Conventional andiometry using pure, tones and monosyllables fail to reveal impairments in the perception of temporal characteristics of speech. Preliminary investigations using natural utterances of disyllabic words indicated specific impairments in the perception of elongated vowels and geminate consonants in hard-of-hearing children. For further analysis of these impairments, computer-generated stimuli were used to measure accuracy of discrimination of duration of non-speech stmuli as well as accuracy of identification of speech stimuli in which segmental duration plays a distinctive role. The results of hard-of-hearing children and adults indicated that none of them differ significantly from the normal group in discrimination of non-speech duration, while their performances in perception of speech stimuli show extensive individual variations, being more strongly correlated with clinical history as well as with past history of education and training than with types and degrees of hearing losses.
Pure tone audiometry, ENT examination, measurement of difference limen for frequencies (DLF) and measurement of difference limen for formant frequencies (DLFF) were performed on 50 deaf school children, aged from 9 to 13 years old. There were many of children with moderate hearing loss and conductive type hearing loss. And it was found a close relation between degree of hearing loss and DLF, DLFF, and it was also found that DLF, DLFF were important tests for the hard of heaping especially refered to communication ability.
The author reported the speech communication ability of the profound deaf child from a stand point of acoustics. Most of children showed the intelligibility of spoken speech of 10-40% There was good relationship between the intelligibility of speech sound and the hearing acuity in the low frequency range, 250Hz and 500Hz, in deaf children. Sound spectrographic studies revealed shifting of the first and second formant frequencies to the lower frequency area and high variability of consonant patterns and transitional temporal orders. It is hypothized that these abnormalities arise from the deficiencies of auditory self control function due to deafness.
Fourty infants under two years of age who were suspected to be deaf by their parents were examined during a period from October, 1970 to March, 1972. Out of the fourty patients, six were under one year of age and included two with unilateral congenital meatal atresia, one who had severe neonatal Jaundice and one with severe retardation of mental and physical developments. Follow-up studies demonstrated that they had normal hearing at least. on one side of the ears. Out of the remaining 34 infants, who were one year old, 27 were found of profound deafness, while in seven patients a definite diagnosis was hardly warranted because of uncertain responses to acoustic stimuli. But it was demonstrated by follow-up studies that three of the seven infants had no hearing impairment but mental retardation, one cerebral palsy associated with profound deafness, one profound deafness associated with severe mental retardation, one moderate deafness associated with auditory agnosia, and one had no abnormalities except for profound deafness. These findings suggest that the younger the child is, the more longterm observations are required to make a definite diagnosis, because responses to acoustic stimuli are more sophisticated by various factors in younger children. Finally, a new method for early diagnosis of deafness using a developmental scale of hearing devised in our clinic on the basis of normal infants' responses to social sounds in a daily life was described.
The effect of auditory training varied in deaf children, even though they showed the same pattern of hearing loss. In this study, therefor, the authors investigated the reason of the above variance by comparing the cases in which the auditory training was effective with the ones in which it was ineffective. As the results of this study, it was proved that the intrinsic factors were significant for the effect of training in the deaf children. The intelligence and the family circumstances were considered to be the most important intrinsic and extrinsic factors.
From 1966 to 1974, 79 hearing-impaired children who accomplished auditory training of the Hearing Clinic for Mothers and Children affiliated with the Kobayashi Institute of Physical Research entered regular primary schools. A questionnaire concerning of child adaptation to the class-room was sent to each class-room teacher. The contents of the questionnaire were as follows; achievement of school curriculum, the ability of adjusting a hearing aid according to the environmental situation, listening attitude and ability with hearing aid, the ability of language use and the ability to participate in the group activity of the class. Twenty nine answers were replied. Of the items above mentioned, tho ability of adjusting a hearing aid and of listening were analyzed in this paper. Generally speaking, the pupils became accustomed to wearing their hearing aid even though they did not know how to operate the hearing aid's controls. The authors thought that a guidance in learning the mechanics of operating hearing aid should be continued in prmary school. Their ability to discriminate sounds was slightly poor, and it is one of the problems that has to be overcome in future. However the authors insist that the hearing capacity is not the only important ability necessary for integration of the hard of hearing children in regular school, but their attitude and ability such as the aggressive attitude toward the environment, the quick thinking ability to follow other pupils and cooperation in the family. An example of such a pupil with severe hearing loss is shown as a case report.
