A Survey of Exceptional Children in Huntingdon County, Their Incidence and the Distribution of Multiple Handicaps

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The Pennsylvania State College The Graduate School Department of Education and Psychology

A Survey of Exceptional Children in Huntingdon County* Their Incidence and the Distribution of Multiple Handicaps

A Thesis

Rutherford B. Porter Submitted in partial fulfillment of the requirements for the degree of

Doctor of Education. August, 1942

Approved^^^*^-#^

^ yfys.

ACKNOWLEDGMENTS

I appreciate the assistance of the following persons in carrying out this survey and in preparing the manuscript, and I wish to thank them:

J. H. Neff,

County Superintendent of Huntingdon County Schools; Frank Magill, Assistant County Superintendent of Huntingdon County Schools; Dr. T. Ernest Newland, Chief, Division of Special Education, Department of Public Instruction, Harrisburg; Dr. Harold Westlake, Advisor, Division of Special Education, Department of Public Instruction, Harrisburg; I. Newton Taylor, District Attorney of Huntingdon County; Grace Porter, my wife; the Teachers of Huntingdon County; and my advisory committee.

CONTENTS

Page

Chapter

3

I

Statement and Analysis of the Problem

IX

The Data and Their Treatment

10

III

The Mentally Exceptional

17

IV

The Deaf and Hard of Hearing

25

V

The Visually Handicapped

32

VI

The Speech Defective

38

VII

The Crippled and Physically Delicate

42

VIII

The Behavior Problem

48

IX

Summary and Conclusions

53

Bibliography

60

Appendix

68

TABLES Page

Number I

Distribution of IQs for 3694 Children in Grades 3-8

II Mental Ages by Grades with Medians and Range III

19 20

Incidence of Mental Retardation among School Children of Grades 3-8 and the Severity of the Handicap

21

Incidence of Mental Superiority among School Children of Grades 3-8 and the Degree of the Exceptionality

22

Mentally Retarded Children Who Presented Multiple Handicaps, Grades 3-8

23

VI Mentally Superior Children Who Presented Multiple Handicaps, Grades 3-8

23

IV V

VII

Percentages of Children with Impaired Hearing as Reported by Several Investigators

26

Incidence of Defective Hearing among School Children Distributed by Grade Groups and Severity ofthe Handicap

28

IX Distribution by Mental Ages of the Passing or Failure of 276 Children on First and Second Hearing Tests

30

VIII

X XI XII

Children ivith Defective Hearing Who Presented Multiple Handicaps

31

Percentages of Children with Defective Vision as Reported by Several Investigators

33

Incidence of Defective Vision among School Children Distributed by Grade Groups and Severity of the Handicap.

35

XIII Visually Defective Children Who Presented Multiple Handicaps36 XIV XV XVI XVII XVIII

Percentages of Children with Defective Speech as Reported by Several Investigators

38

Incidence of Defective Speech among School Children Distributed by Grade Groups and Severity ofthe Handicap

40

Children with Speech Defects Who Presented Multiple Handicaps '

41

Percentages of Physically Handicapped Children as Reported by Several Investigators

43

Incidence of Crippled and Physically Delicate Children Distributed by Grade Groups

45

TABLES Page

Number XIX XX XXI XXII XXIII

Crippled or Physically Delicate Children "Who Presented Multiple Handicaps

46

Percentages of Children with Behavior Problems as Reported by Several Investigators

49

Incidence of Behavior Problems Distributed by Grade Groups

50

Children with Behavior Problems YYho Presented Multiple Handicaps

51

Incidence of Handicaps, Single and Multiple, Grades 3-8, 4177 Children, Huntingdon County Rural Schools, 1941-42

54

XXIV Distribution of Children According to the Number of Handicaps Each Child Presented XXV An Estimate of the Reliability of the Incidence of Handicapped Children Reported for Huntingdon County • XXVI XXVII

XXVIII

56 57

Statistical Comparison of Huntingdon County with Pennsylvania

68

Percentages of Different Types of Atypical Children in School Population for Whom Special Remedial or Educational Provision Should be Made in Regular Classes, Full Time Special Classes, and Part Time Special Classes

70

Age-Grade-Progress Table, Huntingdon County

71

3

Chapter I STATEMENT AND ANALYSIS OP TES PROBLEM Special education is regular education for exceptional children. It endeavors to make provisions for hoys and girls -who are mentally, physically, or socially handicapped to such an extent that they cannot receive adequate educational training through ordinary school procedures. The aims of special education are specifically: 1.

To identify e/very exceptional child.

2.

To determine the type of exceptionality.

3.

To help the teacher to understand the exceptional child and plan her program to include him.

4.' To help the exceptional child make more satisfactory adjustment to school and community. 5.

To help the parent understand his child in terms of individual performance and abilities.

This survey relates directly to the first two aims:

to~ identify

the exceptional children and to determine the type of exceptionality. Specifically, it is set up to attempt to satisfy the following state­ ments: 1.

To make available more accurate figures on the number of handicapped children, both those who are in school and those who are out of sohool, in a representative rural area.

2.

To make available more accurate figures on the degree of the handioapping condition of children, both in school and out of school, in this representative rural area.

3.

To obtain figures on the multiple handicaps of exceptional children for this rural area.

4.

To enable others to more accurately estimate the number of exceptional children in a specific area of similar nature.

5.

To serve as a first step in a more accurate state-wide enumeration of exceptional children.

The term "exceptional children" as used in this study includes the

4 mentally retarded, mentally superior, deaf and hard of hearing, blind and partially-sighted, speech defective, behavior problem, and crippled or physically delicate. The problem of finding the exceptional children is a difficult one anywhere and is doubly difficult in rural areas.

Very few exhaustive

studies have been made that include all types of exceptional children. Newland^ thus expressed the need for further study: "The school system or state that knows accurately the frequen­ cies with which the different types of exceptional children exist is rare indeed,...We are failing to locate our excep­ tional children early enough or accurately enough. As a result we are not fully aware of the size of the problem of educating these children and are, therefore, not doing the job as well as it should be done." Too often a survey of the incidence of exceptional children goes only as far as obtaining the number of children enrolled in special classes, special schools, hospitals, and those receiving home instruc­ tion.

The Office of Education, Yfashington, D. C.,2 reported the number

of children of each type of exceptionality in each state and indicated which had classroom instruction, which home instruction, which hospital instruction, et cetera.

This is important information and quite useful,

but it does not tell how many children were in the same population and not receiving any kind of organized instruction, nor does it cover all children in special schools and classes, since some questionnaires are not returned.

Also, a common characteristic of these studies is that

the data reported were from city rather than rural areas.

1. 2.

Newland, T. Ernest, "Editorial Comment", Phi Delta Kappan, Vol. 23, Ho. 2 (October, 1940) p. 33. Advance Statistics of Special Schools and Classes for Exceptional Children 1939-40, Federal Seourity Agency (U. S. Office of Eduoation, January, 1942)

5 The State of Virginia^ has attempted a survey of exceptional children and the usual weakness of suoh a study was noted in the report: “In the spring of 1937 teachers co-operated with the State Department of Education in an effort to identify the children whose handicaps were so severe that they required services not then available in public schools. This survey was made in a limited time without adequate preparation on the part of the teachers for recognizing and identifying the handicaps of children. Consequently, many children who should have been reported were overlooked when the study was made and it is possible that some were erroneously classified." Moss^ reported that in the Province of Ontario certain rural areas have been rather completely surveyed: "Twenty-one of the ninety-eight rural inspectorates in Ontario have been completely surveyed and provision made for all the handicapped children in each area. Four more have been partially surveyed and twelve rural surveys are being undertaken in 1938." If this survey was as complete as the statement implies, valuable data have been collected.

However, Stothers^ wrote that the results

have not been carefully analyzed; and although he had recently summarized some of the findings, he questioned their reliability due to the failure of teachers to make reports on such children. The complexity of the problem was described by Ade6 who has sanc­ tioned this statement: "To deal intelligently with exceptional children it is necessary to be able to identify and diagnose them scientifically. For the most part, this responsibility has been met by such public servants as the teachers, school medical inspectors, and school nurses. Such attempts were distinct improvements over a

3.

4. 5. 6.

Virginia, "A Description of Services Available to Local School Divisions Through the Division of Rehabilitation, Special, and Adult Education", Reprint from Bulletin, State Board of Education, Vol. 24 No. 2 (August, 1941) p. 99. Amoss, Harry, "Special Education in Rural Communities", Journal of Exceptional Children, Vol. 5 (January, 1939) p. 93. Stothers, Charles E.~, Personal Letter (June, 1942) Ade, Lester K., "The Place of Special Education in Our Modern Program" (mimeographed, Harrisburg, Pa., Department of Public Instruction, 1938) p. 18.

6

laissez-faire polioy. There were, however, numerous oases that were, from a mental standpoint, either overlooked or incorrectly diagnosed. On the one hand, teachers reported children as having low mentality who were really solely emo­ tional problems, and on the other hand, overlooked instanoes of low mentality where the children were not getting along satisfactorily but were so pleasant about it that they failed to receive necessary attention. Moreover, some physicians diagnosed sensory-handioapped cases as mentally backward, and failed also to recognize less obvious cases of intellectual inferiority." Legislative provision for a periodic census of all children of school age is an accepted state practice, even though few states have made legal provision for enumerating all types of handicapped children needing special eduoational facilities.

