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0 Commonwealth of Kentucky 0

EDUCATIONAL BULLETIN

.3“ are 3Q
' A'

‘1' ' DEPARTMENT OF EDUCATION _
BOSWELL B. HODGKIN, Superintendent of Public Instruction

,2 /'
0N?L Alf/(E

Published by

ISSUED MONTHLY

Entered as second-class matter March 21, 1933, at the post office at
Frankfort, Kentucky, under the Act of August 24, 1912..

Vol. XVII

JULY, 1949

No. 5

FOREWORD

This bulletin was prepared by members of a class in Modern
Educational Problems: Education ot‘ handicapped children at the Uni-
versity ot‘ Kentucky in the 1948 summer school sessions. Eight
members of this class were given scholarships to the University of
Kentucky by the joint el'l'orts ot’ the Kentucky Society for Crippled
tr‘hildren. the Fayette ("onnty Society for Crippled Children and the
Bourbon (‘ounty Society for ("rippled Children. It should be of
particular interest and significance to class room te
giving.r instruction for handicapped children.

The Kentucky Society for Crippled (‘hildrcn has furnished funds
to cover the cost of printing. The State Department of Education is
glad to assume responsibility for distributing this publication to the
school units of the state, as well as to any other state or group
interested in the valuable contributions which it makes to education of
handicapped children.

.tchers interested in

The material contained in this publication was prepared under
the direction of Miss GWE‘II Retherford, Director of the Division of
Education for Exceptional Children of the State Department of
Education. Grateful acknowledgment is given to:

Mrs. Mary K. Duncan, Professor of Elementary
Education, University of Kentucky, as consultant

for the sections on The Gifted Child and The Slow
Learning Child.

Dr. H. Humphries, Professor of Psychology, Uni-
versity of Kentucky, for his helpful suggestions on
the section, The Mentally Retarded Child.

Dr. Robert Milisen, Division of Speech and llearing

Clinic, Indiana University, for his consultative
services on the section pertaining to speech.

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TABLE OF CONTENTS

Page
Philosophy—Exceptional Children Included ................................................ 218 '
PART I
Exceptional Children with Physical Handicaps
Orthopedically Handicapped Children .................................................. 219
Deaf and Hard of Hearing Children ..................................................... 224
..... 227

Visually Handicapped Children ........

The Child with Defective Speech .................................................... 231
PART II
Exceptional Children with. Mental Handicaps
Gifted Children ....................................... 239
Slow Learning Children ............................................................................ 243
Educable Mentally Retarded Children .................................................. 248
PART 111
Selected Referenceq . ...... 250

EXCEPTIONAL CHILDREN INCLUDED

A consideration of children should he the foundation of any
educational program. Every child is worth educating, has a right to
be educated, and the school has an obligation for service to all children.

Every child needs happy parents who love him; a home that
provides for his physical needs and where there is respect, harmony
and understanding; a social group that inflicts minimum pressure and
frustration on him; and a community which assumes responsibility
Toward its children.

As administrators, supervisors and teachers assume responsibility
for all children, the education of: the exceptional child will be assured.
Most teachers realize that every child should be with a group of other
children of like ages to develop most normally. Exceptional children
should, therefore, be included in regular classrooms, whenever possible.

Since each child in the classroom is planned for as an individual
the characteristics and qualities that create the exceptional child can
be recognized. In proportion to identification and understanding of
the child ’s needs will the teacher provide for the exceptional child.

III

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III

Part I

ORTHOPEDICALLY HANDICAPPED CHILDREN

(Reference numbers refer to Bibliography on page 224.)

DEFINITION

An orthopedic or crippled child is one Who has a defect which
causes a deformity that interferes with the normal function of
bones, muscles and joints. These deformities may be congenital,
or caused by accident, injury or disease.1 They may be aggravated
by neglect, disease or ignorance.

INCIDENCE

In 1945 crippled children in the United States numbered 336,040 of
which 112,013 were in need of education. “In Kentucky during the
fiscal year of July, 1946 to June, 1947 there were 4,163 crippled
children examined.”2 Of this number, according to national figures,
about one-third are in need of education.

