MARYLAND SCHOOL BULLETIN CONSERVATION-OF-HEARING PROGRAM FOR MARYLAND COUNTY SCHOOLS VOL, XXIV JUNE, 1943 No. 3 ISSUED BY STATE DEPARTMENT OF EDUCATION BALTIMORE • MARYLAND CONSERVATION-OF-HEARING PROGRAM FOR MARYLAND COUNTY SCHOOLS MARYLAND SCHOOL BULLETIN CONSERVATION-OF-HEARING PROGRAM FOR MARYLAND COUNTY SCHOOLS VOL XXIV JUNE, 1943 No. 3 ISSUED BY STATE DEPARTMENT OF EDUCATION BALTIMORE • MARYLAND The French-Bray Printing Co. Baltimore-2, Maryland CONTENTS Foreword 1 Purpose of Bulletin 3 Introduction 3 Present Facilities 3 Use of Available Facilities 4 A Well-Rounded Conservation-of-Hearing Program 5 Helps for the Teacher 6 Helps for the Parents 7 Helps for the Child 10 FOREWORD During the past five years, the Maryland State School for the Deaf, at Frederick, and the State Department of Education have conducted a continuous audiometer testing program among the public schools in Maryland counties. The results obtained indicate that a considerable number of the children have actual or potential hearing impairments that require special attention on the part of teachers or parents. The purpose of this bulletin is to provide information about the Maryland program for the conservation of hearing and to give some practical suggestions to persons most interested in the children con- cerned. The material was prepared by Miss Helen Monterey Collins, teacher of lip reading in Montgomery County, was revised by R. C. Thompson, Supervisor of Vocational Rehabilitation of the State De- partment of Education, and edited by Merle S. Bateman, Editor of Publications, State Department of Education. Thomas G. Pullen, Jr., State Superintendent of Schools June 15, 1943. 1 CONSERVATION-OF-HEARING PROGRAM FOR MARYLAND COUNTY SCHOOLS PURPOSE OF BULLETIN This bulletin is offered as a brief guide for the use of superintendents of schools, supervisors, and teachers in planning and conducting pro- grams for conserving the hearing of pupils. The suggestions take into account the State and local facilities which are available in Maryland. INTRODUCTION At preventive stages the hard of hearing form the largest single group of potentially handicapped people in the United States. At the same time they are most difficult to recognize and follow adequately. This impairment least stirs the emotions because, to the observer, a deafened person generally presents a normal physical appearance. Never- theless few physical defects can so blight the personality and cause more real tragedy. It is these negative psychological effects, rather than the impairment itself, that are easily observed and that often prove to be socially the greater handicap. The misinterpretation of these observable psychological effects causes much unhappiness to the person himself and confusion to the normally hearing person, who will label the deaf- ened person as immature, retiring, peculiar, feeble-minded, suspicious, unsocial, stubborn, inattentive, etc. The hearing impairment is often complicated by accompanying head-noises of varying loudness and kind. Boards of Education and Departments of Health are realizing more and more that most cases of deafness originate in childhood and these agencies are increasingly interested in establishing conservation-of-hear- ing programs to prevent deafness and to provide the best medical and educational adjustment where needed. PRESENT FACILITIES A Facilities for finding the child with impaired hearing 1 Annual census of handicapped children 2 Survey conducted jointly by the State School for the Deaf and the State Department of Education a All children in selected grades are given a whisper test by a teacher from the State School, b Children who fail on the whisper test and any who report ear diseases are checked on a pure tone audiometer, c Also all children in other grades who are suspected of having impaired hearing are tested on the pure tone audiometer. 3 Children discovered by the Health Department in pre-school clinics and in periodic school examinations 3 B Facilities for medical examination and treatment of the child with impaired hearing 1 The ear clinics by the American Legion and the American Legion Auxiliary in cooperation with the County Health Departments and the Boards of Education1 a Children showing a hearing loss of fifteen decibels or more on the State tests are referred to the clinics for examination, b Conditions are diagnosed and recommendations for treatment are made by a competent ear specialist, c Wax is removed and in certain cases radium treatments are given at the clinics. d The recommended follow-up work is provided for by the parents, hospital clinics, Health Departments, Welfare Organizations, and in- terested clubs. C Facilities for vocational training (Impaired hearing limits a person’s vocational possibilities.) 1 Pupils with impaired hearing are urged to graduate from high school or take as much academic education as possible before transferring to specialized or vocational education. 2 At graduation from high school or at the age of 16 or over, any person with impaired hearing may avail himself of the voca- tional guidance service offered by the State Rehabilitation De- partment. If it develops that special vocational training is neces- sary, this may be secured, at no cost to the applicant, either at the Maryland State School for the Deaf or, through the Voca- tional Rehabilitation Service, at some other institution or place of business. 3 In certain cases a client is helped to secure higher or more specialized education. 