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52
Impaired
hearing in
elementary
school
children.
Dr. Mabel
Russell.
III.—Hearing Tests.—Continuous attention has been paid at school medical
inspection to the question of hearing tests when reliance must be placed upon such
a test as that of the forced whisper. As an example of the work done in this way the
following report has been submitted by Dr. Mabel Russell, who has paid special
attention to the hearing of the children in three of the elementary schools under her
charge.
It is generally agreed that with the age group examinations and special cases
referred by teachers or parents few, if any, children with any gross degree of deafness
miss detection during their school life. On the other hand, minor degrees of impaired
hearing (from a preventive point of view, the most important) can more easily
be missed, and it was with a view to ascertaining to what extent this was true that
enquiry was made, limited to three of the Council's schools in Chelsea.
As a class test the children were asked to write down two words which were
given with the ordinary spoken voice, care being taken not to raise the voice in the
slightest. For the first word the examiner faced the class, but with the lips hidden,
and for the second word went to the back of the class (i.e., behind the children) thus,
children in front and back rows had an equal chance of hearing ; in some of the larger
classes it was found necessary to divide the class into two sections for the purpose
of carrying out the test. Any child who failed to write down both words correctly
was examined later in more detail to ascertain whether there was any physical
cause for deafness or a past history of otorrhcea or other aural ailment. The forced
whisper test was then applied.
The children examined varied in age from 8 to 14 years.
Total number examined ... ... ... ... ... ... ... ... 434
„ „ failing in class test ... ... 129
„ „ with slight impairment of hearing (after forced whisper test applied) 18
„ „ definitely deaf ... 2
Of the 2 definitely deaf—one well known to the school doctor has been under
treatment for some long time without improvement, and has now been passed for the
hard of hearing class. The second child has only been in London some 11 months,
but in the re-distribution of the children from one school to another had missed being
brought up for a special examination. She also has been now passed for the hard of
hearing class.

Many of the failures to pass the class test were found to be due to inattention,
mental dullness or difficulties in spelling the words given.
Arising out of the enquiry the most impressive fact is that so many of the children
who failed in the class tests had a history of ear or throat trouble and although, in a
room in which there was more or less freedom from noise, some of them responded
quite well to individual tests, there was evidently some slight impairment of hearing
which might progress to a more serious degree of deafness later.
It is difficult to secure treatment for these very slight impairments of hearing,
mainly for the following reasons :—
(a) Parents do not notice anything wrong, or do not realise the need for
treatment at this stage.
(b) The general hospitals and some children's hospitals are so over-crowded
in their out-patients' departments that the physician or surgeon has no time to
make a detailed examination of a child who apparently hears ordinary speech
quite well, a first impression probably confirmed by the parents' own conviction
that there is nothing wrong.