Units for Partially-hearing Children (1967)

The Department of Education and Science (DES) replaced the Ministry of Education in 1964. This survey, the first in a series, was written by members of HM Inspectorate and Medical Officers of the Department. (See also Survey 6 Peripatetic Teachers of the Deaf 1969.)

The complete document is presented in this single web page. You can scroll through it or use the following links to go straight to the various sections:

Introduction (page 1)
The survey (7)
General observations and recommendations (45)

The text of Units for Partially-hearing Children was prepared by Derek Gillard and uploaded on 2 December 2022.


Units for Partially-hearing Children
Education Survey 1

Department of Education and Science
London: 1967
Crown copyright material is reproduced with the permission of the Controller of HMSO and the Queen's Printer for Scotland.


[cover]


[title page]


Units for
Partially-hearing
Children




Education Survey 1


Department of Education and Science




London: Her Majesty's Stationery Office 1967


[page iii]

Foreword


Units for Partially-Hearing Children is the first of a new series of occasional publications - Education Surveys - prepared by the Department of Education and Science. Education Surveys will cover specialised aspects of education and will be written mainly by HM Inspectors and by the Department's medical officers.

The present survey was prepared because it was felt that a great deal of progress has been made in the development of special arrangements to help this kind of handicapped child, and that more detailed information should be available about the overall pattern of such provision.

Impetus was given to the survey by a consideration of the need to select very carefully the type of child to attend a special unit, to provide an effective supporting organisation and to ensure that liaison with parents is possible when such a unit is set up.

The survey was carried out jointly by members of HM Inspectorate and Medical Officers of the Department, whose names are listed inside the cover of the report. The survey makes a number of recommendations for the future development of units for the partially-hearing, in such matters as organisation, staffing, and conditions under which it is thought these units might operate.




[page v]


Contents


page
Introduction1
The survey7
General observations and recommendations45






[page 1]

Introduction


History

The education of children with impaired hearing has been a subject of controversy in this country ever since the first school for the deaf in England was opened in London in 1792. The controversy was related to methods of teaching, that is, whether a manual or an oral approach was the more suitable vehicle of instruction. Although at the Conference of Milan in 1880 it was decided internationally that an oral method should be adopted, nevertheless, dissensions continued for many years. Dissatisfaction about standards of literacy reached in the schools to-day has led to a revival of the argument and to the formation of the Lewis Committee to investigate the place, if any, of finger-spelling and signing in the education of the deaf.

The manual method involved the use of the hands for finger-spelling or signing the words contained in the information or thought that was being communicated whereas, in the oral method, the pupils were taught not only to follow the movements of the speakers' lips and in this way to gain information by lipreading but also to speak themselves. The manually taught did not learn to speak. The aim of both methods has never been in doubt. This is still to give each pupil, so far as he is able to achieve it, an understanding of his mother tongue, the English language, so that he can use it with skill in communication and through it, know himself, the community of which he is a part and his responsibilities as a citizen within that community.

In the early days it was thought that segregation was an essential factor in the education of deaf children. They were withdrawn from the ordinary schools and brought together in large residential establishments. It became evident that some children, when taught orally, made more rapid progress than others and many teachers became convinced that there should be two methods of instruction, an oral one for those who could make progress in this way and a manual one for those who could not. Many of the teachers were also convinced that the two types should be kept separate. This conviction introduced another topic into the controversy, namely in what kind of school they should be taught. This led to a need for re-organisation. Already by 1877, the pupils who had been transferred from the first school in the country, the London Asylum for the Deaf and Dumb to its branch school in Margate, were taught orally whereas those who remained behind at the main school were taught manually.


[page 2]

Initially, pupils in most boarding special schools for the deaf were separated into departments that catered for one or other of the two different ways of learning. At the turn of the present century, after the Elementary Education (Blind and Deaf Children) Act of 1893 had laid upon local school authorities the duty of providing efficient and suitable education for blind and deaf children, many day classes were opened and, with them, the belief grew that children who could be taught to speak intelligibly should be separated from those who could not. It also became evident that there was much to be gained by making it possible for children to live at home with their families.

The day classes at first were very small. Oral education in them, like that of the boarding special schools, brought evidence that some of these children, too, were more successful than others. Although no accurate measurement of response to sound was possible at that time, it was thought that some of the pupils were able to use residual hearing to improve their skill in oral communication. For these children, who became known as the partially-deaf, mechanical group aids to hearing were devised and used for special ear-training lessons. Such a group aid was recorded to be in use in London in 1907. Consideration of the particular educational needs of partially-deaf children led to a limited experiment with special classes in ordinary schools. By this means children were brought into closer contact with their hearing peers than was possible in special schools. Such a class was opened in Bristol in 1907. As, at this time, there were no electrical aids to amplify sound, progress was not sufficiently outstanding to merit much growth of this system and it was eventually abandoned.

In the twenties, precise measurement of hearing for pure tones became a reality and there was confirmatory evidence that there was great variation in hearing loss from one child to another. At the same time, electrical aids that would amplify sound were produced. These aids catered for groups of children in a classroom situation and, once again, those in obvious possession of useful hearing were drawn together in experimental classes. These classes were, for the most part, within the special schools. There is no documentary evidence of their success and there was no marked development until after World War II.

In 1934 a Departmental Committee of the Board of Education was established with the following terms of reference:

'To enquire into and report upon the medical, educational and social aspects of the problems attending children suffering from defects of hearing not amounting to total deafness.'
This Committee, in its Report which was published in 1938, recommended that partially-deaf pupils should be educated separately from deaf pupils; and in the 1945 Regulations made under the Education Act, 1944, there was for the first time a separate category of the partially-deaf. This led to the provision of separate educational arrangements for the partially-deaf.


[page 3]

A change in the Regulations in 1962 redefined this category as partially hearing. The current definitions are as follows: (1)

'deaf pupils, that is to say, pupils with impaired hearing who require education by methods suitable for pupils with little or no naturally acquired speech or language';

'partially-hearing pupils, that is to say, pupils with impaired hearing whose development of speech and language, even if retarded, is following a normal pattern, and who require for their education special arrangements or facilities though not necessarily all the educational methods used for deaf pupils.'

These changes and technical advances in electronics during the Second World War led to significant changes in the education of hearing-impaired children. Classroom aids were markedly improved and small individual aids for both school and home use became available to all children who needed them; after 1948, the individual Medresco aid became available through the National Health Service.

More accurate measurement and diagnosis revealed the fact that many more children were in need of special educational help than had previously received it. It was clear that these children along with some others who, up to that time, had been educated in special schools for the deaf, should be taught to use what hearing they had and encouraged to learn in more natural ways. Special schools for partially-deaf children were opened and special classes or units formed within ordinary schools. The first four such units were opened in London in 1947.

The purpose of the first units

Initially the classes or units were set up in primary schools to cater for those children who could gain benefit from the stimulus of listening to normal conversation going on around them and who could take part in some of the lessons and activities that went on in the main school. It was thought that these children would be able, by the time they reached the age of transfer to a secondary school, to transfer full-time into the normal classes in an ordinary school and to continue without any special help. If, by this time, such a standard had not been reached, the pupils would be transferred to a special school for the partially-deaf. An extract from the Health of the School Child 1956-57 is of interest since it helps to clarify the purpose for which these first units were started. It says, 'The Education Officer's Department of the London County Council has supplied figures showing the number of pupils transferred from these units over a period of years, 1954-57 (inclusive). The total number

(1) The ideas underlying these definitions are set out in Ministry of Education Circular 10/62 issued in September 1962.


[page 4]

of pupils transferred was 122, of whom exactly half transferred to ordinary maintained schools. There were 6 transfers to schools for educationally subnormal pupils, 1 to an open-air school, 1 to an independent school and 1 to overseas. There were 40 transfers to schools admitting partially-deaf pupils and 12 to schools for the deaf.'

This extract shows clearly the purpose for which the units in London were set up. The pupils were being prepared to follow ordinary school programmes at secondary level and become independent of special help. This was possible only when good academic standards and skill in oral communication were both achieved.

The growth of units

The four London units were opened in 1947 and the first Salford unit in 1948. After this there was no development until 1955 when others were started in Tottenham and Reading. Slow growth up to 1960 was followed by a period of acceleration so that in 1966 there were 162 units in England and Wales. This is not a complete picture because in some places, as in Salford, units have been closed for want of suitably qualified teachers.

The character of the present-day unit differs markedly from those of 1947. It has become increasingly clear that many pupils will not be able to take their place in the normal classes of an ordinary school when the secondary stage is reached, and units for partially hearing pupils of secondary school age have therefore been established. Although, as a result the educational purpose of these units is less well defined than it was originally in 1947, their intention, nevertheless, should still be to provide opportunity for partially-hearing children to acquire such mastery of oral communication that they can take full part in normal education.

Scope and purpose of the survey

The survey on which the present report is based was undertaken by four of HM Inspectors of schools and two of the Department's Medical Officers, and covered 74 units (15 of them in Wales). The units were of different types: 64 of them functioned as classes, each with its own teacher; some units contained more than one class, and the total number of classes inspected was 90; in 10 units, the pupils were dispersed in ordinary forms, and these pupils were seen both at their tutorials with the teachers of the deaf and at their ordinary work.

Table 1 Opening dates of units included in the survey


[page 5]

The decision to carry out the survey arose from the doubts and feelings of disquiet expressed among teachers of the deaf in special schools and others interested in the education of partially-hearing and deaf children. Doubts may have been caused by several factors. Pressures from various sources - parents, teachers, otologists and local education authorities - had resulted in a mushroom-like extension of the service within which it was thought there might be children for whom such a mode of education was not suitable. There were said to be problems of organisation and staffing; the heads of special schools for the deaf complained that the attractions of this new service were denuding their schools of experienced teachers.

The findings of the survey tended to confirm these doubts and to reveal manifest weaknesses which could have been avoided. At the same time, the success of the best units seen indicated the essential conditions needed for this work. As a system of educating partially-hearing children there was much to recommend the establishment of units provided that these conditions were satisfied.