STANDARDS '

According to House Bill No. 16 the attendance officer of each school
district shall ascertain annually all children within his district
who are physically handicapped and report same to the Division
of Special Education for Exceptional Children.3

The classroom teacher through her direct contact with school-age
children can give valuable assistance to such a report by fettering
out unknown cases. Families are prone to hide their deformed
children. “Too many families are ashamed of the child born
Without an arm or a leg.“ '

For educational purposes crippled children who would profit from
normal classroom activity are those:

A. Who have a crippling condition mild enough not to require
hospitalization, home—teaching, a convalescent home or
special facilities, and

B. Who can attend regular classrooms if special consideration
is given transportation, special equipment and materials,
and a modified school program.

DIAGNOSIS .

A school receiving a child as a transfer from a hospital,
convalescent home, home-teaching program or special class should
request a summary report from the agency; giving a medical
diagnosis, description of the case, recommendations relative to
wearing appliances, restrictions of activity, and periodic returns
to hospital or physician for a check-up. The report should also
state that the child may be referred back to the referring agency
at any time if a question arises concerning his physical condition.5

219

In the event the child is not an agency transfer, such information
should be requested from the physician in charge of the case.
If the child received educational instruction during this period
an achievement report should also be requested.

Questionable cases relative to profit a child would receive from
normal school activity and probable need for special training
should be submitted for decision to the Director of Special Educa-
tion for Exceptional Children. A certiﬁed diagnosis of the phySi-
cal defect by competent professional authorities and a complete
general case history are necessary for a final decision about the
individual needs.3

CLASSIFICATIONS

CEREBRAL PALSY. This is a type of paralysis that results in
lost or impaired muscular control. This impairment more often
affects the motor areas of the brain than the intelligence areas.
Sometimes both areas are affected. The lost control may be in the
arms, legs, tongue, speech mechanism, eyes or hearing. Cerebral
palsy may be the result of injury to the brain during or after birth.
The majority of cerebral palsy cases are both treatable and
educable. About three-fourths of them have normal intelligence.“
Slow development seems to characterize many of these children
but they may later become normal in intelligence.7 Much emphasis
should be placed upon achievement of speech and face control.s

POLIOMYELITIS OR INFANTILE PARALYSIS. One of the most
common causes of crippling conditions; it is thought to be con-
tagious and caused by a virus. It often reaches epidemic propor-
tions in the latter part of hot, dry summers. Infection spreads
rapidly to the spinal cord where an extreme inflammation sets up.
Paralysis varies in intensity with different patients. The muscles
of the legs are affected more often than those of the arms. The
muscles become limp, weak, flabby and helpless.9

OSTEOMYELITIS. An acute inflammation 0f the bone. This
may develop from injuries to the bone. Sometimes there is a
complete destruction of the bone.

BONE AND JOINT TUBERCULOSIS, A disease of childhood
where the germs gain entrance to the growing portions of the
bones. The joints may become deformed and large.” The joints
affected arranged in order of frequency are spine, hip, knee, ankle,
elbow and shoulder.9 The “hunchback” is often the victim of
tuberculosis of the spine.

CONGENITAL DEFORMITIES. These are the deformities that
exists at birth. Included are Clubfoot, harelip, cleft palate, wry
neck, and hydrocephalus (very large head).

Other Classifications. Although these are a small percent of the
total number of crippling conditions they are, nonetheless, com-
mon. MUSCULAR DYSTROPHY (weakness of the muscles),
SCOLIOSIS (curvature of the spine), ARTHRITIS (inflammation
of the joints), OSTEOMALACIA (brittle bones) and conditions

220

VII

VIII

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ditions

VIII

resulting from injuries (burns, cuts and gun wounds), and ac-
cidents (broken bones and loss of arm or leg).

CARDIOPATHICS. Children with heart disease are grouped with
the orthopedics because of the weakness of the heart muscles.
There are five functional cardiac classifications according to
Baker.10

A. Organic but able to carry on ordinary physical activity.

B. Organic but not able to carry on ordinary physical activity
—may have to omit sports, gym classes and climbing
stairs. Transportation will probably have to be provided.

C. Organic but unable to carry on any physical activity—
symptoms and signs of heart failure. Should not be in
school.

D. Possible heart disease—symptoms evident but not yet
diagnosed.

E. Potential heart disease—some illness or factor which
might result in a cardiac condition.
Most of the heart conditions develop under ten years of age.

