932. 
Distinguishes between the deaf and the hard of 
hearing child and the educational methods needed by 
each. 
Tracy, Louise Treadwell. Suggestions to the Parents of 
Deaf and Hard of Hearing Children. Los Angeles: John 
Tracy Clinic, n.d. 7p. 
Excellent general instruction in very readable lan- 
guage, based on Mrs. Spencer Tracy’s own experience. 
Winston, Made E. “What the Parent Can Do for the 
Preschool Child." Volta Review. 35:10, p.41 Iff; October 
1933. 
A summary of the essential points parents need to 
understand in the care of the preschool deaf child. 
59 White House Conference on Child Health and Protection. 
Section HI. Special Education, the Handicapped and the 
Gifted. New York; Century Co., 1931. 604p. 
, Section IV. The Handicapped Child. 
New York: Century Co., 1933. 452p. 
Detailed material on problems and needs of handi- 
capped children, including sections on the deaf and the 
hard of hearing child. Many interesting data, though 
some of the material is now dated and no longer entirely 
accurate. 
Hearing News—monthly—official organ of the American 
Hearing Society, Washington, D. C. 
A wide range of material about and of interest to the 
hard of hearing. 
The Volta Review—monthly—The Volta Bureau, Wash- 
ington, D. C. 
Material about and by both the deaf and the hard 
of hearing. Includes much about the oral education of 
young deaf children. 
In addition to the above specific references, many 
valuable reprints and other printed material about the 
deaf or hard of hearing can be secured through the 
American Hearing Society and The Volta Bureau, both 
located in Washington, D. C. 
60