Interpretation of the term 'unit'

The survey revealed, however, that much confusion exists in the use of the term 'unit'. It is interpreted in this report as a group of partially-hearing children which is being educated in any one school which also has children of normal hearing, (2) and is under the care of one or more teachers of the deaf appointed for this purpose. A unit may consist of one class, several classes or a number of individual pupils distributed amongst the ordinary classes, who return to the special teacher for tutorial periods.

(2) This may include special schools for children with normal hearing, as well as ordinary schools; thus, as will be seen later, two of the units visited in connection with the survey were in special schools for delicate children (open-air schools).




[page 7]

The survey


Types of units

Not every local education authority has established units in ordinary schools for the education of partially-hearing pupils. At the present time 53 LEAs in England and six in Wales make such provision. At the time of the survey, 162 units were in existence, and these could be broadly classified as follows:

(1) Single class units in which the teacher of the deaf is working in complete isolation from colleagues in other units and without special guidance from LEA officers.

(2) Single class units supported by or in some way linked with a peripatetic service for children with impaired hearing.

(3) Single class units under the direction of the principal schools' medical officer.

(4) A number of single classes in an area working in isolation from each other and having no association with either a nearby school for the deaf or a peripatetic service.

(5) A number of classes under the general direction of the head teacher of the local school for the deaf.

(6) A number of separate classes under the direction of an organiser who is a qualified teacher of the deaf and has been specially appointed by the LEA to do this work.

(7) Units in which there is more than one class.

Some of the units, however, could be placed in more than one category, while the special characteristics and problems of others were more concerned with the age-range of the pupils and their ages in relation to those of the pupils in the main school then with organisational categories. It was therefore decided to set aside the original intention of using the seven categories as a basis for the report.

Types of schools in which units were based

Facilities for diagnosing impairment of hearing in childhood have increased since the first primary units were opened and many children of a much younger age are now recommended for special educational treatment in them; in consequence, it had been found necessary to make provision for children of nursery and infant age. At the same time, as already mentioned, since many


[page 8]

pupils, by the age of transfer at eleven, were not ready for full-time work in ordinary classes, secondary units had been opened. Nevertheless the total number of nursery, infant and secondary units was still small. Table 2 shows the distribution of units in the schools visited.

Table 2 Distribution of types of schools in which units were placed

Transfer to secondary education

Since the 16 units for pupils of secondary age were directly connected with primary units, and provision was made for the young children from the 16 nursery and infant units to proceed to the next stage, transfer in all these cases was easy. Similarly there was no difficulty in the two all-age, open-air schools. In each of two other units, where there were three classes, infant, junior and secondary, housed in a primary school, there was no proper provision for the oldest pupils.

For the pupils of 20 of the junior units, there was no secondary provision. These pupils were transferred either to special schools or to ordinary secondary schools where there was not always special help available for them.

Number of pupils on the roll

The total number of pupils on the roll of the units visited was 828. They covered an age-range of two to sixteen, much the greatest number lying between the ages of seven and eleven. A few of the youngest pupils attended part-time. Table 3, which shows the distribution of ages, indicates an equal number of boys and girls up to the age of twelve and an interesting divergence in numbers that increased significantly over the secondary years.

Table 3 Distribution of ages of pupils

In spite of the fact that one of the secondary units was for girls only, there was over all a majority of boys. This may have been related to their naturally slower rate of maturation and acquisition of linguistic skills. One of the most pronounced difficulties in the secondary units lay in the paucity of language with which the majority of the partially-hearing pupils were equipped to start their


[page 9]

specialist subjects. The girls may have found it easier to reach appropriate standards for working in ordinary classes by the time they left the primary units. In a recent survey on illiteracy, the development of language and reading skills of boys was shown to be slower than of girls. Table 3, in revealing that this fundamental difference in maturation rate between boys and girls is also applicable to those who have impaired hearing, points also to the possibility that it is more difficult for the boys, whose language is correspondingly more retarded than that of the girls, to reach comparable standards by the time they are eleven years of age unless their specific needs are taken into account.

Sizes of the units

There was no consistency in size in the units; the single classes in charge of one teacher varied from three to 15 on roll. The present growth of demand for places, however, indicates that it is unlikely that the smallest units will remain for long with such small numbers. Out of the 53 single class units, 39 had less than 10 pupils and in several of the junior units the already favourable staffing ratio was further aided by the appointment of full-time ancillary assistants who were all of good calibre. The policy of some authorities to restrict the intake, at junior level, to seven pupils and at the same time to provide the teacher with ancillary assistance of the quality that was seen, laid the foundation for successful work and contrasted markedly with less generous staffing both in other units and in some special schools for the deaf.

In the 21 units containing more than one class, 15 were of two classes and six were of three; in some of these there were supernumerary teachers appointed for specific purposes. In these also there was a favourable staffing ratio. The largest unit contained three classes and had 30 on roll.

Table 4 Units with numbers on roll less than the statutory maximum

It was evident that in the complex structure of units and classes for partially-hearing pupils the statutory maximum number of ten pupils in one class was frequently too large for successful work to be done. Some teachers, by reason of peripatetic duties in school hours that took them away from their pupils for part of the day, were disquieted by the limited time they had for working with the children. Others were also far from satisfied with the progress that their pupils had been able to make and the results that they had achieved. Table 5 shows the number of units that were facing difficulties through over-large groups.


[page 10]

Table 5 Units with numbers on roll greater than the statutory maximum

11 pupils with 1 teacherin 1 unit
12 pupils with 1 teacherin 1 unit
13 pupils with 1 teacher (part-time only)in 1 unit
14 pupils with 1 teacher (part-time-temporary)in 1 unit
15 pupils with 1 teacher (part-time only)in 1 unit
15 pupils with 1 teacher (full-time)in 2 units
22 pupils with 2 teachers (with other duties)in 1 unit

Age range of pupils in class

The range in age between the oldest and the youngest pupil in each class extended from eleven months to seven years nine months. It can be seen in Table 6 that, with the exception of the open-air schools where the pupils were dispersed amongst the ordinary classes and returned to the specialist teacher for tutorial periods, the widest spans occurred in the primary units.

Table 6 Age range between the youngest and oldest pupils in class

11 months in 6 classes(including 2 for pupils of secondary age)
1 to 2 years in 23 classes(including 2 for pupils of secondary age)
2 to 3 years in 30 classes(including 8 for pupils of secondary age)
3 to 4 years in 21 classes(including 8 for pupils of secondary age)
4 to 5 years in 12 classes
5 to 6 years in 3 classes
6 to 7 years in 3 classes(including 1 open-air school)
7 to 8 years in 2 classes(including 1 open-air school)

In some single class junior units, the age-range was narrow; in others it was wide; both gave rise to problems. The effects of a narrow age-range were three-fold. When the pupils were of an age, and the unit was housed in a small school, although the basic language lessons could be given to the group, there were more partially-hearing children in need of experience in the same ordinary class than that class could absorb, Admission of children all of an age blocked further entries for as long as they remained in the unit and when they reached the age of transfer to a secondary unit, while the junior unit was almost denuded of pupils, the secondary unit was over-crowded.

In many single-class junior units where there was a wide age-range, there was also a wide range in ability and attainment and the amount of time that the majority of the pupils could spend profitably in ordinary classes was limited. Because of this, most of them remained in the unit for the greater part of the day, needing individual attention and going out only for physical and creative activities. Since their educational needs were chiefly linguistic and the reading skills of many of them were not far developed, they were not able to follow individual programmes without constant help, and the resources of the teachers were severely taxed. It could be seen that since, as in all schools, the success or failure of the work of the unit was directly related to the skill of the teacher, those pupils who were fortunate enough to have a skilled teacher made good progress, whereas those in the hands of less skilled teachers did not. As Table 6


[page 11]

shows, pupils in single class units could have the same teacher throughout their primary years; it is important that such an arrangement should be avoided whenever possible.

Sizes of units and staffing in relation to main schools

Staffing, as has already been said, varied greatly in the units, the least generous being in the proportion of one teacher to fifteen pupils, and contrasting markedly with the most favourable where the ratio was one teacher to three pupils. Generous provision, in some cases, had had indirect effect upon the attitude of some of the staff in the main schools. Unless the purpose of the unit was fully understood, and the idea accepted that the unit was placed in the school in order to give the partially-hearing pupils opportunity to work in class alongside their normally hearing fellows and foster natural development of speech and language, there was sometimes reluctance to have them in already large classes. In contrast to this, where a group of partially-hearing pupils was large and staffing was meagre, there was sometimes too much integration. The pupils were not always capable of following the progress of lessons in ordinary classes and the educational profit was minimal. The balance between readiness for integration for practical subjects and readiness for academic work is a delicate matter and calls for much thought.

Table 7 Teacher pupil ratios

The remaining four units were staffed by part-time teachers only. The difficulties inherent in this situation showed that such organisation is not satisfactory.

1 part-time teacher to 4 pupils in 1 unit
1 part-time teacher to 8 pupils in 1 unit
1 part-time teacher to 13 pupils in 1 unit
2 part-time teachers to 15 pupils in 1 unit

Total 4 units

Sizes of schools with units

It was evident that the size of an ordinary school was a vital factor in considering where units should be placed. Those seen varied from comprehensive secondary schools of 1,500 pupils to primary schools of fewer than 100.


[page 12]

Some schools were too small for successful integration to be possible. In such cases there were too many partially-hearing pupils for the number of available classes and the class balance was upset. Since the handicap leads to heavy demands for individual attention, over-weighting with partially-hearing pupils created difficulties.

It cannot be assumed, in any school, that the teachers are all equally skilled, experienced and willing to receive into their classes pupils who create special demands when, already, they may be greatly pressed by numbers and by unfavourable teaching conditions. This is likely to be emphasised in small schools where there are few teachers and the range in age and ability amongst the hearing children is as wide as that of the unit.

Several units were seen in schools where the roll was less than 100 but generalisation about optimum size would not be justified because the ages of the pupils appeared to be a determining factor in the degree of success achieved. One small infants' school with a nursery class of 25 housed a unit of five nursery-age partially-hearing children, Although this ratio of 5 to 25 was high, at this stage the children were readily adjusting themselves to the society of others; in learning about their environment through the experience and experiment contained in play, they were making good progress under the careful guidance of their teacher.