Pennsylvania's law7 is repre­

sentative of one of the more inclusive ones: "It shall be the duty of the secretary of the school board, teachers, school enumerators, home and school visitors, and attendance officers, in every school district in this Com­ monwealth, in accordance with rules of procedure prescribed by the Superintendent of Public Instruction, to secure infor­ mation and report to the county superintendent of schools, on or before the fifteenth day of October each year, and there­ after as cases arise, every child of compulsory school age (6 to 17) within said district who, because of apparent exceptional physical or mental condition, is not being properly educated and trained, and as soon thereafter as possible the child shall be examined by a person certified by the Department of Public Instruction as a public sohool psychologist or psychological examiner, and also by any other expert which the type of class and child’s condition may necessitate and a report shall be made concerning his fitness for special education." In most cases the actual number of children thus reported would seem to be quite inacourate.

A count over a period of five years in Huntingdon

County showed less than 1 per cent of the known seriously handicapped children were reported as a result of the law.

Therefore, even after

the legal provision for enumerating was made, it was still impossible to accept literally the results as a true picture.

7.

Pennsylvania, School Laws of Pennsylvania, 1941, Section 1413, par. 1 p. 168.

7

In 1936 in the State of Ohio, E. L. Bowsher, State Director of Education, sent out a questionnaire to all superintendents of public schools in the state.

The purpose was to discover the number of pupils

in the kindergarten, the elementary grades, and the high schools who, in the judgment of the teachers, were mentally retarded, defective in speech, or behavior problems; and further to find out how many children had more than one of the three handicaps. teachers’ beliefs, were:

The results, according to the

mentally retarded 3.4 per cent, speeoh defec­

tive 1.1 per cent, behavior problems 1.5 per cent.

Approximately one-

fourth of the children reported had two or all three of the handicaps. Dr. Berry,8 who reported this study, stated that the estimates shown were probably too conservative. In the State of Wisconsin, J. A. Young^ reported a survey oonduoted in rural schools with special reference to speech and hearing.

Out of

9,553 children examined, 488 or 5.1 per cent had defective speech, and 155 or 1.6 per cent had defective hearing.

Intelligence tests and

personality tests were also given, although the results were not reported. Ho comparative results were given for children with multiple handicaps. Hilleboe-*-® summarized the research up to 1930.

The statement of

his problem explains his viewpoint: "It is the purpose of this study to classify atypical boy s and girls from the viewpoint of selection for special education; to determine the probable percentage of childrenin each of the classifications, including the degree to which the school systems investigated are providing for atypical children, the

8. 9. 10.

Berry, Charles Scott, "A Survey of Mentally Retarded, Speech Defec­ tive, and Behavior Problem Children in the Public Schools of Ohio" (Ohio State University, October, 1938) p. 6-7 Young, J. A., "Speech Rehabilitation in the Rural Schools of Waukesha County, Wisconsin", Journal of Speech Disorders, Vol. 5 (March 1940) pp. 25-27. Hilleboe, Guy L., Finding and Teaching Atypical Children (Hew York, Teachers College, Columbia University, 1930) p. 3.

8 probability of reductions in numbers in the future, and the relation of the program for atypical children to the state’s minimum program; and to set up the current practices in, the methods of and the agenoies for the selection, diagnosis, assignment and follow up of eaoh of the types requiring special education. The school cannot be fitted to the individual unless the needs of the individual are scientifically deter­ mined, and this study is an attempt to determine such needs of children as will form the basis for an adequate adminis­ trative program." The data for Hilleboe's study were selected largely from city enrollments by the questionnaire and interview method.

It covered a large sample

in a general way and was probably as carefully done as anything in the field to date.

As the various investigators had reported such a wide

range on prevalence of exceptional children, Hilleboe reported his summary in terms of median percentages. divisions were:

The percentages for the major

mentally atypical, not including mentally superior,

6.53; physically atypical, 27.90; and temperamentally atypical, 4.80. The complete table of his findings is inoluded in the appendixll Df this report. In November, 1930, 73,000 men and women, leaders in the medical, educational, and social fields as they touch the life of the child, were in attendance at a meeting called by President Hoover. known as the "White House Conference of 1930.

This was

The purposed as stated

was: "To study the present status of the health and well-being of the children of the United States and its possessions; to report what is being done; to recommend what ought to be done and how to do it." Preliminary to the conference, sixteen months were devoted to prepara­ tory study, research, and assembling facts on the part of 1200 experts working in 150 communities.

11. 12.

Estimates from this conference have been

Appendix, TableXCV1I. The White House Conference On Child Health and Protection, White House Conference 1950 (Hew York, Century Co., 1931) p. V.

9 widely quoted on the study of incidence of handicapped children.

New

publications are still prefacing their remarks with these figures. Many states and cities are calculating the probable extent of their own special education problem by the ratios established by this report. However, the 'White House

Conference-*-*^

report on crippled children, which

has been one of the more carefully surveyed fields, stated: "There is little definite knowledge of the numerical extent of the problem and even in many well organized communities the task of finding the (crippled) children still presents baffling difficulties." That there is a need for additional data on the prevalence of exceptional children is also indicated by Martens14 who wrote: "The logical point of departure in any serious approach to the problem of organizing educational facilities on a State-wide basis for exceptional children is to be found in seeking an answer to the question: How many exceptional children are there in the State? Before one can attack any problem intel­ ligently, one should know something of its magnitude. Sometimes one attacks a problem without knowing its magnitude until one is deeply involved in it. So it has been with State programs of special education; yet the question of incidence is an ever­ present one and must be answered sometime if the program is to proceed along effective lines." It would seem, then, that there is a need for ascertaining more accurately the extent of the special education problem in many communi­ ties.

Several carefully made studies in representative type areas, rural

for example, should add to the accuracy of prediction not only in the total estimate but more especially in estimates of other small areas of a similar type.

13. 14.

The White House Conference, Committee on Physically and Mentally Handicapped, The Handicapped Child (^ew York, Century Co., 1933) p. 167. Martens, Elise, "State Supervisory Programs for the Education of Exceptional Children", Bulletin Ho. 6, Monograph Ho. 10 (Washington, U. S. Office of Eduoation, 1940) p. 4.

10

Chapter II THE DATA AND THEIR TREATMENT This survey on the incidence of handicapped children was conduoted in Huntingdon County during the 1941-42 school year.

This county is

distinctly a rural area with 83 per cent of the population classified as rural whereas for Pennsylvania as a whole only 33 per cent is rural. It lies south of the center of the state, mainly in the upper valleys of the Juniata River and its tributaries.

Through it run the rugged

mountain ranges of the Alleghenies in their southwesterly course.

Hence,

the surface is greatly broken, and much of it cannot be profitably cultivated.

The land area is 918 square miles; the population 41,836.

In the southern part of the county are fields of bituminous coal, and along the Juniata is found ganister rock of superior quality. iron ore was mined.

Formerly

Recently coal mining, quarrying, agriculture, and

miscellaneous manufacturing have been the chief pursuits.

Crushed

limestone and sandstone for building are other mineral products, while one of the largest glass sand quarries and plants in the eastern states is at Mapleton Depot.

The principal classes of industry are clay, glass,

and stone products. Statistics pertaining to public schools are as follows:

number of

school districts, 48; number of high schools, 10; number of school buildings in use, 120; valuation of school property, §19,613,431; current expenses, §617,171; debt service, §127,173; capital outlay, §42,700; total expended, §807,044; number of teachers and supervisors, 330; total enrollment, 9,990; average daily attendance, 8,911; average current expenses cost per pupil, §69.26.1

1.

Appendix, Table XXVI, "Statistical Comparison of Huntingdon County with Pennsylvania", 1939-40.

11

Public Welfare agencies are few and inadequate to meet the need. There are no child study centers. year.

Orthopedic clinics are held twice a

Service clubs assist in many ways, but mainly by giving financial

assistance for correcting vision.

Many doctors have personally given

some of their time when the need was urgent.

On the whole, however,

the children have probably had as much attention and service as have children in other similar rural areas. This survey was concerned with a total of 6666 county school chil­ dren.

Huntingdon Borough, which is the only third class school district

in the county, and the high school of Mount Union were the only sohools not included in this total. included.

For some handicaps all grades were not

However, grades 3-8, with an enrollment of 4177, were surveyed

for each handicap and made the nucleus for comparing results.

For the

present study the 3-8 grade group included children who were ten years of age or more but registered in a lower grade and children not in school who were eight years of age or more but had not passed the eighth grade. The study includes a complete survey within the limits of the definitions of the number of exceptional children of the following types:

mentally retarded, mentally superior, blind and partially-

sighted, deaf and hard of hearing, speech defective, crippled and physically delicate, and behavior. A starting point for locating exceptional children was to collect information from records of the various agencies and from available lists.

The names of children reported to the County Superintendent of

Schools as a result of Section 1413 of the School Laws of Pennsylvania, quoted in Chapter I, served as a basis for an approach to the problem.