4 If possible the trainee is placed in a job. A Arouse in the community appreciation of good hearing and interest in conservation-of-hearing programs. B Invite parents, educators, doctors, club members to witness pure tone tests as given in the State Survey. C Make public the findings of the Survey. D Educate parents and educators as to the importance and means of counteracting diseases in childhood and the early correction of any impairment before it may become chronic. USE OF AVAILABLE FACILITIES SS SLISiXSTS &£ss-te"s priatelv clas°s1fiede’acToUrdeine£raCth ptysical.ly handicapped child to be examined and to be appro- s 4 E Educate parents and teachers as to means of detection of deafness where audiometers are not available. A child who appears inatten- tive, listens with one ear more than the other, asks for repetitions, appears dull, does poor school work, or presents behavior problems may have a hearing impairment. F Where no lip-reading teacher is available, the teacher and parent can be of practical help to a child with a hearing impairment.2 G Send children to nearby lip-reading classes when they are available. H In certain cases, a child is helped to secure an individual, wearable, vacuum tube hearing aid. I Children whose hearing impairment is such that they cannot get proper benefit from the public school facilities are eligible for ad- mittance at the Maryland State School for the Deaf. A WELL-ROUNDED CONSERVATION-OF-HEARING PROGRAM A well-rounded conservation-of-hearing program must include the following steps: A Detection: No child is to be said to have impaired hearing until he has been tested on the pure tone audiometer and has received a clinical examination by a physician. 1 Group audiometer: A phone-audiometer testing forty children simultaneously and screening out those with impairment 2 Pure tone audiometer: An individual and accurate hearing test for those persons failing on two group tests B Medical treatment: The immediate aim of the conservation-of-hear- ing program is preventive, seeking to get the child into the hands of a physician before impairment in the hearing of speech occurs. 1 Ear clinic: Examination, diagnosis, and recommendation of needed treatments 2 Follow-up; Treatments arranged by the parents or health and welfare groups C Educational help (exclusive of the excellent program conducted for deaf and hard-of-hearing children by the State School for the Deaf, at Frederick) : 1 Special seating for children with a slight impairment 2 Lip reading for those with a handicapping impairment or if the prognosis is not favorable 2See supplement of practical helps for parents and teachers, pp. 6-9. 5 HELPS FOR THE TEACHER Possible signs of deafness in a child 1 A puzzled expression on the face 2 Inattention or over-attention 3 Asks that statements be repeated 4 Makes wrong answers or repeatedly says “I don’t know.” 5 Cocks head to one side 6 Poor speech 7 Peculiar voice quality 8 Low in orally taught subjects 9 Ears discharge and ache 10 Has to repeat grades 11 Complains of noises in head Things to remember 1 The child with a hearing impairment has to be taught to preserve his speech. 2 The hard-of-hearing child is first of all a child and must be kept in as normal an atmosphere as possible. 3 A child need not have a severe impairment in order to be handi- capped. This depends upon the child and upon the type of deaf- ness he has. Some children handle a great loss better than others do a lesser one. 4 Hard-of-hearing people may seem odd and indifferent at times: usually this is just a pose or a defense mechanism. Things to do 1 Understand the purpose of a conservation-of-hearing program and visit a lip-reading class. 2 Know something of the psychological effects of even a slight im- pairment of hearing. 3 Have a sympathetic understanding of the child’s problem and let him know you are on his side. He needs constructive help. 4 Use visual education whenever possible. 5 Get the child’s attention before speaking to him. 6 Be sure your face is in a good light, so that the lip-reading child can see you clearly. 7 When it is necessary to repeat for the child, it may be helpful to reword your statement or question, as some words are more easily seen and heard than others. 8 Be sure the child gets new instructions. Let him come to you after class to ask for help and clear up misunderstandings. 6 9 Give the child every chance to develop self-expression and con- fidence. 10 Watch the speech, voice, and mannerisms of yourself and the class. Don’t put the hands to the face when speaking or exagger- ate lip movements and gestures. Be easy and natural. Insist on the child’s taking a similar attitude. 11 Know the child’s parents. 12 Know where to go for help a The Volta Bureau, 1537 35th Street, N. W., Washington, D. C., (a clearing house for all problems concerning the deaf and hard of hearing) b State Rehabilitation Service, Lexington Building, Baltimore-1, Maryland c The County Superintendent of Schools d The lip-reading teacher in your county e Staff of the Maryland State School for the Deaf The Classroom 1 Give the child a proper seat—one near you and placed so that his better ear is toward you. 2 Never have the child facing the light—this prevents him from seeing others clearly. 3 Allow the child to turn around in his seat to watch other children recite. 4 Other children in the classroom will reflect the teacher’s attitude toward children with impaired hearing. Caution 1 Do not advise a hard-of-hearing child regarding a definite oc- cupational objective. Leave this to experts. 