In another two-class infant and junior school, with 80 on roll, there were five partially-hearing children to be fitted into some lessons in the junior class of 27 and two partially-hearing children into the infant class of equal size. In spite of the wide age-range of these classes, the determination of the headmistress to help these children was affording them much opportunity for individual development. This was a close-knit family school.

In a third junior school the 75 on roll were organised in two classes, junior one and two with 39 pupils and junior three and four with 36. There were 10 pupils in the unit, four of whom were of an age to fit into the younger class and six into the older class. Since the retarding effects of the handicap have increased by the junior stage, integration at this school was difficult to arrange and the unit had become a special class in isolation within the school.

There were similar problems in a fourth junior school of 75 where there were two classes of ordinary and 12 children in the unit. An added difficulty there lay in the presence of two infant children for whom there was no ordinary infant class in which to work.

The ratio between partially-hearing pupils and hearing pupils varied from more than 1 to 5 in a nursery class to 1 to 175 in a comprehensive school. The experience of some teachers showed that not only can a parent school be too


[page 13]

small but it can also be too large for the unit to function successfully. This was seen to depend partly upon the organisation of the parent school and partly upon the skill of the unit teacher in making himself a part of it.

Selection of children for admission

An analysis of the arrangements for the discovery of the hearing handicap and subsequent selection of children for admission to the units showed that they varied considerably among the 32 LEAs responsible for the units visited. Eighteen had comprehensive arrangements for this purpose, three used clinics based in hospitals, nine had joint consultations between school doctors and teachers of deaf children, and in two the school doctor alone was responsible for selecting children for admission.

In the majority of cases, comprehensive arrangements included keeping a register of children considered to be 'at risk' and screening babies, pre-school children and school entrants for hearing handicap with subsequent follow-up of those who failed the test. The screening tests were as a rule carried out by specially-trained health visitors, school nurses or, in a few areas, by clerks who had attended special training courses. It is important that short refresher courses in testing techniques for all those who may be concerned in the testing of hearing should be held from time to time to ensure that uniform standards are maintained. Children who failed routine screening tests were usually referred either to a school doctor or to a peripatetic teacher of the deaf for further tests. Any child about whom there was still doubt after this second test was referred to a consultant otologist or to an assessment team. This team differed in composition from place to place although, usually, it consisted of an otologist, a teacher of deaf children and a school doctor with special interest and sometimes special training in the assessment of hearing handicap. Educational psychologists who had special knowledge of the learning problems of children with impaired hearing were members of the team in areas fortunate enough to have them. Some of the larger authorities employed an audiometrician for carrying out hearing tests.

The smaller team of school doctor and teacher of the deaf was generally employed by smaller authorities. This team reviewed all children referred to them after failing hearing tests. They re-tested them in conjunction with otologists' reports before making final decisions about placement in school.

The hospital-based clinics were primarily otological and had grown up because of the great personal interest that individual consultant otologists had developed in the education of hearing-impaired children. School doctors and teachers of the deaf were invited to attend the clinics. They were regarded by the otologists as members of the team and joint discussions about individual


[page 14]

children took place. Not all otologists had time to visit the special units regularly but, when they did, their visits were much appreciated by the teachers.

Criticisms of selection procedures

Whenever the school doctor alone was concerned in the selection of children for admission to the units there was, not unnaturally, some criticism from the teachers. In assessing the needs of children who have some degree of hearing impairment, the degree of handicap and the extent of their educational progress are so closely related that it would seem essential for consultation to take place before children are recommended for placement. In general, teachers tended to be critical of doctors, mainly for putting too much reliance on the pure-tone audiogram as a criterion for placement and too little emphasis on language development or on the need to provide an educationally viable class. Doctors, on the other hand, were critical of teachers who, when discussing very young children with a hearing loss, were sometimes too definite and dogmatic about future educational placement.

There was also some criticism by doctors of teachers' possessive attitude to hearing-handicapped children and their assumption that they and they alone were qualified to express opinions about them.

Importance of contacts between teachers and other workers

Since the percentage of children who suffer from the handicap of partial-hearing and who need special educational treatment in a unit is small, the number of units provided in areas, other than those of dense population, is also small. In consequence the teachers appointed to take charge of them were often far apart from each other and a sense of isolation was evident. It was important for them to keep contact with other workers who were interested in the pupils. Their main sources of active co-operation were the parents, the peripatetic teachers, the otologists, the schools' medical officers and the staffs of school and hospital ENT clinics.

In 39 units, there was close contact with a peripatetic teacher, in 11 more there was infrequent contact, in four there was no contact although there was such a teacher in the neighbourhood. Eight unit teachers carried out peripatetic duties themselves and for 12 units there was no complementary peripatetic service. The links between the consultant otologists and the units were not strong. Only 4 otologists visited units regularly and 31 others visited occasionally. Of 37 who never visited the unit, seven saw the children regularly at clinic sessions. Very few of the schools' medical officers visited the units except for routine medical inspections. A similar pattern of linkage between units and school and hospital ENT clinics is shown in Table 8.


[page 15]

Table 8 Linkage between units and school and hospital ENT clinics

Factors to be observed in recommending placement in a unit

School placement for children with impaired hearing is a complex matter. Those whose hearing impairment has been recognised while they are still very young are well placed in a nursery unit which should have a diagnostic purpose and give opportunity for close observation of linguistic development. For the older child, not only is it necessary to diagnose hearing loss but other factors must be considered. For education in a unit, which should lead subsequently to education in an ordinary class, the personality and character of the child must also be taken into account. He will be expected to take part in ordinary lessons with boys and girls who have no hearing handicap and whose response will be quick in comparison with his own. He must be able to hold his own amongst them; able to give and take. He must be able to learn through listening, looking and reading so that he can keep pace with the growth of knowledge which the class around him is achieving so much more easily. The pupil's own ability and determination will need to be supplemented by intensive help from the special teacher in the unit and good support from the home. Many of the pupils in the units had not been selected with this kind of care.

It was not always sufficiently appreciated that the placement of a child in a unit is necessarily experimental, and that there is a need for his progress to be kept under constant review. This should be made clear to the parents at the outset, and it is important that they should not be misled by over optimistic forecasts. Any advice given to parents should be based on consideration of all the factors, both medical and educational.

Pure tone audiograms

Pure tone audiograms were available for 721 of the 828 children in the units. All of them were thought to be a reliable indication of responses to sound. Of the remaining 107 children, some had normal hearing; others were young children whose response to this kind of testing was considered to be uncertain. Evidence of the past few years has led to the conclusion that the shape of an audiogram has greater significance than responses calculated over a specified number of frequencies and expressed as a percentage. The audiograms were therefore analysed according to their shapes into 13 different categories; some


[page 16]

of them were recognisably linked with the cause of deafness. It was realised that these 13 categories did not cover all the permutations that were discernible and that further subdivisions might have been made.

Special attributes to some categories of audiogram

Category 1 A flat loss between 0 and 30 db.

This audiogram indicates a very slight hearing loss, compensation for which should be provided by an efficient hearing aid. It was to be expected, therefore, that there would be very few pupils in the units with this type of audiogram. In terms of hearing alone, such children could be expected to make progress in an ordinary school with only occasional special help. Additional handicaps, however, often aggravate the hearing disability; and, of the 16 pupils in this category in the units visited, seven were educationally subnormal, three were aphasic and one was non-communicating. These were wrongly placed, made demands on the teachers' time that could be ill-afforded and showed no chance of being integrated with hearing children. (3)

Categories 2 and 3

Category 2 A flat loss between 30 and 60 db.

Category 3 A flat loss between 60 and 90 db.

Children in these categories are partially-hearing. An efficient hearing aid, properly and consistently used, should allow them to develop speech and language in a natural way, given skilled help and good classroom conditions. In the majority of cases seen in the units, this was so.

Category 4 A flat loss greater than 90 db.

Children with hearing loss of this severe degree were very seriously handicapped and needed intensive help both at school and at home. Some of them had this kind of support and made good progress; others did not. In all of them, the gap between their progress in achieving intelligible speech with natural intonation on the one hand and their general educational progress on the other was difficult to assess unless the special teacher was fully conversant with ordinary standards. Without close co-operation with the main school, the degree of retardation was difficult to assess until the secondary stage was reached.

(3) Pupils with this slight degree of hearing loss would normally be in ordinary schools. It is interesting that of the 16 pupils in this category found in the units visited, only three were girls. This may be related to the known tendency or girls in the normal population to develop linguistic skills in advance of boys, and may be a subject for deeper investigation.


[page 17]

Category 5

CHARACTERISTIC OF ANOXIA AT BIRTH

After an initial slow rate of development of speech, and corresponding retardation in language, pupils with this type of hearing loss appeared to make good progress.


[page 18]

Category 6

CHARACTERISTIC OF MATERNAL RUBELLA

First consideration of this shape of audiogram suggested that, on hearing alone, these children should learn to speak normally and make good educational progress in natural ways. Many of them were handicapped through maternal rubella and on investigation it was found that they suffered from additional slight disabilities that, together with the hearing loss, made for serious learning problems. Some of their teachers also reported personality and behaviour problems that still further aggravated their inability to learn easily.


[page 19]

Category 7

CHARACTERISTIC OF RHESUS NEGATIVE FACTORS

This type of hearing loss is known to lead to particular difficulties in understanding words spoken in conversation and in imitating what is heard in articulate, intelligible speech even though the intonation is quite natural. The audiogram is characteristic of the effect of incompatible blood groups (rhesus negative factors) in one of the parents. This was known to be the cause of deafness of many of the pupils in this category.

Some of these children were also spastic, and they were very retarded. They had learning problems that were likely to have been related to the length of time in which their pre-occupation was in gaining control of their body movements when they were young. For as long as they were unsure of their body movements and of spatial relationships, their rate of development of speech, language and academic learning was slowed down. Many of these


[page 20]

children were very intelligent and they needed more help than a teacher in a unit could give. This was intensified at secondary level. Children in this category constitute a substantial proportion of the pupils at present in schools for the partially-hearing, where they seem to make good progress.