12 The report of the last school medical inspection (1938) made under the auspices of the School Division of the State Department of Health was scrutinized for the names of children with mental handicaps, visual handicaps, hearing handicaps, speech handicaps, and other physical handicaps.

The handicap and its seriousness indicated "by the examining

doctor -were oarefully noted and investigated. Conferences were held with the state nurses who made available the records from the orthopedic clinics conerning the children who had visited them and the degree of their handicaps.

The clinic records

covered a period from 1936 to 1942 and were supplemented with verbal observations by the nurses.

They also provided some faots on other

handicapped children whom they had discovered through their visits in the county.

Additional information was given by a former state nurse

who had served eight years in the county and who personally knew many of the handicapped children and their home life. A YiPA project sponsored by the State Department of Public Instruc­ tion and co-sponsored by the Pennsylvania Society for Advancement of theDeaf was conducted to determine the number of deaf and hard of ing

children in Blair and Huntingdon Counties.

hear­

The project opened in

March, 1941, and oompleted its aim in March, 1942.

The YVPA examiners

were carefully trained before the testing started, and were closely supervised throughout by a county supervisor of special education.

This

report made available complete data on the number, location, and degree of hearing loss for the hard of hearing children. A group

test of mental ability was administered to all school chil­

dren in grades three through eight in January and February, 1942. Approximately 30 per cent of the children considered mentally excep­ tional by the group intelligence test were given an individual psycho-

13 logical examination to determine their final classification. The enumeration form for school children includes a section for the listing of handicapped children not in school. examined for the years 1937 to 1941.

These records were

For two years previous to 1942

some of the school census takers had been given specific instruction as to particular items to look for and record.

This tended to make

at least some of these reports more accurate than usual. The number and names of children who were in public or private institutions or hospitals and were complete or partial wards of the county were discovered by examining the bills which the county commis­ sioners received from such institutions.

The records of the Bureau of

Mental Health, of the State Department of Welfare, revealed the names of mentally retarded children who were in state institutions and those for whom application to an institution had been placed, but who were not yet accepted. in investigation to locate exceptional children was made with the assistance of the local agency secretary of the records on file with the following county welfare societies: Child YTelfare Services.

Red Cross, Tuberculosis, and

Many of these records included social case

histories and a medical diagnosis of the handicaps. A list with notations had been made during a period of three years of all children reported or in any way intimated by teachers or parents as being exceptional.

Also notes had been kept on all children referred

or especially mentioned by the County Superintendent or the Assistant County Sup erintendent. All schools were visited by a county supervisor of special education who was certified as a public school psychologist.

He examined each

child who had been reported through any of the above sources in light

14 of more specific definitions for the purpose of verifying the report and determining the extent of the handicap. investigator in the following ways.

Each teacher assisted the

First, she indicated in her room

those children whom the various lists had shown as exceptional, and commented on the presence or absence of a handicap serious enough to interfere with school success.

Secondly, she pointed out other children

in addition to those already know who, because of symptoms of one or more handicaps, should be studied.

To assist a teacher in determining

what type of disability a child must have in order to be considered handicapped, a definition of each exceptionality stated in common terms was individually discussed with her.

The definitions will be found at

the beginning of the following chapters which relate to the specific handicaps.

In most cases each teacher checked through her oomplete

class roll for each handicap, thus keeping only one definition in her mind at a time.

Most of the children mentioned by a teacher were

immediately investigated by a county supervisor of special education by means of a brief conference with the child.

The teacher’s judgment

of the ohild’s adjustment to school and her report on the child’s handicap vrere carefully considered.

Whenever possible the child’s

alleged condition was checked by means of an objective soale, for example the Snellen Eye chart in case of visual acuity.

Also, in many cases

local doctors gave information as to the diagnosis of medical aspects of exceptionality.

Only those children were considered exceptional for

whom definite evidence was available. All teachers, most of them local persons, were individually asked to name any child of school age who was exceptional and not in school. Teachers were encouraged to do this and also to mention rumors of the

15

existence of exceptional children by explaining that often help can be given such children when they are discovered.

All homes were visited

by a county supervisor of special education where rumor or fact indica­ ted a non-attending exceptional child.

Thus, with all teachers, many

school directors, and some parents reporting the children not in school, it can be expected that a rather complete coverage of each community was obtained. An important consideration for this study relates to the collecting of the data.

Several of the sources used would, if they were function­

ing as set up or as they were intended, make such a study as this unnecessary because the incidence of exceptionality already would be known.

Such is not the case, however, as was explained in Chapter I.

It should be noted that many overlapping sources of data were used, that this enabled a cross check on results, and that all leads found through any source vrere followed to an end. Children were found to have unsuspected handicaps, as for example, a boy temporarily housed in the county jail on a family charge of immorality and considered feebleminded was, in addition to these handi­ caps and much to the surprise of those concerned, found to be nearly deaf.

Also, the existence of a feebleminded child, who apparantly was

unknown to welfare agencies and was not reported through any of the usual enumerations, was discovered through a conference with a child in school who mentioned a sister who "could not talk". Data were organized by schools with a brief case record prepared on each child.

This record showed the nature of the handicaps which the

child had, whether there was one or more than one handicap, the degree of the handicap, and source of the data.

Many of these records were

16

checked several times by further testing, clinic reoords, or doctors' reports.

The number falling "within the definition of each handicap was

counted, and percentage of the total sample which the particular group represented was found.

The number of children having more than one

handicap was tabulated, and percentages found.

Handicapped children

not in school were included in the tabulation of single and multiple handicaps, and in addition their incidence was separately reported. The reader should realize that simply examining existing records would not give results comparable with those herein reported, but rather a painstaking search into every corner of an area by every means possible would be necessary.

17 Chapter III THE MENTALLY EXCEPTIONAL The mentally exceptional children inolude both the mentally retarded and the mentally superior.

The problem of treatment presented by the

two is vastly different, but from the standpoint of their prevalence, they can be considered together. Since the advent of intelligence tests, the intelligence quotient (IQ) has been used in most definitions of the extremes.

However, tests

differ in what they test, how they test, and how they reflect what they test.

That factor has encouraged investigators to write varying defini­

tions of the mentally exceptional.

Some writers define those who need

special educational facilities as the lowest 3 per cent and highest 1 per cent of any unselected group.

Others set an IQ limit, for example,

below 75 for mentally retarded and above 125 for superior.

Most authori­

ties agree that other factors such as social competence should be considered in addition to intelligence test results. For the purpose of the present study, children vrere considered in need of special educational facilities if their IQ was below 75 or above 125.

In many cases, but not in all, the classification of a

child was checked with school success and social competence.

However,

no change of classification on this basis was made without conclusive evidence. The data for this study were partially obtained from teachers, parents, state and school nurses, records of persons in institutions and those who have applied for institutional placement, county superin­ tendent and assistant superintendent, and school records.

These sources

were especially useful in locating children who vrere seriously retarded mentally.

18 The chief source of data was a test of mental ability given to each child in grades three through eight in the county schools under the county superintendent.

The number of school children included was 4177.

Of this group the Henmon-helson Tests of Mental Ability, Elementary Examination for Grades 3-8, were given to 3694 children.

These tests

were administered by three well-trained persons vdao attempted as much as possible to keep the testing conditions similar.

All tests were

scored centrally, and all birthdates were verified.

The remaining 483

children were given group mental tests, not all of them the same test, by the supervising principals in the schools. The facts concerning the very seriously mentally handicapped, both those at home and in institutions, were established by individual psycho­ logical examinations and case studies.

The presence of such children

was determined by the various investigations enumerated above.

The actual

verification of the child’s existence and the determination of a handicap was the result of careful personal investigation by a county supervisor of special education.

One hundred sixty-six individual psychological

examinations were made using one or more of the following measuring devices:

Binet Intelligence Scale, Form L or M, Comell-Coxe Perform­

ance Ability Scale, and the Vineland Social Maturity Soale. social case history was also made.

A brief

In most of these cases physical

condition was checked by the medical case history supplied try the family doctor. Grades one and two were investigated for children retarded three or more years which would, except for their extreme retardation, cor­ rectly place them in the grade range of 3-8.

These children were

individually examined and included in the figures reported.

19 Table I shows the distribution of IQs for the 3694 children who were given the same group test.

The mean of the distribution is 94.44*

and the standard deviation is 16.5.

This standard deviation is rather

large, but is within the limits specified by the test makers as expected. Table I Distribution of IQs for 3694 Children in Grades 3-■8 ---

IQ

Prequency 2 12 25 43 66 120 181 218 284 405 444 416 421 385 283 183 101 56 36 11 2

145-149 140-144 135-139 130-134 125-129 120-124 115-119 110-114 105-109 100-104 95-99 90-94 85-89 80-84 75-79 70-74 65-69 60-64 55-59 50-54 45-49 Total Mean

94.44

(Jm

.

3694 16.5

Three hundred eighty-nine* or 10.5 per cent, of this group made scores below IQ 75, while 206, or 5.6 per cent, made soores below IQ 70. One hundred twenty-eight, or 3.5 per cent, made scores above IQ 125, while 69, or 1.9 per cent, made scores above IQ 130.

20

An examination of the Age Grade Progress Tablel shows a very small percentage of the children accelerated administratively, and in some grades as many as 40 per oent retarded administratively.