GENERAL SCHOOL ADJUSTMENTS

The staff should have a well coordinated plan to use in helping any
crippled children, the plan to include possible change of classroom
location to eliminate step climbing, special supervision during
recess, lunch and rest periods, if necessary, and supplemental
instruction according to individual needs.

CLASSROOM ADJUSTMENTS

The teacher of such children should be of sound physical and
mental health with a happy outlook on life. She will be called
upon to observe, more carefully than in the normal child, the
physical and emotional needs of the crippled child. A pillow under
a tired arm or leg, a Word or two more of encouragement, or the
prevention of a social blunder from a normal child.

THE CLASSROOM

Classrooms somewhat larger than the average are recommended
as being better to care for the needs of crippled children. It is
preferrable that the classroom be located on the ground floor.
These rooms should be well lighted, decorated with soft colors,
orderly arranged with the pleasant, attractive things that help
create a happy atmosphere for any normal group.

SPECIAL EQUIPMENT

Adjustable desks or tables
Reading racks, easels, lapboards
Special transportation

221

A. Cot, pillows and blanket

B. Wheelchair and walker

C. Ramps

D. Adjustable table for standing children
E. Foot rests

X INSTRUCTIONAL MATERIALS .
The teacher will need little in the way of special instructional

materials if she has found ways to provide the classroom with ap.
plicable special equipment listed above. Unless the crippled child
has an additional handicap in another area, such as a hearing or
visual defect (necessitating instructional materials for that par.
ticular handicap) such adaptations as larger pencils or a pencil
inserted through a small rubber ball, and Wide—spaced tablet
paper are easily supplied and will be conducive to the successful
achievement of a child learning the use of a new prosthetic ap-
pliance or the one suffering a muscular loss from a severe hand
burn. An imaginative teacher can make similar adaptations of
materials to fit the individual needs.

XI INSTRUCTIONAL METHODS

The teacher of the crippled child will find that instructional
methods suitable to the normal child are quite adequate provided
she gives special consideration to the tremendous phychological
adjustments which, generally speaking, must be made by crippled
children. It is recognized that the attitude of the crippled child or
person toward his disability is probably the most important single
factor toward making him a normal member of society.

Instructional methods should embrace the following psychological
interpretation of the crippled child:

A. “A crippling condition often leads to exaggerated attention
from families and in some cases may delay emotional
maturity. Others develop compensatory energies or
abilities that make them outstanding. Any disabling
illness provides the child with the opportunity to gain
the center of the stage and to unconsciously utilize the
disability to reclaim the golden phase of childhood power,
normal in early childhood, but psychologically crippling
as the child grows older.”11

B. Sympathy and understanding but not sentimentalism are
needed.

C. With minor exceptions he should expect and receive the
same treatment as the normal.

D. It is necessary to make the crippled child realize that he
is not alone in his difficulties and that in one way or
another all people have handicaps.

E. As life is rarely a segregated one, a crippled child has a
great need for soeial contacts with normals. Classroom
teachers can cultivate a sympathetic and cooperative Iai-
titude on the part of the normal child to prevent setting
the handicapped apart.

F. The child must be guided to a reconciliation of his aspira-
tion level with his performance level.
G. Motivation material can be included in a study unit whiCh

reveals world figures who have succeeded despite their
handicaps.

222

XII INST
I

REFERRAI

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tructional
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earing or
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ations of

ructional
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hological
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attention
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lism are
eive the

that he
way or

[d has a
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itive at-
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l aspira-

it which
te their

H. Due to the limited mobility of the crippled child an

enriched program will bring much satisfaction.

I. The development of an incentive in the child for construc-

tive leisure activity is vital.

XII INSTRUCTIONAL ACTIVITIES

A. Units of work:
The fire station
Circus
Store
Airport
Farm
Home
Science

B. Construction work:
Kites
Dolls
Puppets
Puzzles
Soap carving
Painting
Weaving
Sewing
Hobby collections

C. Physical games:
Bouncing balls
Croquet
Marbles
Simple rhymes
Darts
Blowing balloons

REFERRALS:

Kentucky Legal Agencies:
The Kentucky Crippled Children Commission
301 Heyburn Building
Louisville, Kentucky

(For the assistance and treatment of PHYSICAL conditions

the crippled child.)