Category 8

CHARACTERISTIC OF FAMILIAL DEAFNESS

This category deserves special mention. Children with this type of loss have, in the past, most often been placed in special schools for the deaf where, when well taught, they have made good progress in speech, language and academic subjects. The handicap is mainly familial and a significant proportion of the children had deaf parents. When such parents are highly intelligent, they are ambitious for their boys and girls and their encouragement fosters an early start in speech which is usually limited to words and phrases that have been taught in the same way that the parents themselves were taught when they were


[page 21]

young. This ability to use words and phrases at an early age can influence decisions unduly when placement in school is at issue. By itself it does not indicate a capacity to learn language quickly and naturally through listening, unless help can be intensive and continuous. This was not always possible in the units where the teachers were faced with many problems of organisation. Further research into the learning potential of children in this group would be of value to their teachers.

Category 9 A flat loss in one ear only.

There were very few pupils with this type of loss, which was in one ear only, in the units. Such a loss does not usually prevent the natural development of speech and language so that pupils with a monaural loss usually fit quite well into ordinary schools. The 8 children in this category were suitably placed at the time of the visits.

Category 10 A flat loss in both ears, with a difference of 20 to 30 db.


[page 22]

This category aroused particular interest and called for further investigation since as many as 51 boys and girls were involved. Their hearing loss was expressed as a flat audiogram at about 30 db. in the better ear and promised well for natural ways of learning while the loss in the other ear was between 20 and 30 db. greater. Whereas children with monaural losses (category 9) appear to make good progress in ordinary schools unless they have some additional handicap, many of the pupils in Category 10 were finding difficulty in learning that sometimes resulted in behaviour problems.

Category 11 A sloping loss from 30 to 65 db.

The majority of these pupils were partially-hearing and, given good conditions, were able to make progress in units.


[page 23]

Category 12 and Category 13:

Category 12 Islands of response at 90 db. and beyond.

Category 13 No response at any frequency.

These pupils were profoundly deaf and, unless the onset of their deafness was adventitious so that their speech and language was well developed, or unless they were both intellectually gifted and well-supported at home, they were not suitably placed in units.

Incidence of these categories

The incidence of the categories into which the audiograms were divided is shown in the following table.

Table 9

Pupils with normal hearing

There was a small group of seven children whose difficulties were not those of loss of hearing. They were dull and grossly retarded and in their need for remedial help they took from the partially-hearing pupils valuable time that could be ill-spared. Their main difficulties were those of communication in speech. Provision for such children is known to be a matter of concern to local authorities since there are, as yet, few schools catering specifically for those handicapped in powers of communication.

Provision for children in the various categories

The distribution of the categories showed that, although there were examples of all the shapes of audiogram recognisable at the present time, the majority were of such type that, provided that no other variables militated against it, provision for education in a unit was suitable. In such circumstances, the 584 children who fell into categories two, three, five, six, seven, nine, ten and eleven had a reasonable chance of success. In a minority, the degree of handicap, when seen in relation to the whole life of the child, was too great for success to


[page 24]

be possible. Nevertheless, there were amongst these children some whose deafness was adventitious, onset having occurred after speech and language had been established; there were others whose high intelligence and strength of support from the home, coupled with skilled teaching in a sympathetic school, enabled them to profit from this kind of education.

Accommodation

The area of the classrooms in which the units were housed is shown in Table 10. It ranged from one of 72 sq.ft. [6.7m²] that was too small, to one of nearly 800 sq.ft. [74.3m²] that seemed unduly large.

Table 10 Area of classrooms: in square feet [1 sq.ft. = 0.3m²]

A total of 102 rooms were inspected. In 78 of them the acoustic treatment appeared to be satisfactory and in 14 to be unsatisfactory. The remaining 10 had not been treated; in some cases treatment was unnecessary, owing to the quiet situation.

It was disquieting to find that in 13 of the rooms which had recently been acoustically treated the acoustics were not satisfactory. Some of the classes shared large rooms and the noise of one so affected the other that the efficiency of both individual and loop aids was diminished unless a rigid timetable was devised. In seven of the units, noise from outside, that is, either from playground or street, or from inside, that is, from adjacent classrooms or assembly hall, reduced the efficiency of the hearing aids. In schools built on a central hall plan with glazing to ceiling height, there was difficulty in providing adequate acoustic treatment. In ten rooms there was ineffective treatment with consequent problems of reverberation.

Apart from the question of acoustics, some of the classrooms were unsuitable for other reasons. One was also a medical room that was frequently used for that purpose. Another was in a staff room, which led to much dissatisfaction since neither the staff nor the unit could look forward to settled, uninterrupted occupancy. Another was housed in a community wing, where it was subject to frequent interruption. Poor lighting or poor ventilation and heating were also causes for complaint in several units. There were often limited facilities for storage, both for general stock and for the special large equipment that is basic to the needs of units. Some of the units for nursery and infant children needed


[page 25]

a water-supply in the classrooms; in others, the sanitary offices were inconveniently distant. Some of the rooms also were not conveniently placed in relation to the main school.

Audio-visual equipment

The majority of the units were well-equipped and had most of the necessary audio-visual aids either for their exclusive use or on loan from the main school. These are listed below. It was noticed that there has so far been little serious development in the use of programmed learning, of film loops or of film cassettes with or without synchronised sound tracks. One or two overhead projectors were in use.

Table 11 Equipment held by the units

All the children who needed them had individual hearing aids and, in ten of the units, children for whom an otologist deemed it advisable had two each. In 13 schools, the assembly hall had been fitted with a loop system and in seven of them some ordinary classrooms had also been equipped.

Additional speech training units were held by ten units and they were loaned to parents who were anxious to give extra practice in intensive listening to their child at home.

In a few of the units the major auditory equipment was out of order and there was such manifest variation in the arrangements for repair that it was plain that servicing facilities should be given more consideration when equipment is ordered. In only 50 of the units was it considered that service arrangements were entirely satisfactory; in others there was much criticism about the maintenance of both individual and classroom-aids. Occasionally, a teacher


[page 26]

was skilled in electronics and able to deal with repairs but this is not part of his duty as a teacher. Without such ability and interest, however, repair of both group and loop aids was subject to great delay when the unit was remote from the supplier or his agents and when there was no local technician sufficiently knowledgeable to do it. This delay had adversely affected the work in some cases.

Although there was an established link with a hearing aid centre in 63 units, arrangements for the repair of individual aids often presented difficulties. There was no link in three units and in eight others it was tenuous. Criticism of the service related not only to repair of the Medresco aid that is supplied through the National Health Service but also to badly fitting inserts and to delay in returning them to the school. In six units, similar criticisms were made about the repair of commercial aids. Other causes of dissatisfaction all related to wastage of time for both teachers and pupils in checking aids and in going to the centres to obtain repairs and to be fitted for ear moulds. There is room for improvement in the arrangements for the repair of aids and equipment and for the renewal of inserts; the responsibility of teachers, in this field, needs also to be much more clearly defined.

Requisition allowances

Allowances for purchase of materials followed no one pattern. Whereas 34 units obtained their stock through the main school, 34 others had a separate allowance; in the rest, arrangements varied. Although difficulties were apparent in a few units, in general there was fairly generous provision. Difficulties had sometimes arisen because some units were opened before they were fully equipped; these could have been avoided if the teacher had been consulted at the planning stage.

The following were some of the methods used to increase the capitation allowances in units:

(1) The allowance for partially-hearing pupils was double that of hearing pupils.
(2) A unit of 10 pupils had an additional 25 per year.
(3) A single class unit had an additional 1 per month.
(4) A single class unit had an allowance of 50 per year for apparatus and books while consumable materials were supplied from the main school.
(5) A unit of 7 pupils had an allowance of 100 per year.
(6) A unit of eight pupils had an additional 40 per year.
(7) A unit could claim extra money as need arose.
Staff

Staffing regulations state that all teachers who are appointed to posts in units for partially-hearing pupils must be qualified teachers of the deaf who have


[page 27]

previously obtained a certificate or diploma at one of the two training departments or the diploma issued by the National College of Teachers of the Deaf. Local Education Authorities have been advised to appoint only those teachers who have already had several years' experience of work with deaf children but many authorities have found it impossible to recruit such people. Table 12 shows the number of years in which unit teachers have worked in schools and units for the partially-hearing and reveals the present staffing situation.

Table 12 Unit teachers' length of service in the education of deaf and partially-hearing children

From Table 13 it can be seen that of the 106 full-time teachers, 47 had not had the recommended period of work in a school for the deaf before entering a unit; of these, 18 had had no special training. This training is essential if teachers are to make the most of the auditory equipment provided. This equipment is of value only when effectively used and well maintained. Lack of training was made obvious by the number of teachers who were unable to exploit its possibilities. Only about three-quarters of them were skilled; the rest had very little knowledge or experience on which to base their work.

Table 13 Qualifications of full-time teachers

teachers
(1) Manchester University, Department of Education of the Deaf
(a) experience in ordinary schools and in schools for the deaf19
(b) experience in schools for the deaf only24
(c) experience in ordinary schools only17
(d) no previous teaching experience: first posts12

(2) National College of Teachers of the Deaf
(a) experience in ordinary schools and schools for the deaf6
(b) experience in schools for the deaf only8

(3) Approved training elsewhere
(a) experience in schools for the deaf in the Commonwealth2

(4) No special training
(a) experience in ordinary schools18
Total:106

Concern has been expressed by many head teachers of schools for the deaf about the recent rapid development of the unit service which, with its attractive conditions of employment, had tended to entice experienced teachers away from work with the severely deaf in special schools. Enquiry into the present staffing position in the 48 maintained and non-maintained schools showed that there had in fact been a significant amount of transfer from schools to


[page 28]

units. The returns from 47 of the 48 schools showed that, in the past five years, out of a total of 517 full-time class teachers and 86 full-time specialists, 61 had left to take up work in units and 62 to enter the peripatetic service. This loss of one-fifth of the total full-time strength was serious when related to total staff changes; of the rest, 93 had received promotion and 337 had left for other reasons, the most frequent being maternity and family commitments. Since Education Authorities were known to have had difficulty in obtaining qualified staff both for new units and for those already well-established, it was clear that growth of demand had created vacancies in both special schools and in units. Substantial movement of teachers caused by lack of uniformity in salary additions had masked an overall shortage. This shortage was seen to have reached serious proportions.

