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It is interesting to note that nearly all the children in whom hearing loss
was confirmed are in the group referred because deafness was directly suspected as a
sensory loss, and not indirectly because of impairment of other functions, such as
speech and mental development. No deafness was confirmed among children referred
because of speech defect or delayed speech. It may be that when the children with
speech defect are old enough to give a reliable audiogram, minor degrees of deafness
will be found, but it is unlikely that we are failing to detect the degree of deafness
which will interfere with the child's development of language, or require special
educational treatment. Our survey seems to confirm the opinion that in order to
discover children with hearing loss at an early age, it is necessary to search for them
directly be screening tests. Those suspected of deafness need thorough investigation
this is best undertaken by an "Audiology Team".
Gradually a picture of a complete scheme has emerged and though there are still
many pieces missing, we are at present working towards the following scheme. No doubt
new knowledge will make us change our "blue print" even before we have realised it in its
entirety:
1. Health visitors to screen babies at about nine months, particularly those
"at risk".
2. Further screening at four years, if indicated because of history of otitis
media, speech defect, etc. When practicable screening of all four year old children
for high tone deafness.
3. Referral of pre-school children who fail repeated screening, to the Audiology
Team.
4. Annual pure tone audiometry surveys of all children aged six years and ten
years.
5. Referral to school medical officer (with special experience) of all children
who fail the audiometric tests.
6. Medical Officer to refer to the Audiology Clinic, children with hearing loss
who do not seem to require treatment from the general practitioner or the E.N.T. Surgeon.
7. Provision of auditory training and parent guidance for ohildren with hearing
loss who are (a) under two years; (b) two to five years, but not recommended for
admission to the School for the Deaf; (c) recommended to wear hearing aid but to attend
ordinary school.
8. Follow-up and supervision of all children with hearing loss in ordinary
schools whether or not a hearing aid has been recommended.
9. Audiometric testing of all children prior to ascertainment as handicapped
pupils or as ineducable, and prior to referral for speech therapy.
10.The keeping of a Register of all children known to have suffered from otitis
media - frequent observation of these children including audiometric testing.
11.Register of adults known to wear a hearing aid and follow-up by health visitor.