The Division of Education for Exceptional Children
Department of Education
Frankfort, Kentucky

(For EDUCATIONAL problems of the crippled child)

Vocational Rehabilitation Division

Department of Education

Frankfort, Kentucky

(For POST-SCHOOL training of the crippled child)

223

10.
11.

I DEFINITION

Federal Agency:
The Children’s Bureau
Department of Social Security
Washington, D. C.

Private Agencies in Kentucky:

Kentucky Society for Crippled Children |

840 South Third Street
Louisville, Kentucky

Kentucky Chapter for the National Foundation
for Infantile Paralysis

Marian E. Taylor Building

Louisville, Kentucky

BIBLIOGRAPHY

Handbook for Teachers of Exceptional Children, University of Texas, 1
1947, page 46

Biennial Report of the Kentucky Crippled Children Commission,
1947, page 20

House Bill No. 16, Kentucky Legislature, 1948 1
“Education Is Denied Million Children,” The Crippled Child, Decem-
ber, 1947

Education of the Handicapped in Detroit Public Schools, Detroit
Board of Education, Detroit, Michigan, 1937

“Gary Grows Up,” State Department of Education, Sacramento,
California, 1948

Psychological Experiments of the Cerebral Palsied,” Journal of Ex-
ceptional Children, March 1948, page 165

“The Medical Aspects of Cerebral Palsy,” Public Welfare in Indiana,
Indianapolis, Indiana, page 13 ,i
Special Education for Exceptional Children in Texas, State Depart- ‘
merit of Education, Austin, Texas, 1948, page ’75

Baker, Harry J., Introduction to Exceptional Children, pages 191-192 _
Strecker, Dr. Edward A, “Doctor Says Polio Changes Personalityy” ’
The Courier- Journal, Louisville, Kentucky, July 16,1948

DEAF AND HARD OF HEARING CHILDREN

Today the deaf and hard of hea1 111g a1e beginning to come int0

their own They have been neglected £01 years. Now the whole nation ,
is beginning to realize that this group can be made much happie1 111
giving them special training, both educational and vocational, so that
they can become economically and socially independent.

A Hard of Hearing—are those in whom the sense of hearinir ,

although defective is functional with or without a hearing I
aid.

B. Deaf—Those in whom the sense of hearing is nonfunctional
for the ordinary purposes of life.

224

II OCCUR
A.

III FIN DIl‘
A.

W DIAGN
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[functional

II OCCURRENCE AND STANDARDS

A. The occurrence of hard of hearing is great. It was reported
by the American Federation for the Hard of Hearing that
14% of pupils have hearing defects. Out of a class of 35,
approximately 5 would have defective hearing.

B. Standards—the deaf have their own schools. The only
standard considered for entrance to these schools is being
deaf and whether the person considered has learned
language usage. Today there are approximately 20,000
deaf pupils and 3,000 teachers. "

III FINDING THE HARD OF HEARING AND DEAF CHILD

A. These children should be identified at the earliest possible
age. Identification is essential in preventing the hearing
loss from becoming more serious or permanent.

The following symptoms may be of help to the teacher in
identifying them:

Failure to respond—says “what?”

Moves closer to the speaker 7

Peculiar posture and tilts head at unusual angle

Mouth breathing ‘

Running ears and earaches

Defective speech and peculiar voice

Retarded in school work

Appears listless, inattentive, dazed or confused

Sensitive, aloof, suspicious, hard to accept as cordial

acquaintance

@WﬂP‘Sntkwpt"

B. Some informal testing can be used in the class room but

only as screening device.

1. The whisper test
Whisper numbers softly. Have child stationed so that
he is unable to see the speaker’s face. The child should
be twenty feet away from the person doing the testing.
Have child repeat the numbers whispered.

2. 6-A audiometer—gives careful individual screening and
is pure tone.

3. 4—A audiometer—a group test designed for finding
gross errors.

4. Watch tick test—this test has been used but is now
considered obsolete. It is not ' reliable as different
Watches have different pitch.

IV DIAGNOSIS

The above tests are are strictly informal methods of raising
reasonable doubts about the hearing and must be followed by more
fOrmal and exact methods of, diagnosis.

Final judgment as to deafness should lie in the hands of a com—
DEtent physician who has specialized in problems of deafness—
known as an Aurist or Otologist.

225

V EDUCATION
A. What can we do for these children?