The length of time that teachers had spent in their present posts gave some indication both of the growth of unit provision and of the movement of staff from one unit to another. It is shown in Table 14. Demand for this type of education increases year by year and it may be that recruitment only from the ranks of those who are experienced teachers of the deaf will not provide adequate numbers to ensure a satisfactory service for many years to come. It was reported to HM Inspectors that several classes had been without qualified teachers for a substantial period of time and that, for this reason, others had been closed.

Table 14 Number of years of service in present unit

In order to overcome staff shortages and temporary unit closures there is a growing tendency to second interested teachers from ordinary schools to one or other of the university training departments and for them to return to units in their own home areas. In units where the children were carefully selected, this was successful. Although it may be that previous experience in a school for the deaf is not essential for all teachers, the survey underlined the inadvisability of appointing to the units newly-qualified teachers of the deaf without any other teaching experience. Thrown upon their own resources in single class units, they lacked the skill that comes only from practice in the classroom. Their knowledge of the basic skills of teaching was too theoretical for them to be able to relate the special work of the unit to that of the main school and to organise their groups on progressive lines unless they could turn to an experienced teacher for guidance. Twelve of the teachers seen were in their first posts.


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Salaries

There has been comment that teachers are drawn to the units from special school work by the inducement of increments additional to those that are related directly to special school work and the diploma or certificate for teachers of the deaf. Enquiry showed that 59 of the 106 teachers in the 74 units were receiving amounts that exceeded the 180 payable to all specially-qualified teachers in schools for the deaf. Of these, 34 were in single class units, nine were in multi-class units, all of whom received an extra amount, and 16 were teachers in charge of multi-class units. Concern was expressed by more than one authority that it was necessary to offer these inducements in order to attract teachers. By this practice, the staffing of units had become a highly competitive affair.

Absence of teachers and stability

The specialist nature of the work in units makes it obvious that the absence of teachers on sick leave or for any other reason would create difficulties. A study of the arrangements made at such times showed that, provided the period of absence was not protracted, the problem was less serious than might have been anticipated. In some cases, teachers of the deaf and supply teachers from elsewhere had been available; in others, there were either supernumerary teachers or ancillary assistants who assumed temporary responsibility. Where no such help was possible, head teachers and teachers from the main school had co-operated; in no case had the pupils been sent home. The situation was less acute where there was a group of classes that could be merged. On such occasions, the advantages of multi-class units and of single-class units with supernumerary and ancillary staff were evident.

Although this has been advised by HM Inspectors, not all unit teachers took any part in ordinary class teaching. In the 44 units where this was done, arrangements for the care of the partially-hearing children were made in different ways. In one unit, the teacher took her whole group with her to join an ordinary class. In others, teachers took small groups with them while the rest were distributed amongst classes with children of their own age.

Longer periods during which classes and units had been without specialist teachers had created difficulties. In 35 units problems had been varied; in some, changes in staff such as those listed below, had affected stability.

Single Class Units
3 teachers in 5 years - 4 units
3 teachers in 3 years - 2 units
4 teachers in 4 years - 1 unit
5 teachers in 5 years - 3 units
7 teachers in 5 years - 1 unit
Multi-Class Units
11 teachers in 5 years in a 3 class unit
16 teachers in 5 years in a 3 class unit


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For a number of reasons, 22 other units had been without specially qualified teachers for periods ranging from two months to three years, several of them having suffered repeated periods of difficulty; three others were closed and the opening of thirteen more was delayed because of lack of response to advertisements. In only 20 had there been no abnormal staffing problems in the past five years; 19 others had been opened so recently that conclusions drawn from them could not be regarded as statistically valid.

So many units had had staffing difficulties in the past five years that it seemed advisable to attempt to find out what were the factors that may have led to the greater stability of those that had not suffered in this way. It was found that 12 of them were in pleasant places; 16 were in the southern half of the country; nine were staffed by local people who had either followed their own interests and become qualified teachers of the deaf before seeking a post at home, or were experienced married women who had returned to teaching. Of these nine also, a few had been seconded by the Authority to the Department of Audiology and Education of the Deaf at Manchester University for training. In others, there was strong evidence of support given by the head teacher of either the main school, the adjacent school for the deaf, the peripatetic teacher or the specially appointed organiser who was also a teacher of the deaf. The team work seen where units were grouped under the care of an organiser, as distinct from work in isolation in separate units, was a significant factor.

The place of the unit teacher in the school

The majority of the unit teachers realised that the extent of their own co-operation in the life of the school would affect the attitude of their colleagues towards the units, and they sought to become accepted members of the staff room. This was not always easy. Of the 106 teachers, 92 were regarded as members of the main school staff and took their full share in its life and extraneous duties. Nevertheless, in their own classes, they worked independently and without guidance unless there was either more than one class or there was an organiser or peripatetic teacher of deaf education in the area. The advantages of a system whereby an organiser supervised the units were noticeable. In spite of it, however, there was a possibility of strained relationships when the powers and duties of a peripatetic teacher who was expected to organise units were not clearly defined. There seemed to be need for the position to be clarified so that the necessary authority was established. Without it, the teachers in the units were faced with the problem of divided loyalties. To whom were they responsible, the peripatetic teacher or the head teacher? Definition was seen to be particularly necessary after the appointment of new head teachers.

Eleven of the teachers from 6 units were on the staffs of local schools for the


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deaf. In these cases, success lay in the quality of relationships that existed between the head teachers of the two organisations, the school for the deaf and the ordinary school. This was not, in all cases, harmonious. In two of the units, where the teachers were working for only part of the week, there had been difficulties that had arisen from lack of guidance and from lack of mutual understanding between special school and ordinary school.

Three teachers were not considered to be part of the main school staff. One worked in a unit only in the mornings and carried out peripatetic duties in the afternoons. This was unsatisfactory for the pupils. Two others, who were appointed by the School Health Department, had met many obstacles before they achieved smooth running of their units. The head teachers had not been made aware of the function of the units. This last situation pointed clearly to the need for the purpose of units to be fully known by the head teachers and explained to the staff before a unit is opened and children are admitted.

There was abundant evidence to show that, once the purpose of the unit was understood and a policy was established in the school, the success of a unit was dependent upon the skill, personality and driving force of the unit teacher. Where this was not of a high order, the work was mediocre and the system as a whole was laid open to doubt. Any system of education that relies upon the work of only one teacher merits deep consideration before it is embarked upon.

Pupils

Since it is not always possible to make a clear-cut decision about the educational placement of partially-hearing children, some are admitted to units either on a trial basis or because there is nowhere else, at the time, for them to go. It was therefore expected that there would be children in the units who were unsuitably placed and for whom transfer was advisable. In fact, the number of such children was small. Out of the 74 units, 16 had retained, for too long, individual pupils for whom arrangements should have been made elsewhere; in 11 others, there were pupils whose demands on their teachers were so pressing that retention in a unit was open to doubt. In the light of the purpose for which units have been set up, that is, to provide opportunity, through association with children who hear and speak normally, for partially-hearing children to develop such skill in oral communication that they can take a full part in ordinary school education, these pupils had either too profound a degree of deafness or an additional handicap of mind or body that retarded their progress along these lines. There were also others who, because of local conditions and the composition of the units, had not been able to make this kind of progress. Their problems will be discussed later in the report.

Transfer of pupils to other schools

As was shown earlier, the initial placement was usually decided at a case


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conference. Although transfer of children below the age of eleven was not dealt with in the same way, the decision was often taken by a team. Case conferences were said to be held by 36 units but the personnel attending them varied from place to place. For four units, there was a special clinic at which children were seen by an appointed team of workers. In most others, the head teacher, the unit teacher and the school medical officer were involved in making the decisions. Sometimes the head teacher of the receiving school, a specialist inspector or organiser, a peripatetic teacher of the deaf, an assistant education officer and an educational psychologist were drawn into the discussion. Although in only seven units were the parents included, this did not imply that the wishes of the parents were ignored.

The reasons for suggesting transfers were varied; sometimes they involved transfer to an ordinary school; sometimes to a special school either for the deaf or for some other handicap. Transfer to special schools was a difficult decision to make and in some cases there was resistance to such proposals. Some parents, like some teachers in the schools, were not fully aware of the educational purpose of units and were not ready to accept that their children would be better placed elsewhere. A significant number of parents were unaware of the quality of provision that is made in special schools. Some otologists and members of assessment teams in clinics were also resistant to education in special schools. There seemed to be confusion between assessing a child's ability to speak and assessing his capacity for learning in an ordinary, speaking environment. For all these reasons, some children were kept in the units where the programme could never be related to their particular needs and the problems facing the teacher were thereby increased.

Transfer to secondary schools

Transfer at eleven years of age to secondary units that were directly connected with primary units presented no difficulties except when the pupils were not ready for work in specialist classes. Where there was no connection, as in 20 of the primary units, problems arose. Three units had sent some pupils to day schools for deaf and partially-hearing children; some had been transferred to schools for the partially-hearing; one had gone to a school for the educationally sub-normal; others had gone to the Mary Hare Grammar School for the Deaf. A fairly constant number of about five per year over the past few years has been admitted there as a result of the entrance examination. Other pupils have been transferred to ordinary secondary schools where only a few would have the support of a peripatetic teacher of the deaf although the majority would need it.

Late admissions

Just as there were difficulties in transfer from the units, difficulties sometimes


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arose over admissions. Many children who had been admitted too late were seen in the primary units. Although speaking fairly normally, they were grossly retarded and it was unlikely that by the time they reached the age of transfer to secondary schools, their teachers could bring them to standards of work in language, reading and writing that would enable them to take profitable part in ordinary lessons. Their work was in marked contrast to the pupils who, although more severely deaf, had had the advantage of an early start. These late comers upset the balance of those units that were working along progressive lines.

Relationship between unit teacher and main school

Unless relationships between teachers in the units and their colleagues in the main school were good, the ultimate purpose of educating partially-hearing children in this way could not be fulfilled. It was not easy to assess the degree of understanding and co-operation between them in the short period of the visits but it appeared that in 47 of the schools it was developed to a considerable degree. In 29 of these schools, the head teachers were high in praise of the skill of the teachers of the deaf in establishing themselves as full members of the staff and in gaining the support of their colleagues. Head teachers in 22 of them also recognised the responsibility that the teachers had accepted in taking up their posts and commended them in their efforts to carry out their duties.