This retarda­

tion seems to be somewhat justified in the results of the intelligence test by the low mean of 94.44. Table II shows the median mental age (M.A.), the 75th percentile point, and the 25th percentile point for each of the grades 3-8. data are also based on the 3694 children.

These

The first figure in each case

Table II Mental Ages by Grades with Medians and Range

Grades 3

4

5

75 Percentile Median M. A. 25 Percentile

9-2 8-4 7-8

10-9 9-11 8-11

12-0 10-9 9-10

12-9 11-7 10-8

13-5 12-7 11-4

14-4 13-0 11-11

Number

670

686

580

677

566

515

Range

6--3:12-6

7-0:14-6

7-9:15-9

6

7-3:17-0

7

7-6:17-9

8

7-6:17-3

represents the age, and the figure after the dash represents the month. For example, the median mental age for grade 3 is 8 years, 4 months. The range of the middle 50 per cent for grade 3 is M.A. 7-8 to M.A. 9-2. The last horizontal column shows the extreme range of mental ages for each grade.

Although this range is large it is not unexpected.

That

great individual differences were found in each grade was thus verified for this group of children.

1.

Appendix, Table XXVIII.

21 Considering these results in light of the Age Grade Progress Tabled, it will be noted that the grade retardation tends to keep the median mental age of eaoh grade more nearly where it is traditionally expected to be. There is always the doubt, when considering individuals, as to the validity of intelligence test results.

This is true even when eaoh child

is tested individually with a specially constructed test, but it is doubly true when group-measuring devices are used.

In addition to the

regular published data on validity available for the group test used, a correlation using the Pearson Product-Moment formula was made between the group test results and results of the Terman-Merrill Revision, Form L, of the Binet Intelligence Scale.

The correlation coefficient for 52

children, all with IQs under 100, was .80.

This result compares favora­

bly with the correlation coefficient of .81 reported by the authors of the test. Table III shows the number of mentally retarded children in grades 3-8 and divides them into groups by intelligence quotients.

Of the

Table III Incidence of Mental Retardation among School Children oir Grades S-ii and the Severity of the Handicap

IQ 70-74 60-69 50-59 0-49 Total handicapped

2.

Ibid.

Grades 3-8 with Pop. 4177 No. Per cent 182 4.3 174 4.2 53 1.3 32 .8 441

10.6

22 4177 children surveyed, 441 were, according to the definition set forth, mentally retarded. the group.

This represents slightly more than 10 per cent of

About 1 per cent were seriously retarded mentally largely

based on the results of individual psychological examinations. Table TV shows the number of mentally superior children in this group and divides them into groups according to their intelligence quo­ tients. Table 17 Incidence of Mental Superiority among School Children of Grades 3-8 and the Degree of the Exceptionality

Grades 3--8 with Pop. 4177 Per cent No.

IQ 140-above 130-139 126-129

15 74 48

.4 1.8 1.1

Total Superior

137

3.3

According to.the definition followed, 137 or 3 per cent of the 4177 children were superior.

These children were distributed from the large

schools to the smallest isolated one-teacher school. Table V shows the number of mentally retarded children who had additional'handicaps.

Of the 441 children recorded as mentally retarded

in grades 3-8, 132 or nearly 30 per cent had some other handicap.

The

combination most often occuring was mental retardation with defective speech which occurred in nearly 13 per cent of the multiples.

A

combination of a behavior problem with the mental retardation ranked second in frequency with nearly 8 per cent.

Of the 30 per cent with

multiple handicaps, 23 per cent had one additional handicap and 7 per cent had two or more additional handicaps.

23 Table V Mentally Retarded Children TIVho Presentedku itip1e Handicaps Grades 5-8

Mentally Retarded No. Per cent

Handicap Hearing Vision Speech Physically Delicate or Crippled Behavior

14 11 39 11 26

3.2 2.5 8.8 2.5 5.9

Speech, Hearing 5 Speech, Phys. Delicate or Crippled 10 Speech, Behavior 7 Vision, Hearing 1 Vision, Physically Delicate or Crippled 1 Behavior, Phys. Delicate or Crippled 3 Four handicaps Total multiple handicaps

1.1 2.3 1.6 .2 .2 .7

4

.9

132

29.9

Table VI gives the number of superior children having multiple handicaps.

As might be expected superior children were found to have

few handicaps.

Only 9 of the 137 children recorded as mentally superior Table VI Mentally Superior Children TiVho Presented Multiple Handicaps trades 3-8

„

,.

H^dieap Speech Vision Physically Delicate or Crippled Behavior Total multiple handioaps

Gifted

No.

per cent

1 2 5 1

.7 1.5 3.7 .7

9

6.6

24

were so classified.

Five of these nine children were indicated to be

in the physically delicate or crippled group. These data seem to indicate that mental retardation was linked with other handicaps of all kinds while mental superiority was quite free from such handicaps. Three children were extremely retarded and were in institutions for the feebleminded.

Twenty-two, or one in each two hundred children,

were not in school because they were uneducable for mental reasons.

In

the case of only one of these children an application was on file for placement in an institution. There were found a few strange instances of segregation of mentally superior children and mentally retarded children in small communities; for example, in one school with an enrollment of twenty-two children, seven had IQs above 125, and in another school with an enrollment of thirty-two children, twelve of them had IQs below 75. point worth following up.

This may be a

25 Chapter IT The Deaf and Hard of Hearing The generally accepted definition of deaf and hard of hearing divides the two according to the method of instruction which is needed, rather than the degree of hearing loss.

The deaf are those who have

been thus handicapped from such an early stage of their development that proficient speech has not been acquired.

The hard of hearing are those

who hear with difficulty, and those who have lost their hearing after speech was acquired. spoken word.

They are sound conscious and have memory for the

Therefore, the sense of hearing although defective, is

functional with or without a hearing aid.

The hearing loss may be slight

or may develop so gradually that the child himself does not realize that he has poor hearing, because he has no standard by which to compare his hearing with others. Probably one cause for the numerous studies on defective hearing was this statement from the White House Conference report:! "In view of all these needs, and in view of the enormous number of deaf and hard of hearing children, it may seam strange to say that the primary need is provision for the discovery of deafness; but such is actually the case. Vfe need also to discover the degree and type of deafness." Several representative studies are reported in Table VII to show the incidence of defective hearing which have been found by certain investigators in various localities.

Studies were selected in which

large numbers of children were examined under somewhat similar conditions. In each case a hearing loss of nine sensation units or more was considered

1.

White House Conference, Committee on Physically and Mentally Handi­ capped, The Handicapped Child (New York, The Century Co., 1933) p. 13.

26 a failure on the test.

In many cases an individual test and an otologi-

oal examination followed the group testing, but these were not indioated Table VII Percentages of Children with Impaired Hearing as Reported by Several Investigator's

Author

Per cent Defective

Gardner, 37 Iowa School Systems^ Ciocco® Wallin, Delaware^ White House Conference® Pennsylvania, State Summary® Hilleboe, median for 19 studies7

in every report.

5.0 5.36 5.0 12.0 4.9 9.2

The White House Conference report was an estimate

based on a study by Fowler and Fletoher.

In some publications the

percentage considered hard of hearing was 14.

However, if the estimate

for the entire United States of 3,000,000 school children was divided by the school population at that time, which was 25,000,000, the quotient would be 12 per cent.

Hilleboe’s study is included in this table

because it in itself had summarised a large number of studies.

2. Gardner, Warren H., "Hearing Tests in 37 Iowa School Systems", The Volta Review, Reprint Ho. 479., (December, 1937) p. 3. 3. docco, Antonio, "Audiometric Studies on School Children", Publio Health Reports, Reprint Ho. 1776 (United States Government Printing OWiceT 193'fO' p. 5. 4. Wallin, J. E. W., "An Investigation of the Acuteness of Hearing of Children in the Delaware Publio Schools by Means of the 4-A Audio­ meter" (Division of Special Education, Wilmington, Delaware, 1942) 5. -Yihite House Conference, Special Education; The Handicapped and the Gifted (Hew York, The Appleto n-Century Co., 1931) p. 5. 6. Department of Public Instruction, "A Summary of Pennsylvania’s Hearing Testing Program", Public Education Bulletin, Pennsylvania Vol. 7 Ho. 7 (March, 1940) p. llV 7. Hilleboe, Guy L., Finding and Teaching Atypical Children (Hew York Teachers College, Columbia University7 p. 3i.

27 The data for this study were available from. WFA Projeot Number 166-1-23-970 entitled "A Survey of the Hearing of School Children in Blair and Huntingdon Counties in Grades 3-12".

The Pennsylvania Society

for Advancement of the Deaf assisted by paying the travel expenses of the examiners. 1942.

The survey started in March, 1941, and closed in March,

One examiner, with the same helper, did all the testing of

Huntingdon County children in grades 3-12.

The examiner, an experienced

registered nurse, was given specific instruction in the use of the audiometers and was carefully supervised throughout the survey.

The

Western Electric 4-C multiple audiometer was used for the group testing and the Western Electric 6-B'or 2-A were used for individual testing. All equipment was checked for accuracy at the beginning of the project and periodically throughout the testing. Approximately three-fourths of the children were given the first group test in March, April, and May of 1941.

