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hearing both in the school and later, adult population.
To deal effectively with the question of deafness in a large
population of school children it is essential to have an exact
means of detecting the hearing loss, from the slightest impairment
to the most severe. It is also necessary that this detectionexamination
of a very large number of pupils should be carried out
within a reasonable time without sacrificing accuracy. The
ordinary routine methods of clinical testing such as "conversational
voice", watch, tuning forks, etc. would be unsuitable and unreliable
as regards the time involved and accuracy. The invention
of the audiometer in America in 1927 was the answer to
the large and growing demand for a suitable method of detecting
quickly and accurately any defect in hearing among large numbers,
such as in schools, industrial works, etc.
The audiometers, there are two types - the "Speech" and the
"Pure Tone" are very highly developed scientific, electrical
instruments and so sensitive that they can detect and measure
accurately in "units of hearing loss" the slightest to the most
severe impairment over the whole hearing range.
From 1927 onwards the hearing of thousands of children has
been investigated in various cities in U.S.A. The first similar
investigation of hearing loss, on a large scale among school
children in this country an audiometric survey was conducted
in the Tottenham Schools in 1930 by Professor G. p Crowden of the
London School of Hygiene when he completed a survey of 2,000
children (Prof. Roy. Soc. Med. 27 1934) and in Hornsey in
1931. (Annual Report of M.O.H. 1930). From then onwards regular
routine audiometer testing has been carried out in Tottenham
schools with the exception of an unadvoidable interruption during
the war years. Those children who "failed to pass" the tests
were referred to the ear clinic where a detailed enquiry and
clinical examination was made in each case as to the "history",
cause, duration, complications any treatment already received
etc. and a course of special treatment was carried out. The
results of the special treatments given at the clinics are very
interesting. The following account taken from "Children with
Defective Hearing", Board of Education publication, 1938 and 1950
is an example. "Between 1932 and 1936, 10,171 individual children
were tested as a routine by gramophone audiometer in Tottenham.
Of these children, 8,8% "failed to pass" in either or both ears
Yet after treatment had been given where necessary only one child
(0 1 per thousand) had to be sent to a special school as Grade II.