In other cases, when units had been set up without first making their purpose clear, misunderstandings had arisen. Head teachers were not sufficiently aware of the need of the teachers of the deaf to keep close contact with the homes and considered that their prerogative in relation to the parents was being usurped. This fact, together with the unfamiliar equipment and terminology, gave rise to the idea that teaching children with impaired hearing was a mystique. This was regrettable, since the children were part of the school and were the ultimate responsibility of the head. Naturally, not all head teachers were equally interested in this work. Their immediate responsibilities in the main school took up their energies and, in consequence, they had little time to make themselves knowledgeable about the work of the units. Their lack of involvement contrasted markedly with the enthusiasm of those whose interest had been aroused. The extent of this growing interest can in some part be measured by the response to a course, for head teachers of schools containing units, run by the Department of Audiology and Education of the Deaf at Manchester University. It was held in September, 1966, and more than ninety attended.

From 27 schools there were reports of dissension, such as to cause anxiety, since the success of units for partially-hearing children is dependent on an atmosphere of goodwill and acceptance. There was criticism of teachers of the


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deaf by five of the head teachers and by other teachers in 11 schools. These criticisms seemed to stem from two sources; the low numbers on roll in the units gave the impression that this was a less exacting job than their own; the additional increments paid to them for such work appeared to be unnecessarily generous. Consequently, there was sometimes unwillingness to receive partially-hearing children in ordinary classes unless there was a reciprocal exchange that, in their eyes, was frequent enough to be regarded as fair. Similar reluctance to accept a partial-hearing unit was shown by a small number of head teachers who were conscious of the fact that, for salary purposes in special schools, the unit value of children with impaired hearing is six, whereas, when placed in special classes in ordinary primary schools they count only as one each. These critical attitudes were all understandable and they pointed clearly to the need for clarification and explanation of the purpose and work of units and of the role of the head teacher who accepts a unit within the organisation of his school.

Understanding of the work of the unit

Investigation into the amount of understanding that the ordinary class teacher had of the units with which they were in daily contact proved that in many cases it was very slight. This could be understood in areas where staffing conditions were very poor and the ordinary class teachers were working under pressure. Three of the schools were so under-staffed or had suffered so many changes that it was difficult to envisage any improvement until this situation eased. Even when good relationships existed, very few teachers in primary schools had enough free time to allow them to observe the work of the unit. In only one school was a definite encouragement given to teachers to visit the unit. In addition, it was disappointing to find that few of the teachers of the deaf had been invited to explain to the staff as a whole the educational and social barrier that impaired hearing creates, and the purpose of the unit in overcoming it. In order to meet this situation, some teachers in the units had prepared useful leaflets and pamphlets for their colleagues in the staff room. In 67 schools, the only means of learning about the needs of the partially-hearing pupils and their place in their own school was through informal conversation; in five of them, even this seemed ineffective.

In seven other schools, different ways had been devised for informing the rest of the staff. In one, the specialist inspector from the Authority had addressed them; in another, the teacher in charge of the unit was also a housemaster in the main school and had discussed the implications of the handicap with heads of departments; a third gave instruction on the use of a speech-training unit to all teachers to whose classes partially-hearing children would go; a fourth discussed with the head teacher and the class teachers the individual


[page 35]

problems of each pupil who was ready for experience in ordinary classes; in the fifth school, warm staff relationships enabled an easy interchange of information by discussion to take place. In the remaining two, the teachers accompanied their pupils to their new classes, sitting with them to observe their reactions in order to be able to discuss their problems more realistically. This last was particularly commendable since teachers do not usually invite colleagues into their rooms while they are teaching.

Understanding the work in the main school

Since one of the aims in units for partially-hearing children is to prepare the pupils to join ordinary classes alongside their hearing peers, it is essential that the specialist teachers of the deaf shall have good knowledge of the standards of work that are expected at each stage in the main school. This may seem to be less important in the nursery or infant school but it is essential at junior and secondary level.

Those teachers who had had the experience of teaching hearing children before they became teachers of the deaf were seen to be in a fortunate position. Those who had had little or no such experience were at a disadvantage since they were less able to decide whether a pupil was ready to join the normal classes, particularly at the time of transfer to secondary schools. Various methods were employed to find out about the standards of work in the main school. Some teachers studied the syllabuses and tried to follow them, though this was difficult in those junior units where the age-range extended over the whole of the school and involved preparation of widely differing material. More acute problems arose at the secondary stage where a single teacher could not be expected to be a specialist in every subject. In one unit, discussions were held on the content of the various specialist subjects; teachers in six of the units were allowed to 'sit in' at lessons in ordinary classes; fifteen unit teachers themselves taught ordinary classes in academic subjects. These were all commendable attempts to marry the work of the units with that of the schools in which they were housed.

In too many units there was no systematic way of ensuring that the teacher was fully conversant with the curriculum and methods used in the ordinary classes. In as many as 55 units only informal discussion in the staff room was possible. In 27 units, the efforts of teachers to inform themselves by means of a study of exercise books could not convey a clear picture of standards and content of the oral work, particularly at the secondary stage. One teacher whose pupils returned to the unit for tutorial sessions found that their notebooks gave her no real insight into their problems nor could she determine how well or how ill they fitted into the ordinary class in spite of friendly discussion with her colleagues in the main school. The class teachers, in the same way, found it


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difficult to make valid appraisals of the partially-hearing children's understanding of the lessons.

Three unit teachers took lessons in non-academic subjects in the main school; one organised the remedial work for retarded pupils. These arrangements, though valuable in promoting good relationships, did not help the teachers to gain knowledge of the work in academic subjects. Two schools were reported, however, to be so small that each member of staff was aware of the work of the rest.

One of the teachers was perturbed both by her own lack of knowledge of standards of work in the ordinary classes and by her inability to discover how well her pupils fitted into them. Although one of her pupils was seen during the inspection to be making poor progress, this teacher was reluctant to 'sit in' at an ordinary class lesson to observe her pupil at work because she feared that any decision to withdraw a child from that class might reflect against the class teacher and disturb the good relations that existed between the unit and the school.

It appeared that teachers in five units had only a little opportunity, and in seven more had none, to find out what kind of work went on in the other classrooms. One teacher had no wish to participate in work in ordinary classes and five others were already fully engaged with either over-sized classes of pupils with impaired hearing or with outside duties.

Estimate of educational progress

Assessment of the educational progress of children with impaired hearing is not a simple matter. Ability to converse in good speech is not a valid guide and actual attainment in basic-skills often lags far behind what appears to be their potential. Consequently it is difficult to forecast, at the primary stage, their ability to succeed in academic work later on and it is essential that careful records of development be kept. In many of the primary units there were no records of any judgements on general progress; some of the teachers used ordinary school record cards. In 23 units there was a systematic attempt to assess reading and arithmetic ages through objective testing. Since these results often did not reflect the innate ability of the pupils, this basis for forming opinion about progress was open to doubt. Because of these particular problems, assessment of readiness to participate in ordinary class lessons in primary schools and of placement on transfer to secondary schools was difficult to make. Repeated comment was heard on the low attainments of the pupils. Two secondary schools used the results of objective testing for grading partially-hearing children along with hearing children at the time of transfer. This was an unreliable means of deciding placement in form since it resulted in diverting the majority, many of whom were not innately dull, to the lowest


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streams along with hearing pupils of much lower intelligence than themselves. Partially-hearing pupils, although retarded and frequently immature, may nevertheless be of good intelligence and do not necessarily need to learn through methods applicable to dull children. It was interesting to see that in three schools, the teacher of the deaf had considered the potential of the hearing pupils to be below that of the majority of the pupils in the unit. This was a harsh judgement to have made unless the teachers were fully conversant with the work and standards reached in the ordinary schools. Not all the teachers were seen to be so.

Assessment of the work of the units

Much good work was seen at all levels in the units. Any general assessment was difficult to make since the policy underlying the organisation of most of them was vague. It was further complicated by the many other factors involved. It is axiomatic that partially-hearing children learn best through listening and so there is much to recommend a system that brings them into close contact with children who hear and speak normally. This contact is achieved by working in ordinary classes. Many of the pupils who were known to be severely retarded at the start of their education in units were very successful and had proceeded to work in ordinary classes with confidence. They proved the value of the system for some children.

In contrast to the early days of units, there was, in general, no clear statement of aim and many teachers seemed unsure of the ultimate goal for their pupils and how best to help them to reach it. There appeared to be confusion between the need to help their pupils to achieve intelligible speech as a means to acceptance in the social community and the need to achieve academic standards that would enable them to take full part in ordinary lessons. The long view of education that includes the eventual place of the child as an adult in the world of work was not often considered.

The majority of the teachers seen were hard-working, conscientious and concerned for their pupils but the problems they faced and the conditions under which they worked in many cases made total success impossible.

Some of the teachers were inclined to think that theirs was a branch of education that was remote from that of the rest of the school. Since several of those in primary units were young, inexperienced, as yet unskilled and working in isolation from other units, they were in need of guidance. They were neglecting opportunity to draw upon the skill of their heads and their staff-room colleagues from ordinary classes to develop progressive, stimulating programmes which could be adapted to their own work. The advantages that could stem from a two-way association was not always recognised.


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By contrast, in some primary units, there was interesting, progressive work that was related to the development of each individual pupil. Since, in the education of deaf children, a high degree of motivation through personal involvement is called for, several teachers had made effective use of the environment. Those to whom a minibus was available had been able to stimulate the growth of language and learning through projects that had arisen out of interesting visits of many different kinds. These projects gave rise to a better use of books and more purposeful writing; mathematics work was seen to be related to visits to places of interest, exhibitions, and youth hostels and to sea voyages.

