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18
With the object of obtaining the percentages of passes and failures at various ages, the
records of 12,959 children were taken and the results are given in the subjoined table. It will be
noticed that, on the whole, the greater percentage of failures is with the vounger children.
Table 9.
Age.
Pass.
Fail.
Number.
Percentage.
Number.
Percentage.
6 years
82
93.1
6
6.8
7 „
813
91.7
73
8.2
8 „
1,629
90.2
176
9.7
9 „
1,818
92.5
146
7.4
10 „
1,991
93.4
140
6.5
11 „
1,697
93.1
124
6.8
12 „
1,789
92.8
137
7.1
13 „
2,326
96.4
85
3.5
This must not be taken to indicate a higher incidence of hearing defect in the younger
children as compared with the older, indeed, the opposite is the case, but it is confirmatory evidence
that correct recording by the younger children is influenced by some one or more of the factors
already stated.
Fig. 1 shows the differential analysis of all ears before and after treatment, and indicates
clearly the improvement in hearing as the result of treatment.
The clinical examination of the failed children conducted by the otologists revealed
the following defects which were partly or wholly responsible for their loss of hearing:—
Catarrhal condition of middle ear 964
Wax 487
Nasal defects (rhinitis, deflected septum, ethmoiditis) 446
Otonrhoea 304
Defects due to past suppuration 301
Tonsils and adenoids 145
Old mastoid operation 73
Adenoids 60
Foreign body 16
External otitis 4
Congenital malformations 2
Debility 2
Nothing found 59
Total 2,863
Among the 28,038 children tested, there were 66 who appeared to be possible cases for
transference to a " partially deaf " school, that is to say, all these children showed a loss of 18
decibels or more in their better ear.
As a result of treatment 24 of them were improved sufficiently to enable them to benefit
from elementary school education.
The remaining 42 were invited to County Hall for a special examination, and 5 of them
were found to be suitable cases for a "partially deaf" school. Four were certified, while the
remaining child who was due to leave school in 2 months was allowed to remain in elementary
school. The special examination included voice tests, clinical examination, a pure tone
audiometer test, tuning fork tests, and a consideration of the speech, language, lip.reading and
mental ability of the child.
Thus out of 28,038 children examined with the gramophone audiometer in the elementary
schools, 5 or .017 per cent. were in an unsuitable educational environment. A careful comparison
between the results of tests by the gramophone audiometer, pure tone audiometer and voice,
shows that the relationship between these tests is not constant.
It is quite clear that, although the audiometers (both gramophone and pure tone) and the
tuning forks provide most valuable data, and may even be regarded as essentials in this work,
they are quite insufficient without a complete investigation of a child, including the voice test,
to make a " placing " examination satisfactory, that is to say, to make possible a correct decision
as to whether a child needs educational training in an elementary school, a " partially deaf "
school or a " deaf " school.
There are certain cases in which it is quite impossible to use tuning forks or audiometers.
Young and backward children are most difficult to deal with, and very little reliance can be placed
on any response which they may feel inclined or be persuaded to give. Another type of child who
is extremely difficult is the child who wilfully refuses to co-operate. Tuning fork tests and audiometer
tests are impossible with such children, and the only way to deal with them is to use some
device which will cause them to disclose the position, and this can most easily be done with the
voice test in some form. One good example of this tvpe of case, was a child who refused to cooperate
in any way. I asked questions, gave commands, tried to get him to count after me, to