Capability of severe hearing handicapped children to integrate in school life and social life was studied. The subjects' adjustment in classroom was evaluated by their classroom teacher and also by the individual psychological tests. The subjects included 7 severe hearing handicapped pupils, 6 in 3rd or 4th grade of regular class and one in special (Fukushiki) class of elementary school. All of them have been receiving the intensive auditory training program from early childhood in addition to the group play and learning exercices in regular kindergarten or nursery school. The results and consideration were as follows: 1) Though their lacks in aural communication were striking, it was recognized that the subjects received rehabilitation programs from early childhood had positively showed a good relation with the playmates in kindergarten or nursely school and also in elementary school. It was recognized that their psychological adjustment in classroom was generally positive and good. 2) The subjects who were given personal and intensive auditory training based on the group interaction with normal young children showed conspicuous progress in learning on their general behavior, particulary on language and speech behavior. 3) Through the life of kindergarten or nursery school and the life of subsequent 3 or 4 years in elementary, school, the subjects showed agressive and impulsive behavioral features that would be apparently thought as maladjustment behaviors. The authors, however, evaluated these behavioral features as positive ones, because the authors considered their behaviors in connection with their attitudes to exchange their will each other, to participate themselves to a group and also to establish their own selves. 4) Though the subjects' hearing loss was severe, their ability of abstraction was increased as much as normal children by experiences of learning, at some times in competition and at other times in cooporation with normal children by the performance of living language.
The hard of hearing class has been established at many areas in Japan since 1960, but the types of hearing-hard class is different in each area because of different circumstance. In order to know what type of the class is desirables to integrate hearing impaired children into regular school, the authors investigated 147 children in 31 schools who entered the hard of hearing classes on April in 1972, and 107 children in 9 schools who graduate from the hard of hearing classes on March in 1972, and their auditory sensity, mental abilities and preschool history were studied. The results were as follows: 1) Hearing loss more than 80dB, were found in 42 out of 147 children who entered the hard of hearing class, and hearing loss less than 60dB were found in half of 107 children who graduated from the class. 2) On mental abilities, both of graduates and new-comers had I. Q. between 90 and 109. 3) About preschool history, most of the children who had a heavy handicap more than 80dB were educated at the school for the deaf and they showed I. Q. more than 110. Most of the children who had hearing handicap less than 60dB were educated at regular school, and they had I. Q. less than 90. This fact showed than in the hard of hearing class the children who had a higher learning ability in spite of heavy hearing hardicapwere competed with the children who had a lower learning ability in spite of mild hearing handicap. 4) From the above mentioned results, the authors think that the special class closely connected with regular class in a same school may be the most disirable style for education of the hearing impaired children. They can be classified in regular class as handicaped and, on the other hand, their learningdelay due to the handicap will be caught up in special class. It is enhanced that the special class has to be established in the same school so as to have smooth co-operation between the special and the regular class.
In order to find the possibility of the integration of young children with hearing impairment into kindergartens or nursery schools, , qestionnaires were sent to 73 kindergartens and 70 nursery schools in the two wards (Itabashi-ku and Kita-ku) of Tokyo. Responses were received from 29 of the 73 kindergartens and 40 of the nursery schools. The results of the survey indicated that there were 73 mentally or physically handicapped children including eight suspected to have hearing impairment, 18 with mental retarbation and 31 with speech and language disorders. It was also indicated many kindergartens and nursery schools in which the hearing-impaired children were integrated might encounter the following problems: 1) Most of the kindergartens and the nursery schools do not have facilities as well as the personal enough to secure hearing-impaired children. 2) The teachers may be overworked. 3) Parents of children whose hearing is normal may object. 4) A class that a child with hearing impairment attend might be disrupted. 5) The teachers are not well trained to teach a hearing-impaired child. From these results, it is concluded that we must strive to overcome these difficulties to integrate hearing-impaired children successfully into regular kindergartens or nursery schools