Retardation in basic skills

The responsibility for overcoming retardation and developing the skill of the pupils in using spoken and written English, in reading and in mathematics and for giving them a good foundation of general knowledge lay for the most part, in the primary units, with the teachers of the deaf. For all pupils to reach a reasonable standard in a group that usually included a wide range in age and ability, some with individual disabilities and others returning from ordinary classes for special tutorial periods, was in many cases an impossible task. Only the most gifted were able to reach standards that would allow them to go on into ordinary classes, full-time, to work with confidence in their own abilities.

In those primary units where objective tests of reading and arithmetic were made at regular intervals, results showed that retardation was considerable. This, together with the fact that in many units, there were not enough books of quality available in the rooms to foster interest in reading as a means to self-education, led to the not surprising conclusion that, by the time many of the pupils had reached the age of transfer to secondary schools, their ability to read with comprehension was very limited. Their progress was hindered by continuing paucity of vocabulary; their written expression was immature and their general knowledge was much less than that of pupils of comparable intelligence and normal hearing with whom they should be working in the secondary school. In such cases the speed of ordinary lessons was too great. More than one, on returning to the unit from such a lesson was heard to say 'I don't know what it was about'.

In these cases, the pupils were not receiving their due. Although fluent speakers at a conversational level appropriate to their age and interests, they were not able to follow the lessons in the ordinary classes. In consequence, not only were they not able to enjoy them, it was also unlikely that they would be able to reach standards that would allow them to achieve success in external examinations at the end of their school courses. In those families that have no particular ambition for their children, this may seem to be of little importance: in others, it is of great importance. It is seldom that parents have


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any real insight into the educational progress that these boys and girls are making in school until the examinations are over and the time for leaving school has come. Many employers now demand evidence of attainment by means of paper qualifications before jobs of any quality or prospect are offered and it is therefore the responsibility of the teachers to ensure that their pupils are placed in schools or units where they will have the most favourable conditions for developing their full potential.

Assessment of the value of the units, as classes in which partially-hearing children receive much of their education, was subject to so many variables that it seemed unlikely that many would be satisfactory from all aspects. Nevertheless, out of 74 units visited, as many as 15 were thought to be so. Analysis of their success brought interesting features to light. Nine of them were in infants' schools; the pupils in five of these were mostly of nursery age; two were in junior mixed and infants' schools; two were in junior schools and two were in secondary schools. All worked under particularly favourable circumstances.

Integration appeared to be more easily achieved at nursery and infant level when all were entering school together, and when the development of social habits and spoken language was relatively more important than academic attainments. The junior and secondary units that were most successful had either small numbers or favourable staffing ratios, good organisation, interested colleagues in sympathetic main schools and experienced teachers who were able to recognise and provide for the needs of both the least and the most able of their pupils.

Pupils not suitably placed

There were 106 pupils, representing 12.5 per cent of the total, who were thought not to be receiving the kind of education that was suited to their needs. Not all of them were failing: five were ready for transfer to ordinary schools. It was disturbing to find that two of them had had no opportunity to work in ordinary classes prior to transfer. They would thus lack the bridge that this experience would provide for them before they took the step out into the unknown of a busy, different school.

The problems of the rest were diverse and did not present a simple pattern. Although teachers recognised that some of their pupils should have been transferred to other schools and a few were awaiting such placement, the progress of others demanded reappraisal in relation to placement. Apart from the few who had no hearing loss and were unsuitably placed from the start, there were others who, although rightly placed at the nursery or infant stage, had subsequently made such poor progress that education in a school or other unit where they would receive more intensive teaching was needed. These


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pupils were either profoundly deaf or they suffered one or more additional handicaps that hindered their progress. Yet others who had come late to the units and were grossly retarded also needed more help than a teacher in a unit could give.

Some of these pupils should have been transferred to special schools of one kind or another - for the deaf, the partially-hearing, the partially-sighted, the physically handicapped, the educationally sub-normal or the maladjusted. A number exhibited such behaviour problems that the calm atmosphere so necessary to this kind of organisation was upset, to the detriment of the rest of the pupils.

A growing problem was seen in the admission of children from immigrant families whose first language was not English. Here, as in a unit in a Welsh speaking area of Wales, the English taught in the unit was not reinforced at home or in the rest of the school and progress was slower than the potential of the pupils merited.

It could be seen that because of the diversity and severity of the additional handicaps amongst the pupils, many teachers, whose groups were at or above the statutory maximum number, were faced with a very difficult task. The response of many of them reflected greatly to their credit. They were working to full capacity and, in the complexity of their classes, they could do no more.

Unless they were linguistically gifted, the difficulties that faced many of the partially-hearing pupils in acquiring both knowledge and a normal usage of English became progressively more serious until, at secondary level, when class teachers were replaced by specialist teachers, it was acute. It was disturbing to see the degree of retardation amongst many of the pupils for all of whom the educational goal should have been placement in an ordinary class. Those older pupils in secondary units who were still very retarded and for whom a suitable programme of experience in ordinary classes was limited to games and practical subjects were inevitably retained by the unit teacher for most of their time. Since it should not be assumed that their real interests lay in physical education and craft work and since it was almost impossible, in the unit, to provide a range of subjects which compared with that of the main school, their curriculum was a poor substitute for one planned to satisfy their special needs.

Assessment of integration

It has been suggested to unit teachers that, in order to be aware of academic attainments in the main school, to achieve good standards in the unit and to decide with fair accuracy when partially-hearing pupils are ready for experience in ordinary classes, it is advisable that they shall have experience in teaching in them. In 35 of the units seen, 54 teachers were having such practice. A few


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were taking academic subjects but the majority were taking lessons in music, music and movement, dancing, games, hobbies activities and needlework. These subjects, although bringing the teachers into contact with the hearing children and helping to maintain good relations with the staff, were not the most useful for assessing comparative attainments. One teacher was involved in careers guidance, another in religious education and a third in remedial work. Many also co-operated generously in school journeys and extra-curricular activities.

It was difficult to assess the success of the arrangements for giving pupils a chance to work in ordinary classes. All but five units and schools were making conscious efforts to achieve both social and educational integration. With one exception there was no real problem in nursery and infants' schools. For individual reasons, attempts at placing children in ordinary classes in 12 other primary schools were not successful. Irrespective of their readiness for it, in the two primary schools where the unit teachers also carried out peripatetic duties, the partially-hearing pupils joined their own age groups in the main school in the afternoons. In another of these schools, the rigidity of the organisation was a handicap; in yet another, overcrowding, large classes and continual staff changes so impaired the stability of the school that successful placement was almost impossible; the use of Welsh as a teaching medium in the main school in contrast to English in the unit has already been mentioned.

By reason of the bad siting of some units, it was impossible to arrange for partially-hearing pupils to join in ordinary classes of their own age. This occurred when infants' units were in junior schools: when junior units were in infants' schools: when all-age units were in primary schools: when primary pupils were in secondary schools. The siting of the units was seen to be of major importance. In more than one case it could be seen that changes in the population of the neighbourhood had wrought corresponding changes in the main school where problems had become so pronounced that plans to introduce any pupils from the unit into ordinary classes were at a standstill.

Some primary head teachers had devised interesting ways of introducing the children from the unit to those of the main school in order to foster friendships between them. It could be seen that in at least 20 primary schools there was a policy of progressive integration from simple beginnings at meals and in physical education to full-time placement in ordinary classes for those pupils who could achieve it, but difficulties had been encountered. In some areas school hours for the unit differed from those of the main school; as a result, many partially-hearing pupils took no part in morning assembly and were therefore unable to experience its sense of community. They also left in the afternoon before the end of the session and they missed both opportunity to take part in the last lessons of the day and, at the secondary stage, to join in


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after-school clubs and activities. It seemed evident that, in many cases, unless these pupils were in ordinary classes for the greater part of the day, they remained apart, even at break, and in spite of great effort from the head teachers and the staff, they did not become an integral part of the school.

It was thought that the distance many of them lived away from the school and the length of the journeys they undertook were contributory factors to this difficulty.

Conditions varied so considerably that it was not easy to evaluate statistical information about the classes attended in the main school. Infant and junior schools following a flexible time-table presented a different picture from those having a formal type of organisation. A very small number of pupils had been removed from the roll of units and transferred to that of the main school. In 18 schools, a few pupils were placed full-time in ordinary classes but returned to their special teacher for tutorial periods. Although a small number of pupils were working in ordinary classes for academic subjects in only twenty schools, many were taking part in non-academic subjects in 46 schools. At the secondary stage subjects were extended to physical education, needlework, housecraft, woodwork, metalwork, art and craft.

The difficulties encountered in the secondary units, where, in the majority of cases, the pupils as far as possible, were dispersed amongst the ordinary classes, have already received comment. From the records and the work seen, the retardation that began to be more apparent at about the age of nine was a cause for anxiety when the age of transfer to secondary school was reached. It may be that in order to make better provision for the slower pupils, some of them should be transferred at this stage to special schools for the partially-hearing where classification into viable groups would ensure that good secondary education could be given.

Educationally handicapped though they are, children with partial-hearing can eventually overcome their retardation if given intensive help over a long period. Since, in contrast to most ordinary schools and schools for the deaf, the units were generously staffed, other ways of providing this intensive help should be sought. Once initial placement in a unit has been made, periodic reassessment and appraisal of progress to estimate the suitability of such provision should follow. Numbers, in comparison with total population, are small and any development that may prove to be needed is likely to be possible only when planned on a regional basis.

Parent guidance

The social and educational handicap imposed by impaired hearing was very little understood by many of the parents. Throughout the school life of the


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children, parents are in need of guidance and support in helping them to accept and face the fact that their child may not make normal progress without special help. The need for guidance was made clear by the number who, in spite of being aware of the severity of the impairment, did not realise the degree of retardation that was impeding progress. They were concerned only about their child's ability to talk, which they could assess, and had been unable to accept advice given about special schooling.

Enquiries made during the survey about the possibility of making firm and regular arrangements for giving advice and guidance revealed that in 54 units there were such arrangements; in 20, there were none. The duties involved were sometimes heavy: six teachers were additionally engaged in guidance of parents with children of pre-school age: two had undertaken peripatetic work with children in other schools: four had a combination of both these duties: eight worked as a member of an assessment team in a clinic: 16 visited children in their own homes. In some cases these out-of-school duties placed a heavy burden on the shoulders of conscientious teachers.