The best thing for a teacher to keep in mind is that deaf or

hard of hearing is the same as a hearing child except that

his hearing is impaired. Treat him as a normal child be. ’

fore and after he has been given special adjustment to

enable him to work in a regular class room.

The teacher should see that:

1. Medical attention is given (complete physical check up)

2 Hearing tests are made

3. A remedial education program is provided

4 Proper seating is utilized—Le, a child with a deaf
right ear should be seated to the left of the teacher’s
desk and vice versa

5. An enriched school program is offered with lots of 3

reading

6. That group activities include the Whole group

7. Parents develop a wholesome attitude toward his
impairment

8. If doctor advises, a hearing aid should be procured for
the child

It is best to adjust the child to the public school if possible. Hard of
hearing classes can be set up in the regular school. But these children
must not be isolated from the normal school room. They should do as
much work as possible in the rooms with children of normal hearing.

For the totally deaf child an entirely different program is necessary. ,
He must first be given an understanding of language, be taught lip

reading and speech correction. After years of preparation he can be
placed in the regular class room but must still have some supplementary
work.

B. STATE AGENCY:

The Kentucky State School for the Deaf, Danville,
Kentucky

It is important to recognize the value of an investment in children,

who, with special assistance, will become useful and self supporting .

citizens.

BIBLIOGRAPHY

Baker, Harry J., Introduction to Exceptional Children. New York,
MacMillan Co., 1943.

Best, Harry, Deafness and The Deaf in the United States. New York,
MacMillan Co., 1943.

“Helping the Exceptional Child in the Regular Classroom.” Michigan
Department of Public Instruction, Lansing, 1941.

“The Classroom Teacher Can Help the Handicapped Child,” New
Jersey State Department of Education.

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VISUALLY HANDICAPPED CHILDREN

I CLASSIFICATION AND DEFINITION
A. Children with Impaired Vision:

PARTIALLY SEEING: Any child who because of some
visual defect or restriction 'other than blindness and cannot
successfully pursue his school work Without great fatigue,
effort or further injury to his eyes is classified as partially
seeing.
BLIND: An individual who must learn to live aided by
senses other than vision is blind.
a. He may be totally without sight
b. He may have object or light perception
c. His ’visual acuity is 20/200, or less, after correction.
He may be able to read very large type in a limited
amount

B. Incidence: 20% of all children have eye defects, i.e., 1 out of

every 5 children.
rected.

19.75% of all children’s defects can be cor-
.25% of remaining are partially seeing or blind. Of

this .25%—4/5 are partially seeing and US are blind.

C. Standards: Standards for eligibility for sight saving classes.

1.
2.
3.
4.

Visual acuity of 20/70 to 20/200

Serious, progressive eye defects

Children suffering from diseases of the eye or diseases of
the body that affect vision

An unclassified visual defect (under ophthalmological care)
which impairs school progress

An eye weakness or maladjustment as a result of treatment,
operation or convalescence

II ENUMERATION
A. Teacher Observation for the Following Symptoms:
1. CONDITION OF EYES—crusts on lids among lashes, red

eyelids, styes, swollen lids, watery eyes, apparent lack of
coordination in directing the gaze of the two eyes.

BEHAVIOR which may indicate visual difficulties among
children:

Attempts to brush away blur

Holds his body tense when looking at distant objects
Inattentive to wall chart, map or blackboard work
Rubs his eyes frequently

Screws up his face when looking at distant objects
Thrusts his head forward to see distant objects

Poor alignment in penmanship

227

gut-99???

h. When reading: blinks continually, holds book ex.l
tremely close or far away from face or makes frequem
changes in distance; screws up face; shuts or cover3
one eye, tilts head to one side; tends to look cross.
eyed; confuses letters which are similar in appearance) D'
such as “O” and “A”, “E” and “C”, tends to lose the
place on the page, complains of dizziness, headache“
nausea as a result of reading. ‘

B. Inspection by screening devices: l

1. Snellen E chart test which is adequate for the function all
clearness of vision

2. Betts’ Telebinocular

3. Massachusetts Vision Test

III DIAGNOSIS ;
The above screening tests, even though carefully administered,
may not discover all children who need attention. Any child!
exhibiting a visual disturbance should be reported to the parents i
for competent diagnosis and care by an Ophthalmologist, a medical 3
man who has specialized in eye diseases. ‘

IV EDUCATION AND TRAINING I A.