As soon as schools opened

in the fall, the first group test was completed for all the children. Those showing a loss of 9 sensation units or more were retested with the multiple audiometer.

As this double soreening process left only a very

few, if any, with suspected hearing loss in each of the small schools, the 2-A pure-tone battery audiometer was used for the third test.

In

the larger schools where group testing, because of numbers, continued to be economical, the third test was continued with the 4-C instrument. This was followed for those children who continued to show a hearing loss by the use of the individual 6—B pure-tone electric audiometer or the 2-A battery set.

Children who were absent on the day of one test

were examined on the second or third visit to the school.

At the time

of making the first group test, teachers were asked to name the children

28 who they suspected were hard of hearing, and special attention was then paid to testing them.

Teachers were also asked to name deaf children

or children they suspected of "being deaf who were either not attending school or were in a special school.

These latter findings were used in

conjunction with information found through the sources described in Chapter II for locating the out of school children. Table VIII gives the number and percentage of children found with defective hearing in three grade groups.

The extent of the handicap

is partially shown by the descriptions at the left of the table.

"One

or both ears slight"8 should be interpreted as a loss in either ear of Table VIII Incidence of Defective Hearing among School Children Distributed by Grade Groups' and Severity of the Handicap "■ ■■■-*■ ■ Grades 3-12 Grades 3-8 Pop. 5168 Pop. 4177 No. % No. % One or both ears slight One ear severe, one good Both ears severe Deaf Total Handicapped

49 37 38 5

1.0 .7 .7 .1

129

2.5

Grades 9-12 Pop. 991 No. %

45 1.1 37 .9 37 .9 5 .1

4 0 1 0

3.0

5

124

.

.4 .0 .1 .0 .5

more than 9 but less than 20 sensation units found from the individual audiogram by averaging the four middle frequencies. sensation units or more was considered severe.

A loss of 20

The entire group showed

a ratio of five children with defective hearing for each two hundred of school population.

8.

Nearly 1 per cent of the total group would be

Vocational Rehabilitation, "Rehabilitation of the Deaf and Hard of Hearing" (Washington, TJ. S. Office of Education, February, 1941) p. 17.

29 considered severely handicapped in this respect. The survey revealed, in addition to the actual number of handicapped children, some specific data on the usefulness of the multiple audiometer with certain school groups.

For example, the percentage of children in

grades 4-12 failing the first test was quite regular with an average of 12 per cent of the group failing.

Children in grades 3-4 in consolidated

schools showed an average of 17 per cent failing the first group hearing test; while in these same grades in one-teacher schools, an average of 22 per cent failed.

Twenty-five per cent of the children in grade 3 in

these one-teacher schools failed the first test.

As the individual

tests revealed no larger percentage of children in grades 3 or 4 with actual hearing losses, one might conclude that more preliminary instruc­ tion pertaining to group hearing testing in these grades and especially in one-teacher schools would yield dividends in time and accuracy. That the problem of reacting favorably on the group test was prob­ ably not as much one of mental ability as it was one of experience and background is indicated by Table IX.

The 276 children were a fairly

representative sample, with some of them from grade 2 examined for the purpose of having a group with lower mental ages and the-remainder from grade 3 as reported.

The sample was not large enough to warrant drawing

any major conclusions, but it would seem that within this range of mental ages children of low mental age were about as efficient with the testing technique as those individuals with higher mental ages provided that their general experience was about equal.

Children in isolated

one-teacher schools did much poorer on the first group test than did children with equal mental ages from consolidated schools, but they improved considerably in their ability to do the second group test.

30 Table IX Distribution by Mental Ages of the Passing or Failing or~2T6' ffilTdrgn" on First and Second ^Hearing Test

Mental Age 9-0 8-10 8-8 8-6 8-4 8-2 8-0 7-10 7-8 7-6 7-4 7-2 7-0 6-10 6-8 Total

First Test Passed Failed 20 20 18 22 26 24 29 35 12 14 14 26 7 4 5 276 (88.5#)

3 2 1 2 2 3 9 4 4 5 2 1

36 (11.5#)

Second Test Passed Failed 2 1 1 1 2 2 6 3 2 3 2 1

1 1 0 1 0 1 3 1 2 2

12 24 (7.7#) (3.8#)

Many children classified as hard of hearing also had other handi­ caps.

For the purpose of comparing multiple handicaps* grades 3-8, with

a population of. 4177, were used.

Table X gives the number of children

with another handicap in addition to defective hearing.

Of the 124

children handicapped by a hearing loss, 47 or nearly 38 per cent had other defects.

As might be expected, 12 per cent of the hard of hearing

children had speech defects and 15 per cent, according to the results of the group mental ability tests, were mentally retarded.

There is

reason to doubt the adequacy of an ordinary group verbal intelligence test for hard of hearing children, and although nearly one-fourth of these group test results were checked by an individual psychological examination, there may still be a few too many of the hard of hearing

31 children recorded as mentally retarded. Table X Children -with Defective Hearing who Presented Multiple Handicaps

Handicap

No.

Hearing Per cent

1 14 11 7 1

.8 11.3 8.0 5.7 .8

Mentally retarded, speech Three handicaps (others)

5 5

4.0 4.0

Four handicaps Five handicaps

2 1

1.6 .8

47

37.9

Vision Mentally retarded Speech Physically Delica.te or Crippled Behavior

Total

The table shows separately the triple handicap of hearing, mental retar­ dation, and speech, because this combination occurs most frequently. The other triple handicaps are few, so are grouped together. Five children were deaf and four of these were in special schools for the deaf.

The fifth child was attending grade 2 of public school,

and medical specialists to date have not been able to decide what is best for him because there seem to be other physioal handicaps. children were confined at home as a result of a hearing defect.

No

32 Chapter T TEE VISUALLY HANDICAPPED The National Society for Prevention of Blindness and the American Medical Association have in conjunction set forth a definition of the partially-seeing child: 1.

Children having visual acuity between 20/70 and 20/200 in the better eye after refraction.

2. Children with progressive eye difficulties. 3. Children suffering from non-communicable diseases of the eye or diseases of the body that seriously affect the vision. For the purpose of this study, two additions were made in the definition. 4. Children having visual acuity between 20/70 and Z0/Z00 in the better eye without correction were included if that was the defect they labored under in school. 5. Children having visual acuity of 20/200 or more in the poorer eye after correction were included because of the severe vocational handicaps-*- which they would encounter later. The children with this latter type of defect were not included in report­ ing multiple handicaps. Table XI shows the incidence of the visual handicap as reported by several investigators.

Hilleboe2 reported the visually handicapped

as 7.55 per oent, but explained that 7.32 per cent of the basic popula­ tion studied could be educated in the regular classroom after proper correction had been made. figures were based.

He did not report the standard on which these

The 'White House Conference report indicated .20

per oent as partially sighted.

1. 2.

This referred to those needing education

B ureau of Rehabilitation, Pennsylvania Department of Labor and Industry (mimeographed, 1941) Hilleboe, Guy L., Finding and Teaching Atypical Children (New York, Teachers College, Columbia University! l93o| p.’ 31". ’

33 in a special class for such children.

It did not include the number who

were partially-sighted but able to receive regular class instruction if this instruction was somewhat revised to fit their needs. Table XI Percentages of Children with Defective Vision as Reported by Several Investigators

Fox* coxvfc Author u%hite House Conference (l930)3 Hilleboe (median of 14 studies)^

Blind Partially Sighted J Toi .20 .05

7.55

Much of the data on blindness was the result of regular or special census-taking.

Chief among the difficulties was lack of specific defi­

nition, lack of medical information, errors in judgment of enumerators, reluctance to admit blindness, especially in children, and failure of enumerators to inquire about or to report blind persons. The data for this study were found through the following sources:

3. 4.

1.

Records of state and school nurses and, in one district, the records of a school doctor.

2.

Results of school medical inspection, (1938), School Division, Pennsylvania Department of Health.

3.

notification to county schools office by dootors when defects too great to be immediately correoted by glasses or progressive eye difficulties were found.

4.

Reports of teachers, parents, the County Superintendent and A ssistant Superintendent.

Heck, Arch 0., The Bduoation of Exceptional Children (lew York, McGraw-Hill Book Co., 1940J p. 2ib. Hilleboe, op. cit., p. 31.

34 5.

¥1811: to every school where teacher’s reports of symptoms and their judgment of defects were checked by use of the Snellen, Mixed Letter, Eye Chart and often a doctor’s examination.

Eaoh teacher was directed in her thinking by the investigator who named some of the most common symptoms of eye trouble previous to asking her for the names of children with suspected defective vision.

The following

symptoms were the ones discussed as they are usually considered the common indications of eye strain and defects of vision: T/Vhat is the condition of the eyes as to crusts on lids, red eyelids, styes, swollen lids, watery eyes, apparant lack of coordination in directing the gaze of the two eyes, et cetera? YJho has the following symptoms whioh may indicate visual difficulties: attempts to brush away blur, inattentive to wall map or black board, rubs eyes frequently, thrusts head forward to see distant objects; when reading, holds book extremely close or far away, screws up face, holds one eye shut, confuses letters which are similar in appearance, or who frequently complains of headaches? Teachers were also asked to name children who were blind and were either at home or in a special school. All children whose vision had been questioned through any of the sources mentioned in Chapter II, or who were reported by the teacher, and some who reported themselves were checked by means of the Snellen, Mixed Letter, I?ye Chart.