The majority of the arrangements for parent guidance were thought to be satisfactory, but some appeared to be of limited value, either on account of the short time available for the purpose or because of the poor quality of guidance offered. In areas where there was an organising teacher in charge of arrangements for guidance and for peripatetic work generally it was obviously possible to have more comprehensive schemes for parent guidance without depriving the children in the special classes of the teacher's services than in the areas where there was only one specialist teacher of the deaf with responsibility for a unit. In areas where there were good arrangements for pre-school training of the hearing-handicapped child the teacher responsible for these was often able to continue helping parents after their child had been admitted to the special class. In this situation it was essential that there should be good and effective liaison between the two teachers involved.

Where there was no scheme for parent guidance by the teacher of the special class, this did not always mean that no help for parents was available in that area. In several places this function was undertaken by the local branch of the National Deaf Children's Society, and in one region by the university department concerned with the education of deaf children. Where another agency was involved, it was sometimes difficult to maintain lines of communication between interested individuals, with the unfortunate result that parents were sometimes given conflicting advice.

It was interesting that in one area the reason for not carrying out parent guidance was stated to be the teacher's dislike of and disbelief in the value of this side of the education of the handicapped child. In others the distance of


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the children's homes from the unit, transport problems and the resulting difficulty in arranging for parents to be seen except at very infrequent intervals all limited the amount of guidance that could be arranged.







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General observations and recommendations


Principles determining establishment of units

No clear policy underlying the establishment of units was apparent, and the growth of the service has been haphazard.

(a) Functions of units should be clearly defined, and the pupils selected accordingly.

(b) Any further extension of units should be planned on a regional basis.

Selection of pupils

The majority of pupils were suitable for admission to units when they were young. The facility they achieved in speech and in conversational language was commendable. Comparable standards, however, were seldom reached by pupils who were more severely deaf. Some of the children seen were too severely deaf to benefit from being in the units; on the other hand, some children seen had no hearing loss at all.

(a) In admitting children after the infant stage, care should be taken to select only those who function as partially-hearing children.

(b) They should be seen to have a prospect of learning to speak, with or without amplified sound, in a natural way more by listening than by lip reading.

(c) They should be capable of acquiring language along natural patterns rather than by the imposed patterns that are needed by the profoundly deaf.

(d) In order to select children who collectively do not present too heavy a load of additional handicaps, the teacher of the unit should be consulted and should take part in all conferences.

Admission of pupils

There were obvious advantages, both in greater certainty of diagnosis and in rate of progress, when provision was made for children of nursery age to have special help either in units or in small nurseries where the services of a teacher of the deaf were available.

(a) It is advisable to consider, first, the needs of very young children and to avoid late entries.

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(b) Units for young children should be diagnostic in function, and this function should be understood by the parents.

(c) Care should be taken to ensure that overloading and over-frequent admissions do not disrupt the work.

Educational needs of pupils

The variations between the pupils in age, ability and disability were enormous. It has already been pointed out that, although the majority were suitably placed, some were either too deaf or too handicapped in other ways to justify retention. They needed full-time education in a special school. Some needed more intensive help than their teachers could give them. Their difficulties were not lessened by the fact that, in single-class units, some children might have spent four years with the same teacher and that the school day was short. To provide more intensive and individual teaching, additional teachers might be needed, but this is hardly possible in small units in the light of the national shortage and the much greater staffing problems in the special schools.

It may be that, at this time of national shortage, intensive help can be provided only in special schools for the partially-hearing, regionally planned. The difficulty in some primary units was in some part met by the appointment of ancillary assistants, who were of good quality and who worked alongside the teachers, following their guidance. At secondary level, no such solution appeared possible. The retention of pupils who were so retarded that they received all their academic instruction within the unit meant a very meagre educational diet compared with the rest. More consideration should be given to:

(a) a means of providing more intensive help for those pupils who need it and are suitable for retention in primary units;
(b) alternative provision for pupils who, by secondary age, are making progress that is too slow for integration with educational profit;
(c) the length of the school day.
Organisation

The survey revealed that single-class units in isolation have difficulty in providing the progressive work needed from stage to stage. There are advantages when more than one class and more than one teacher are working together. There is an added advantage when units within an area are grouped together under a skilled leader whose duty it is:

(i) to correlate the work;
(ii) to provide guidance for teachers who need it;
(iii) to assess, along with the heads, the pupils' progress;
(iv) to help to maintain good relationships with the teachers and heads in the main school.

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Such a leader should also be expected:

(1) to arrange for regular meetings of the unit teachers;
(2) to arrange a scheme of parent guidance;
(3) to decide when it is propitious to move a unit from one school to another.
In dealing with a handicap of such slight incidence as impaired hearing, these factors enhance the need for regional planning.
(a) Care must be taken in deciding the age range of pupils to be included in a single class. Too wide an age range makes it impossible for the teacher to satisfy the wider educational needs of the pupils: too narrow an age range means that not only are further admissions blocked for several years, unless another class can be opened, but also, on transfer of the group to a secondary school the junior unit is left half empty. It also accentuates difficulties of integration in the secondary school.

(b) In many units greater thought should be given to integration and its purpose. There is a risk that for the sake of achieving the maximum amount of integration pupils may be given experience in ordinary classes which may be unsuitable and is at best only administratively convenient.

(c) It is essential that there shall be flexibility in organisation so that when necessary, changes can be made.

(d) In avoiding single-class units, with one teacher in isolation the total unit should not become too big for the main school.

(e) The appointment of teachers in charge of units composed of several classes should be considered with as much care as are heads of departments.

(f) Whenever possible, teachers should be appointed in advance of the opening of units to enable them to establish good relationships in the school and with the parents.

(g) The size of the classes should be closely watched and kept to workable numbers particularly in those places where the teachers are attempting to combine both peripatetic and school duties.

(h) A balance between school and peripatetic duties should be preserved. When the keen interest of dedicated teachers has been aroused, there is danger of pressures from overwork.

Conditions under which units work

Particular difficulties arose when the purpose of units was not understood in the main school. In such cases, facilities for providing experience in ordinary classes were not available and the units became tiny special schools within them. This was the result also when units were badly sited. Complete inte-


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gration is possible only when units conform exactly to the age-range of the school to which they are attached. Care should be taken to ensure that:

(a) there is reasonable opportunity for integration at all stages for all the ages represented in the unit;
(b) the unit classrooms for young children are within easy reach of those in the main school to which they will go;
(c) the sanitary provision for young children is close by their classrooms;
(d) the rooms are of good size and in a quiet situation;
(e) there is possibility of additional rooms or space that can be adapted for individual tuition;
(f) the storage area is adequate.
Auditory equipment

Although the majority of the units appeared to be well equipped, the auditory aids were not always in good working order. The education of children with impaired hearing depends largely on these aids and the skill with which they are used. Authorities should consider:

(a) ways of improving the maintenance service;
(b) revision of the system by which aids are taken for and collected from repair;
(c) means by which better fitting inserts, particularly for young children who outgrow them quickly, can be obtained without undue waiting;
(d) intensive training for those teachers who, in the absence of fully qualified personnel, have undertaken this special work without any appropriate training.
Staffing

Frequent staff changes or periods without qualified and experienced teachers had left their mark on some of the units. Although there was a general impression that the majority of teachers were hard-working and conscientious, the sense of urgency that must accompany the education of children with impaired hearing if they are going to overcome their inevitable retardation was sometimes missing.

Most of the teachers realised that their duty was to become an integral part of the main school, to join in as many of its activities as possible and to make themselves and their pupils welcome. Those who seemed to consider that their work, by its special nature, ",:as unrelated to that of the rest of the school were losing valuable opportunities for expanding the scope of their own teaching. Serious thought should be given to ways of determining both when pupils have reached standards that are propitious for useful integration in ordinary classes and when they should be withdrawn.


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Out of the general staffing situation, the following points arose:

(a) every effort should be made to achieve stability of staffing;
(b) similar effort should be made to obtain suitably qualified, experienced teachers;
(c) guidance is needed by inexperienced teachers in developing progressive programmes and organising their work;
(d) the help that heads and others can give should be recognised.
Relationships

The teachers in the units clearly desired to establish good relationships with the heads and the rest of the staff but this wish was not always fulfilled. There were some heads and teachers who were not willing to accept the extra responsibility of a unit for partially-hearing children. There was a lack of appreciation, on both sides, of the difficulties to be faced both in teaching in ordinary classes and in units. In demanding reciprocal help for accepting a child from the unit into an ordinary class, it was not always understood that even in a small group of partially-hearing children the problems can be so individual that intensive teaching on an individual basis still might not allow the pupil to reach his full potential and the strain suffered by the teacher is quite as great as that experienced in working in an ordinary class. The urgency of the need, therefore, did not always make much of this kind of exchange possible.

This lack of understanding when combined with the dissatisfaction that some teachers in ordinary schools felt about the additional increments paid for work with such small groups of children led to disagreements and lack of co-operation. The disparity in unit values was also a source of discontent in some schools.

It is advisable that authorities should:

(a) reconsider, in the light of the national shortage of teachers of the deaf, the extra increments offered as inducements to work in units;
(b) recognise the additional burden that units bring to the heads of primary schools;
(c) adjust, as far as possible, the numbers in class in primary schools in order to make conditions for integration easier;
(d) define the status of the teacher in charge of units.
Work

Standards in written language, comprehension of reading and mathematics of all except the most able pupils were indicative of retardation persisting at secondary level and affecting the programmes of work that could be followed. This pointed to the difficulty of organising progressive courses and should be


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borne in mind when making provision for pupils of secondary age. Attention should be given to the following considerations:

(a) if strict principles of selection were adhered to, and after considering the potential of each individual child, only those who had shown ability to communicate easily and to learn through auditory methods were retained in the units, then the services of fully qualified teachers of the deaf might not be required after the infant and early junior stage. The need for such teachers would lie more specifically either with the young children or as heads of department and in organisation;
(b) for teaching the older pupils, it might then be possible to arrange short, intensive courses in the special techniques, to which interested teachers from the ordinary schools could be seconded;
(c) by this means fully qualified teachers of the deaf could be released for work with the children who are handicapped by more profound deafness and whose plight is more desperate.