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The services of a psychologist were also available. She was already working
in the Child Guidance Clinic and was experienced in the testing of pre-school children.
Thus, with no increase in staff and with £50 at our disposal for equipment, the Team
came into being and started to function at Maybury Road Maternity and Child Welfare
Centre. The two health visitors attended two courses in the Department for the
Education for the Deaf at Manchester University, firstly, a two-day course on screening
tests and, secondly, a two-week course which included some diagnostic testing and
auditory training. They also visited the Unit at Gray's Inn Road.
It was found that very little equipment was needed. Our purchases consisted
mainly of play material used for distracting children and for testing, and simple items
such as a drum, rattles, bells, musical boxes, and books and pictures used to illustrate
certain words and sounds. In later years, as we become more expert, we added pitch
pipes, xylophone-pitch bars, and a sound level metre. Referral was mainly from health
visitors, medical officers and general practitioners, and for each child referred the
health visitor was asked to complete a special form giving a detailed history. Whenever
possible the clinic medical officer also added his report. Our Director soon became so
impressed by the value of the "Team approach" that he referred to the Audiology Clinic
all pre-school children suspected of deafness, whether referred in the first place to
the Local Authority or Hospital Clinics. Gradually, some of his colleagues in
neighbouring areas became aware of the work of the clinic and referred children direct
to Mr. Scott at the Audiology Clinic. In this way the Team, under the very patient
guidance of its Director, and with much help from the Head Teacher of the School for
the Deaf, began to build up their skill.
A number of young children were ordered hearing aids, and the problem of auditory
training and parent guidance then had to be faced. It is a problem which has not yet
been satisfactorily solved, and indeed it cannot be without extra teachers, though the
staff of the School for the Deaf, where there is a nursery class, have been most helpful.
When the child is considered to need admission to the nursery class, and is of the
appropriate age, there is no difficulty. When the child with hearing loss is under two
years, or if over two, is not considered to have reached a stage of development
appropriate for special education at achool, auditory training sessions for ohild
and parent are necessary. The staff of the School for the Deaf have been most generous
in giving their own time to this work, and have been rewarded by the progress made by
the children and the appreciation shown by their parents. When the children have
subsequently been admitted to school, the teachers have been impressed by the rapid
progress they have made in comparison with children admitted without such prior training.
We hope also that this early training will eventually be reflected in the quality of
speech and language achieved by school leaving age. At the Head Teacher's {suggestion
some of the children in whom it has been extremely difficult to make a diagnosis at the
clinic, have attended the nursery class for a day. The skilled observation of the
teachers has then been most helpful in enabling a diagnosis to be made. As a Team, we
are convinced that the proper person to undertake auditory training Is a trained teacher
of the deaf, though the health visitor can help a great deal to make "parent guidance"
effective and In encouraging the parents to achieve a constructive attitude towards their
deaf child.
The health visitor's main contribution, however, is in the screening of babies
at about nine months and, where indicated, a second screening for high tone deafness at
about four years. When the Audiology Team had been functioning for over a year it was
felt that the children were not being referred early enough. Although one or to babies
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