The criterion as to whether or not a particular

vision problem would be included in this study was based on the results of this test, or on the report of an eye specialist, and these results had to fall within the limits of the definition. All children in grades 1-12 were included which made a total of 6666 school children surveyed.

According to the definition of partially-

sighted set forth at the beginning of this chapter, eighty-six children were found who would be considered exceptional and in need of speoial eduoational consideration.

Table XII shows the number and percentage

35 of handioapped children in four grade groups, and some particulars concerning the extent of the disability found. Table XII Incidence of Defective Vision among School Children Distributed by Grade Groups and Severity of the Handicap

Grade 1-12 Pop. 6666 No. Both eyes 20/70 to 20/200 One eye 20/200 or worse, other normal Both eyes 20/200 or worse Total Handicapped

Grade 3-8 Gra.de 1-2 Pop. 4177 Pop. 1498 No.

%

No.

%

Grade 9-12 Pop. 991 No. %

%

63

.9

51

1.2

7

.5

5

.5

20

.3

16

.4

3

.2

1

.1

3

.05

.05

1

.1

0

.0

11

.7

6

.6

86

1.3

2 69

1.7

The first columns of the table give some data for the entire population studied.

A pproximately one child in each hundred was found to be

handicapped within the limits of the definition.

The same technique of

locating the children for all twelve grades revealed a slightly smaller percentage handicapped in both the grade groups of 1-2 and 9-12 than was found in grades 3-8.

That one child in three hundred had vision in

one eye as defective as 20/200 or worse presents another important problem. These data should be interpreted in light of the fact that the definition of partially-sighted for the present study includes those who have not had their vision refracted or eyes treated even though suoh a correction would perhaps render their vision normal.

Therefore, to

compare these findings on partially-sighted with results of other

36

studies which did not include the "one-eye problem", subtract numbers in horizontal column "one eye 20/200 or worse, other normal" from corres­ ponding numbers in horizontal column "total handicapped".

(Table XII)

Table XIII gives the distribution of the multiple handicaps. Grades 3-8 and only those children who were classified as defective according to the definition of the National Society for Prevention of Blindness set forth at the beginning of this chapter were included in reporting multiple handicaps, thereby making these results comparable to studies which have used this definition. Table XIII Visually Defective Children Who Presented Multiple handicaps

Vision per (jen-fc

Handicap

jj0#

Mentally retarded Mentally superior Hearing Speech Physically Delicate or Crippled Three handicaps Pour handicaps Total multiple handicaps

11 2 1 2 1

20.7 3.8 1.9 3.8 1.9

4 2

7.5 3.8

23

43.4

The children considered visually defective from the standpoint of com­ paring multiple handicaps excluded by definition the 16 who had the "one eye problem".

Therefore, the number of children in grades 3-8 with

defective vision was 53.

This reveals 43 per cent of the children with

vision handicaps to have other handicaps. The number found to be blind was very nearly what was predicted.

37

None of the three blind children -was in a school for the blind. were eligible for such education and should have been getting it.

Two One

of these attended publio school and had been taught braille by a teaoher from the WPA Education and Reoreation Project.

The school district

bought the regular grade textbooks in braille and the child has been making noticeable progress.

The third child had other physical handicaps

which made attendance at any school practioally impossible. then, two were at home.

Of the three,

38 Chapter VI THE SPEECH DEFECTIVE Van Riper^ has set forth the following very practical definition of defeotive speech; 'Speeoh is defective when it deviates so far from the speech of other people in the group that it calls attention to itself, interferes with communication, or causes its possessor to be maladjusted to his environment." Disorders of speech fall into three groups:

disorders of articulation,

disorders of voice, and disorders of rhythm.

These include stuttering,

lisping, lalling, cluttering, nasality, thick speech, hoarseness, and others.

Any of these disorders in a degree extreme enough as to be

conspicuous, confusing, or unpleasant is considered handicapping. The percentages of ohildren with speech defeots. as found by several investigators is summarized in Table XIV. Table XIV Percentages of Children with Defeotive Speech as Reported' by Several Investigators'

Author

Per cent Defective

White House Conferenoe2 Blanton in Madison^ Root, South Dakota^ Loutitt and Halls^ Hilleboe, median for 12 studies^

1. 2. 3. 4. 5.

6.2 5.69 6.3 3.7 2.60

Van Riper, Charles, Speech Correction (New York, Prentice-Hall, 1939) p. 6. 'White House Conference, Speoial Eduoation; The Handicapped and the Gifted (New York, The AppJeton-Century Co. / 1'931) "p. 357. £eck, Arch 0., The Eduoation of Exceptional Children (New York, McGraw-Hill Book do., 1940J p. 294. Loutitt and Halls, "Survey of Speech Defects among Public School Children of Indiana", Journal of Speeoh Disorders, 1; 73-80 (September, 1936). Hilleboe, Guy L., Finding and Teaching Atypical Children (New York, Teachers College, Columbia tJnTversity/T930) p. 31.

39 The percentages of incidence of defeotive speeoh range from Hilleboe*s report of 2.6, to the White House Conference report of 6.2, and Root's report of 6.3.

The differences were undoubtedly due partly to the

lack of a common definition and partly to population differences. The data for the present study were obtained from reports of state and school nurses, the school medioal inspection of 1938, a school doctor, some parents, and the County Superintendent and Assistant Superintendent. Further data were found by visiting each teacher in her school room, explaining to her the characteristics.of defective speech, and asking her to name the children in her room whom she would classify as defeotive in speeoh.

In most cases the teacher's class roll was used as

a guide so at least a few seconds of thought were given to the speeoh of each child.

The ohildren whose names were learned through this

procedure were then interviewed by a county supervisor of special educa­ tion to determine the nature of the speeoh defeot and to confirm the teacher’s selection.

The criterion for defective speech was as near as

could b e determined that of Van Riper's definition stated at the beginning of this chapter.

Only those children with easily distinguish­

able defects were recorded as defeotive.

Many children with noticeable

defects which were not interfering and probably would not interfere with their sohool progress or social or vocational adjustment were, according to our definition, not considered handicapped. The survey included grades 1-8 of Huntingdon County with an enrollment of 5675 children. Table XV shows the number and percentage of children by three grade groups recorded to have defeotive speech.

It will be noted that children

in grades 1-2 showed a greater prevalence of both articulation disorder

40 Table XV Incidence of Defeotive Speeoh among School Children "" distributed by Grade Groups and Severity of the Handicap

Grades 1-8 Pop. 5675 No. Voice Stuttering Articulation

No.

%

Grades 1-2 Pop. 1498 No.

%

%

.2 .5 4.0

11 20 154

.3 .5 3.7

3 8 71

.2 .5 4.7

267 4.7

185

4.4

82

5.5

14 28 225

Total Handicapped

Grades 3-8 Pop. 4177

and stuttering than did children in grades 3-8. hundred was found to have defective voice.

About one child in four

Approximately five children

in a hundred were found to have some speech handicap.

This was in

agreement with earlier findings, and it would seem from these results that this rural area has no more children with speech defects than have cities. The number of children with handicaps who also had speech defects was many.

Table XVI shows the distribution by numbers and percentages.

The handicap appearing most often with defective speech was mental retardation, which occurred with 61 of the 101 children who had multiple speech handicaps and which characterized 33 per cent of all children with speech defects.

The triple handicap of mental retardation, a

crippled or physically delicate condition, with a speeoh defect occurred in 10 per oent of the combinations of handicaps.

Of 185 children who

had speech defects, 101 or 54.5 per cent also had other handicaps.

41

Table XVI Children with Speeoh Defects “Who Presented Multiple "Handicaps

Handicaps Mentally superior Hearing Mentally retarded Physically Delicate or Crippled Behavior Vision

Speech No. Per oent 1 11 39 9 6 2

.5 5.9 21.1 4.9 3.2 1.1

Mentally retarded, Hearing 5 Mentally retarded, Phys. Delicate or CrippledHD 7 Mentally retarded, Behavior 1 Hearing, Phys. Delicate or Crippled 5 Behavior, Phys. Delicate or Crippled 1 Vision, Phys. Delicate or Crippled

2.7 5.4 3.8 .5 2.7 .5

4

2.2

101

54.5

Four handicaps Total multiple handicaps

No children were out of school or in an institution solely because of a speech handicap.

However, seventeen of the forth-eight children

who were not in school because of some other handicap also had defective speech.

Also, there were found in public school children who could

not make themselves understood except to close associates. Although many of the speech defective children were reported as mentally retarded, this retardation did not seem to be great enough to represent the sole cause of the speech defect.

Apparently, though,

there is some relationship between the two even in the higher levels of the mentally retarded group.

42

Chapter VII THE CRIPPLED AND PHYSICALLY DELICATE For the purpose of this study the crippled and the physically delicate were considered together to include the handicapping physical conditions of children other than the sensory defects and speech defects.

Definitions are very difficult to formulate, and many which

have been set forth tend to be too technical or too philosophical to be practical.