A. Classroom Adjustments: Get a doctor’s recommendation and
follow it. If the child is fitted with glasses and remains in the
regular classroom the following points should be observed:

1. Glasses should be worn constantly, if recommended

2. Glasses should be kept clean and should be properly worn;
this means that the child should look through the center
of the lens at all times

3. Light should be good and come from over the left shoulder, ‘
except in cases of left—handedness ‘

4. Children should sit so that all blackboard work, charts, \
demonstrations, etc., are visible

5. Permit child to sit or move where he has good light and i
can see class work; he should not sit facing the light .

6. There should be no glaring surfaces Within his line of
vision i J

7. He should sit erect and bring his work up to the necessary
level for seeing

B. General Adjustments:
1. Encourage adequate rest
2. Balance diet
3. Normal outdoor activity
4. Close cooperation between parent and teacher

C. Instructional Material: I
1. Large size soft chalk to make broad, heavy lines 1
2. Pencils with fairly soft, thick, heavy lead making a broad
line
3. Pen with broad writing point
4. Slightly rough, unglazed, cream manila paper

228

appearance )
to lose that
headache; '

)

function of I

ministered,
lny child
e parents
a medical

tion and
ns in the
erved:

i
y worn;
a center I

loulder, 5

charts,
t

ht and

ine of t

cssary i
t

road

5. Books printed in large, clear 24-point type with plenty of
picture

6. Material for motivated handwork such as clay, finger
painting, plasticine

D. Instructional Methods:

1. Avoid excessive or unnecessary reading; employ the
services of a reader“ whenever possible, especially in the
upper grades where assignments are long

2. Plan work so the child’s schedule is based on eye work
followed by eye rest periods ,

3. Rest the eyes frequently by closing them or by looking
away from the book or work '

4. All writing on blackboard should be large manuscript
writing

Equipment:

1. Use movable, adjustable, tilt-top desks. If the desk top is
flat use copy holder for resting working material on eye
level -

2. Use a bulletin typewriter with upper and lower case letters

3. Radio, record player, the talking book and di‘ctaphone

GLOSSARY OF TERMS

HYPEROPIA (farsightedness), a refractive error in which,
because the eyeball is short or the refractive power of the
lens weak, the point of focus for rays of light from distant
objects (parallel light rays) is behind the retina; thus, ac-
commodation to increase the refractive power of the lens is
necessary for distant as well as near vision.

MYOPIA (nearsightedness), a refractive error in which,
because the eyeball is too long, the point-of focus for rays of
light from distant objects (parallel light rays) is in front of
the retina; thus, to obtain distinct vision the object must be
brought nearer to take advantage of divergent light rays
(those from objects less than twenty feet away).
ASTIGMATISM, refractive error which prevents the light
rays from coming to a single focus, because of different
degrees of refraction in the various meridians of the eye.
STRABISMUS (cross-eyedness), squint; failure of the two eyes
to direct their gaze at the same object because of muscle
imbalance.

ASTHENOPIA, eyestrain caused by fatigue of the internal or
external muscles.

OPTOMETRIST, one skilled in the measurement of the refrac-
tion of the eye for prescription of glasses.

OCULIST OR OPHTHALMOLOGIST, terms used inter-
changeably; a physician who is a specialist in the diseases and
defects of the eye.

A READER* is a fellow student who has been carefully
selected to read materials to the partially seeing child in order
to save his vision from further strain when he has an excessive
amount of reading to be done.

229

AGENCIES

State Department of Education
National Society for Prevention of Blindness
State School for the Blind—Louisville, Kentucky

BIBLIOGRAPHY

Hathaway, Winifred, Education and Health of the Partially Seeing
Child.

Baker, Harry 8., Introduction to Exceptional Children.

“The Classroom Teacher Can Help the Handicapped Child,” New
Jersey State Department of Education.

“Helping the Exceptional Child in the Regular Classroom,” Michigan
Department of Public Instruction, Lansing, 1941.

“Suggestions for Classroom Teachers,” Division for Exceptional Chil-
dren, Kentucky State Department of Education, 1947.

I Seeing

b” New
Iichigan

a1 Chil-

THE CHILD WITH