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16
The very large increase in the numbers submitted for nutritional classification
should be noted, as it is due to the anxiety that the children needing milk in school
or other help should not be missed. Although more children were considered than
in previous years, the number found to be seriously ill.nourished was fewer, being
450 compared with 493 in 1936, and 827 in 1935.
Audiometric
examination
in
elementary
schools
In November, 1934, following experimental use, systematic audiometric examination
of children in the elementary schools, by means of the gramophone audiometer
was introduced by the Council. The object of this scheme is the ascertainment of
defective hearing in one or both ears, especially in its early stages, so that (a) by
means of timely treatment the defective condition may be remedied and permanent
deafness in later life averted, and (b) the suitable educational environment for the
child may be decided upon. One unit was established in the north.west division
of the county in November, 1934, a second unit in the south.east division in May,
1935, and a third unit in 1936 in the south.western division thus completing the
development foreshadowed in the three.year programme.
A unit consists of one gramophone audiometer; one full time nurse, who carries
out the testing of the children in the schools, and is present at the clinical examination;
and an otologist, who conducts one clinical examination and one treatment session
each week.
The work is under the direction of Mr. A. G. Wells, F.R.C.S., who has submitted
the following report:—
Audiometric
work
The number of children tested by the gramophone audiometer during the year was 60,440,
and the total number of individual tests was 69,759. Particulars of children who failed are
shown in the following table:—

The subjoined table gives the total number of ears tested in 1937 and 1936, and shows the
number falling in 4 separate groups, viz.—3 to 6 decibels = the passes; 9 decibels = those who
just failed; 12 to 18 decibels = moderate degree of hearing loss; 21 to 30 = severer degree of
hearing loss. (The audiometer records are graded in steps of three decibels.)

Fig. 1 is a differential analysis of failed children, and shows the hearing in the better ear
before and after treatment. The amount of educational handicap is shown in this graph. Fig. 2
shows the differential analysis of all ears before and after treatment. Both graphs show clearly
the improvement in hearing as the result of treatment.