For example, the definition of a crippled child according

to the report of the White House Conference wassl "The crippled child in the orthopedic sense is a child that has a defect which causes a deformity or an interference with the normal functioning of the bones, muscles, or joints. His condition may be congenital, or it may be due to disease or accident. It may be aggravated by disease, by neglect, or by ignorance." Henry C. Wright^ defined the crippled child in more practical terms as follows: "A Crippled child is one whose activity is, or due to a progressive disease may become, so far restricted by loss, defect, or deformity of bone or muscle as to reduce his normal oapacity for education or self-support." The term "physically delicate" was taken to include the children with heart ailments, syphilis, tuberculosis, St. Vitus dance, nervousness, kidney condition, malnutrition, asthma, epilepsy, et cetera.

In general,

the designation was very broad and covered the host of children who ■were not in good health, who could not stand the strenuous play of the average child, and who needed additional physical care if their bodies

1. White House Conference, Special Education: The Handicapped and the Gifted (Hew York, The Appleton-Century Co.,_±y3ij p. 23. 2. McTeocT, Beatrice, "Teachers' Problems with Exceptional Children, Crippled Children" Pamphlet No. 55 (Washington, U. S. Government Printing Office, 1934) p. 8.

43 were to meet the demands of play and work. The problem involved in a definition of the crippled and the physically delicate for the present study was two-fold.

First, it was

necessary to locate the children who exhibited certain symptoms, and second, to determine whether or not their handicap was great enough to warrant inclusion of their case.

The major criterion for the study

for the seriousness of the crippling condition, or the extent of the handicap of the physically delicate was whether or not the child was getting a satisfactory education in regular school without special educational adjustments being made.

A satisfactory education was

determined by comparing mental ability level with school achievement level as measured by a standardized test or as calculated by the teacher by means of estimating the grade levels in reading and arithmetic. Table XVTI gives the percentages of physically handicapped children reported by various investigators. Table XVTI Percentages of Physically Handicapped Children as ’Reported by 'Several Invest'i'ga't'ors

. ,, u or

Per cent Per cent Crippled Physically Delicate

"White House Conference^ Hilleboe (median of 13 studies)^ McLeod (reporting estimates)^

1.2 5.8

10 3.3 10-25

3. White House Conference, op. cit., p. 6. 4. Hilleboe, Guy L., Finding and Teaching Atypical Children (Hew York, Teachers College, Columbia University, 1930) p. 31. 5. McLeod, Beatrice, "Teachers* Problems with ExceptionalChildren, Children with Lowered Vitality" Pamphlet Ho. 56 (United States Government Printing Office, 1934) p. 7.

44 It should be noted that this table shows a wide range of incidence of these handicaps. The source of the data used in the present study was the record of the 1938 school medical inspection; and the reports from teachers, school and state nurses, parents, growth charts, and family doctors. data were verified in one or both of two ways.

These

For some children

medical records were available, such as those from orthopedic or tuber­ culosis clinics, and for some others who had symptoms of a handicap parents were encouraged to have them taken to a doctor for examination. Y/here medical records were not available, the teacher's report as to the child's condition and physical ability to do school work was made the criterion.

McLeod® said "The Presence of a crippled child in school

will not escape the attention of the teacher", and as this study deals only.with those seriously enough handicapped to need special educational adjustments this statement is probably nearly true.

Locating the

children to be classified as physically delicate was a more difficult task, but when keeping in mind the broad statement of the definition which relates the physical condition to educational adjustment the problem does beoome tenable.

In addition to children who were known

through doctors' reports to be physically delicate, teachers were assisted in locating others by directing their thinking to the following symptoms:

thin, underweight, pale irritable, refused to eat, has diffi­

culty in breathing, tires very easily, misses a large amount of school with illness reported as the cause, et cetera.

Children for whom the

evidence available was not conclusive were not included in the study. Children who were reported as having a slight defect, as were many of

6.

Ibid, p. 9

45 the oases of malnutritionj but who "book part in all school activities and were successful in the regular school program were not considered sufficiently handicapped to be included. The survey included the children under the county schools’ office in grades 1-12 with a school enrollment of 6666. Table XVTII shows the number and percentages of children who were either crippled or physically delicate by four grade groups. Table XVIII Inoidenoe of Crippled and Physically Delicate Children ^is'fcViEuted by' Grade Group’s

Grade 1-12 Pop. 6666 No. Crippled Heart Delicate Total Handicapped

Grade 3-8 Pop. 4177

Grade 1-2 Pop. 1498

Grade 9-12 Pop. 991

No.

%

No.

%

No.

43 .6 21 .3 106 1.6

30 19 82

.7 .5 2.0

8 1 23

.5 .1 1.5

5 1 1

.5 .1 .1

170 2.6

131

3.1

32

2.1

7

.7

%

%

Approximately one child in two hundred school children was recorded as crippled.

This ratio varies only slightly in the different grade groups.

Heart condition is included under the term "physically delicate" every­ where in this report except Table XVIII where something of the importance of the "heart condition" problem is shown.

About five in each two

hundred children surveyed were recorded to be either crippled or physi­ cally delicate to such an extent that special educational provision was needed. It should be noted that this study did not attempt to include any of the lesser handicapping physical conditions except when school failure

was "braced directly to such condition.

Although special attention was

not paid to many of these minor physical defects, it was noted that they existed in large numbers; and in very few cases was correction being provided, nor, in fact, was any recognition being given the defect. This statement seems to be strengthened by the reports that a large number of adults were not meeting army physical standards.

A detailed

physical examination by a school doctor would be highly desirable and likely reveal a large number of children with defects.

However, 2.6

per cent of the school children surveyed probably closely represents the percentage of children in this particular rural area for whom special educational attention should be given. Table XIX shows the number of physically handicapped children reported who had additional handicaps. Table XIX Crippled or Physically Delicate Children 17Ko~'Presexited Multiple Handicaps

Handicap

Crippled and Physically Delicate Humber Per cent

Hearing Mentally retarded Speech Mentally superior Behavior Vision

7 11 9 5 15 1

5.3 8.4 6.9 3.8 11.4 .8

Mentally retarded, vision Mentally retarded, speech Mentally retarded, behavior Hearing, behavior Speech, behavior Hearing, speech Speech, vision Hearing, vision Four handicaps

1 10 3 2 5 1 1 1 4

.8 7.6 2.3 1.5 3.8 .8 .8 .8 3.0

76

58.0

Total multiple handicaps

Of "the 131 physically handicapped ohildren in grades 3-8, 76 or 58 per cent had other defects. The most common combination was a physical handicap with mental retardation which accounted for 25 of the total 76 multiple handicaps. Twenty-six children were recorded as not attending public sohool because of severe physical handicaps.

Six ohildren were in special

hospitals or homes, four of these being in the State Hospital for Crip­ pled Children at Elizabethtown.

Twenty were out of school on the orders

of doctors who diagnosed their case and recommended that they not attend school at this time. school was as follows:

The distribution of reasons for not attending heart condition, two; severely crippled, five;

and other physical handicaps such as epilepsy, Bright’s disease, St. Vitus dance, tuberculosis, et cetera, thirteen.

Of these twenty, thir­

teen had handicaps other than the physical one which was given as the excuse for their non-attendance at school.

Mental retardation and

defective speech were the additional handicaps most often recorded. Some of these children were as seriously handicapped in other ways, for example mentally, as they were physically. However, it should be noted that this report classified only one handicap for each child as the reason for the non-attendance, and the other additional handicaps regardless of severity as only contributing causes.

48 Chapter VIII THE BEHAVIOR PROBLEM The behavior problem children are the socially handicapped who exhibit characteristics that are noticeable and undesirable because they are not accepted by society, and also those who exhibit emotional traits that cause maladjustment to school. exemplified by the following qualities:

These latter traits are

peculiar or odd, over sensi­

tive, extremely shy or bashful, not having friends or not taking part in games, very unhappy, over critical, too easily discouraged, a bully or cruel. groups:

Martens and Russ-*- divided these problems into ten major irregularity, disobedience, lack of application, dishonesty,

damage to property, cruelty, profanity, emotionality, instability, sex difficulty, and personal uncleanliness.

Cornell^ related the problem

to mental hygiene in the classroom and defined the group for teachers in these statements: 1. 2. 3. 4.

"Overt conduct that is queer or unusual. Personality traits that are socially undesirable. Abnormal emotional reactions. Peculiarities of the intellectual process."

Table XX gives the findings of several investigators on the incidence of children with behavior problems.

The percentages are in

rather close agreement considering that the definitions of this handicap vary so much.

1.

Martens, Elise H., and Russ, Helen, "Adjustment of Behavior Problems

2.

of School Children" (Washington, D. C., U. S. Government Printing Office, Office of Education, 1932) p. 33. Cornell, Ethel L., "Mental Ifygiene, Its Place in the Classroom," Bulletin Ho. 875 (University of State of Hew York, May, 1927) p. 120.

Table XX Percentages of Children with Behavior Problems as "Reported by Several investigators

Author

Per cent Defective

Martens and Russ (Berkeley)^ White House Conference^ Hilleboe (Median for 5 studies)5

2.5 3 4.8

For this study it seemed desirable to simplify the definition of the behavior problem as much as possible.

