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The most useful method for school work is very rough but fairly reliable, giving what may be
called the educational value of the hearing. The observer, after emptying the chest as much as possible,
whispers as loudly as he can, using no voice, the “ forced whisper ” and repeating numbers between
ten and a hundred. The child, especially if somewhat deaf, frequently lip-reads ; it must, therefore,
after it has understood the method, again be tested with its back to the observer. With such methods
of testing I have found that in the open air, in a comparatively quiet playground and still atmosphere,
the normal hearing distance is 25 metres facing the examiner and 21 metres with the eyes covered. It
is not merely the actual deafness which requires investigation but also allied conditions which later
may cause deafness, and more particularly conditions indicating the presence of quiet catarrh in the
middle ear. This would be work of great educational value, and requires to be done for sufficient numbers
to make our statistics of value ; it also requires much experience on the part of the examiners to assess
the exact conditions as seen under the circumstances necessary for school examinations. The results
so far obtained show that defects in hearing, and all the associated troubles, are intimately related to
neglect and ignorance in the care of childhood.
Miss F. Ivens, M.S., has investigated the hearing powers of 1,000 children in East End schools,
namely, at Myrdle-street (H.E.), Heckford-street, Cable-street (H.E.), Berner-street and Lower Chapmanstreet.
These schools, however, are not representative of average conditions, as most of the children
have foreign names. There were 439 boys and 567 girls, and partly to eliminate the mental factor
and partly to save time unselected children were taken only in the higher standards, and aged 10 to 14.
They were of poor class, except Myrdle-street, which is somewhat better, and where many gave an account
of previous treatment and even of throat operations, All who heard the " forced whisper " at 20 feet
were taken as " educationally " of normal hearing, although this is a trifle less than one-third the distance
at which healthy children should hear. Only 6 per cent. of failures to this test occurred amongst the
suburban children in Bradford, from whom the standard for hearing was determined, but Miss Ivens
found five times this amount fail in the East End, which accords with the high percentage found some
years ago in examinations of the Poor Law children at Hanwell. On the other hand, Miss Alice Johnson
only notes 12 per cent. among 500 mentally defective English children in South London.
One-third of the East End children are therefore not merely subnormal, but have a defect in
hearing that may be expected to affect their educational capacity, and their efficiency in after life. The
psychology of defective hearing in an uneducated child is very intricate. Such a one misses many details,
possibly misinterprets others ; its pronunciation is seriously modified if very young and its understanding
vague. The teachers note that deaf children often prefer to sit in a back row of a class and lip-read, rather
than in front, especially during a dictation lesson. Here, as in all educational matters, so very much
depends on mental capacity, but the partially deaf child always fails to attain the full level of its intellect,
and usually has only moderate success in school, its failure being marked in the highest marks or classes.
Some of the sharper children when deaf seem nervous almost to overstrain ; this is also noticeable in
schools for the deaf; but in most of the 30 per cent. here noted defective attention was evident, and appeared
to be associated with ill-nourished, possibly poorly fed children, many of whom indeed suffer
from insufficiency of sleep. Each child had been recorded by the teacher as to its mental capacity in
marks from 1 (lowest) to 5. This marking has been done carefully, many cards showing that the teacher's
judgment had been revised. It is probably the best assessment of intellect that can be made at present,
but is not entirely satisfactory and must not be accepted as more than an estimate of an immeasurable
quality and possibly not as good as the standard of the child in school.

This table shows the pulling down of intelligent children with aural defects from the excellent
class to the merely fair or good. Careful records were made of each child. Testing by the watch was
only occasionally used in special cases, as its unreliability as a general test is well known. Adenoids
were inferred when not seen, from mouth-breathing, discharge and facies, actual palpation with the