2 Let the child try out as many types of work as possible both in and out of school, but have him keep an open mind regarding his occupational choice. See that a guidance program for each child is begun as soon as possible under the supervision of the State Rehabilitation Service. HELPS FOR THE PARENTS Possible signs of deafness in a child 1 A puzzled expression on the face 2 Inattention or over-attention 3 Asks that statements be repeated 4 Makes wrong answers or repeatedly says “I don’t know.” 7 5 Cocks head to one side 6 Poor speech 7 Peculiar voice quality 8 Low in orally taught subjects 9 Ears discharge and ache 10 Has to repeat grades 11 Complains of noises in head Things to remember 1 The child with impaired hearing is first of all a normal child and must be kept in as normal an atmosphere as possible. 2 The child with a hearing impairment is not “deaf.” 3 A child need not have a severe impairment in order to be handi- capped. This depends upon the child and upon the type of deaf- ness he has. 4 Hard-of-hearing people may seem odd and indifferent at times. This is a pose or defense mechanism. Things to do 1 Understand the purpose of a conservation-of-hearing program. Visit a lip-reading class, 2 Know something of the psychological effects of even a slight impairment. 3 Maintain toward the impairment a wholesome attitude, which the child will reflect, 4 Watch your own speech, voice, and mannerisms. Don’t put your hands to your face when speaking or exaggerate lip movements or gestures. Be easy and natural. Insist on the child’s doing likewise. 5 Get child’s attention before speaking to him. 6 Have the light on your face and, when feasible, on the faces of others. Be watchful of this at the dining table and in the living-room. 7 Know the child’s teachers—especially the lip-reading teacher. 8 Form the habit of speaking to the child in a normal tone of voice but at a distance of three feet or less. Home training 1 The health of the child is of primary importance and all remedial impairments should be corrected. Good eyesight is invaluable. 2 As far as possible correct the hearing impairment, under the direction of a competent ear specialist. 8 3 Admit to yourself and to the child that the impairment exists but do not let it assume undue proportions. Do something con- structive about it as early as possible. 4 Watch the child’s speech and voice. Encourage the learning of new words and the reading of good books. 5 See that the child supplements his hearing by watching the lips of the speaker. 6 Give the child useful things to do at home. Train him to be in- dependent in thought and action. 7 Give a wide variety of experiences and develop vocabulary rele- vant to the experiences. 8 Discover any special abilities and develop them early. 9 Encourage a hobby and interests in many things. Have the child be especially good at some one thing. 10 Help the child to develop a sense of humor. This is a saving grace! 11 Recognize any psychological disturbances and ward them off or instigate a remedial program. Don’t pamper the child. 12 See that the child has normal or nearly normal emotional de- velopment. Be sure he gets the common, “taken-for-granted” things. 13 Encourage the child to use his hearing—by radio, telephone, musical training. 14 Encourage the child to be friendly and to learn how to make friends. 15 If others in the family have hearing impairments, be sure their attitude and reaction to their impairment is a constructive one. If it is not, greater care must be taken to develop good mental habits in the child. 16 Do not advise regarding an occupational objective. Let him try out as many types of work as possible in and out of school, but have him keep an open mind regarding his occupational choice. Leave that responsibility to the Rehabilitation Service. 17 Know where to go for help; a The Volta Bureau, 1537 35th Street, N. W., Washington, D. C. (a clearing house for all problems dealing with the deaf and hard of hearing) b State Rehabilitation Service, Lexington Building, Baltimore-1, Maryland c The County Superintendent of Schools d The lip-reading teacher in your county e Staff of the Maryland State School for the Deaf 9 HELPS FOR THE CHILD If you are to live as normal a life as possible, it is necessary for you to develop a wholesome attitude toward your impairment. These sugges- tions will help you do this: 1 Understand the essential fact that your hearing is not normal. 2 Practice Up reading whenever the opportunity presents itself. 3 Don’t take yourself too seriously. Develop a good sense of humor. It will save you from many a bump. 4 Don’t be sensitive and hold grudges—you probably misunderstood something. Clear it up at once. 5 Tell teachers that you need an advantageous seat near them. Study each teacher and decide how you can best get along with her. 6 Check with the teacher directions not heard or points not clear. 7 Never say “no” or “yes” when you are not sure what has been asked or said. 8 Be interested in activities that give one wide experience. Go places whether you understand all that is said or not. 9 Build up a good vocabulary. The more things one is familiar with the better chance one has of being a good lip reader. 10 Talk to people—you will get practice in lip reading different types of mouths and build up self-confidence. 11 Be friendly and make friends. 12 Learn about as many vocations as possible. 13 Develop a hobby. Sometimes an avocation leads to a vocation. Think, but also learn to do things with your hands. 14 Never use your impairment as an excuse for some failure on your part! 15 Keep well! 16 Read good books and magazines on a variety of subjects. 17 Always place yourself in as advantageous a position as possible when in a group—have no light in your eyes, stay close to a friend or someone you can understand, avoid getting into jams, use your best judgment. 18 Watch your speech, pronunciation, voice quality, and strength. (Ab- dominal breathing will help voice quality and strength.) 10