It is often too easy to label

a child as "bad" -without taking time to analyze the reason.

Therefore,

the words "Behavior problem" were not mentioned to the teacher, but rather several descriptive phrases were used which according to authori­ ties seemed to be symptomatic of such behavior.

Each teacher was

visited in her classroom where the statements of Cornell, set forth in the beginning of the chapter, were discussed from the standpoint of their application to children in that school.

Vdhen a child’s name was

mentioned, the reasons, including symptoms and specific characteristics of his problem, were recorded and evaluated by a county supervisor of special education.

In about one-half of the cases a special study was

made of the child and his problem, and in every case at least one conference was held by a county supervisor of special education and the child in an attempt to clarify the problem.

3. Martens and Russ, op. cit., p. 30. 4. White House Conference, Special Education: The Handicappedand the Gifted (Hew York, The D. Appleton-Century Co., 1931) p. 498. 5. HQYeBoe, Guy L . , Finding and Teaching Atypical Children(New York, Teachers College, tfolumbia University, 1930) p. 31.

Although the case study may have revealed the likely cause of the behavior problem as resulting from some other handicap, for example, mental retardation, the present study did not attempt to eliminate certain problems on that account, but rather it included all cases "which clearly and definitely exhibited one or more of the characteristics of a behavior problem. In addition to a careful survey of the children in all schools of this rural county, a record of behavior problems reported by state and school nurses, parents, school directors, or others to any member of the county schools office staff was kept and the children investigated as described above.

Also, leads were followed from court records of

juvenile delinquents. The survey included data fox* grades 1-8 with an enrollment of 5675 school children. Table XXI gives the number and percentage of children reported with behavior problems for three grade groups. Table XXI Incidence of Behavior Problems Distributed byGrade' 'Group's

Grades 1-8 Grades 3-8 Pop. 5675 Pop. 4177

Behavior Problem

No.

%

119

2.1

No. 90

Grades 1-2 Pop. 1498

%

No.

%

2.2

29

1.9

The number of behavior problems found was 119 which was 2.1 per cent of the school children surveyed.

No attempt was made to specify the

specific reason for classifying a particular child as a behavior problem. In many cases several characteristics applied equally -well.

In fact,

Martens and Russ say that all children are really "problem" children in that they present overt behavior difficulties which should receive attention.

The problem, then, is a matter of degree along with causative

factors. Many children classified as behavior problems also had other handi­ caps.

For the purpose of comparing multiple handicaps, grades 3-8 with

a population of 4177 children were used.

Table XXII gives the number

of children with handicaps in addition to behavior. Table XXII Children with Behavior Problems Yflio Presented' Multiple Handicaps

Handicap

Behavior No. Per cent

Hearing Mentally retarded Speech Mentally superior Physically Delicate or Crippled Mentally retarded, speech Mentally retarded, phys. delicate or Crippled Speech, phys, delicate or crippled Hearing, phys. delicate or crippled

1 1.1 26 28.9 6 6.7 1 1.1 15 16.7 7 7.8 3 3.3 5 5.6 2

2.2

Four handicaps

3

3.3

Five handicaps

1

1.1

Total handicapped

70

77.8

Of the ninety children who were reported as having behavior problems, seventy or about 78 per cent had additional handicaps.

The combination

which occurred most often was a behavior problem with mental retardation,

52 and the second most frequent combination was with a physical handicap. Seven children were not attending public school because of severe behavior problems.

Three were in special schools or homes where some

educational facilities may be available, while four children were in their own homes.

The reasons reported for the non-attendance in school

of these children were delinquency and emotional breakdown.

The oases

of these latter children had all been diagnosed by a doctor.

1

53 Chapter IX SUMMARY AND CONCLUSIONS This study was an endeavor to survey in Huntingdon County the exceptional children) namely:

mentally superior, mentally retarded,

deaf and hard of hearing, blind and partially-sighted, speech defective, behavior problem, and crippled or physically delicate. primarily to answer three questions.

It has attempted

First, what percentage of the

Huntingdon County rural school children had each of seven handicaps? Second, what percentage of this group of children with handicaps had more than one handicap?

Third, how many of these children were so

severely handicapped that they had to remain at home or were retained in institutions?

Further, this study has attempted through answering

the above questions, to make available figures which will enable others to more accurately estimate the incidence of exceptional children in areas similar to this one, and to be a first step toward a more accur­ ate state-wide enumeration of exceptional children. The data were gathered in the 83 per cent rural county of Huntingdon for all school children in grades 3-8 and the children in grades 1-12 for certain handicaps, excepting the children in Huntingdon Borough schools.

The method of finding exceptional children was;

first, to

get the names of handicapped children from all local and state records, both of school and public and private welfare agencies, which were found to exhibit information on Huntingdon County children; and second, through a visit to each school by a supervisor of special education to evaluate the information previously obtained and to learn from the teacher about additional handicapped children.

All children in grades

3-8 were examined by means of objective tests to locate those who were

mentally superior, mentally retarded, or hard of hearing.

For the

children with the handicaps of vision, behavior, speech, and crippled or physically delioate, case studies and objective tests were used with only those children who exhibited symptoms of the handicap or those who had been reported through some specific source. It should be noted that in addition to obtaining all possible information from usual sources that all schools were visited with the specific aim of locating the handicapped children, that teachers were directed in their observations by a definition of each handicap, and that all leads coming to light through any source were followed to their end. Table XXIII summarizes the major findings. Table XXIII Incidence of Handicaps, Single and Multiple Gr&des' 3-8, 4177 Children Huntingdon~(?'ounty Schools, 1941-1942 (Rural)

Handicap (1)

Handicapped Multiple Children Children at Children Handicaps in Ho. % Ho. Home Institutions % (4) (5) (6) (2) (3) (?)

Mentally retarded Mentally superior Hearing Vision Speech Phys. Dslicate or Crippled Behavior Handicapped Children

441 10.5 137 3.3 124 3.0 53 1.3 185 4.4 131 3.1 90 2.1

132 29.9 6.6 9 47 37.9 23 43.4 101 54.5 76 58.0 70 77.8

22 0 0 2 0 20 4

3 0 4 0 0 6 3

924 22.1

205

48

16

21.8

Column (3) indicates the percentages of 4177 school children, the entire enrollment in grades 3-8, who were found to have each of the handicaps

mentioned in column (1).

Column (5) is the quotient of column (4) by

column (2) and shows the percentages of children reported with a handi­ cap who had more than one handicap.

Columns (6) and (7) respectively

give the number of children at home and in institutions.

Of the total

group of school children studied, about 22 per cent were found to be exceptional to such an extent that some special educational provision should be made for them.

If the group of mentally retarded were omitted,

the other six classifications would still indicate about 12 per cent of the children as needing some special attention.

Approximately three

children in a school population of two hundred were so exceptional that they were not in public school.

Of these out-of-school children, about

one in a hundred population was at home with limited educational facili­ ties while the remainder were in institutions.

One-fourth of the

children out of public school as handicapped were in institutions. Studies have revealed very little information on the extent of multiple handicaps, because seldom has the incidence of handicap been found for all types of exceptional children for the same school population. Table XXIV shows, for each type of exceptional child, the number of children having each of the several numbers of handicaps.

Column (1)

shows the number of children reported to have single handicaps of each type.

Column (2) gives the number of children having two handicaps

with one of them the handicap recorded at the left.

Columns (3), (4)

and (5) give similar figures for children with three, four, and five handicaps respectively.

The sum of the total number of handicaps was

1161 which included the over-lapping of children with multiple handicaps. The total number of children with handicaps vras 924, and the number of

56

Table XXIV Distribution of Children According to the Number of Handicaps Each cKTld Presented

Handicap

Children with the Following Number of Handicaps Tv,+nl w-i+h One Two Three Four Five (1 ) (2 ) (3 ) (4 ) (5 )

Mentally retarded 309 101 Mentally superior 128 9 Hearing 77 34 Vision 30 17 Speech 84 68 Phys. Delicate or Crippled 55 48 49 Behavior 20

children with multiple handicaps was 205.

27 0 10 4 29 24 17

4 0 2 2 4 4 4

0 0 1 0 0 0 0

441 137 124 53 185 131 90

This gave an actual over­

lapping of 22.2 per cent, or about two children with more than one handicap out of each ten handicapped children.

However, if the single

handicaps had been counted and summed to find the total number of children handicapped, as some investigators have done, 1161 children would have been reported instead of the correct number, 924.

This

report would then have given 237 too many children as handicapped, which would represent an error of 25.7 per cent. Table XXV shows the standard errors of the percentages of handi­ capped children of each type found by using the regular formula for standard error of a percentage.

It is a well-known fact that in a

normal distribution, about 99 per cent of the sample values lie within a plus or minus two and one-half standard errors of the true value.

Although our distribution was not strictly normal, this rela-

57 Table XXV An Estimate of the Reliability of the Incidence of Handicapped Children Reported for Huntingdon County

Pop.

Handicapped Ho. %

4177 Mentally retarded 4177 Mentally superior Hearing 5168 6666 Vision 5675 Speech Phys. Delicate or Crippled 6666 5675 Behavior

441 10.57 137 3.28 2.50 129 66 .99 267 4.70 2.55 170 2.10 119

Handicap